Stroke center for Las Vegas closer to becoming a reality

Friday, Nov. 28, 2003 | 2:17 a.m.

WEEKEND EDITION Nov. 29 - 30, 2003

Las Vegas letter-carrier Carl Seitz never thought twice about the possibility he would suffer a stroke.

Sure, he smoked 2 1/2 packs of cigarettes a day, but he otherwise never had any serious health problems. And he always got plenty of fresh air walking his longtime route around Tropicana Avenue, Nellis Boulevard and Boulder Highway.

But, after suffering a dizzy spell on his route in August 1996, he saw a doctor who ordered tests that would take about a week. It was too late. That night, Seitz suffered a stroke that initially paralyzed his right side and temporarily took away his ability to speak.

"What you see today is a miracle," said Seitz, 64, who walks with a limp, speaks with a slight hesitation and counsels stroke victims as a volunteer of the American Stroke Association, a division of the American Heart Association.

"I sure could have benefited from a stroke center, had Las Vegas had one. There are many others who were not as fortunate as I was. And, unless we establish a stroke center there could be a lot more people who will suffer."

John McNeil, director of "Operation Stroke," an awareness campaign of the American Stroke Association, says Las Vegas is one of the larger metropolitan areas in the United States without a stroke center.

"If we had a stroke center, patients like Carl would have been treated at the time and not been sent to other locations for tests," McNeil said. "And, when he suffered his stroke, he could have been treated with (the blood clot-busting drug) TPA within three hours and could have fully recovered."

A stroke is a type of cardiovascular disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a blood clot or bursts.

Stroke is the third leading cause of death in the United States and the fourth leading cause of death in Nevada with 55.6 stroke fatalities per 100,000 population. That's far ahead of the No. 5 killer in Nevada, which is all types of unintentional injuries, with 38.8 deaths per 100,000, according to the Bureau of Health Planning and Statistics. The leading cause of death in Nevada is heart disease, the second is cancer and the third is chronic lower respiratory disease, according to the bureau.

The American Stroke Association warns that every 45 seconds someone in America suffers a stroke and each year 500,000 Americans have their first stroke.

The signs of stroke include a sudden numbness of the face, arm or leg -- especially on one side of the body; sudden confusion, trouble speaking; sudden vision problems; dizziness or loss of balance; and sudden severe headache.

Stroke is the leading cause of longterm disability in the nation, costing the United States $30 billion to $40 billion annually, the stroke association says.

Seitz, who quit smoking, is on a healthy diet and takes blood thinners, spent seven days in a hospital and three months in voice and physical therapy sessions. He had to quit his well-paying U.S. Postal Service job and go on Social Security disability. His pre-insurance medical bill was $200,000.

"With immediate treatment from a stroke center, Carl's medical bills could have been reduced to between $12,000 and $15,000," McNeil said.

McNeil and Southern Nevada group insurance benefits coordinator Georges Maalouf are pushing for an existing Southern Nevada hospital to open a stroke center.

"We need to look at the cost-effectiveness of establishing a stroke center," said Maalouf, who is the health benefits coordinator for the Greenspun Corp., which owns the Las Vegas Sun.

"If we can get a stroke victim treated quickly and prevent permanent damage, he can return to work and continue to provide for his family as well as decrease lost productivity for the employer who otherwise would have to train someone to replace the person who had the stroke."

Maalouf estimated it would cost at least $500,000 to start a stroke center in an existing hospital -- and most of that would be to pay two neurologists to be available 24 hours a day, seven days a week. The center would generate revenue to pay the doctors and staff in the coming years.

Dr. Sean Ameli, a local cardiologist and president of the Southern Nevada American Heart Association, says with Las Vegas having a trauma center and high-volume emergency rooms, the city needs to establish a stroke center.

"Stroke centers in large metropolitan communities have proven to reduce long-term problems for stroke survivors," Ameli said. "We have a stroke center in Northern Nevada and we should have one here."

However, getting a stroke center started locally, Ameli said, won't be easy.

"First, we do not have enough physicians in this city, let alone enough neurologists," Ameli said. "Also, with TPA there is a risk of hemorrhaging into the brain and people can die. Therefore, (medical malpractice) insurance will be very high for neurologists who agree to operate a stroke center."

At a recent meeting of the Operation Stroke Task Force, a committee including insurance and business leaders was created to determine the feasibility of a stroke center for an existing Southern Nevada hospital.

"I am optimistic we can establish a stroke center locally by early next spring or by the fall of 2004," McNeil said.

Seitz said awareness is the key to avoiding stroke.

"No one ever thinks something like this will ever happen to them," he said. "A local stroke center will raise public awareness and make people aware of the signs of a stroke."