Fate, destiny, luck — there are many words for something that happens at just the right time, with just the right people. Maybe it's running into a long lost friend and rekindling your relationship over a cup of coffee. Maybe it's finding the perfect job opportunity right when you need it most.
Or, maybe it's presenting a case study about a stroke patient whose life was saved by your team of physicians — only to find out his wife is in the audience.
No matter the word you choose, there's no feeling like when the stars align. At Chester County Hospital, two healthcare workers experienced their own serendipitous moment at a quarterly emergency medical services (EMS) forum that joins CCH employees with local EMS providers.
For Melissa Spahr, RN, Coordinator at The Chester County Hospital Stroke Program, and Tammy Whiteman, EMS provider, SCCEMS-Medic 94 Paramedic/Community Education/Outreach, and Advanced Life Support Coordinator for CCDES, and everyone else involved, it was certainly a forum to remember.
Forgotten Prayers and a Quick Response to Stroke Symptoms
During her 17 years as an EMS provider, Tammy Whiteman brought hundreds of stroke patients to Chester County Hospital. But she never thought that one of them was going to be her husband.
On October 18, 2020, Tammy’s husband, John Whiteman, had a stroke, which is a brain attack that occurs when the blood supply to part of the brain is suddenly shut off by a blood clot or piece of plaque, or when a blood vessel in the brain bursts.
"It was a Sunday morning,” recalls John. “I got up early, and I’m having coffee and saying my prayers. I felt something — I could feel my blood pressure go up."
John went to find Tammy, and while he wasn’t showing other common signs of stroke, like slurred speech or face drooping, he told Tammy something that immediately got her attention — he couldn’t remember his prayers.
Tammy first took John's blood pressure, which was 164/78 mm Hg — well over the normal 120/80 mm Hg. Then, she gave him a F-A-S-T test. This test is a way to check for signs of stroke and quickly determine if 9-1-1 needs to be called.
Chester County Hospital is about 8 minutes from where Tammy and John live, so she could have chosen to drive John to the hospital. However, thanks to her medical background, Tammy knows firsthand the importance of calling 9-1-1.
"By calling 9-1-1, EMS providers can contact Chester County Hospital before they even get to the hospital and prepare them for an incoming stroke patient like John. That allows us to gather our resources to be best prepared," explains Melissa Spahr, Chester County Hospital Stroke Program Coordinator.
This is important because, when it comes to stroke, chances of survival are significantly greater when emergency treatment begins as soon as possible. If a patient comes in by private vehicle, that critical advance notification isn't there.
"You should be calling 9-1-1 in the event of an emergency — stroke included," Melissa emphasizes.
Once EMS got John to the hospital, Chester County Hospital Stroke Program team members got to work immediately. They administered Alteplase, which is a medication that is used to manage stroke by dissolving blood clots to restore critical blood flow. There is a short window in which this effective treatment can be used — usually about 3 hours.
Fortunately, John arrived within a window of treatment for this effective medication.
John went on to receive comprehensive stroke care from the Hospital of the University of Pennsylvania and had a clot retrieval surgery called a thrombectomy. Since then, John has made a full recovery with minimal problems.
"He’s the perfect scenario. EMS was involved early, 9-1-1 was called. He had a great door-to-treatment time," Melissa explains.
In short, when Tammy made the decision to dial those 3 numbers, she knew exactly what she was doing — saving her husband’s life.
A Stroke Case Study Presentation With a Surprise Guest
On November 19, 2020, Melissa Spahr virtually logged into what she thought would be a typical quarterly EMS forum. She expected to engage with Chester County Hospital employees and EMS providers about stroke awareness, prevention and treatment.
What she didn’t realize, however, was that the wife of her stroke case study presentation would be (virtually) sitting in the audience.
"This patient was chosen out of a handful of patients who came in and had a quick response time," Melissa explains. One purpose of the EMS forums is to inform future success, and John"s case highlighted what the American Heart Association emphasizes as critical to stroke treatment — decreasing arrival time to treatment time.
"This patient had a great response time. And he's had a wonderful recovery. It was kind of the perfect package," she says.
Meanwhile, Tammy logged into the same forum from home. While she's been to many of these forums over the years, this one was destined to be a little more personal.
"I was sitting and listening to the case study, and John was working on a speech at the end of the table. The slide popped up — 66-year-old man, difficulty saying prayers — and in my head, I went, 'Oh my god, that’s John!'" recalls Tammy.
"At the very end, they said, 'Does anybody have anything they’d like to add?' I popped John on the screen, and said, 'This is your patient.' And he said thank you to everyone," she recalls. "It was amazing. It was very emotional."
As for Melissa, she was similarly moved. "I was completely blown away," she says. "I thought that someone had set me up in a way, but then it was revealed that everyone else was caught off guard, as well. We all had chills."
Tammy says she and her husband were grateful for this unplanned but special surprise. “It was a really touching moment where it sort of all pulled together. We were able to say thank you to those people who do this every day and let them know that what they do means so much to not only every provider they work with, but the families that they touch," she says.
The Chester County Stroke Program
Every 40 seconds, someone in the US has a stroke. Despite the fact that John's experience is a common one, not everyone knows when to seek emergency care — one of the most critical factors of surviving stroke and preventing disability down the line.
Though Tammy is equipped with her own medical training, her urgent actions that day did not require her to draw on advanced expertise. She knew then what she wants everyone to know now — if you suspect a loved one is having a stroke, call 9-1-1.
"If you can remember the acronym F-A-S-T, that's all you need to do," says Tammy. She also notes that writing down the time you first notice signs of a stroke can help healthcare providers determine the best course of action. Her tip? Jot down the time in your phone or on your hand, and relay that information to healthcare providers right away.
John, who works in sales, is also aware of how critical his wife’s quick actions were when it comes to his recovery process. As of December 2020, his recovery has been impressive.
“I have a lot to go, but the fact is, I can work already. And I can have conversations with people. It’s slow, but I can talk about any subject I need to talk about right now,” John says. “You can’t look at me and tell that I had this bad of a stroke. I’m so appreciative to all of the providers from Longwood Fire Company, Chester County Hospital, and the Hospital of the University of Pennsylvania. Without each of the individuals involved in my care, my story would have been very different.”
Now, John has taken steps to stay healthy and prevent issues down the road. He has physical therapy twice a week, and he walks the family dog on his days off. As a family, they’ve also switched to a low-carb Mediterranean diet. Additionally, John has managed his mental health by attending the Penn Medicine Virtual Stroke Support Group, engaging in meditational breathing, and completing speech therapy at Penn Medicine.
At the quarterly EMS forum, Tammy and Melissa may have experienced a moment of fate — one that will certainly leave an impact on everyone involved.
However, John’s stroke experience and recovery was no accident. Instead, it was the result of something each and every person can have — awareness, knowledge, and life-saving action.
Knowing the signs of stroke is key to survival. If you suspect a loved one is having a stroke, don’t hesitate — call 9-1-1.
If you have questions about stroke prevention, call 610-431-5000 to talk to a healthcare provider at the Penn Heart and Vascular at Chester County Hospital.