PANAMA CITY — It’s shocking how quickly Dee Palmer’s health deteriorated, her husband said.
But it could have been worse. Ray Palmer’s quick recognition of stroke symptoms might have saved her life.
Every year, 130,000 people die of stroke in the United States, according to the Centers for Disease Control and Prevention. It’s the country’s fourth leading cause of death, and the National Stroke Association urges everyone to be aware of stroke symptoms and how to respond.
Dee and Ray Palmer were relaxing in their Panama City home Sept. 16. Dee had plopped down in a recliner in the office area, informing her husband she was tired after exercising on an elliptical machine.
Roughly a half-hour later, Ray Palmer asked his wife how she was feeling. She did not respond, only smiling at him. Ray then asked his 74-year-old wife if she could talk, but she still did not respond. His last question was whether she could walk. Amazingly, she could and Ray Palmer guided her down a step and into the garage. Dee Palmer had the presence of mind to buckle her seat belt, recline her seat and adjust the visor on the windshield to block the afternoon sun.
“She was in no visible pain,” Ray Palmer said. “She didn’t hold her head.”
Still, he guessed his wife had suffered a stroke because he knew speech impairment was one of the telling symptoms — the S in the FAST acronym used by the National Stroke Association.
He raced down U.S. 231 to get to the hospital. She was rushed into ICU, where a CT scan was performed. The test showed a dime-sized spot, a hemorrhage, on the left side of Dee Palmer’s brain. The doctor thought the hemorrhage would dissipate and she would be fine. However, her condition continued to worsen; she could not move the right side of her body.
A subsequent CT scan showed the hemorrhage had grown to the size of the golf ball. The neurosurgeon on call urged Ray Palmer that surgery was necessary or the stroke would prove fatal. Ray Palmer signed the waiver forms that have the risk of death prominently displayed.
The surgery was a success, but Dee Palmer has been unable to talk or move her right side for the past two weeks. She now communicates with smiles, shrugs and with the squeeze of a finger. Ray Palmer said her condition has improved in gradual increments, but there is the concern that she won’t recover completely.
Dee Palmer was seeing three doctors per day — a neurologist, nuerosurgeon and Bay Medical Center Sacred Heart Health System caseworker. All recommend a transfer to Health South Rehabilitation hospital, where she would receive three hours of intensive occupational, speech and physical therapy per day.
Visit from a stranger
In a coincidence, an event Ray Palmer still finds surprising, Dee Palmer received a visitor during the first week at Bay Medical — a man neither of them had ever met. His name was Don Schaefer and he is a parishioner at St. Andrew Baptist Church, where Ray Palmer used to teach Sunday School. Schaefer saw Dee Palmer’s name on a prayer list. Schaefer showed Ray Palmer a horseshoe-shaped scar, visible in his hairline. The scar is identical to the one Dee Palmer received after surgery.
Schaefer said he was in the same position 13 months ago. He walked into the hospital room and spoke clearly, no lasting effect from the stroke lingering. He adds that he went to Health South.
This visit makes the transfer even more prescient in Ray Palmer’s mind, walking and talking proof that Health South can provide the care his wife needs. Health South already has approved the transfer and has a bed waiting.
The holdup was the Palmer’s insurance company, Humana — their Medicare Advantage plan provider — denied the transfer as medically unnecessary. They recommended Dee Palmer be transferred to a nursing home where she would receive 45 minutes of therapy per day. Ray Palmer has decided to pay for the transfer himself. He believes he can afford about two weeks of treatment at $7,800 per week.
“Her neurologist said she is a slam dunk for Health South,” Palmer relayed.
Humana’s Northwest Florida Medicare Chief Medical Officer Dr. Albert Tzeel responded to a question about the situation in an email to The News Herald:
“Our policy, which is consistent with Medicare, is that for a member to be transferred from one facility to another, the member must meet specific criteria (such as services needed can be provided at the receiving facility and are not able to be provided at the original facility). The services a member needs at, for example, an in-patient rehab facility, versus those that may be provided at a skilled nursing facility, must be significantly different to support medical necessity for the transfer request.”
Tzeel added that Palmer has the right to appeal to a different medical director, which Palmer already has done. On Monday, Humana told Palmer they needed to wait two weeks to process Palmer’s appeal.
Since then, Dee Palmer’s health has deteriorated. She never left Bay Medical Center as Ray Palmer intended and is now under Hospice Care. Despite recent developments, Ray Palmer said he still intends to warn other seniors of problems with Medicare Advantage plans.
ACT FAST
- F: Face. If one side of the face droops.
- A: Arms. Ask person to raise both arms; does one arm drift downward?
- S: Speech. Ask person to complete a simple phrase; is their speach slurred or strange?
- T: Time. If you observe any of these signs, call 911 immediately.
Stroke symptoms:
- Numbness or weakness of face, arms or legs — especially on one side of the body
- Confusion, trouble speaking or understanding
- Trouble seeing on one or both eyes
- Trouble walking, dizziness, loss of balance or coordination
- Severe headache with no known cause