Stroke Treatment: Time Matters

Divine Savior Healthcare Emergency Department Director, David Spannagel showcases new TeleStroke services available to patients.

The emergency department at Divine Savior Healthcare has been setting gold standards in response times and treating patients for strokes, heart attacks, and other life threatening conditions. Whether making a 9-1-1 call or coming directly to the emergency room, patients can rely on Divine Savior’s ER and EMS crews to respond to their conditions and receive world-class care.

Divine Savior has made continued investments to insure the stroke response and treatment times for our patients are the best possible and their team is excited about the opportunity to offer TeleStroke, a.k.a bedside neurology consultation, in their emergency rooms.

When a patient arrives with stroke symptoms a physician and/or nurse in the emergency room will assist the patient and begin to use TeleStroke services. This videoconferencing and image sharing technology allows patients to be examined by a neurological physician from miles away and allow emergency rooms, like Divine Savior, to start immediate treatments if necessary or plan for the next appropriate step.

 “Having TeleStroke allows Divine Savior to make more rapid judgements about the use of tPA in patients with stroke symptoms,” shares Spannagel.

TPA stands for Tissue Plasminogen Activator and is a medication used to help dissolve blood clots in the brain. Based on research, if given to patients within the first 3 hours of a stroke, tPA could possibly help reverse disability of a stroke.  

 “We are able to treat patients at a maximum of a half hour from the time they arrive in the ER to connecting with a neurologist, usually sooner if neurologists are not involved in other cases,” states Spannagel.

Spannagel has been quoted recently about the impressive response times the DSH emergency team is known for when responding to heart attacks, stating “time is heart”. He says the same about strokes, and that “time is brain”.

“Additionally, this TeleStroke gives our team more confidence and resources to manage care for patients at Divine Savior and keep them in our care rather than transferring them to Madison. When considering all things, time is brain,” says Spannagel.


What is a Stroke?

A stroke happens when there is interruption of blood flow to the brain. The brain cells are not getting enough oxygen-rich blood and those brain cells die. The American Stroke Association shares, “87 percent of strokes are classified as ischemic. An ischemic stroke occurs when a clot or a mass blocks a blood vessel, cutting off blood flow to a part of the brain.”

There are other forms of strokes, such as a hemorrhagic stroke, a cryptogenic stroke, and a TIA transient ischemic attack. A hemorrhagic stroke happens when a weakened blood vessel or cerebral aneurism ruptures and that blood spills into the brain. A cryptogenic stroke is from an unknown cause, and a TIA is also called a “mini stroke” or “warning stroke”. This stroke is similar to an ischemic stroke in blockage of blood flow, but the blockage is temporary and symptoms last less than five minutes. Although symptoms are temporary, it is still important to seek medical help right away.

Timing is everything. The critical moments, from the time a patient starts experiencing stroke symptoms to the time they receive treatment can save a life. The American Stroke Association references the acronym F.A.S.T. and encourages everyone to remember this to help save your own life and others.


F = Face Drooping

A= Arm Weakness

S= Speech Difficulty

T= Time to Call 911


It’s important to make note of what a stroke is and what it may look like as majority of strokes are preventable. According to the American Stroke Association, 80 percent of strokes are preventable and the most important controllable risk factor associated to having a stroke is from high blood pressure.  The American Stroke Association shares, one in three American adults have high blood pressure, and most people who have a first stroke have high blood pressure.

Other stroke risk factors include:

  • Atrial fibrillation
  • Smoking
  • Physical inactivity
  • High sodium intake
  • Family history in a first-degree relative


If you’re interested in finding out what your blood pressure is, you can attend anyone of Divine Savior Healthcare’s FREE Blood Pressure Screenings throughout the area.

Times and Locations include:


Date: Every Wednesday

Time: 1:00 – 5:00 p.m.

Location: Divine Savior Healthcare, Clinic Atrium

2817 New Pinery Road

Portage, Wisconsin 53901



Date: 2nd Friday of the month

Time: 12:00 – 3:00 p.m.

Location: Divine Savior Healthcare – Crossroads Clinic

N4390 Crossroads Clinic Rd

Oxford, Wisconisn 53952



Date: 4th Friday of the month

Time: 1:00 – 3:30 p.m.

Location: Divine Savior Healthcare – Pardeeville Clinic

102 Gillette Street

Pardeeville, Wisconsin 53954


No appointment necessary. Call 608 745-6289 for more information.

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Experiencing a dull pain in the pit of your stomach

Stomach PainGastroesophageal reflux disease, or GERD, and gallbladder disease are two very common disorders. Knowing which one you have may be trickier than you think. Symptoms may be vague, such as a “dull pain in the pit of your stomach”, making it hard for you to explain to your doctor what’s exactly going on.

At Divine Savior Healthcare, General Surgeons, Dr. Eric Anderson and Dr. Joshua Pogorelec, have seen many patients with these symptoms and after further examination are able to help  diagnose and treat both diseases.

What is GERD?
Gastroesophageal reflux disease GERD refers to stomach contents moving into the esophagus causing a burning sensation commonly referred to as heartburn. Other symptoms may occur as well, such as pain in the upper abdomen, bloating, nausea and an acid taste in your mouth.  If this continue, prolonged exposure of the esophagus to stomach contents can result in damage to the lining of the esophagus.  This in turn can result in difficulty swallowing, pain with swallowing or permanent damage to the esophagus.

Although not all reflux results in symptoms or damage to the esophagus, common symptoms include:
• Heartburn
• Acid regurgitation
• Belching
• Difficulty or pain when swallowing
• Waterbrash sudden excess of saliva
• Dysphagia the sensation of food sticking in the esophagus
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath
• Coughing at night

What is gallbladder disease?
The gallbladder is located below the liver on the upper right side of the abdomen. The main function of the gallbladder is to store bile, which is made in the liver and allows fat-soluble vitamins and nutrients to be easily absorbed into the bloodstream. Any condition that affects the gallbladder is considered a disease, and there are many different scenarios that fall under gallbladder disease:
• Inflammation
• Gallstones
• Common bile duct stones
• Biliary Dyskinesia
• Infection
• Perforated gallbladder
• Gallbladder polyps
• Porcelain gallbladders
• Gallbladder cancer

Dr. Anderson and Dr. Pogorelec share "the most common disease of the gallbladder is gallstones. Most people with gallstones do not even know they have them.  Once they cause problems, the gallbladder may need to be removed. Symptoms include pain below the right rib cage or in the “pit” of the stomach. This pain may radiate to the right upper back, chest, or shoulder. Other symptoms may include, bloating, nausea or vomiting, fever or chills, chronic diarrhea, jaundice yellow-tinted skin, or unusual lighter-colored stools or dark urine.”

After taking a closer look at GERD and gallbladder disease, Dr. Anderson and Dr. Pogorelec are able to provide helpful insight on common distinguishing factors between the two diseases.

Common distinguishing factors:
• Location: Although both may feel like a “pit in your stomach”, if you experience symptoms located closer to your throat or in your chest it is more likely to be GERD related. Symptoms located near your right lower rib radiating into your right upper back, chest and shoulder are more likely to be associated to your gallbladder.
• Pain: Unlike GERD, gallbladder pain usually begins suddenly, and changing positions, belching, passing gas or taking medications rarely helps pain symptoms go away.
• Timing: With heartburn being the most common symptom of GERD, symptoms of reflux are likely to occur shortly after eating, where symptoms of gallbladder disease usually occurs several hours after eating and have more consistent patterns of reoccurrence the same time each day.

What does treatment look like?
The symptoms of GERD are commonly and effectively treated with over-the-counter medications such as anti-acids and proton pump inhibitors. However, if relief does not go away from these medications your provider may recommend you be evaluated by one of our surgeons at Divine Savior.

After a thorough history and physical, our surgeons may recommend further evaluation of the esophagus and stomach with endoscopy.  Similar to colonoscopy, but without the need for prep, upper endoscopy allows the surgeon to visualize the esophagus, stomach and intestine to evaluate for damage to the esophagus, infection and a hiatal hernia.  Depending on the findings, further testing may be indicated to evaluate the function of the esophagus. 

Patients with severe GERD benefit from surgery to prevent reflux from occurring.  This procedure is commonly performed by both Dr. Anderson and Dr. Pogorelec, is minimally invasive, and very effective at treating GERD.  In fact, most patients no longer require any antacid medications after the procedure.

If you are found to have stones in the gallbladder causing symptoms, the best course of action is to have the gallbladder removed.  Leaving the stones in place will continue to cause pain and may result in serious infection of the gallbladder and bile ducts, jaundice or pancreatitis. 

Both Dr. Anderson and Dr. Pogorelec routinely perform minimally invasive removal of the gallbladder.  This is most often an outpatient procedure and very successful.  After a short recovery, most patients will find their symptoms are gone and they are able to live a normal life. 

If you experience symptoms related to GERD or gallbladder disease, or have concerns about either, it is best to consult your provider for further examination. Treatment for either disease varies person to person, but taking action immediately and being properly treated can help you prevent problems from worsening.

To schedule an appointment with Divine Savior Healthcare General Surgeons, Dr. Anderson or Dr. Pogorelec, call 608-745-5176.

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