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Robert R. Cawley, D.O.

Dover, NH 03802

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Stroke Care: How Early Stroke Symptoms Can Guide Stroke Treatment

Bruce Cossette knew something was wrong that day when he reached for his water glass and couldn’t quite grasp it.

“My hand went numb and I dropped the water,” says the 74-year-old retired pipefitter from Somersworth, NH. “When I went to the sink to put the glass back, I suddenly couldn’t talk, I could only mumble sounds.”

Bruce was having an ischemic stroke, says Dr. Thomas J. Lydon, a board-certified emergency medicine physician in the Wentworth-Douglass Hospital Emergency Department.

Fortunately, Bruce’s wife immediately called 911. Studies have shown that immediate treatment can minimize a stroke’s long-term effects. If someone is exhibiting stroke symptoms, it is best to call 911, as treatment may start with the EMS team in the ambulance.

“It happened so quickly,” Bruce says. “Thinking back, I now think I was a little more tired than normal that week, but I really felt fine, nothing hurt or anything.”

Within minutes that day, Bruce was in an ambulance on his way to WDH, a Joint Commission certified Advanced Primary Stroke Center. Once at WDH, Dr. Lydon immediately used the hospital’s TeleStroke program. Through videoconferencing equipment, Dr. Lydon consulted with a Massachusetts General Hospital specialist about Bruce’s diagnosis and best stroke treatment options.

In Bruce’s case, he was a candidate for tissue plasminogen activator (tPA). It works by dissolving the clot and improving blood flow to the part of the brain deprived of blood flow.

“It all happened so fast,” Bruce says. “I remember seeing the doctor from Mass General on the TV screen. He was talking back and forth with the doctor in the ED and I tried to say a few things but I couldn’t talk. It just wouldn’t come out.”

Thanks to WDH’s advanced stroke care, after a couple of days in the Critical Care unit, Bruce was up and walking with the assistance of a physical therapist. Working with a speech therapist, Bruce began talking within a day and now has only a minimal speech deficit.

“My speech is not quite 100 percent, I notice it a little bit, but it’s not really a deterrent,” Bruce says. “And my motor skills are great. It’s amazing, but I don’t seem to have any lasting effects.”


Every second counts when someone has stroke symptoms. If you see, or have, any stroke symptoms, immediately call 911. BE FAST helps you recognize the common signs of a stroke – Balance, Eyes, Face, Arms, Speech and Time. Look for sudden loss of balance; sudden blurred or double vision or vision trouble; a drooping face; weakness or numbness in an arm and/or slurred or garbled speech. Most importantly, call 911 for immediate medical attention as treatment can begin with the EMS response team. Take note of when symptoms began.

Learn more about Wentworth-Douglass Hospital’s stroke care!