Heather Ly (Host): Hi there, everyone. Thanks so much for joining us for this latest episode of Medically Speaking. I've got some very special guests here today. We've got Erin Rogers, who is the Director of Adult Quality Registries at Buffalo General Medical Center and Gates Vascular Institute; and Nicole Haymes, Clinical Stroke Coordinator at BGMC/GVI as well. So, you guys are colleagues?

Erin Rogers: We are colleagues, yes. Thank you for having us.

Host: Yes. Yes. We really appreciate you being here today. We've got a lot of important things to talk about, so we're going to dive right in. I guess, first of all, when it comes to stroke, recognizing the symptoms and recognizing them quickly so that you can get help quickly, it really is key. What are we looking for?

Nicole Haymes: Yeah. So, I go into the community a lot and we discuss recognizing stroke symptoms. So usually, people are familiar with the FAST acronym, which has recently been changed to BEFAST to pick up in some of those atypical stroke symptoms. So, we look at things like if you're having slurred speech, weakness in one side of the body, facial droop, things like that.

We kind of want to bring more recognition to atypical stroke symptoms. That's why they added the BE before BEFAST because we have balance and eye. So, vision is a really important one. And then, also, for your hemorrhagic strokes, we're looking at things like they call it the worst headache of your life. So, things like that. We're just educating the community to recognize these symptoms. Do not drive yourself to the hospital. Call 911. Get down to us at Buffalo General GVI, and we want to make sure that this is known as a medical emergency.

Host: Yeah. So when we talk about BEFAST, again, it's B-E-F-A-S-T, correct? Let's go over again. You said B for balance.

Nicole Haymes: Balance, yes.

Host: Is this, you know, slightly off or very unsteady. What are we talking about?

Nicole Haymes: It could be a variety of things. I would say anything that is acute, very new onset.

Erin Rogers: Anything that's outside of your baseline. So, what your typical balance may look like, if it's something that's drastically off of your day-to-day balance abilities, that's what would raise the signs where, "Okay, this is my normal being." And so, that should be, you know, your first thought is, "Okay, something's off here."

Host: Yeah. And then, moving on to that E, so we're talking about your eyes. What might one notice with your eyes?

Nicole Haymes: So, a lot of times, it's loss of vision in-- it could be one, usually, typically it's one eye, like a vision cut in an eye. Sometimes we see blurred vision. But once again, it's something outside of your normal, that, you know, it's something acute.

Host: Or, you know, me having a blurry contact is one thing, but not being able see out of one complete side is something different. When you talk about the F, that is the facial droop, and that's typically one side as well, right?

Nicole Haymes: Yes.

Erin Rogers: Yep. Yes. Usually, all of the symptoms will be one-sided because our strokes are typically on one side of our brain. So if you're having a left sided stroke, then you would see the symptoms in your right side. Rarely you would see signs and symptoms in both sides.

Host: Good to know.

Erin Rogers: I'm not just saying it's not impossible, right? But typically, it would be that one-sided.

Host: Yeah. Okay. How about A?

Nicole Haymes: So, A would be arm, like arm weakness. It can also be leg, but it's usually considered with arm. You can't pick your arm up. A lot of times, you pick your arm up and it just falls down to the side of your body.

Host: And I would imagine if you lose control of, you know, one half of your body, that's where the S comes in. And that would be your speech? Slurred speech, not able to speak at all.

Nicole Haymes: So, there's a couple things. There's slurred speech. There's also not able to speak at all. Some people might just have word-finding issues. You know, when you look at a pen, you know that's a pen, but you just can't get the word out.

Erin Rogers: You can't connect the dots.

Nicole Haymes: You can't connect it. So, it's just not making the pathways there.

Host: All right. And finally, T in BFAST.

Nicole Haymes: Time.

Erin Rogers: So, time is of the essence, as Nicole said. And that's what we educate our community on, is time is brain. So, every second, every minute counts. So, to call 911 and have emergency services take you to the closest stroke center.

Host: Yeah. And we're so lucky to have Buffalo General and Gates Vascular Institute right in our own backyard. And that is where some really incredible work is happening to help stroke patients become stroke survivors.

Erin Rogers: Right. And also, I just wanted to make one other comment about the signs and symptoms, knowing it just for other loved ones too. So, acknowledging it and knowing it for yourself, but also for anyone that you may be noticing that they're having the signs and symptoms of a stroke. So, being aware if you're out in the community and something, you know, that a person seems off and say, "Okay, we need to call 911 now and we need to get to Gates."

Host: Yeah. I mean, I've heard of stories where people are watching, you know, newscasts in other parts of the country and they notice that the anchor is, you know, slurring their words or they start to see some of that droopiness, and they're able to step in. You know, even just being a viewer at home, which is something really incredible. But yeah, I think we all need to be aware of our surroundings and the people around us to be able to help. Time is of the essence. The quicker the doctors can get in there, the faster they can do to remove the clot. And talk about how that makes such a difference in terms of outcome and recovery.

Nicole Haymes: So yeah, there's a couple options with stroke. So yes, we have like the typical, what they call clot-busting medication. And the reasons why time is of the essence is because there is a timeframe that we can give that medication typically within four and a half hours of what we call your last known well. So, your last known well is when was the last time I didn't have these symptoms. So in order for that medication to work, that's why you have to get there quickly.

And then, we also have like mechanical thrombectomies and stuff where they go in and get the clot out. But all of these interventions, the quicker that we get to them, we're saving neurons of the brain and then you are going to have a better outcome.

Host: Yeah. And when you save the neurons of the brain, you're saving that function and the speech and the mobility and all of those things, right?

Nicole Haymes: Exactly. Yep.

Host: So, all of that, again, amazing work is happening within the walls of BGMC and GVI on the medical campus. But once folks leave, the work doesn't stop. And that's especially where the two of you come in. It's about building that community and really letting the community know about the other resources aside from just the medications and the surgeries, the treatment that continues after, if you will.

Erin Rogers: Right. So, when being out in the community, we hear a lot of feedback on, you know, "I had fantastic care when I was at Buffalo General Gates Vascular. And then, I got discharged and I really didn't know where to turn to. Google was my best friend at the time," and didn't really feel like they had the proper resources or understanding of where to go.

So in 2024, we developed a stroke survivor support group to kind of bridge the gap of stroke survivors and caregivers to have a community of other survivors and caregivers to provide resources to each other. And also, a way that we can continue the care that they have received after being discharged from our facility and then, once they get, you know, thankfully home and post their rehab, all of that. So, we've developed a monthly stroke survivor caregiver support group. And it's been a very meaningful and rewarding initiative that we have.

Host: Because it doesn't end when you walk out of those doors. There are a lot of folks that continue with their therapies, physical speech, occupational therapy. But to have that community of people who know to a certain extent what you've been through. The caregivers being able to bond with one another. How does that help in somebody's recovery knowing that you're not alone?

Nicole Haymes: Right. And that's the thing I think the most important is like kind of the peer-to-peer support. A lot of them, they just share stories. Actually, a couple of them were chitchatting about just like, "I need to get this jar open. Like, how do I do that?"

Host: It's real life stuff.

Nicole Haymes: It's real life stuff. And he said, "Well, I had to do that too. You just shove it like up against the counter and you use your one hand." And it was just like little tidbits like that. That people just share and they share their emotional stories too, and just to know that they have a friend and a resource.

Erin Rogers: Right. And it's things that we take-- you know, like Nicole said, opening a jar.

Host: We take for granted.

Erin Rogers: We take for granted and wouldn't, you know, hearing from a peer saying, "Okay, this is the solution of how I've reintroduced baking back into my life." And just simple things that it's been really eye-opening for us, as you know, people who are involved in the stroke program at Buffalo General Gates Vascular, getting that feedback, and then using it to improve the stroke care that we are providing in-house and then following their discharge.

Host: It's getting back to real life. It's getting back to, you know, the person hopefully that you once were before and the things that you were able to do. Like you said, simple baking or cooking, you don't think about all of those small things that might become big obstacles in your recovery. Talk about, again, wanting to get out into the community. You know, we bring this community together for this meeting. But this is really open to everybody, not BGMC GVI patients.

Erin Rogers: Correct. Heather, you do not need to be a past patient of Buffalo General Gates Vascular. We're open to the community. Unfortunately, as I'm sure everyone has been, has a loved one or someone that they know that has been impacted by stroke. So, it's really to improve the health of our community as a whole.

And I've been able to attend a couple of the meetings and meet some of the patients. And it's really great to get a wide variety. You've got a wide variety of ages, different abilities, different stages in their recovery. And I think that sometimes it's nice for maybe some of the earlier discharged or earlier diagnosed to see sort of what the possibilities are and what recovery can be like, and maybe give them a little glimmer of hope as well.

Nicole Haymes: Yep, yep. That's what we intended to with this group, is to show everybody's stories, what challenges, also to show their growth. And like I said, we opened this up also, you know, not to just stroke survivors, but we do actually have a woman who it's her husband had the stroke and sometimes she just comes by herself to just discuss challenges she's having with communicating with her husband. So, it's really open for whatever their need is.

Erin Rogers: Right. And they will share small wins of, you know, what in the past month were you able to accomplish that you hadn't been able to accomplish. And even the stroke survivors who have had their strokes, you know, 15 years past still have those small wins that we all can celebrate together. And I think seeing for those who have been newly discharged strokes, seeing that, you know, recovery doesn't happen within three months, six months, a year.

Host: And it's not necessarily linear either.

Erin Rogers: Right, right. So, seeing that, you know, it's constantly building and seeing the veteran stroke survivors, giving them that encouragement that let's celebrate those small wins. It might seem so daunting at the time, but celebrating one small step in recovery and improvement is something to be very proud of. And just as we are celebrating them, they get a chance to celebrate one another, which I think is really, really special.

Host: Talk about some of the things-- I guess my first meeting, I didn't know what to expect when I walked in. You know, is it going to be clinical? Is it just going to be sort of a round table? Guys offer a little bit of everything. There's cooking classes, there's doctors speaking. How do you choose what you present. And why are all of those things-- albeit different, they're all important in their own way.

Nicole Haymes: We kind of go by the feedback from the survivors. They express, or sometimes we will ask the group, you know, what are your concerns or what would you like discussed? And kind of just listening to their stories, listening to their struggles. That's where we kind of brainstorm the ideas to bring in these, you know, speakers or cooking or whatever we have. So like we had, you know, somebody who wanted to have a physician present on something, okay, we will do that.

Host: Yeah. So new technology.

Erin Rogers: New technology.. Yes, that was one of the feedback that we had received. So, you know, we brought that in. And one of our endovascular surgeons was able to present that, and now they're enrolled in that new technology. And they're in the process of hopefully getting that procedure.

So, just really exposing them to different resources and things that can help them in their recovery. So, like you said, yeah, we've had a cooking demonstration of healthy foods, because nutrition is very important for post-stroke to prevent, you know, having a secondary stroke. What else have we had? We've had a lot of different topics.

Nicole Haymes: People to discuss their mental health struggles. And depression is big. So, we had, you know, a doctor come in and talk about that and different services and what's available out there.

Host: I think it validating people's feelings to know that you were not alone. And it is okay to feel all of these feelings while you're going through your recovery.

Erin Rogers: Exactly. Yeah. And we have some exciting topics and presentations aligned for 2025. Next month, we have Elder Justice coming in and discussing living will and a MOLST form and power of attorney, where some of us might not ever have the opportunity to discuss those important things.

We're going to be doing chair yoga and meditation in May, you know, again, with the mental health and ability, just to name a few. But we have a calendar slated for the year or at least the next couple months. So, we're just really trying to make it diversified and meet the needs of our survivors and our caregivers.

Host: And I feel like when somebody is in the hospital or they're in the MRU, you know, receiving their rehab and, you know, continuing with the treatment. That in and of itself is so overwhelming, right? That the things that you talk about in the stroke group are probably not even top of mind while they're in the hospital. But it's afterwards where you're like, "I want to know more about that. I need somebody to break that down for me or guide me in the right direction to the right expert." So, you guys, instead of putting a period at the end of the sentence when they leave the hospital, it's more of like a comma and you guys are the continuation of that.

Erin Rogers: Right. And our survivors and caregivers, they bring the resources that they have utilized and can almost validate, you know, "I've had success with this occupational therapist and for this reason." And then, so their peers can then say, "Okay, I'm going to contact that," "Okay, can you write that down for me?" And that's just one, one example, but the community of resources that I think is most valuable to having all of the different things brought to their attention from peers.

Host: And I've also seen people in the meetings, you know, grab a piece of paper and jot down a name or a phone number. And they're exchanging whether it's each other's phone number, so that they can become friends and stay in touch or "I know the name of a therapist," or "I know, you know, this worked for me. Allow me to share it with you." That has to be just so rewarding for the two of you.

Nicole Haymes: It is very rewarding. And it's just seeing just how they're engaging, how they're sharing resources and kind of going back to what you said about being in the hospital, like at discharge, like they just want to go home. Yeah.

Erin Rogers: That's their number one goal. There's so much information that they're receiving. There's a lot of noise and to process it all. It takes time.

Nicole Haymes: So, that's why we know we want to now bring this forward to after they go home and say, "You know, these are other resources and all the things that are available."

Erin Rogers: And it's not even just services that they're sharing. They're also sharing Amazon purchases that they have. You know, one caregiver was saying something that he bought to help his wife with her her hand mobility. He's like, "I just bought this on Amazon," so he shared the link with everyone.

Host: I'm sure everybody was on their phone.

Erin Rogers: He brought the product in and was demonstrating it. And it's like you're not even a medical rep. You're just somebody who bought this and it worked.

Nicole Haymes: And it worked for you.

Host: Yeah. Simple things that can help another person in their recovery. And when people go home and go, "Well, now what?" You're able to help sort of answer that question. What is some of the feedback that you have gotten from the survivors and the caregivers who some are at every single-- it is a monthly meeting, right? The third Wednesday of every month. But what are you hearing from them about what you're offering?

Erin Rogers: Appreciation. Yes. They are just so thankful that this has been established and that it's something to look forward to every month for them too. So, I think that would be my number one takeaway is the feedback of appreciation. And that just makes our work so meaningful that we know that we're impacting all of their lives.

Nicole Haymes: Yeah.

Host: Yeah. And so, third Wednesday, every month, 5:00 to 6:30. It's at Buff General GVI in the Swift Auditorium. And free and open to everybody.

Erin Rogers: Free and open to everyone. The Swift Auditorium also is located right near our front lobby entrance, which makes it easy and accessible to our survivors and caregivers. So, we try to make it accessible. We always offer refreshments too.

Nicole Haymes: Yeah, we do.

Host: And valet parking and free parking, which is really nice too, right? So, you don't have to worry about having to trek through the hospital. And worried about whether or not you'll be able to make it to a certain space.

Nicole Haymes: It's very easily accessible. In the Swift Auditorium, I mean, there's a bathroom right there, so you don't have to worry about going through the hospital to find one. And even for like wheelchair accessibility, it's all one level. You have no challenges.

Host: And the Swift Auditorium is a very, very large room. So, we're hoping that we can fill it with more and more folks. Usually what? I've usually seen about a dozen or more.

Erin Rogers: Yeah, we've gotten around 20 to 25 at some months. It always depends on the weather too.

Nicole Haymes: This is true.

Erin Rogers: Weather and traffic sometimes. But yeah, we're always looking to grow and get the word out about what we're offering.

Host: Yeah. Fantastic. Well, we thank you so much for joining us. Thank you. I think there's a lot of really good information. Again, remember that BEFAST that is, you know, the acronym for the different symptoms and signs that you should be looking for. And again, if you think that you or someone that you know is experiencing a stroke, 911 because time is of the essence.

All right. Well, I wish you the best of luck this year in growing the program. We hope to have you on, you know, at another point to talk more about what you have to offer. But again, it is a great resource that is open to everyone, not just patients at Buff General and Gates Vascular Institute.

Erin Rogers: Thanks so much, Heather.

Nicole Haymes: Thank you.

Host: Yeah, thank you. And thank you for listening to this latest episode of Medically Speaking. We'll see you next time.