PEMBROKE — November 10th, 2017 was a typical day for Chichester resident Earl Lepine. The 79-year-old owner of Lepine’s Garage had travelled to Pembroke to pick up new glasses, returned home, changed into his work clothes and headed out to his garage at his home to boost his gravel truck so that he could repair a bridge for a snowmobile club.
Describing himself as quite active and in perfect health, he said he had no symptoms or warning signs when all of a sudden he found himself lying on the ground.
“It all happened in five seconds – it was the funniest feeling I’ve ever had but I knew right away I had taken a stroke as I couldn’t feel my right side,” Mr. Lepine recalled.
“Once I fell down, I moved myself a little – rolled about 150 feet closer to the house but still no one was able to see me,” he said.
Nearly two hours later it was his wife Sharon who finally found him.
“I hadn’t returned home for lunch at noon so by 1 p.m. she was calling around and people suggested she check the garage in case something had fallen on me,” he continued. “When she did find me, I told her I had taken a stroke and she called the ambulance.”
According to Pembroke Regional Hospital physiatrist Dr. Debbie Timpson, when a stroke happens, blood flow to the brain is disrupted, brain cells die, and function is lost. She said 80 percent of strokes are caused by a blockage while 20 percent are caused by a hemorrhage or bleed when an artery in the brain breaks open.
Dr. Timpson said Mr. Lepine experienced a hemorrhagic stroke deep in his brain, thought to be related to unrecognized high blood pressure, which can weaken arteries over time.
“Most people with high blood pressure feel well and don’t know that they have this problem so it is important to have this assessed regularly,” Dr. Timpson said.
Because of the type of stroke he had, Mr. Lepine was taken to Ottawa for his initial care, then returned to PRH nine days later where he remained as an inpatient on the Rehabilitation unit until February 1.
“We had the privilege of working with Mr. Lepine and his family,” Dr. Timpson said. “He spent two months with the Rehabilitation team and was very hard working. He made enough improvements that he was able to return home.”
Mr. Lepine said, “The nurses and health care team at PRH were great, noting that now, five months out, he can walk a little with the assistance of a cane – much better than before, and he has also seen good improvement in the mobility of his fingers and arm.
Mr. Lepine continues to work hard with two hours of daily home-based exercise and he attends appointments for therapy in Pembroke and Hull four times per week. In addition to receiving home care several times a week, Mr. Lepine said his wife has been a great support and does as much as she can.
As the region’s designated District Stroke Centre, Pembroke Regional Hospital provides a high standard of care to patients with stroke in its Emergency Department, Stroke Prevention Clinic, Acute Stroke Unit, and in its Inpatient Rehabilitation Unit.
Between April 2017 and March 2018, 210 stroke patients were admitted to the hospital’s integrated stroke unit and treated by a multi-disciplinary specialized stroke team.
“The District Stroke Centre at PRH is the only integrated stroke unit in the Champlain LHIN meaning, in most cases, our stroke patients stay on the same unit in hospital for both their acute stay and to meet their inpatient rehabilitative care needs,” said Beth Brownlee, Clinical Director of the Rehabilitation program.
She said that therapy time has been a real focus for PRH’s inpatient Rehabilitation Unit.
“Best practice research shows that increasing a stroke patient’s amount of therapy time per day results in better outcomes in their functional abilities,” Ms. Brownlee said. “With investments in additional occupational therapy and speech and language pathology time, and the implementation of daily therapy schedules for each stroke patient, our patients are now averaging one hour and forty-five minutes of daily direct therapy.
“Staff have worked very diligently to increase the amount of time stroke patients are engaged in active face-to-face rehabilitation therapy during their hospital stay.”
Local stroke survivors have also benefitted from the new collaborative Community Based Stroke Rehabilitation Program which launched in March and is led by the Champlain Local Health Integration Network (LHIN) – Home and Community Care. Funded by the LHIN, 38 patients to date have been referred to the bilingual outpatient program which includes care coordination, nursing, occupational therapy, physiotherapy, speech language therapy and social work and provides intensive, time-limited stroke rehabilitation targeting individual patient goals.
Those who meet the program’s criteria are referred directly from the Pembroke Regional Hospital’s Acute Stroke Unit, Stroke Prevention Clinic and/or the Stroke Rehabilitation program. Patients are seen one to two times per week for each type of therapy for approximately eight to 12 weeks in a clinic setting located at PRH in addition to receiving a home therapy program to continue throughout the week.
