Albuquerque Journal
By Leslie Linthicum
ALBUQUERQUE, N.M. — Let’s view the early morning hours of Sept. 7 first through the eyes of Al Urbaitis.
Al wakes up in the middle of the night with a splitting headache. He gets up and goes to the bathroom and then can’t get back to sleep, so he asks his wife, Daina, to please bring him an ibuprofen. He repeats this request quite a few times, politely and clearly, and he’s increasingly miffed that his wife is ignoring him.
“It’s pretty clear that Daina’s not doing what I’m telling her to do, which is simply get me an ibuprofen,” Al says. “I’m trying to be like a good guy and not get mad about the fact that she’s not doing what I’m telling her to do, but I’m getting more and more annoyed.”
Now let’s look at the same scene through Daina Urbaitis’ eyes.
She’s a light sleeper, and so she wakes up when she hears her husband come back to bed. “Are you OK?,” she asks him. He seems incoherent, mumbling, but she thinks maybe he’s still half-asleep.
When he tries to get out of bed again, he falls down, and Daina still can’t understand much of what he’s saying, except that he’s telling her he’s fine.
She looks at the clock and notes it’s 4 a.m.
“At that point, I knew something was wrong,” Daina says. “To me, it’s pretty clear at that point that something major is going on with him.”
Al Urbaitis, 53, is an electrical engineer who works on emerging medical imaging technology at Los Alamos National Laboratory. Daina, also 53 and his wife of 29 years, comes from a family of doctors and has a gift for remembering medical information she’s read.
At 4 in the morning on Sept. 7, that trait literally became a lifesaver. Daina remembered reading about the F-A-S-T (Face-Arms-Speech-Time) test for recognizing the symptoms of a stroke and reacting quickly. She asked Al to smile and lift his arms. Only the right side of his face moved, and he couldn’t lift his left arm. She couldn’t understand his speech.
Daina, alert to the “Time” component of the mnemonic device, dialed 911 and told the operator she thought her husband was having a stroke.
As Al and Daina recount this episode, we’re sitting in their sunny den in Albuquerque more than three months later. Al gives Daina a kiss and tells her she’s the hero of the story.
“It’s frightening,” he says, “to think of how lucky I am.”
After Daina’s 911 call, EMTs arrived, Daina made sure she told them he was a smoker and Al was quickly on his way to the University of New Mexico Hospital, the only hospital in New Mexico with a primary stroke center designation. Daina straightened up the house so their teenagers wouldn’t be too alarmed when they woke up, and then she raced to the hospital. When she arrived, she found Al with his entire left side paralyzed and the resident on duty weighing whether Al was a candidate for tPA, the clot-busting drug that translates into a much lower rate of disability for victims of ischemic stroke.
The window for receiving tPA is 4½ hours after the stroke hits. Given within that window, it can blow up a clot and get oxygen flowing back to the brain. Given too late, it can increase bleeding and cause worse damage.
To be safe, everyone at the hospital was counting from the time Al went to bed, which was around 10:30 p.m. But both Al and Daina knew he had read in bed for at least an hour and probably more and might have been awake until midnight. That would still have eliminated him from safely being given tPA.
By the time the attending physician arrived, it was 6 a.m. and the tPA window was closing fast. But Daina knew Al had walked on his own to the bathroom, an act that requires stepping over their dog, Ziggy, who sleeps directly outside their bedroom door. He couldn’t have done that if he had already had a stroke. She figured it had to have been when he got out of bed a second time, right around 4 a.m., and his left side gave away that he had the stroke.
With that information, the doctor injected the tPA into Al’s IV. Within 15 minutes, Al lifted his left arm and in short order could move everything on his left side.
He spent the night being observed in the hospital’s intensive care unit, and the next morning he went home and took his dog for a walk. A day later, he worked out at the gym. And two weeks later, he went back to work at Los Alamos.
Months later, Al has only two lingering effects of his massive stroke: Two of the fingers on his left hand continually feel cold, and he experiences the taste of food differently. The stroke, which could have killed him or put him in a nursing home, only killed his love of pizza.
The survival statistics for victims of stroke are terrible. Strokes are fatal in 20 percent of cases, and only 10 percent of stroke victims recover almost completely.
Al and Daina are still stunned by their good fortune. And they don’t want to waste what they learned.
So let’s review what makes Daina the hero of this story and file it away.
She remembered the F-AS-T device to recognize a stroke. She resisted her husband’s insistence that he was OK. She called 911 quickly. She paid careful attention to the time so she could give accurate information at the hospital. She got to the hospital quickly, advocated for her husband’s care at the hospital and didn’t panic.
It’s a new year for all of us, but especially for Al and Daina Urbaitis. Al has cut way back on smoking, down from a pack a day to a pack a month, and his blood pressure and cholesterol are being monitored closely. He’s living life more fully and savoring the little things - an orange that tastes the way he remembers an orange tasting, that walk with the dog, getting together with friends, going to his daughter’s orchestra concert.
“I have an urgency now to make all these events because I realize in an hour this could be over,” Al says. “I should make use of this hour.”
Copyright 2011 Albuquerque Journal