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>> My arm is weak.
I can't hold it up.
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>> So they said I had a stroke and then they left.
What happens next?
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>> Hello I'm Dr. Lewis Morgenstern, Director of the Stroke Program.
I'm sure that you and your family are wondering what the next few days will be like
and how long you'll be at University Hospital.
We hope this video will provide useful information to you and how we care
for stroke patients at the University of Michigan.
We have a great team of doctors, nurses and therapists who have spent years of training
to care for you at this important time in your life.
We know that this can be a scary time; we hope to make this as easy as possible.
>> I wish they'd come back, I still have some questions.
>> It looks like they have some really sick people here.
>> I'm Dr. Saucer, the emergency department attending in charge of your care here.
When you first came in we asked you questions and examined you
to quickly determine the diagnosis.
As the team told you before, you had a stroke.
Most strokes occur when a blood vessel is blocked
and blood cannot get to a part of the brain.
That small part of the brain dies.
Some strokes occur when a blood vessel ruptures.
We have special treatment for stroke that we can use when patients come early enough
and that is why we usually surround you quickly to determine if you can get that treatment.
After that we wait for test results and we ask the stroke team
to come see you and evaluate you.
>> Wow okay, makes sense.
>> He thought you forgot about him.
>> No I didn't.
>> Even though I'm not always at your bedside, we're always taking care of you
and the nurse is constantly monitoring your condition and updating me.
>> See, I hope you get to each lunch too.
>> Yes, thank you.
In the emergency department we usually get a CT scan and we get blood tests
and we ask the stroke team to come see you and evaluate you.
>> Hi I'm Dr. Morgenstern.
I'm the attending physician from the stroke team that will be taking care of you upstairs.
I've reviewed what's happened down here and now it's time for me to get
to know you and your family a bit better.
I'd also like to hear a bit more about the symptoms that brought you
to the emergency department today.
>> Well, when do we go upstairs?
>> Sometimes it can take quite a while to free up a bed in the stroke unit
but the stoke team starts taking care of you right down here in the emergency department.
>> Thank you.
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>> Hi I'm Kate Maddox nurse practitioner with the stroke team.
Most of our patients are taken care of in the stroke unit on the fourth floor of the hospital.
The stroke staff is specially trained and we meet daily to discuss your care.
Some patients are taken care of on other units but no matter
where you are you'll receive excellent care.
>> Kind of like a four star hotel.
>> Well, more like four star stroke care.
>> Most stroke patients get an MRI scan or another CT scan after admission.
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>> MRI's make a lot of noise and you need to hold very still for us to get good images.
See it's really open.
Some people feel claustrophobic but no one has ever been stuck in an MRI scanner.
>> I'll just think about puppies instead of this machine.
>> One of the most important parts of your stay is trying to find out why you had a stroke
so we can work with you to prevent it from happening again.
>> Well, please do.
>> The CT and MRI scans are a big part of that.
Sometimes the heart can be a source of clots that break off and travel to the brain
so we will examine your heart and monitor your heart
in the stroke unit and we'll get an echocardiogram.
>> I'm Dr. Bock, the cardiologist.
We do two types of echoes.
One of them is a Transthoracic Echo or a TTE.
With that procedure we use an ultrasound machine to take pictures of your heart
through the surface of your chest.
The other is a Transesophageal Echo or TEE.
With that procedure we use the ultrasound to take pictures of your heart from the esophagus
with a food tube after you swallow the probe.
>> More thinking about puppies.
>> Puppies?
>> Never mind, just the tube down the throat sounds unpleasant.
>> It's not that bad.
We use a spray to numb the back of your throat and give you a medicine to make you sleepy
and you don't really feel the procedure.
Maybe a little bit of a sore throat when it's all done.
>> Well, can I get some ice cream maybe for the sore throat?
>> Sure, as long as its low fat.
>> We want to get you better and minimize the symptoms of your stroke.
>> I'm going to need a cigarette.
Where's the smokers lounge?
>> We'll be talking about your risk factors for stroke like smoking for example
and helping you minimize your risk.
Stroke is very preventable.
>> Do family play a role in this education?
>> Often times family is key to helping patients reduce their stroke risk
>> I can't wait.
>> We put together a fantastic team of professionals with the training, experience,
and motivation to take care of you.
You've met a few already.
I'd like to introduce you to a few more.
>> Hi. I'm Hendrica, I'm a physical therapist.
I'll be helping you if we find you need to improve your walking or your balance.
>> Hi I'm Kaitlyn and I'm an occupational therapist.
I'll be working with you to improve your hand and arm function.
>> Hi I'm Karen I'm a speech language pathologist and I'll be evaluating your speech
and language and the nurses and I will be assessing your swallow function.
>> It was nice to meet you all.
I like having an entire team taking care of me.
>> Well don't get too used to it.
>> I mentioned that I'm the attending physician.
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We are faculty members leading the team, caring for patients and teaching.
You will likely have residents, interns and medical students also involved in your care.
They are at different stages of their training and while they're here
to learn they are also here to take care of you and they do it exceptionally well.
It is just one of the reasons why the University of Michigan provides
such a high level of medical care.
>> I can see you'll get great care.
We may spar a bit after all of these years together but my husband means everything to me.
What if he needs something at say 3 am?
>> We are here for you.
There are always doctors and nurses around to answer your questions.
We regularly make rounds to review what has happened and work with you
to decide what the next step should be.
Please ask us questions.
The person to start with is your nurse.
Please let her know if you are not feeling well or have any concerns.
>> Thank you.
Let's get started.
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