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The Catalyst

Former president thanks brain activation team

 

By Mikie Hayes
Public Relations

 

Dr. Jim Edwards reflects on his patient experience at MUSC. photos by Sarah Pack, Public Relations

It was June 1999.

MUSC president, James B. Edwards, D.M.D., took time from his busy schedule to stroll the hospital halls shaking hands and returning hugs. On his way to visit a heart patient at the Palmetto Pavilion, Dr. Edwards asked a nurse if her lab had delivered her puppies yet and an orderly if the fish were biting over on the creek. 

Both answered yes and lively conversation about family and life in the Lowcountry ensued.

This was a typical occurrence in the life of the medical university president who knew his people by name and enjoyed being among them. It didn’t matter what day or what floor, Dr. Edwards was always a welcomed caller and patients and employees alike were happy to see him round the corner.

After serving as South Carolina’s governor and secretary of energy in President Reagan’s cabinet, Dr. Edwards assumed the presidency of MUSC in 1983. For 17 years he committed his time and energy to the institution as president and another decade–plus working on special projects. In all the years he spent establishing programs and recruiting faculty, he never expected to be back on campus for such a personal reason: to thank doctors and nurses for saving his life.  

On June 7 2013, at about 4:30 a.m., Dr. Edwards fell to the floor, unable to move his left arm or leg or get up. Still able to communicate, he called to his wife, Ann, a retired R.N., who recognized his complete paralysis on one side as a stroke. She immediately called EMS, although Dr. Edwards protested it wasn’t necessary.  

“Jim argued that he was not having a stroke, as many stroke patients do. Time was of the essence. He was not in a position to call the shots, so I took control of the situation. During a medical emergency, there has to be a change in the chain of command,” she said. “The cardinal thing to do is to seek help.”

Mrs. Edwards also called to granddaughter, Catharine Wingate, who lives on their property. She came immediately to help. Wingate, who will graduate in August from the Physician’s Assistant program at the MUSC College of Health Professions, provided a great deal of assistance and support while they waited for EMS.

Fortunately, Dr. Edwards’ primary physician, Donald Fox, M.D., associate professor of medicine at MUSC, had given his private number to the Edwardses with instructions to call him if they needed him. And need him they did.

“I called Dr. Fox and told him Jim was suffering a massive stroke. He immediately called MUSC to alert them of the situation and his forethought directly affected Jim’s outcome.”

When Fox phoned ahead to MUSC, the Brain Attack Team was activated. The team, comprised of emergency physicians; neurology attending physicians, fellows, and residents; neurointerventionalists; a CT tech; pharmacist; and lab personnel, was literally waiting in the Emergency Department for Dr. Edwards’ ambulance to arrive.

Upon arrival, he had a CT scan and neurological exam, results of which showed he was suffering a life–threatening ischemic stroke. Subsequently, a CT angiography was performed. This made it easier for doctors to see his blood vessels and they determined that blood was not flowing in his carotid artery on the right side, indicating a complete blockage in his neck. A large clot had also made its way to the middle cerebral artery in his brain.  

Doctors performed a CT perfusion study to determine the current state of the brain: how much of the brain had already been affected by the stroke and how much could be saved. While a small portion of the brain was already irreparably damaged, a much larger portion of his brain would die if they didn’t move quickly.

Dr. Jim Edwards, right, jokes with neurointerventionalist Dr. Emrin Chaudry, left, and Comprehensive Stroke Program’s Dr. Ed Jauch during his April 14 visit to MUSC Hospital.

The medical staff moved Edwards to the Neurointerventional Angiography Suite. After reviewing his options with Marc Chimowitz, M.B., Ch.B., Imran Chaudry, M.D., performed two procedures: first, an angioplasty with stent placement to open the carotid artery and second, a thrombectomy to remove the clot in the middle cerebral artery.

“Dr. Edwards had a substantial neurological deficit from his stroke when I saw him and when I discussed treatment options with him he had no hesitation in choosing an endovascular approach,” said Chimowitz, the Countess Alicia Paolozzi SmartState Endowed Chair and associate dean for faculty development.

The stent opened up the artery so blood could once again flow to that area, but they had to get to the large clot in the brain.

After the stent was successfully placed, a tiny catheter was threaded through the artery in his groin up to his brain. Once the catheter was in place, Chaudry used a very small device to vacuum out the clot, which they removed in fragments, and the procedure completely restored blood flow to his brain and prevented further permanent brain damage. Dr. Edwards’ clot was 6 centimeters in size, about 2 1/2 inches long, the biggest clot Chaudry had ever removed.

Stroke is one of most rewarding procedures that we do. The ability to see a patient having a stroke and completely resolve on the table after removing the clot is amazing – it’s very humbling,” said Chaudry, associate professor and fellowship director of the Neurointerventional Division of Radiology.

“The actual procedure lasted 27 minutes and not only averted permanent paralysis, it saved his life,” said Raymond Turner, M.D., co-director of the Comprehensive Stroke and Cerebrovascular Center. “Four or five years ago, we didn’t have this technology and wouldn’t have been able to do this.”

Today, Dr. Edwards is doing well. He suffers no paralysis or speech problems from the stroke and has a good long-term prognosis, according to Tanya Turan, M.D., director of the MUSC Stroke Division.

“Dr. Edwards is a wonderful example of someone who had a great outcome after a stroke. He got to MUSC, a stroke–ready facility, as soon as possible, and his stroke symptoms were largely reversed.”

The day before his stroke, Dr. Edwards had spoken to a large crowd gathered at the Yorktown to celebrate the historic aircraft carrier reaching a special milestone. The Yorktown had hosted, as of that day, 8 million visitors from around the world.

Ann Edwards thanks Dr. Tonya Turan for all she did.

When he and Mrs. Edwards went to bed that night, they never considered the next day could be his last.

As Dr. Edwards reflected on having had his life saved by doctors at the very institution to which he had dedicated nearly two decades of his life, it was important for him to go back through the process. Dr. Edwards said, “I had heard various details from people, and I told Ann I wanted to hear what really happened that morning. It was important for me to know the details and thank each one on my medical team personally,” he said.

On April 14, he and Mrs. Edwards spent several hours visiting with the Brain Attack Team and others who cared for him while he fought for his life.

As Dr. Edwards stood in the lobby of the Emergency Department surrounded by a large group of physicians involved in his ordeal, he took his first of many opportunities to express his gratitude. “I want to thank you all,” he said. “Having this kind of team of experts on board is the reason I am here today.”

“You had a big stroke,” said Turner. “You were very lucky.”  

“I was very blessed,” Dr. Edwards agreed.

When the Edwardses visited the Neurointerventional Angiography Suite, he examined his scans and films and asked specific questions about his experience. Afterward, Dr. Edwards took a turn at trying the very procedure that saved his life: removing a blood clot from a vessel on a simulation device.
 
When he completed the task, he said, “I am more grateful than ever for what all of you have done for me. I put my life into making MUSC a better place. Miracles happen every day here and most don’t affect me personally. But this did and I can’t thank people enough for the part they played in bringing me back from the dead. I thank God for you every day. I am blessed indeed.”

Chaudry told the Edwardses, “We treat more than 100 strokes a year and most patients don’t realize what’s going on or what we have done for them. To have a patient that is truly thankful is heartwarming. It is very rewarding to ‘pay it back’ to a man who has given not only MUSC but the entire state of South Carolina so much.”

Mrs. Edwards added, “This really is a miracle. I am overwhelmed with gratitude to the Lord and this team. When I think about him lying on the floor paralyzed, his future looked very dim. But you all knew exactly what you were doing and never hesitated for an instant. We were confident we had the very best team caring for Jim. This was truly a life– or–death situation and I can’t express my gratitude enough to you. You gave Jim to me for a while longer.”  

Silence engulfed the room and Dr. Edwards reiterated, “Thank you, thank you, thank you is just not enough for all you did to bring about this positive outcome for me.”

Edward Jauch, M.D., M.S., director of the Division of Emergency Medicine and chair of the stroke division of the South Carolina Heart and Stroke Care Alliance, commended Mrs. Edwards for reacting so quickly. He also noted the importance of pre-arrival notification. “Calling ahead made an enormous difference,” he said. “Literally, time is brain.”

Dr. Edwards gave her all the credit, “Most men my age show pictures of their grandchildren; I show pictures of my clot. At 6 centimeters, I might have spent the rest of my life paralyzed if it weren’t for Ann who recognized the signs and insisted on calling EMS. I knew 62 years ago it was a smart thing to marry a nurse.”

The Edwardses are committed to spreading the word throughout South Carolina about stroke prevention.

“If you have a stroke, it’s imperative you go somewhere they know how to treat it. I want to spread that message throughout the state. Time is of the essence,” he said. “The right team set in place is the difference between life and death or paralysis. Go to the place they are prepared to save your life. Plan ahead of time so you know.”

Knowing where the closest stroke-ready hospital is located is critical, said Turan, as well as the acronym FAST, which stands for face, arm, speech, and time. It refers to weakness or numbness in the face or arms, difficulty speaking and the importance of time in getting to a stroke–ready hospital.

“The first few hours are critical in terms of reversing the damage of a clot,” she said. “In fact, minutes literally matter. Every minute of a stroke, 2 million neurons die.  
Because Dr. Edwards got to MUSC quickly, and he had the procedures done quickly, his brain is in good condition.”

Turan further explained that a stroke is preventable if attention is paid to keeping blood pressure and cholesterol in check and avoiding diabetes.

Jauch underscored the importance of knowing the signs and where to go.

“People of all ages should know the signs of a stroke since the patient suffering a stroke may not be able to act for themselves. Using the message of FAST, people can remember some of the signs of stroke and act accordingly – call 911.  The importance of time is critical in acute stroke.  Therapies to potentially reverse the effects of the stroke must be administered within just a few hours of stroke onset, so getting to the right hospital is critical.”

 

 

May 2, 2014

 

 
 
 

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