As an engineer who helps ensure that dams in the United States are safely constructed, Bob Waddell relies daily on his math abilities along with lessons he learned in college and over a long career.

When Waddell, 59, fell over last summer after pulling weeds in his backyard garden, all of the knowledge he had about soil assessments, drilling rigs and dam design and construction hung in the balance.

Whether Waddell’s brain would ever function well again depended on rescue workers from a UCHealth Mobile Stroke Treatment Unit who quickly worked to determine that he had a dangerous clot. The Mobile Stroke Treatment Unit is extremely rare in the U.S. and has been revolutionary in saving lives and preventing disabilities from strokes.

After collapsing, Waddell was terrified. He lay in his bushes, unable to move his left side. He knew something was not right but initially, he didn’t understand what was happening.

“I was yelling out to my neighbors and hoping someone would hear me,’’ he said. “I was hoping someone would come and help me get off the ground because I was unable to pick myself up. The deck railing was right there. I tried to grab the rail. I was trying to will myself to get up.’’

Retrieving his cell phone

Waddell remembered that his cell phone was in his left pocket. Trouble was, he couldn’t feel it. His left hand was so numb it was virtually useless. With his right hand, he reached in his left pocket and pried the phone from his pants. He called his next door neighbor, Pat, and asked him for help getting up.

After the phone call ended, Pat, who was at work in Castle Rock, sent a text back to his neighbor: “Bob are you hitting the wine this morning?’’

Pat told Waddell that his speech was slurred. In that instant, Bob said to himself: “I’m having a stroke. Right here and right now, I’m having a stroke.’’

Somehow, Waddell managed to again use his cell phone to dial 911. He told a dispatcher that he was having a stroke. That sent paramedics from the Colorado Springs Fire Department and alerted caregivers on UCHealth’s Mobile Stroke Treatment Unit, a specially-equipped ambulance that responds to diagnose and care for stroke patients.

The beautiful sound of a siren

“Sirens can be a terrifying sound, but as I’m lying there, I heard a siren and it was a relief to know that help was finally on the way,’’ he said.

Lying on the ground, Waddell was frightened by the thought of not surviving, becoming disabled and not being able to go back to work.

“I love my job. I’m an engineer, and I use my brain and education and so I’m lying there and thinking, ‘Am I going to survive let alone go back to work?’ ’’

An EMT from the fire department jumped over a back yard fence to get to Waddell. He then opened Bob’s garage door and firefighters from the CSFD rushed to his side. They scooped him up, laid him on a stretcher and wheeled him to the front yard, where the mobile stroke treatment unit was parked in the street.

A team led by UCHealth Charge Nurse Kirstin Buchanan began assessing Waddell by asking a series of questions, assessing weakness on both sides of his body, checking visual fields and showing pictures on a card and asking him to name what was in the photographs.

The early assessment, Buchanan said, indicated Waddell had indeed had a stroke. Waddell had a CT scan while the Mobile Stroke Treatment Unit was parked in front of his house. Results of the scan were sent to a neurologist at UCHealth who confirmed that Waddell had an ischemic stroke – a blood clot in his brain. Twelve minutes after the CT scan, Waddell was given tPA, a clot-busting drug.

Alerting a team of stroke experts

Buchanan’s team called a “stroke alert’’ to UCHealth Memorial Hospital Central, southern Colorado’s only Comprehensive Stroke Center, and a team of specialized stroke care givers assembled in the Emergency Department.

Dr. Shaye Moskowitz, an endovascular neurosurgeon, ordered more CT tests at the hospital and within 35 minutes after arrival to Memorial, Waddell was in surgery. Dr. Moskowitz inserted a highly-engineered catheter into Waddell’s femoral artery and threaded the catheter, which has a tiny sucking tool and a spring-loaded net on its tip, into his brain to extract the clot.

“He was finished with the procedure within three hours of the first moment his symptoms started, which is amazing,’’ Dr. Moskowitz said. “It’s really truly proof the system (of stroke treatment) can be really quick.”

In a stroke, a person can lose more than 2 million neurons a minute. In an ischemic stroke, quick delivery of tPA, which must be given within the first 4.5 hours after stroke symptoms begin, may reduce brain damage and limit deficits that can occur after a stroke, such as the inability to recognize people, immobility, loss of vision, difficulty with speech and other symptoms.

Mobile Stroke Treatment Unit

Dr. Moskowitz said Waddell’s quick recognition and action in calling 911 may have saved him from a lifetime with disabilities.

The Mobile Stroke Treatment Unit, one of only a handful in the United States, is part of a national research study to determine whether outcomes for patients improve when tPA is given more quickly with the innovation of a Mobile Stroke Treatment Unit. Researchers are also investigating whether tPA, if given more rapidly, results in a better outcome for patients – fewer disabilities, reduced financial impact and a decrease in health care utilization.

“There’s no question in my mind that this is a public service resource that we have to have,’’ Dr. Moskowitz said of the Mobile Stroke Treatment Unit. “In the end I would argue that if it were you, wouldn’t you want everything brought to you, rather than the other way around? Of course you would.”

Back to math

In the days after the surgery, Waddell gradually improved. Initially, math – a subject he excels in as an engineer – was difficult. He knew he had his stroke on July 16, but on July 19, trying to calculate how many days had passed since his stroke, was challenging.

Waddell spent a few days in Memorial’s inpatient rehabilitation unit. He went home after nine days in the hospital. As soon as he arrived, he went into his back yard and picked a few weeds in his garden. He sat down again on the edge of his deck, repeating what happened on the day of the stroke. It was therapeutic, a boost for his mind and reassurance that he could still do the things he loves.

Six weeks after the stroke, Bob went back to work full time. He’s currently working on managing a dam-building project in New Mexico.

“My memory didn’t suffer with this stroke,’’ he said. “I am relieved to find myself able to do my job again.’’