 Stroke is the leading cause of disability in the country. It's the fifth leading cause of deaths. It actually can happen to anyone. Kaiser Permanente, Northern California has 21 medical centers that are all stroke centers. And we work across medical centers to deliver care in a systematic method for those who need a higher level of care, who needed an intervention that isn't provided at most medical centers. The challenge facing everybody in the stroke community is how do we identify people like Robert and deliver the care in an expedited fashion? At Kaiser Permanente, we've developed the Stroke Express project. Robert benefited from this new treatment program in that we were able to very quickly treat him for his acute stroke. When I first experienced something was wrong, my coworker came into the break room at work and I realized that he asked me a question and I realized I couldn't understand what he was saying. At that point, I tried to answer him and I couldn't speak either. My coworker then called 911 right away. The ambulance service showed up and I heard them radioing in that it was a stroke. Kaiser Richmond, Isaac speaking. We got a pre-notification call from the ambulance, the EMS service, that they had a 27-year-old patient, Robert. ETS, 10 minutes, possible stroke. They were concerned with him having acute stroke. They were able to give me his medical record and I could look at his chart. Specifically for the stroke alert, it's an amazingly complex system that all has to work very well, very quickly to get the care as fast as possible. We need to have the pre-notification, we need to have the CT scan ready. We immediately contacted the teloneurologist to have the video cart up and ready for when Robert would arrive. I remember looking in his eyes how scared he was. When Robert rolled into the emergency room, he had stroke-like symptoms. The stroke neurologist is available via teleconsult in a two-way monitoring fashion where the neurologist leads the stroke code. Can you name the objects that you see there? And was able to perform rapid interpretation of all the data at hand. Once we collected all this information, we treated him with the clot-busting drug, or TPA. And we also notified our Redwood City colleagues who would perform an intervention on him later in the day. Time is everything. We needed to save his brain by applying these concepts rapidly and efficiently so that we'd optimize his outcome. It was kind of surreal in the sense that there's all this going on for me. They were such a well-oiled machine. After I was done speaking with teloneurologist Dr. Fox, I alerted the rest of our team and we started to get ready for Robert's arrival. Fox started to get the angiosuite ready with all the equipment that we were going to need. What we did for Robert is a minimally invasive procedure where we placed a small tube or catheter in the artery starting in the leg and navigated up right to the blockage in the brain. And then we deployed a device called a stent retriever which captures the clot and makes it possible to pull it out and restore flow to the brain. Patients that are having a severe stroke. The sooner we get the artery open, the better they do. And my right hand went up as soon as they got the last bit out and that's when I knew that I was going to be alright. Kaiser Permanente Stroke Express Program has allowed us to treat twice as many patients with the life-saving medication TPA and in addition it has allowed us to have the time of door to needle for TPA treatment. But yet we have been able to maintain our low complication rate. So if you happen to present to Kaiser Permanente emergency room with a stroke like Robert did he'll have access to a system of stroke care that includes primary stroke centers and comprehensive stroke centers. And irrespective of the type of stroke, the complexity of the situation you'll get the best care possible. If everything hadn't come together the way it did I could be paralyzed on my right side permanently. So I'm very happy for all the doctors and the teamwork and everything that went so smoothly for me and so fast. I'm back to dirt biking, jet skiing, wakeboarding, working, all that. It seems like it's such a trivial thing to thank somebody but that's all I can offer because it's my utmost thanks, you know?