Pushed tPA for the first time for an acute ischemic stroke patient yesterday, just under the 3 hour mark (although current evidence and AHA/ASA recommendations allow administration up to 4.5 hours after the onset of symptoms).
The patient’s symptoms are predominantly aphasia, one of the more frightening consequences of stroke. Although some people with less exposure to stroke patients may think that hemiparalysis (paralysis on one side of the body) or hemiparesis (severe weakness on one side of the body) would be more frightening, aphasia almost instantly changes the way others unfamiliar with the patient view him: Why does he only say a few words or nothing at all? Why is he answering questions with the wrong words? Why does he look so confused when I’m talking to him? (Is he mentally retarded? Is he stupid?) In every moment of our social lives we take for granted the ability to communicate effectively: to follow commands, to convey humor, to express opinions and feelings. How do you connect with the world without this?
Good luck. We’re here to help.