Donald Hixson doesn’t remember much about that night last summer.
He recalls having a conversation with his son, then suddenly being in
a confused state, unable to communicate, legs and arms not working as
they always had in the past.
He remembers Donald Hixson III calling for an ambulance and hearing a couple
words from the crew as they sped to the Mid-Columbia Medical Center Emergency
Department.
But other than those fuzzy bits and pieces, Hixson has had to rely on others
to tell the story of the night of Sept. 10. It was days later that he
finally understood he had a stroke and was saved from potentially serious
consequences by the efforts of MCMC and OHSU physicians and staff and
the advanced technology they used to communicate with each other to start
treatment quickly and send him on the road to recovery.
That road led initially to Portland and OHSU, but Hixson hasn’t had
to leave The Dalles for any care since then. Thanks to telemedicine technology,
Hixson was seen by OHSU neurologist and stroke specialist Dr. Wayne Clark
that night in the MCMC ER and has had follow-up care from the OHSU specialist
without having to travel any farther than MCMC’s Columbia Crest
Clinic. MCMC staff have directed his rehabilitation in The Dalles.
More and more of the specialized care that Gorge-area patients previously
could only find in Portland is now available in The Dalles, delivered
either by OHSU physicians in local clinics or long distance via telemedicine
technology. In addition to stroke care, telemedicine has previously been
used during pediatric emergencies at MCMC, and OHSU will soon expand its
outpatient telemedicine services to include pediatric specialties and
bariatrics.
Hixson benefited from the use of the technology not only to facilitate
his quick diagnosis and initial treatment, but also for telemedicine follow-up
visits with Dr. Clark.
While telemedicine certainly makes specialized care easier to access, convenience
isn’t the technology’s No. 1 benefit. It can be a lifesaver.
“It sure made a world of difference to me,” says the 76-year-old
Hixson, a retired highway patrolman and sheriff’s deputy. “It’s
not easy for me to travel, so I would have had to arrange special transportation
if I had to keep going back to Portland.”
While telemedicine certainly makes specialized care easier to access, convenience
isn’t the technology’s No. 1 benefit. It can be a lifesaver.
According to Dr. Clark the odds are definitely against patients who have
stroke symptoms similar to Hixson’s and don’t receive timely care.
Unlike his patient, Dr. Clark vividly recalls the night he was beamed via
technology into the MCMC ER and got the chance to exam Hixson as if he
were in the same room. He could see his patient and the MCMC ER physician
clearly, and they him, allowing them to communicate easily.
“Based on his exam and what I could see, I was able to pinpoint the
stroke was caused by a clot in Mr. Hixson’s brain stem,” recalls
Dr. Clark, who directs the Oregon Stroke Center at OHSU. “That is
one of the worst strokes you can have. Without timely treatment the mortality
rate can be as high as 70 percent.”
Dr. Clark prescribed a clot-busting, brain- saving drug call t-PA immediately
and initiated Hixson’s rapid transfer to OHSU. By the time Dr. Clark
saw his patient in person, he was able to determine the clot already had
begun to dissolve.
“Over the next few days Mr. Hixson showed great improvement,”
he says. “Considering the severity of the stroke, he has done really
well.”
One of the primary benefits of telemedicine, Dr. Clark says, is not only
facilitating the rapid diagnosis and initial treatment of patients before
transferring them to OHSU, it’s also determining when a patient
doesn’t need to leave MCMC.
“About half of the time we can determine that a patient does not
have to leave their community hospital,”he says.“Prior to
telemedicine, patients who arrived at smaller facilities like MCMC and
needed highly specialized care almost automatically would have been transferred
to Portland. Now that is often not necessary.”
When transfers do occur, Dr. Clark adds, telemedicine also can help ease
the anxiety of a patient’s family members who have just watched
their loved one loaded into an ambulance or LifeFlight and whisked out of town.
“This allows us to talk to family members, tell them what is going
to be done when the patient arrives, get informed consent taken care of
in advance,” he says. “There is better continuity of care,
and it’s not as scary because the family knows where the patient
is going, what is going to happen when he or she gets to OHSU. And they
know who is going to be continuing the care, because it’s the same
physician who started it via telemedicine.”
Looking back on his experience, Hixson says it was at least three days
after his stroke before he was “really able to understand what was
going on.” But he says from that point forward, and from what he
now knows about the sketchy three days before it, he couldn’t have
asked for better care – from the quick initial work of the MCMC
ER staff and Dr. Clark, to those early days at OHSU, to all the follow-
up care he’s received in his hometown.
And while he doesn’t know the ins and outs of telemedicine, he says
he is pretty sure “That technology saved me. I know it’s real
important, and I am grateful it was available.”