Stroke Perspectives – Provider & Patient

Jameson Crumb, Clinical Director of the Crouse Neuroscience Institute, Oksana Kaskov, Crouse’s Stroke Program Administrator and KatieWeiss, stroke survivor and founder of Triumph Over Stroke CNY, will offer their individual perspectives and experience with stroke, from both the provider and patient standpoint.

Stroke Perspectives – Provider & Patient
Featured Speakers:
Oksana Kaskov, RN | Jameson Crumb, MS, RPA-C | Katie Weiss

Oksana Kaskov, RN is a Crouse Stroke Program Administrator. 


Jameson Crumb, MS, RPA-C is a Clinical Director for the Crouse Neuroscience Institute. 


Katie Weiss is a Stroke survivor, Triumph Over Stroke Support Group. 

Transcription:
Stroke Perspectives – Provider & Patient

 Maggie McKay (Host): Experiencing a stroke is unsettling, and there's a lot to know. So today, we'll learn more about what it means to have a stroke from the provider and the patient perspective.


Welcome to Crouse Healthcast from Crouse Health, I'm Maggie McKay. We're joined by Jameson Crumb, Clinical Director of the Crouse Neuroscience Institute; Oksana Kaskov, Crouse Stroke Program Administrator, and Katie Weiss, stroke survivor and founder of the Triumph Over Stroke CNY Support Group.


Jameson, Oksana, and Katie will offer their individual perspectives and experience with stroke from both the provider and patient standpoint. Welcome and thank you so much for being here to talk about this important topic. Let's start with the basics. Oksana, what is a stroke?


Oksana Kaskov, RN: So yeah, our brain needs a constant supply of blood, which carries the oxygen and nutrients it needs to function. Blood vessels that carry the blood to the brain from the heart are called arteries. A stroke occurs when one of these arteries to the brain is either blocked or burst. So as a result, that part of the brain does not get the blood that it needs, and it starts to die.


So, there are two main types of stroke. There's an ischemic stroke, which is the most common type of stroke, and it happens when an artery in the brain is blocked. And then, there's also the hemorrhagic strokes, and that happens when a blood vessel in the brain bursts and spills blood into or around the brain.


Host: So, what are the signs and/or risk factors?


Oksana Kaskov, RN: So, something that we like to tell our patients is to think of the acronym BEFAST. So, when you're out in public, you might see this acronym. And basically, the B stands for balance. You might have balance issues, you're feeling dizzy or wobbly. And then, E stands for eye deviation or trouble seeing in one or both eyes. Then, we go to the F, which stands for face. Basically, you're looking for a facial droop or facial asymmetry. A stands for arm weakness. So, you'll have weakness on either your arm or your leg on one side. And then, think of S for speech. You'll have difficulty possibly speaking or understanding or communicating. And then, the T is for time. Time is brain and we always say, "Take me to Crouse."


Some of the risk factors is hypertension, so high blood pressure. And that is something that we always tell patients that, you know, you need to take care of and manage with your primary care or your cardiology office. Carotid artery disease also is something that could potentially be a risk factor for stroke. AFib is also a huge risk factor for stroke. If you smoke, smoking could also be a risk factor for stroke. Drinking alcohol is another risk factor for stroke. And also, your cholesterol, try to make sure that you're managing your cholesterol. And that is a simple blood test that your primary care can actually have drawn, and then you will know the level where you're at and if you need to have any type of cholesterol medications prescribed. And diabetes is also a risk factor for stroke.


Host: Does weight factor into it if you're obese?


Oksana Kaskov, RN: Yeah. We encourage daily exercise for our patients to make sure that their weight is within normal limits. And that is another thing that you can discuss with your primary care.


Host: Jameson, what happens when someone comes into the hospital having a stroke?


Jameson Crumb, MS: So, first thing to do is identify that someone actually is having a stroke. So, that usually occurs not at the hospital, but out in public. And someone identifies this, either the person themselves or people around them. They call 911, emergency services arrive, or someone actually takes them physically to the hospital. And they call ahead to us, say, "Hey, we're bringing someone in. We think they're having a stroke." And what we do is we mobilize our stroke team. Our stroke team consists of ER providers, designated neurology providers, as well as our EMS team. So, we meet them right at the door. When they get to the hospital, we do an initial assessment, that's basically to say, "Is this a stroke or is this not a stroke?" You know, we don't know a hundred percent of time. But some of the times, there's some other issues that could look like stroke, we call them mimics. But if it looks like a stroke, we're going to call what's called a code B or it's a code brain in our hospital. As soon as that code is called, everybody mobilizes and we treat this as a medical emergency in the hospital.


So, the first step is that patient gets transported immediately to our CT scanner. That CT scanner gets an initial view of the brain. And that's really just to look to make sure there's no acute hemorrhage. So when Oksana listed those two types of stroke, one was ischemic stroke, which is that clot blocking a vessel. The other is a hemorrhagic stroke and that's the hemorrhage in the brain. So as soon as we are able to say, "Hey, this is not a hemorrhage," then we go evaluate the patient with a neurology provider that's right there, and we see what types of options there are for that patient.


One of the initial options is something called tenecteplase or TNK. It's something we use. It's a clot-busting medication. There are certain people that fit in the appropriate patient population for that medication. There are others that actually don't fit within there. Some of that's based on time. The traditional time is four and a half hours of last known well, that you'll be a candidate for that medication. But if you are a candidate, we'll administer that medication immediately. That will hopefully start to break up that clot and start to supply that nutrients and oxygen to the brain. If you're not, the next step we usually go to is called a CT angiogram. The angiogram looks at the brain and looks at the vessels that Oksana was talking about earlier that bring that blood supply up, and we're looking for any blockage, any aneurysm, we're looking for any vascular abnormality that we can see that could possibly be contributing to the deficit the patient has.


While all this is going on, at Crouse, we actually have an artificial intelligence platform and a communication platform that we utilize where both the neurology provider, the neurologist on-call, the neurosurgery provider are all communicating the whole time as soon as that code B is called, and they're all looking at the films that come through this app right on our phone. And we're using an artificial intelligence component to actually look at the imaging studies and say, "Hey, Does this look like a stroke to the AI component?" And then, we're confirming it on the human end of things.


So then, the last step of this is to say, "Hey, was this patient a candidate for the tenecteplase? Yes, no" is there a blockage?" And if there is an acute blockage and an area of the brain that has salvageable tissue, we call it a penumbra, we actually mobilize our interventional radiology team and our endovascular neurosurgeon. They get to the hospital and we perform what's called a mechanical thrombectomy. And that's a procedure where we actually go in through either the groin or the wrist, go up into the brain and try to remove that clot mechanically to supply blood supply and oxygen back to that area.


Host: And is there a "typical" recovery process for stroke?


Jameson Crumb, MS: Everybody's a little bit different. So, a stroke can be very minor. They could have speech issues. Those issues could resolve, a lot of times they'll spontaneously resolve, we call those TIAs, as long as they resolve in a certain time frame. But then, there's much more devastating strokes where people can't talk, can't move one side of their body and even more devastating than that. So, the recovery is a little bit different depending on kind of the disease process that everybody's experiencing. If we do one of those procedures, either the tenecteplase or the mechanical thrombectomy, the patient's going to go to the ICU immediately after that. They usually stay in the ICU for a couple of days. We'll do a full stroke workup because the secondary question, we know you had a stroke and now we need to figure out exactly why. So whether you have atrial fibrillation or AFib, as Oksana said, or you have a disease process that's making you more hypercoagulable or a bunch of other things that we're actually looking for in the hospital, because the next steps of things are to say, "Hey, we know you've had one stroke. We don't want you to have another. And we're going to start you on a preventative protocol to try to prevent that next event from occurring." Simultaneously, we're doing a rehab rehabilitation process. So, we're having our physical therapist, our occupational therapist, our medicine teams. Everybody evaluates you and kind of get you up and move you around and see how you're doing. And some people will be doing fine. We'll get them discharged, we'll get them home. Some people need rehabilitation. So, we send them to rehab services, either that's inpatient or outpatient. And once they get good enough and family gets ready for them to come home, they go home. So, there's a wide variety of different recovery platforms that people can go through.


Host: And what services, Jameson, or referrals does Crouse offer to stroke patients once they're discharged from the hospital and they go home?


Jameson Crumb, MS: Yeah. So, a really nice thing that we have at Crouse is something called a transitional care coordinator. And we have one dedicated to the neuroscience program. She's an RN that comes to our morning meetings every morning, goes over all the patients that we have on our census. We have multidisciplinary morning meetings every morning at 7:00, where we review all the patients, including those stroke patients that are on our service. And she will actually reach out once she knows a patient is about ready for discharge or after they get discharged, contact both patient and the family and say, "Hey, here's what happened." Because a lot of these people will have all this happen at the hospital. They'll get home and they'll be like, "What the heck happened? I don't know what I'm supposed to be doing next." And it's very understandable, because a lot of this happens rapidly. A lot of the issues can affect mentation. So, she'll reach out to that patient, that family, kind of go through exactly what happened, go through the recommendations that we have, and then actually get them set up for the next steps. And that's either they need imaging studies, they need to be set up with physical therapy or occupational therapy in the outpatient setting, and even that next appointment that they're going to have. We usually like to see our stroke patients within two to four weeks in the office, just to check on them from a provider standpoint, to see how they're doing. And then, at the same time, we actually encourage patients to reach out to Katie's group, to our support group so they can actually interact with other patients that have gone through a very similar thing that they've gone through.


Host: Well, that sounds ideal because I know even when I just go to a normal doctor's office appointment, I can't remember that afternoon what they told me to do or how many to take or this or that. So, I imagine that it's crucial, especially after a stroke. So just to wrap it up with you, Jameson, when you hear about Katie's experience from a medical perspective, what advice to someone in a similar situation in regards to risk factors, lifestyle, et cetera, would you give?


Jameson Crumb, MS: So Katie, she'll tell her story kind of after this. It was a little bit of a unique experience. You know, she's young, she's healthy and that's not the typical population that we see having a stroke. So, hers is a little bit different than our typical story. But just like Oksana listed, those risk factors, a lot of those risk factors we classify as modifiable risk factors, meaning things that we can actively change in our lives. You listed them, being healthy, staying at an appropriate weight level, not being overweight, stop smoking, stop drinking so much, making sure your blood pressure is well controlled, making sure your cholesterol is at the right level. It's basically just living a healthy lifestyle.


There are obviously things that we can't control that could be leading us down that path, but there are many things that we actually can control. And the thing that we like to say to the community is the best thing to do is know those signs and symptoms of stroke, because we see way too often people have one of these symptoms occur, they'll sit at home or someone will see their significant other or family member have these symptoms and they'll say, "Oh, I don't think I need to go to the hospital. I'll kind of wait this out." And like I said, a lot of our medications or interventions are time-sensitive. So if those patients get to the hospital too late, then there's really not many options that we have for them. So if you can recognize those signs and symptoms, both in yourself or in somebody else, and make that initial call, you could potentially save somebody's life.


Host: And I just have to ask, because there's always conflicting information about this. What about baby aspirin? Some people say if you think you're having a stroke, take a baby aspirin right away.


Jameson Crumb, MS: Yeah. So, I'll debunk that right now. Do not do that. And then, I'll tell you the reason why, because you do not know, as we don't know, until we get that first initial CT scan if you're having an ischemic or hemorrhagic stroke. It will actually make your hemorrhagic stroke potentially worse to take that aspirin, because it's an antiplatelet medication and can increase bleeding potential. So, it's unlike the cardiac world where they think if you're having a heart attack, it is actually encouraged. In our world, we don't want you to do that because you--


Host: Good to know.


Jameson Crumb, MS: Yeah. Because if you are having hemorrhagic stroke and you do that, now we're kind of working against ourselves in that world. So, it's better to just get to the hospital, get that evaluation as fast as you can. Don't worry about that other stuff. Just get to us.


Host: Okay. And Katie, as we've been mentioning, you are a stroke survivor and later turned the experience into a positive with a support group. We'll talk about that. But first, tell us about your stroke. Why was it unusual as Jameson mentioned? Did you have any signs or known risk factors?


Katie Weiss: Thank you, Maggie. And I didn't have any risk factors. And I can speak more to that after I tell kind of the onset of the stroke, but I definitely had very classic, I would say, symptoms of a stroke. It happened on a Monday morning in August 10th of 2015. I was a young mother, I was 33 years old. I was home alone I work in the education field as a reading specialist, so I was on vacation. And that was going to be my last day of the week before I was going on to a conference for the rest of the week. So, I was really excited to spend time with my daughter who was two at the time. And my husband woke up, went off to work as he usually does. I very soon after got up, had no symptoms that I noticed at the moment, got my daughter up, kind of got her ready. After walking out of the bedroom, I went to toss my cell phone on the couch, which we lived in a ranch house at the time, and so, it was just kind of right around the corner in the hallway. And I remember dropping it on the floor. Again, there'll be little things that I guess in hindsight you pick up on. But in that moment, nothing was triggered of concern for me. My daughter ended up picking it up and putting it on the couch for at the moment. And then, we ended up making our way to the kitchen. Upon entering the kitchen, which was maybe, I don't know, 10 or 12 feet from the living room area where we had been, I remember trying to turn the light switch on and I could not get my arms to work.


Host: Oh, scary.


Katie Weiss: Very scary. And again, I think in hindsight, when you're having a stroke, the brain is obviously misfunctioning. And I think the connections and the things that you're paying attention to aren't. You're not processing things normally. So again, I simply just struggled through that for probably five, ten minutes and managed to, I don't know, use my shoulder and get the light switch on.


It didn't trigger me to stop what I was doing and call 911, unfortunately, at that moment. I again struggled to try to open the refrigerator door. And I remember I was eventually able to get the bread out, and I ended up trying to get a piece of toast in the toaster for my daughter, which is scary. And somehow I think, when I initially told this story, I think these things that would normally take anybody seconds, moments to do in that morning, took me many, many minutes. And for some reason, my brain wasn't triggering, "Stop. This is not right." I think in the moment I was saying, "Oh, I might be lightheaded. Maybe I'm just, you know..."


Host: Right. Don't you think moms, as a mom, you just do so many things all day long, you multitask and it's kind of, you know, you wouldn't notice maybe?


Katie Weiss: Yep, absolutely. And I continue to kind of persevere. I remember my daughter crying and wanting milk and asking for those things in the background of my mind. And upon getting the piece of bread in the toaster and, unfortunately, pressing the toaster and turning it on, I collapsed and my back was kind of towards the cabinets. And very quickly, I realized that this was not normal. And I could not move the left side of my body. I was completely paralyzed. And then, I realized very soon that I needed help, and I realized my phone was across the house and nowhere near me.


And my daughter viewed this and obviously was very traumatized, so she was clearly upset and crying. And I, in moments, just tried to move myself and tried to get to my phone. That was my mission, right? I needed help. I didn't know if it was possible or if I could, and I ended up just trying to throw my body, really, like I couldn't move the left side and I ended up kind of lurching forward somehow. And I banged my head on the floor. But I was able to kind of be horizontal then on the floor and I was able to kind of use the right side of my body to kind of drag myself essentially, and I couldn't see anything. And at that time, again, I could feel my face drooping. I was constantly trying to articulate to my daughter, "Ava, go get mama's phone." Those were my words. They weren't really coming out that way or so, because I could hear myself. And so, I just inched my way kind of outside of the kitchen and onto the dining room floor. And the whole time, I just kept reiterating those words kind of to myself. They were kind of like, you know... It kept me in the mindset. And I don't know how long of a timeframe. Again, the time of all of this was hard for me to gauge. But I made it almost to the edge of my dining room into the family room, but still had basically a half a house to go to get to my and down a few stairs. It was kind of a sunken living room. And again, I was just kind of focused on the floorboards in front of me and I remember seeing my daughter's shoes in my kind of peripheral. And I ended up looking up, and she had my phone in her hand. So, I struggled with it, and I kind of note to what goes on in your brain when you're having a stroke. Processing things were not connecting very well. And my first thought, I guess, as a mother, was I need somebody here for her.


Host: Take your time.


Katie Weiss: And so, I called my husband, not 911. And he, I think, was still making his way into his office building and didn't pick up and so it went to a voicemail. And I remember leaving him a voicemail. And days later, he, I think, played it for me. And he couldn't understand what I was saying. My speech was slurred so much. And I hung up after I left a voicemail and, again, called him again immediately, and he ended up picking up at that point, and I was able to get enough articulation out to get it clear to him to come home.


Host: Yeah.


Guest 3: I hung up and I called 911. And it was at that moment that I was literally on the phone with 911, even before the operator picked up, that somehow the word stroke popped into my brain. I don't know from where. But when the operator came on, I was somehow able to articulate stroke. And I don't know if they had my address or I was able to give them my address. And the local EMS and fire department were at my house within like a minute. They were able to come in, and they immediately recognized, again, I had pretty classic symptoms of paralysis on the left side, droopy face, slurred speech. And they got me to Crouse within probably four minutes, and I'm on the eastern suburbs. And I can second my experience from what Jameson and Oksana has spoken to about their stroke team in the ER and in the emergency room. When I entered Crousee, it was just this team of people surrounding my bedside. Not only trying to figure out what was going on and how best to treat me, but making sure I was doing okay, encouraging me. I mean, I was really freaking out. I could not move the left side of my body. And that was constantly on my mind that I'm going to be paralyzed the rest of my life.


Host: And you were 33 at the time?


Katie Weiss: Uh-hmm.


Host: Wow. My goodness. So, what was your recovery process like? How long did that take?


Katie Weiss: Well, I mean, treatment wise right at Crouse, within minutes of my arrival, they did all of those tests and determined that I was a candidate for not only the tPA, but I think it was like a full FDA approved clot retrieval device. My husband, after he had arrived, had to kind of sign off on the use of it. And so, they were able to go surgically in and remove the clot that I had in the middle cerebral artery on the right side of my brain. And after that retrieval process and the treatment of the TPA, my paralysis had lifted. I could wiggle my fingers and toes, which I hadn't been able to do at all. So, that was an immediate kind of recovery just from that initial treatment. But even in probably just a matter of hours of being paralyzed, that muscle motor memory disintegrated. So, I had to relearn how to walk in those coming days and months and kind of teach all of those muscles on the left side of my body what to do.


A lot of the peripheral sensory pieces, knowing where your body is in space, was not there initially. So, I had to kind of figure out how to navigate that. It had helped, but during the test, they would have you close your eyes and move your hands and arms towards your face. And normally, you can know where your body is in space without your eyes. And I couldn't on the left side of my body. +


So, I was in the ICU for about a week. And they did all of the stroke kind of workup, looking for kind of that smoking gun, that cause. And there was some little things that they saw initially. We looked into those things. I spent years, and we're still trying to hash out different things. Like, I'll never probably stop wondering the why of it all. But they looked into AFib. I had a surgically implanted monitor for three plus years, looking for even very rare cases of atrial fibrillation and nothing was found. I don't have any of the classic risk factors. And you have to also have confidence in your team and in your doctors that work to save your life, that they're also going to ensure that they're going to do everything they can to prevent another one.


Host: Absolutely.


Katie Weiss: So, you know, over these years, I've obviously grown in that confidence as each year passes and I don't have another stroke. And I also have to gain confidence in the treatments options that they have given me to help prevent another one and ensure that I continue to search out every option as new things get developed, as new maybe DNA mutations, things like that get discovered or different causes or risk factors. And I have to do that not only for myself, but I have to do that for my family and my daughter to make sure that there isn't something that did underlie my stroke that can be identifiable for my family and for myself for preventing it from happening again.


So, it may be something that is just not identified yet or known yet. And so, I do continue to meet with my neurologist and my primary care and my cardiologist and things like that. And I'm constantly asking, "What's the new research? What's the new findings? Is there anything else that we can kind of turn over? Is there any other stone we can turn over to look for those?


Host: Well, obviously, you're very brave, Katie. I mean, thank you for sharing your story. And I am in awe at how you took this experience and tried to help, or you are helping other people, with developing the stroke support group that you did. So, what topics do you cover in that group and who can attend?


Katie Weiss: Anybody can attend. Survivors to caregivers to loved ones, anyone really affected by stroke. And even in the last couple of years, we've joined forces with another support group that does aneurysms and hemorrhagic stroke and we also offer support to anybody with traumatic brain injury, because there's a lot of commonalities with any of those things that deal with the brain and the effects that can come of that.


We have topics that range from occupational therapists to physical therapists, speech therapists coming on different topics, dieticians, grief counselors. We've had caregiver panels. We've had doctors, neurosurgeons, neurologists, cardiologists come and speak on different topics. And we really try our best to reach out to our members and really ask them what are their needs currently? What do they need resources on? And then, we try to guide that.


Host: When did you start the group? How far after your recovery?


Katie Weiss: So, it kind of started very organically, I would say, and not something that I set out to do by any means. It was several months into the fall, so I had my stroke in early August, and I received a mailing from Crouse many months after that, maybe in October or November, to be a part of kind of a stroke patient feedback session. It was going to be like a dinner, and they really wanted us to meet the administrators of the stroke program at Crouse Hospital and kind of give our feedback, our insights. And I was very reluctant. And for a long time, I had to just sit on my counter. And again, I was knee deep and waist deep into my rehab. It was a full-time job at that point.


Host: And you have a little child.


Katie Weiss: Yes, absolutely. And, you know, my parents moved in. I couldn't drive. I couldn't go to my therapies. And I was following the ICU. I was inpatient at a neuro rehab for a week or a week and a half, and then came home and had OT, PT, speech therapies basically three or four times a week, all three of them, for quite some time. And so, I was surviving at that moment. I was going moment by moment.


And when that came across, the only thing that motivated me to keep looking at that invite was I wanted to thank them. I wanted to just attend to let them know how much it meant for them to save my life. I was so grateful for all that they did. And so, I ended up talking my husband into going. And I think one of my biggest reservations about going was I didn't want to see other stroke survivors. I thought it was going to be utterly depressing. I was going to be the youngest one by far. In that moment, I was already overwhelmed with life, and I just didn't really feel like I could take that on. But I think the need for me to just thank them attend and let them know how much their work changed my life. So, we ended up going and I was very scared to go. I was very reluctant to go. And that evening was probably like the most impactful evening. And it wasn't so much of my opportunity to thank them and hear about their program, but it was hearing all of the other stories of survivors who came that night.


And I remember reaching out to one of the Crouse Hospital administrators at the very end, because I wanted to personally thank her and kind of have her pass along my thanks to my doctors. And in a split second, I asked her, I said, "Does Crouse have a support group?" Right? I felt like this was something that was very helpful to me, surprisingly helpful to me, in that moment. And she said, "Well, not currently, but we really support survivor-led support groups for various reasons. We really feel like having a survivor lead these type of groups is really important. And she kind of gave me the side eye. And I remember driving home that night with my husband. And I was in the midst of, like I said, my therapies, just trying to get back to my life, my work, and there wasn't much in my day that I felt competent or accomplished about any longer. I felt like I couldn't be the mother I used to be and want to be. I couldn't be the wife. I couldn't be the educator, the teacher. I currently wasn't working at the time, and I was out on leave, and just trying to get back to those things. But in that drive home, I was like, "This I can do even now. This is something I feel like I could do. And so, in the creation of what ended up becoming Triumph Over Stroke CNY, I started having very initial meetings with admin over at Crouse Hospital, and it was just such a light in my life at that moment


Host: I'm sure.


Katie Weiss: That helped motivate me through the rest of my recovery that I can't never be grateful enough for, but it helped me find a purpose when all of my other purposes in my life were kind of stripped from me at that moment. And so, it truly helped me get through my recovery by being a participant in the creation of what Triumph is now and initially, it was far from this, but it was only through a lot of people's effort and dedication and hours that it truly, I feel like, has found success.


Host: And just think how many survivors you're helping.


Katie Weiss: Yeah, and they helped me. It is completely reciprocal.


Host: That's amazing. Katie, in closing, just what advice would you give to fellow stroke survivors?


Katie Weiss: Yeah. I definitely contemplated this question a lot prior to this interview. And I think in the moment, right after your stroke, you're dealing with a trauma. And so, your body immediately goes and your brain immediately goes to moment by moment and that's kind of your survival mode. And I just want to reassure survivors that it's okay to stay in that moment and not look too far ahead, not even look a day ahead. Sometimes it's moment by moment, hour by hour, and do what you can in that moment. Surround yourself with support, whether that's your family or your friends, or organizations like Triumph. And I think, especially immediately following, bring somebody to your doctor's appointments with you. There's a lot to be said for having an advocate and another ear at those medical appointments following such a traumatic experience. And I was grateful to have those things and hearing other survivors stories as well throughout the years. I think that's a really big piece. But also, never lose hope. Recovering from a stroke is certainly not a sprint. If anything, it's a very long marathon. And because strokes can affect like an infinite amount of different abilities or difficulties they may cause, I found through the years that as much as our members have very different strokes and have very different difficulties and challenges that they face, some being very visual, some being very personal and losses that they've had as a result of having the stroke that there's still so much that we can do for each other to support one another and keep each other hopeful.


The other thing that has really helped me throughout the years is always finding something to be grateful for. That gratitude piece has helped combat depression and anxiety and all of those things that are very, very common for stroke survivors after such a traumatic experience. And so, we try to embed that into a lot of our meetings as well and that has always been the piece that has always gotten me out of those deepest, darkest, you know, moments in my life post stroke. So, those would be my pieces of advice.


Host: Well, Katie, I cannot thank you enough for being so open and generous sharing your story, because I'm sure it's going to help many people. This has been so educational. Thank you so much for sharing your wealth of knowledge, all three of you, from all the perspectives, We appreciate all of you, and Katie especially again, for sharing your story.


Katie Weiss: Thank you so much, and thank you for the opportunity to allow us to share, this resource with the community and highlight the amazing work that Crouse Hospital does with regards to stroke treatment and prevention and the continuing of care that they provide, not only once the patient leaves the hospital, is really, I think, very unique and something that our community should really be grateful for.


Host: Right.


Jameson Crumb, MS: If I could just add one thing, I've heard Katie's story, a multitude of times now, you know, it still makes me emotional to hear it now. But it's kind of why we do what we do at Crouse. We spend a lot of time on our process, on our team. But to even have one story like Katie's makes a lot of it worth it at the end. So, we need to be able to recognize this stuff in the community, because there is the opportunity and we do have the resources available. And if you can get to us, we'll do our best to help you.


Host: Thank you so much. Again, that's Jameson Crumb, Oksana Kaskov, and Katie Weiss. If you'd like to find out more, please visit crouse.org/stroke. That's Crouse, C-R-O-U-S-E.org/stroke, or call 315-470-7479. That's 315-470-7479. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thank you so much for listening to Crouse Healthcast from Crouse Health.