Ronald Paapke sat down on the couch in his Lewis and Clark home one evening this month to watch the news on TV when a massive stroke left the entire left side of his body paralyzed.
Within two days, Paapke, 54, was back on his couch, after a quick response by all involved, a surgery at Oregon Health & Science University and a recovery one of his doctors called miraculous.
After a day of running around, Paapke came home and sat down to watch the news just before 5 p.m. on Sept. 19.
“As soon as I hit my chair, I felt like a weird sensation on the left side, mainly in my leg,” he said.
Paapke tried but couldn’t move his leg. He tried to get up off the couch and crashed to the floor before calling for his wife, Jane Leino.
“He was fighting me, because he wasn’t thinking quite right,” she said. “He wanted me to help him up. I tried one time, two times. I said, ‘Ron, I would like you to lay down on the floor so I can look at you and see what’s going on.’”
Leino, who had worked at a hospital in Alaska, asked Paapke to smile and lift his arm or leg. By then, she knew he was having a stroke and called 911.
Within five minutes, responders with the Lewis and Clark Fire District arrived and stabilized Paapke until Medix took over. Within an hour of the stroke, Paapke was at Columbia Memorial Hospital.
At 5:30 p.m., Dr. Stewart Weber, a vascular neurologist at OHSU, received an alert on his pager from Columbia Memorial, where a doctor determined Paapke was having a sizable stroke. He connected via the hospital’s telemedicine program and examined Paapke. A brain scan showed a blood clot running 12 centimeters up Paapke’s carotid artery from his neck to his brain.
“We decided that he would probably benefit the most from getting clot-busting medication,” Weber said.
Paapke was given a shot of tPA, or tissue plasminogen activator, used to dissolve blood clots. Only about 5 percent of stroke patients receive the drug, which needs to be administered within three hours. But the clot wasn’t dissolved by the medication, making Paapke a good candidate for a newer treatment at OHSU known as a mechanical thrombectomy.
Paapke was flown to Portland by Life Flight Network and by 7:30 p.m. was being stretchered into OHSU’s emergency department.
Plaque from smoking
Dr. Hormozd Bozorgchami, an interventional neuroradiologist at OHSU, inserted a catheter into an artery in Paapke’s groin, threading it through his aorta and into the carotid artery.
“It was filled with plaque from smoking,” Bozorgchami said of Paapke’s artery. The doctor inserted a stent mesh used to reinforce weak vessels.
Within a half-hour, Bozorgchami pulled out the stent, and with it the blood clot, a long, snaking mass of coagulated blood cells. It was the largest blood clot he had pulled out in six years at OHSU, Bozorgchami said.
“Within a minute after we got it out, he could start moving his left arm, which was totally paralyzed, and give us a thumbs up,” Weber said. “It was pretty miraculous, almost an immediate recovery.”
Paapke’s friends and family prayed for him the entire time he was gone, Leino said.
“I’m just praying that it continues to be as great as it’s come out so far, because his life and my life could have been completely different, if everything didn’t work as smoothly.”
With about a month to go before his next checkup, Paapke’s goal is to quit smoking and lose about 5 pounds. Since being released from the hospital, he has been going around thanking the responders with Lewis and Clark, Medix, Life Flight, Columbia Memorial and OHSU whose response he said was textbook.
“I’d like to thank everyone involved,” he said. “It was a great team effort.”