By Jeffery Kurz
Record-Journal staff

MERIDEN — Helen Kasperovich recently felt there was something different about the function of one of her legs, but she didn’t recognize it as anything serious until her daughter visited and noticed her speech was slurred.
After calling her doctor, Kasperovich went to the emergency room at MidState Medical Center, where she went “though all these tests,” she said. “Very thorough.”
A diagnosis, confirmed after a few days at MidState’s Pavilion D, revealed that Kasperovich, who is 83, had experienced a transient ischemic attack, otherwise known as a mini, or warning stroke. Such warning strokes occur when blood flow through a brain artery is blocked or limited for a short period of time, and in about 15 percent of cases they are followed by a more serious stroke.
Kasperovich was at the right place at the right time, at least as far as the state public health department is concerned. MidState is among seven acute-care hospitals in the state so far to earn recognition as a primary stroke center.
The designation means Meriden’s hospital is following American Stroke Association guidelines and in general making a concentrated effort to treat and prevent acute stroke.
A concentrated approach is needed because when it comes to stroke time is of the essence. There are basically two types of stroke, when blood flow to the brain is starved or when it is flooded. In either case, the longer the situation lasts the greater the threat of damage to the brain and brain function.
Effects of stroke include cognitive and behavior changes, weakness or paralysis of a side of the body, difficulty with speech and vision problems. Those effects depend on the area of the brain affected.
What the state designation “really shows is that the hospital has demonstrated that they have a system in place to address it as quickly as possible,” said Christian Andresen, a state public health department spokesman.
The state’s recognition is part of an effort to reduce stroke, the third leading cause of death in Connecticut and the nation, and is a response to a 2006 survey that found just 52 percent of the state’s hospitals had an acute stroke team in place to evaluate patients within 15 minutes of arrival.
About 780,000 Americans each year experience a new or recurrent stroke, and it kills more than 150,000 every year, according to the American Stroke Association.
It was important for MidState, which applied at the earliest available opportunity in January, to receive the designation as soon as possible, said Cindy Russo, the hospital’s vice president of patient care.
“We were already doing the care,” she said. “It was really about putting to documents together to get the state recognition.”
The documentation required is voluminous, but at heart what’s required is demonstrating that the hospital has a dedicated approach to stroke care. MidState has what it calls a FAST team, an acronym for face-action-speech-time, which reflects the warning signs and the importance of responding quickly.
“We want the community to understand that we’ve taken the steps to make sure we’re as progressive as possible on their behalf,” said Russo.
To receive the recognition, Mid State had to show that the hospital is set to handle stroke around the clock. “You have to show that you have the same types of coverage after hours,” said Lori Nohilly, director of inpatient medicine and one of the hospital’s stroke team members.
Pavilion D is the hospital’s dedicated stroke wing, where nurses are specially trained to treat stroke victims. Stroke team member Michele Colby is the pavilion’s nurse manager. The team response also includes a pharmacist, lab technician, physician, nursing coordinator and social worker. Pat Giannelli is MidState’s stroke coordinator. “I just try to prioritize the situation,” she said.
Computed tomography is used to locate the stroke and determine if it’s ischemic or hemorrhagic. An ischemic stroke is caused by a blockage to blood vessels to the brain. Hemorrhagic stroke is caused by a burst or leak in blood vessels to the brain.
There are risk factors that can’t be altered, including age, family history and prior stroke. Risks that people can do something about include high blood pressure, heart disease, smoking and high cholesterol. Part of the state recognition is the hospital’s public education program dealing with those risk factors.
“A large part of what we do is trying to educate you with the intent of decreasing your risk,” said Giannelli.
Since May is national stroke awareness month, MidState is planning a number of public events, including a free risk assessment at the La Planche Clinic on May 14.
The hospital was also handing out refrigerator magnets with information about stroke symptoms during last weekend’s Daffodil Festival.
All this is to help people understand what they can do to reduce stroke risk and to help them recognize how important it is to respond quickly to signs of stroke. The first three hours are considered the crucial time in preventing stroke damage.
“If you lose that time you’re already behind the eight ball,” said Giannelli. “The sooner you can get in and the sooner we can make things happen the greater the likelihood of your surviving. That’s why the community education is enormous.”