“It was a normal day. I woke up at 5:30 a.m., getting ready for work, and I had a little headache,” remembers Stephen Ore, 59, of Harrison, Montana. I was getting something out of the dryer, and that is when my wife found me lying on the floor.”
Stephen Ore’s next 12 hours would be anything but normal as he suffered a large stroke near the base of his brain stem, a rare location for a stroke that can have very debilitating and potentially fatal consequences. Ore described himself as a bystander throughout the entire event, as his wife, Margaret, called in the first responders who would activate a quick chain of response to help her husband.
“I found him on the floor, and he looked wide awake, and he said, ‘I am just dizzy,” Margaret Ore said. “I didn’t even think of a stroke, but the symptoms kept coming, headaches, sweating, and then his speech started to slur.”
Additionally, he began having numbness in his hand and difficulty with his vision.
The Ores live in a rural community in the Tobacco Root Mountains, an hour from Butte or Bozeman. Margaret Ore knew an ambulance would be at least 30 miles away.
When the EMT from Madison Valley Ambulance Company arrived, he recognized that Stephen Ore was having a stroke and called for a helicopter immediately. Ore needed to get to a hospital that provided a higher level of care. The aircraft landed in a field on the Ores' property, and he was taken to Intermountain Health St. James Hospital in Butte.
From the moment Magaret called emergency services, it activated a chain of care that has been developed to improve the care of stroke patients in Montana, especially those in rural communities.
“As we say in stroke care ‘time is brain.’ For every minute that passes once a person suffers a stroke, 1.9 million brain cells are lost,” said Penny Clifton, Stroke Program Coordinator at Intermountain Health St. Vincent Regional Hospital.
“The more time between initial symptoms and treatment, the greater the chance of lasting disability or death.”
Clifton has worked with Intermountain Health facilities and partner hospitals across Montana, as well as EMS providers and the state of Montana, to improve time to care through communication, collaboration, and outreach. In Ore’s case, the system worked exceptionally well to ensure he received the high level of care he needed when he needed it.
When he arrived at St. James Hospital at 8:30 a.m. in Butte, the stroke team was activated and ready to respond quickly. Using the Intermountain Health telestroke service, imaging of Ore’s brain was evaluated remotely by a stroke specialist.
"Because of the prior notification from LifeFlight, we were able to prep the ED staff for a quick assessment of the patient and sent him directly in for a CT scan,” said Alan Mayer, MD, Emergency Physician at St. James Hospital. “With the assistance of a neurologist via our TeleStroke program, we identified the location of the thrombosis. The seamless teamwork of all the departments lead to the patient receiving Tenecteplase (TNK), a clot-busting drug, within 30 minutes of arrival at St. James Hospital.”
The specialist decided Ore needed to go to St. Vincent Regional Hospital in Billings. There, Ore would undergo a procedure to remove the clot blocking blood flow to Ore’s brain.
After less than an hour in Butte, he was taken by helicopter to Billings, and the St. Vincent team was ready to perform the procedure. The procedure was completed by 11:30 a.m., and Ore was recovering in the Intensive Care Unit at St. Vincent. By the time Margaret and her son arrived in Billings by car, many of Ore’s symptoms began to improve.
Ore spent three days in the hospital, and just over a month later he was cleared to return to work. He works for Madison County driving trucks and heavy machinery. He has some loss of vision and is working on strength and coordination in his hand through rehabilitation, but he, Margaret, and his three sons are grateful, considering how much worse the outcome could have been.
“We are an active family. We live in the Tobacco Root Mountains, and we love to get out as much as we can,” he shared. “Just two weeks before my stroke, my son and I went on a 16-mile backcountry ski trek to Potosi Peak and Elbro Lake. I look forward to getting back out again.”
Until recently, the advanced stroke care provided at St. Vincent that was so impactful for Ore was only offered in large medical centers in urban areas. St. Vincent began offering the procedure in 2021, benefitting hundreds of Montanans, like Ore.
“The ability to keep patients close to home and save time when it is most crucial are the driving forces for growing our stroke program,” shared James Richards, MD, Medical Director of the St. Vincent Stroke Program. “We are so proud to offer this advanced level of care 24-7, 365 days a year, provided by the leading specialists in their field.”
“At St. Vincent and across the state, we have been working for the last five years to advance our response and treatment of stroke to improve outcomes for Montanans, especially those in rural communities,” Clifton said. “Stephen’s story is just a great example of the fruits of all of these efforts, and we are very proud of it.”
The Ores hope that telling their story will raise awareness of the importance of recognizing stroke symptoms and help people to act and access care quickly.
“I want folks to know that anyone can have a stroke and to look for those symptoms,” said Ore. “I am healthy and active, and it happened to me.”