Tar Heel: David Huang spreads message that strokes are preventable, treatable

David Huang thought his medical career would be devoted to research – seeking to understand and cure the neurological problems that cause strokes in the same way that his father had studied cancer and AIDS.

But he came to find greater satisfaction in the hands-on work of helping patients. And his firsthand experience with strokes instilled in him another passion – to make sure life-saving treatments were available to everyone who suffers a stroke.

In addition to his work as a professor and neurologist at UNC Hospitals, Huang heads the hospital’s stroke center, which was one of the first comprehensive stroke centers in the Southeast when he helped establish it two years ago.

Over the years, he has worked with state policymakers to strengthen regulations governing the treatment of strokes. As a member and fellow of the American Heart Association, he is also a national advocate for life-saving standards for preventing and treating strokes – the third-leading cause of death in the North Carolina

He’s earned several awards for his work, including one earlier this month from the N.C. Stroke Association and another from the American Heart Association.

North Carolina is part of the “stroke belt” a line of Southern states where high percentages of people die from stroke, according to the N.C. Stroke Association. The coastal region is part of the “stroke buckle,” where the death rate from strokes is twice the national average.

But Huang and others are helping to spread the message that this can change with prevention and proper treatment. In just the past few weeks, he’s spread that message in four North Carolina cities and one in Virginia.

“Dr. Huang’s broad knowledge, passion and unwavering focus on stroke as well as his excellence in teaching and research, all contribute to his leadership for impacting stroke in North Carolina,” says Dr. Charles H. Tegeler, board president of the association. “The inspiration he provides to generations of future physicians and researchers will ultimately benefit countless North Carolinians.”

Preference for patients

Huang was born in Taiwan, but came to the United States as a baby, when his father took a job as a medical researcher at UNC-Chapel Hill. Huang was urged to follow in his father’s footsteps. In high school, he helped out in his father’s lab. He earned his bachelor, medical and doctorate degrees at Duke University, and planned to do research in infectious diseases, inspired by his father’s work on the AIDS virus. Instead, his experiences as a resident at Harvard University and Massachusetts General Hospital treating stroke patients got him interested in neurology.

Huang recalls his first experiences with the drug, tissue plasminogen activator, which is still the gold standard for treating strokes.

“It was instant gratification,” he says. “The presumption was that stroke is not treatable, but if I could get this to them within a few hours, I could make a huge difference.”

Back at UNC-CH, he started a research program funded by the National Institutes of Health focused on how the abnormal processing of proteins can lead to stroke. But his path soon veered from the research track.

He had seen some early signs that the lab might not be his career destination. Early in his career, when a colleague was explaining the value of a research career, Huang paused at his central question: Would you rather affect the health of a million people or heal just one?

“I enjoyed patient care and the logistics of getting a whole team together to try to achieve a clinical goal,” Huang says.

When it comes to strokes, the team includes everyone in contact with stroke victims as they find their way to treatment, from EMS technicians to emergency room staff to stroke specialists.

Every minute that lapses between a stroke and treatment increases the likelihood of death or permanent disability.

“My passion is to make people understand that there’s a lot we can do for stroke (victims), but every person at every step needs to be invested and understand that they have a vital role,” he says.

Getting the message out

One of Huang’s central messages is that strokes are preventable – through exercise, healthy eating and avoiding tobacco – and treatable.

But effective treatment requires a long line of informed decisions. First, the victim, and those present, must recognize the signs of stroke and call 911.

Emergency responders must move quickly. Hospitals must quickly perform a CAT scan, and doctors must administer a medicine that many find controversial.

Massachusetts had been one of the first states to adopt proactive approaches to treating stroke. In North Carolina, that message hadn’t necessarily reached some rural hospitals. When Huang first returned to Chapel Hill in 2003, he was surprised by the discrepancy.

“Every little piece needs to be done as quickly as possible,” Huang says. “Before the early 2000s, many places didn’t even dispatch lights and sirens on ambulances for strokes.”

His advocacy role started when the American Heart Association asked him to speak to state legislators about the impact stroke legislation would have on the health of citizens. Since then, he’s spoken widely at conferences and other events on treating stroke and related issues, such as the role healthy school lunches can play in stemming obesity-related conditions such as heart disease.

In the past decade, North Carolina’s approach to stroke care has radically changed due in part to the efforts of Huang and others to promote consistent practices. State legislators passed legislation to recognize hospitals as stroke centers, for instance, and created maps that would enable EMS responders to bring victims to hospitals with stroke centers.

One of the key issues Huang has tackled is resistance among doctors to administer the drug that helps to mitigate the effects of stroke if given early enough. The drug can cause hemorrhaging, particularly if it is given to patients who suffered a less common kind of stroke. But used appropriately and early, it is a lifesaver.

A recent patient was given the medication before being flown from Onslow County to UNC Hospitals. She couldn’t speak or move her arm, and she was transferred anticipating complications.

But by the time the patient arrived, her symptoms had subsided; she went home two days later without further treatment. Huang made sure to call the emergency room doctor.

“He needs to know he played crucial part of the chain of survival,” says Huang. “The success isn’t mine. It belongs to everyone in that chain.”

This story was originally published October 10, 2015 at 12:27 PM with the headline "Tar Heel: David Huang spreads message that strokes are preventable, treatable."