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Nathaniel Long – Stroke Patient Success Story

Game changers

How Methodist Dallas’ stroke team scored a slam dunk

Team of doctors who helped to save Nathan Long's life. It takes a team to save lives at Methodist Dallas.
Members of the stroke team who helped save Nathaniel
Long’s life are (from left) Juan Santana, team
leader, interventional radiology; Janey Fair, team leader,
diagnostic radiology; Ben Newman, MD, medical director,
neurovascular surgery; Lindsay Rogers, RN, emergency
department; and Crystal Ramirez, RN,stroke coordinator.

Nathaniel Long measures in at 6 feet 9 inches and works out three times a week. Jan. 24 was one of those days, but as Long made his way over to the free weights, he was overcome with dizziness.

He remembers his vision going blurry and then falling to the ground.

He remembers being unable to speak.

And he remembers the point during the ambulance ride when he realized the left side of his body was paralyzed.

Home court advantage for stroke care

Dallas Fire-Rescue brought Long to the nearest Primary Stroke Center: Methodist Dallas Medical Center.

Timothy Rupp, MD, independently practicing emergency medicine physician on the hospital’s medical staff, immediately recognized the signs of stroke and activated a Code Stroke.

Code Stroke puts into action a series of tests and treatments — think of them as perfectly chosen plays from a team’s playbook. And right in sync with Methodist Dallas’ level I trauma center standards, the stroke team executed those plays seamlessly.

“The stroke team has a lot of moving parts,” says Ben Newman, MD, independently practicing endovascular neurosurgeon on the Methodist Dallas medical staff. “A number of people in multiple specialties came together to save Nathaniel’s life.”

Shot clock: Time is brain

“With strokes, you have to move very quickly,” Dr. Newman says. “Our mantra is ‘Time is brain,’ because the longer the brain is deprived of blood flow, the more permanent the damage.”

Advanced imaging showed that a large clot was blocking Long’s right middle cerebral artery. Because the right side of the brain controls the left side of the body, and in Long’s case, also controlled the ability to speak, the clot explained his physical limitations.

When the clot-busting drug TPA proved ineffective, Dr. Newman was called in to perform a cerebral thrombectomy.

Through a tiny incision in the groin, Dr. Newman threaded a catheter through the blood vessels in the chest and neck all the way to the clot, or thrombus, in the brain. Then, with a tiny metal snare, he grabbed hold of the clot and pulled it out.

“It’s crazy,” Long says. “Once they took the blood clot out, I felt like I was fine. They asked my name, and I said, ‘Nathaniel Long.’ Everyone was like, ‘Whoa!’?”

He even started moving his left side mid-procedure.

Long went home from the hospital a few days later and began rehabilitation at Methodist Dallas.

“If Nathaniel were at a hospital without interventional capabilities, he would have been left with a permanent disabling injury,” Dr. Newman says. “It’s gratifying and exciting to see him walk out the door with an unlimited life ahead of him.”

From the summer 2013 edition of Shine magazine.