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OCeanside Tri-City Medical: Dr. Gene Ma
Dr. Gene Ma, an emergency room physician at Tri-City Medical Center, poses with Larry Hull, an Oceanside resident whose life was saved thanks to Ma and the rest of Tri-City’s Stroke Care Center team. Photo by Samantha Taylor
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Stroke survivor talks about available services for victims

OCEANSIDE — For Larry Hull, 80, it’s important that area residents know what services are available for someone suffering a stroke. After all, those services are what saved his life.

In the early morning hours of Dec. 6, 2017, Larry Hull took a trip to the bathroom in his home just like any other time. That changed after he got back to his bedroom and collapsed.

When he came to a few minutes later, he felt hazy and confused. When he tried to get up, he couldn’t — in fact he couldn’t move the left side of his body at all.

Hull, who lives alone, guessed that he had a stroke and needed help fast. He grabbed his emergency alert device and called 9-1-1. His room was full of EMTs within minutes, he said.

Hull was rushed to the emergency room at Tri-City Medical Center where a team of medical professionals awaited him.

The EMTs had already alerted the hospital of a “Code Stroke,” so the team knew to be ready.

That’s where Dr. Gene Ma, an emergency room physician at Tri-City, stepped in to help. He was the first at the hospital to confirm Hull was experiencing a stroke. After that, the rest of the team aids Hull.

According to the National Stroke Association, a stroke is a “brain attack.” Most strokes are caused by blood clots that block blood flow to the brain, which deprives brain cells of oxygen and kills them.

Abilities such as memory and muscle control that are controlled by those dying brain cells are subsequently lost.

Ma said treating a stroke is a “time-sensitive process.”

“Every minute is significantly damaging to the brain tissue,” he said.

Ma explained that when a “Code Stroke” occurs, everyone including ER physicians, lab technicians, CAT scan technicians, radiologists and neurologists drop everything and come to the aid of the patient.

There is even a stroke coordinator that manages all the care the patient will receive. All of those Stroke Care Center team members flock to the back door of the ER where patients like Hull arrive.

“I evaluate him immediately at the back door, and I decide whether he meets the criteria to go on as a code stroke,” Ma said.

Hull had “significant deficits” that indicated to Ma he was indeed having a stroke. The lab technician then drew blood, and Hull was whisked away for a CAT scan.

Because a situation like Hull’s is a top priority in that moment, Ma said it isn’t uncommon for patients undergoing CAT scans to be taken off the CAT scan table so that a stroke victim can be treated immediately.

According to Ma, Tri-City was one of the first hospitals in the state to get a GE Revolution CT Scanner, which is the highest resolution scanner today. It identifies images at a much faster speed, producing 512 images in one second.

The speed particularly helps with stroke victims who might be confused and won’t stay still.

Hull also had dye injected into his veins to light up the arteries in his brain, which gave doctors a three-dimensional model of the arteries in his brain and allows them to spot the blood clot.

After the CAT scan, Ma re-evaluated Hull along with Dr. Laura Desadier, a neurologist and stroke specialist.

The doctors go through a checklist to see if Hull could be administered tissue plasminogen activator (tPA), a blood thinner that works “like Liquid-Plumr,” Ma said.

“It is an incredibly effective medication, but it has very specific inclusion and exclusion criteria,” Ma said. “Meaning if you’re outside those criteria, it’s very risky to give you the medication.”

But if the medicine can be administered and works, the results can be dramatic.

Hull was a “strong candidate” for tPA, Ma said, and was able to consent to taking the medicine.

Most hospitals with stroke centers can administer this drug to patients who arrive within 4.5 hours after the stroke occurs, but what about those who arrive after that time window, or if tPA doesn’t work?

That is where the hospital’s neurointerventional radiology team comes into play. If a hospital has such a team, stroke victims who arrive after that initial time window can still be treated and recover.

Ma said having that “second level” of treatment available, especially by a team with as much experience as Tri-City’s, extends that 4.5-hour time frame to 24 hours. 

After receiving tPA, Hull was taken to the intensive care unit, and shortly after he recovered his strength. He spent two days at Tri-City before he was transferred to Palomar Medical Center and spent another two days there. He then spent three weeks at a post-acute rehabilitation center.

Today, Hull is doing well with the exception of a “few hitches in my giddy-up,” such as a slight limp and some weakness in the arm and leg.

Hull wants to promote awareness about strokes and educate others on what kinds of treatment are available. Both Hull and Ma are discussing giving lectures together around the area on the subject.

Ma said signs of a stroke include weakness or numbness in parts of the body, trouble with walking, speaking, thinking or vision, and confusion.

If one side of the face feels strange, Ma said to look in the mirror and smile or to speak to see if those functions are working normally.

Hull said it’s crucial that people “don’t think, act” if they are experiencing stroke symptoms.

Hull also said having that emergency alert device was a “critical” part of his treatment as well.

“Had I not had that, and I was unable to move, I don’t know how long I would have been there,” he said.

Hull said he was fortunate to live so close to a hospital with a stroke center like Tri-City’s and with professionals like Ma.

“Part of it is obviously the medical part … but probably as important or more important is the empathy and the dedication,” Hull said, tearing up. “I felt that the whole time I was here.

“They were here to help me.”