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Fast Action Beats a Stroke

Dr. Stiefel discusses stroke treatment with patient Jennifer bailey.

Dr. Stiefel discusses stroke treatment with patient Jennifer bailey.

Nanuet resident Jennifer Bailey wasn’t someone you’d expect to have a stroke. The fact that this young, healthy, physically fit woman did suffer one proves that anyone can have such a “brain attack”—and acting quickly, as Bailey did, can mean the difference between a normal life and permanent disability or even death.

At 32, Bailey is one of the youngest people Michael F. Stiefel, M.D., Director of Cerebrovascular and Endovascular Surgery at Westchester Medical Center, has ever treated for stroke. She was also one of the most outwardly healthy. A teacher of deaf students employed by Bergen County Special Services, Bailey also led exercise classes at her local gym. She didn’t smoke, her weight was normal, she was physically fit and she had no family history of stroke—she seemingly had none of the risk factors that would predict such a traumatic event.

Yet, around 4 a.m. on July 7, 2011, she awoke feeling strange. “My arm was tingling, like it was asleep,” Bailey says. “The next thing I knew, I was on the floor.” Bailey had fallen out of bed while trying to get up. Her boyfriend, Omar Olayan, heard her hit the floor and helped her up. Olayan, 41, a police officer with the Ramapo police department, tried massaging her arm but then noticed that the left side of her face had begun to droop. He called 911, and Bailey was rushed to Nyack Hospital.

There she was given the anti-clotting drug tPA (tissue plasminogen activator), which is the standard treatment for stroke. When administered within three hours of the onset of symptoms, the drug can often start to open the clot, return blood flow to the brain and greatly decrease brain damage. “But the drug doesn’t always work,” says Dr. Stiefel. “If the clot is in the wrong part of the brain, or if it’s too big, surgeons need to go in and manually remove it.”

In Bailey’s case, the clot was in a part of her brain that tPA is less successful in treating. She was fortunate, though, that Westchester Medical Center wasn’t far away. That’s where stroke patients are sent if they require additional care. “By the time she got here, her symptoms hadn’t improved and it was clear she needed further intervention,” Dr. Stiefel says.

That meant minimally invasive neurosurgery, which is more immediately effective than tPA treatment can be on its own. Much like an angiogram that is used to open blocked heart vessels, this procedure entails threading a thin catheter from the femoral artery in the leg up to the clogged brain artery. Once it was there, Dr. Stiefel injected additional tPA directly into the clot to loosen it, then broke it up with a surgical tool and suctioned the pieces out.

Bailey began to improve immediately. “I could move my arm and leg again right away,” she says. By October, she regained much of her strength. “My left arm is still weak and running is still hard, but I do physical therapy and occupational therapy twice a week, and it’s coming along.” She even began teaching again at her gym. “I can’t teach a whole class yet,” she says, but she hopes to return to full strength soon.

Though Bailey appeared to be perfectly healthy, looking back she and Dr. Stiefel see possible reasons for her stroke. In 2009 she suffered a blood clot in her lung that may have been caused by birth control pills. She stopped taking those pills and went on the blood thinner Coumadin for a year, but then stopped taking that as well, per her doctor’s orders.

Bailey also realizes that she may have suffered a “mini-stroke” the week before her stroke. “I had a bad headache and my vision blurred, but I disregarded it and it cleared up,” she says. Such mini-strokes, technically known as transient ischemic attacks or TIA s, are often precursors to a more serious attack. Lesson learned, she says: “If you feel something, take care of it. It might help prevent a major stroke.”

That’s a valuable lesson for everyone, Dr. Stiefel agrees. “Anyone can have a stroke, and the best course of action is to get to your nearest stroke center to get tPA quickly. And if you need more advanced care, we’re here.”

 

Know Your Risk for Stroke

Some risk factors for stroke, such as being over age 55, being African American, being male, or having a family history of the disease, are beyond your control. but others can be controlled or treated, including:

  • high blood pressure
  • high cholesterol
  • diabetes
  • cigarette smoking
  • obesity
  • physical inactivity
  • poor diet, including one with too much saturated
  • fat and cholesterol
  • taking birth control pills
  • alcohol or drug abuse

Sources: American Stroke Association and womenshealth.gov.

Westchester Medical Center also hosts stroke support groups covering various subtopics, such as recovering after a stroke, lifestyle changes and other coping skills. Go to westchestermedicalcenter.com/calendar to learn more about these stroke support groups.

 

  Related Read:   Ready when Disaster Strikes

 

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