Nurse is a stroke survivor

Sunrise Hospital's Nevada Neurosciences Institute helped speed recovery

Many area schools observed Nevada Reading Week, Feb. 25-29, with special programs and activities. The week was meant to promote reading among young people. Due to a change in the Clark County School District?s testing schedule, some schools chose to postpone Nevada Reading Week celebrations until April and May so as not to conflict with testing. Left, first-grader Alondra Diaz, dressed in her Dora the Explorer pajamas, reads a book about Chip the Dog at Lake Elementary School, 2904 Meteoro St., Feb. 28. The first-graders were allowed to wear their pajamas to school that day. Top, first-grader Jovana Huato-Cruz reads "Snow White and the Seven Dwarfs" with her stuffed lion in MaryAnn Sanchez?s class. Bottom, first-grader Henry Garcia, right, looks up from reading a book about animals that live underwater. For more photos from Nevada Reading Week, see page 3AA.photos by marlene karas/view Advertisement

October 24, 2007, was just another other work day for 54-year-old Sunrise Hospital nurse Grace Diamonte and her husband, Synor Funcion. Neither had any way of knowing that within minutes, doctors at her workplace would be fighting for her life.

As they prepared to go to work, Diamonte discovered that something was seriously wrong. It didn't seem like much at all at first. She felt a little weird, a little slow in her movements. She tried to tell her husband about it, and that's when she realized she couldn't talk. Any words that she could force out were slurred gibberish.

"It was frightening," she said, "As a nurse, I knew what was going on, but it's different when you experience it firsthand."

Her husband, a public safety officer at Sunrise Hospital and Medical Center, 3186 S. Maryland Parkway, rushed her to the emergency room. Although hospital officials recommend you call an ambulance, in this situation, Funcion was very familiar with the three-minute drive they had taken so many times in the past.

At the ER, the triage nurse confirmed what the couple had suspected -- Diamonte very likely had suffered a stroke.

Fortunately for Diamonte, Sunrise Hospital is home to the Nevada Neurosciences Institute, a medical care and research facility specializing in brain and spine diseases, disorders and injuries. The triage nurse called a Code 100, a message calling for rapid motivation of the staff. A quick battery of tests were performed, and neurosurgeon Dr. Scott Selco examined Diamonte.

"I saw her within 20 minutes of her entering the hospital. She was healthy but for hypertension," Selco said.

Still, the signs of a stroke were there, and Selco was confident that it wasn't one of the many stroke mimics, such as a seizure. Without waiting for the results of all the tests, he administered tissue plasminogen activator, or TPA, a clot-busting drug.

"Every minute that a stroke isn't treated, blood cells are dying," Selco said.

A stroke is the sudden loss of brain function caused by loss of blood flow to part of the brain, which in turn is caused by blockage or rupture of a blood vessel. Part of the brain isn't getting the life-giving blood it needs, either because a clot is keeping the blood from flowing to it or the blood is flowing out of a hole to somewhere else.

"Eighty-five percent of strokes are non-bleeding," Selco said. "Sometimes after administering the blood thinner, we'll see dramatic improvement where the clot is being dissolved right before our eyes."

He estimates that in Diamonte's case, she received the medication 60 to 90 minutes after she had her stroke. Her condition initially worsened before she improved enough to be moved to the neurology intensive care unit.

"Strokes are deadly, even in the modern era," Selco said. "Twenty percent of all stroke victims are dead in 30 days."

According to the American Stroke Association, a division of the American Heart Association, stroke is the No. 3 cause of death in the United States. Selco said "Not only are strokes killers, they're also debilitating." Stroke survivors can end up with a number of challenges, such as paralysis, depression, memory loss, judgment problems and unbalanced emotions, laughing at inappropriate times or behaving unusually. Often their outer emotional expressions are unrelated to their inner feelings. One of the more common and frustrating aspects of a stroke is aphasia, the loss of the ability to make sense of language. Sufferers of aphasia may lose the ability to understand spoken language or writing or even may become unable to name objects or communicate verbally at all.

"By the second day, my husband said my speech had improved," Diamonte said. "I was still weak on my right side, and my balance was off. My tongue was over to the right side, and I kept biting it."

The road to recovery was long and arduous. After five days, she had recovered well enough to be released from the hospital. She told the doctors that her goal was to able to go back to work, and physical and speech therapists set to work taking her through a variety of exercises.

"It was very difficult," Diamonte said. "At first, I couldn't even hold a pen or pronounce certain words or letter combinations."

The hard work paid off. After four weeks, she could write legibly and speak clearly. On Jan. 16, she was given a clean bill of health. She's now back at work at her job as a charts nurse in the pediatric emergency room at Sunrise Hospital.

By and large, Diamonte is doing well, all things considered.

"There's a slight loss of my peripheral vision on the right side," she said. "That's probably permanent, and I have to make some accommodations when I drive."

Her speech is a little slower and more measured than it once was, but she doesn't consider it to be too much of a burden.

"Some people don't recognize that there's a change in me," she said. "Some people who haven't met me think that the way I talk is just part of my accent."

"She's doing well," Selco said. "She's probably about 90 percent back to normal."

Although you become more likely to have a stroke as you age, they can strike anyone. Some of the causes of strokes are unavoidable, such as family history, sex or ethnicity (blacks and males are more prone to it). Many of the causes, however, are modifiable behavior. Smoking, high blood pressure, disordered cholesterol and obesity can all be contributing factors. The increased risk of stroke is one of the many reasons doctors recommend against smoking. You also can decrease your risk of a stroke by keeping your weight down, regularly exercising, avoiding excessive drinking and keeping diabetes, cholesterol and high blood pressure in check with a combination of medication and diet.

Selco also recommends avoiding hardening of the arteries, a condition caused by the build-up of bad cholesterol calcifying in the arteries. "That's damage that's hard to undo as of yet," he said.

Diamonte said she hopes that others can learn from her example.

"I want stroke victims to know that they can recover," she said, "but it takes time and hard work. The stroke victim has to participate in their recovery and not just expect the physical therapist to do all the work."