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TeleNeurology Program Saves Valuable Time for Stroke Patient


Jean Atkinson and her husband were working side by side on their computers one evening when she grew tired and told him she was going to bed.

"I knew immediately that I was having a stroke because I couldn't understand what I had just told him," Jean recalled. "It was mumble jumble."

They immediately drove 45 miles from their home in Downey, Idaho, to the closest hospital, Portneuf Medical Center, in Pocatello, Idaho.

Jean arrived at the hospital in Pocatello at 2:00 am, and the doctor immediately ordered a CT scan and an MRI of her brain to look for a stroke. During her evaluation in the Emergency Department, Portneuf's providers consulted University of Utah Health's Stroke Center team to diagnose her symptoms.

She was diagnosed with a transient ischemic attack, a blood clot in the brain that temporarily blocks blood flow and causes jumbled speech, numbness, and tingling on one side of the face.

After further testing, the doctors also found that Jean's carotid artery—a major blood vessel supplying blood to the brain—was completely blocked on one side, with the other side in jeopardy of closing any day. Clotting of the other carotid artery would cause a severely disabling if not fatal stroke.

The doctor at Portneuf explained to Jean that he was going to request a TeleNeurology consult with a U of U Health neurologist to get another opinion.

TeleNeurology is a new program at Portneuf that launched in December 2018. It allows providers and patients to connect with neurology experts at U of U Health through videoconferencing technology. This means patients like Jean can receive expert care in their local hospital and avoid transfers unless absolutely necessary.

Jean and her provider initiated the TeleNeurology visit with U of U Health neurologist Safdar Ansari, MD at 1:30 pm, less than 12 hours after Jean entered Portneuf Medical Center.

Jean told Ansari to be up front with her. "Don't give me any more of this wishy-washy stuff," she demanded. "What's going on?"

Ansari explained the choices to Jean: she could travel to U of U Health via ambulance on an IV blood thinner drip to have catheter-based surgery to unblock the left carotid artery – which would dramatically decrease her chances of having another stroke. Before the doctor could list the other options, Jean's husband, Glenn, interjected: "We'll do it."

In the same 24-hour period Jean entered Portneuf Medical Center with the symptoms of a stroke, she received a TeleNeurology consult with a U of U Health neurologist and traveled from Pocatello to University of Utah Hospital in Salt Lake City, Utah. Four days later, she had the carotid artery stent placement procedure.

In 2007, Jean had suffered from a stroke so severe that she could no longer work. Her fear of having another stroke was real, but she also feared the possible complications that came with surgery. "It was really scary," she said. "What if I bleed to death? What if I quit breathing?"

The surgery only took 45 minutes, though, and everything went smoothly. "As I was recovering, I realized there were no problems anymore!" she said excitedly. "I could immediately breathe better and had more energy."

On the drive back home to Downey with her husband and son, Jean was feeling so good she insisted they pull off at a rest stop in Brigham City to take a walk around the entire rest area. "My husband asked if I was up to it," Jean said, "and I said, 'I know I'm up to it!'"

When they arrived home, the first thing Jean did was find her cane and start moving around the house like before. Again, her husband's concerns got the best of him. "He chewed me out and told me to take it easy because I just got out of the hospital, but I felt so good," Jean said. "And it's only gotten better since then."

She feels grateful for the partnership between Portneuf and U of U Health. "The ease of mind of knowing care is so close means a great deal because it saved my life," Jean said.

Ansari is the medical director of TeleNeurology at U of U Health and an advocate for using technology to deliver care to people in hard-to-reach places. "TeleNeurology allows patients in rural and regional areas to receive specialty care in their local community where they are most comfortable – surrounded by family and familiar surroundings," he said.

Jean agrees, saying she thought the care she received through the TeleNeurology program was just as good as an in-person visit. Since then, Jean is back working on her computer and living life without skipping a beat.