PORTSMOUTH — When we think of someone who has suffered a stroke, we don’t automatically think of a healthy 50-year-old man. But that’s exactly what happened to Wells, Maine resident Bob Hoffman. His stroke was so atypical that the usual approach to care was not what he needed to survive.

A dramatic reaction saved his life.

Bob Hoffman is feeling well now and is approaching the point where he has the level of function he had before the stroke.

“I feel good physically,” Bob said. “It doesn’t look like I’ve been through such an ordeal, but I know I did. I know I’m lucky to be alive. I know it will take time to complete my recovery and achieve this new normal for me. I am now working towards returning to work.”

Bob Hoffman with his daughters Katrina, 16, Malina, 13, and wife Amanda.

He is a supervisor at Pratt and Whitney, an aerospace manufacturer in North Berwick, Maine.

Hoffman’s stroke was associated with an aneurysm

There’s a lot about that time that Bob Hoffman doesn’t remember, so his wife Amanda, who can’t forget, told much of his story.

“It was Monday, March 22, 2021, a normal day for all of us,” Amanda said. “I worked. Bob went to the gym and came back bragging that his class topped the others. We went to bed. I woke up around midnight and heard what I thought was snoring. J I thought about poking him, but realized he wasn’t snoring. . He was on his back, making those noises.”

Amanda said her husband had pulled himself together a bit, but she was still worried.

“I told him to get dressed because we were going to the hospital, because he might have had a stroke,” she said. “He suddenly grabbed his head, said it was the worst pain ever and he started throwing up. I took him to the car, then he had a second stroke, with seizures. With the help of the family, we got him out of the car and called 911 for an ambulance.”

Hoffman was taken to York Hospital, where an ER doctor determined he had suffered a stroke and an aneurysm that had ruptured. It was decided to transfer him to Portsmouth Regional Hospital, where there is a specialist stroke centre.

Fortunately, the Hoffmans found their way to Portsmouth Regional Hospital and neurointerventional radiology specialist Dr Francesco Massari in time.

Regarding Bob’s specific case, Massari said it was complex and there were risks.

“A brain aneurysm is uncharted territory, especially when there is a rupture,” he said. “You have to work with the family, to keep them well informed of what is happening.”

The wait has been painful for Amanda

“It was my first encounter with COVID protocols because I couldn’t accompany him in the ambulance,” Amanda said. “They told me I couldn’t go to hospital either. York nurses were so mad for me. They were calling everyone they knew to make sure I could see him.”

It was 2 a.m. and Amanda was sent home to wait for a call, which didn’t come until 7 a.m. the next day.

“They told me he was stabilized but they were calling a surgical team from Boston because it was the biggest break they had ever seen. This is my Bob – go big or go home “, she said. Massari actually splits his time between Portsmouth Regional Hospital and UMass, so he’s not based solely in Boston.

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He survived thanks to this procedure

Dr. Francesco Massari

Bob Hoffman underwent surgery, but because of the rupture, the usual treatment of using coils to stabilize the stroke was not correct. Instead, a stent was placed in his brain, a mesh web to allow blood flow.

Massari explained that there are two different types of stroke: ischemic, caused by a blockage in a blood vessel that supplies the brain, and hemorrhagic, where the brain loses access to its blood supply due to a bleeding from a blood vessel.

Bob was the second guy. Massari said his brain wasn’t getting the blood it needed.

“Only 40 to 50 percent of patients survive a rupture like this,” he said. “Bob’s aneurysm was the worst case, with only 1% surviving. If the patient survives the first bleed, it becomes crucial to prevent a second one by sealing the aneurysm. A real challenge arises here because we have to use blood thinners in order to place the stent.”

“Day 14…we just held our breath”

“Bob was intubated for 14 days in the intensive care unit,” Amanda said. “I didn’t know what the outcome would be. Would he be able to talk, walk? Again, because of COVID, I was only allowed to be with him for two hours a day. He knew who I was .For the first four days he didn’t respond to the staff, but when he heard my voice I knew he knew it was me.”

Bob was in intensive care for four weeks, then moved to a hospital floor for two weeks to recover, then he was transported to a rehabilitation center in Massachusetts near Boston, where he remained for six weeks from more.

“It was our first experience with something so remotely traumatic,” Amanda said. “I called the office every morning and tried to plan my two hours around when I could catch the doctor. On day 14 when they removed the intubation tubes, we just held our breath “Will he talk? Did he know who I was and what happened?”

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Bob knew his family and knew he was in the hospital. Amanda said her sense of time was upset and the stroke affected her left side.

“Physically things came back pretty quickly,” Amanda said. “In rehab, they really got him moving. But he doesn’t remember that, and maybe that’s a good thing. He’s an endurance athlete, running, cycling and we have a farm. I have to think his prior physical condition has given him a boost in his recovery. He is still in occupational therapy and speech therapy to help rewire his brain. We are grateful to everyone involved.

Hoffmans gives thanks

The Hoffmans said they were grateful to the staff at Portsmouth Regional Hospital for their excellent care and gave special thanks to nurse practitioner Maddie Dalgliesh, the nurses on their floor and, of course, Massari.

Maddie Dalgliesh, nurse practitioner at Portsmouth Regional Hospital

“I’ve been doing this for a long time and this disease process can be deadly,” Dalgliesh said. “When there is a brain aneurysm, the conversation with the patient becomes very important. Everyone knows what to do when a patient breaks their leg, but a brain aneurysm is uncharted territory. I want to keep the family informed about this is happening. I tell them it’s a marathon, not a sprint. I want them to understand that recovery is hard work.

Massari said the stent used to save Bob’s life is a revolutionary tool developed in New England.

“Portsmouth Regional Hospital uses the most modern tools and expertise,” he said. “We employ highly technical skills, and I’m glad we’re there for our patients. In the case of something like this, we rely on timing, luck and having the patient in good hands.

“It’s always a team effort,” Massari said. “It’s why we wake up in the morning, and it can be hugely rewarding.”

The hospital in the spotlight

Portsmouth Regional Hospital recently received the American Heart Association and American Stroke Association’s Get With The Guidelines – Stroke Gold Plus Quality Award with Target: Stroke Honor Roll Elite Plus with Target: Type 2 Diabetes Honor Roll

Get With The Guidelines – Stroke is a hospital-based program aimed at improving stroke care by promoting consistent adherence to the latest scientific treatment guidelines, according to the American Heart Association’s website.

The awards recognize hospitals’ proven dedication to ensuring that all stroke patients have access to best practices and life-saving care. This is the fifth year in a row that Portsmouth Regional Hospital has received this award.