There was a time when the prospects of recovering from a stroke were more or less hopeless.
"They basically just underwent physical therapy and went to rehab," said Dr. Sarabjit Atwal, the newest neurologist on staff at the Kadlec Neuroscience Center. "There was not much that could be done."
But in recent years, medication has been developed that can give stroke patients significant improvement in their symptoms and reduce the possibility of complications later, she said.
That is if treatment begins quickly, however, because there only is a small window to administer the drug after a stroke -- four and a half hours at most.
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That makes having to transfer patients from the Tri-Cities to Spokane or Seattle for treatment a race against time. Time passed means brain cells lost.
It isn't that the expertise or technology don't locally exist to treat those patients. What has been lacking is a sufficient number of doctors to provide a specialist around the clock in the case of emergency.
Lacking until now.
With 12 physicians on staff with the neuroscience center -- encompassing specialties including neurology, neurosurgery, orthopedic spine surgery and pain management -- Kadlec now can offer 24/7 coverage. That means patients can be locally treated and save precious time, even lives.
"Historically over the last, almost 10 years now, patients that came to the emergency room with neurological trauma that called for neurosurgery had to be transferred to Seattle or Spokane," said Rand Wortman, CEO of Kadlec Health System. "In some neurological cases, the faster you can provide treatment, the better the outcome."
Dr. Matthew Fewel, the first neurosurgeon to join Kadlec Neuroscience Center, said at times when no surgeon was on duty, patients with brain injuries or spinal fractures would have to be sent to the University of Washington.
That process can take six hours to transport and admit the patient.
"Any type of emergency they would have to be transferred, or they wouldn't come to us (when no one was on duty)," Fewel said. "Now we have full-time coverage for the foreseeable future."
The Richland hospital has had round-the-clock neurology and neurosurgery coverage since October.
"For individual patients, it's going to make a big difference," said Al Wichtendal, director of the Kadlec Neuroscience Center.
But 24/7 coverage by physicians only is part of Kadlec's ultimate plan.
The neuroscience center is note centralized, with services split among several locations in Richland.
That probably will change by 2012, when the center moves into a four-story, $27 million building that will house the various specialties making up the neurosciences.
It will include the Kadlec Neurological Resource Center; diagnostic imaging such as X-ray and MRI machines; and speech, physical and occupational therapy under one roof.
"We realized if we could have it in a central location with diagnostic and therapeutic tools ... we could achieve better access and higher quality both," Wortman said. "It makes it easier for the patient. It's one-stop shopping for neuro services."
Fewel said that is something unique for a neuroscience center.
Most other centers in the nation are a collection of practices at different locations.
The building also will house growing gastroenterology and pulmonary medicine practices, with a fourth floor built as a shell for future Kadlec expansion.
Kadlec also is working to become accredited as a primary stroke center, which would be a facility recognized by The Joint Commission as making exceptional efforts to improve outcomes for stroke patients.
Accreditation takes years to achieve, but Atwal said the time and effort are worth it because of the higher standard of care stroke patients receive.
"It's a lofty goal," she said. "It does involve setting in place all different types of services, getting different disciplines to work together. But it can be achieved."