Early Recognition of Stroke Symptoms Saves Patient’s Life

By Wendi Hope Bishop, Editor

Marion Mulcahy certainly knows how to enjoy life. With her husband, John, they share a full social, travel and exercise schedule, including regular visits to the gym. However, last year, tragedy almost brought that to an end. Luckily, John recognized Marion’s stroke symptoms and acted quickly to get her help.

In September 2005, 76-year-old Marion suffered a stroke. One evening, shortly after dinner, Marion fell down and was unable to get back up. Lying on the floor, Marion was incapable of speaking, but John noticed a strange facial expression. Recognizing these as stroke symptoms, he immediately called 911. “My husband recognized that it was a stroke, because I had fallen down and could not get back up,” Marion explains. “Then he saw my face and how it was paralyzed. When he dialed 911, he knew it was a stroke.”

Some symptoms of stroke may include sudden weakness or paralysis; sudden onset of double vision, dimness or loss of vision; sudden difficulty speaking or understanding language; sudden severe headache without apparent cause; or unexplained dizziness, unsteadiness or loss of balance.

Marion was awake the whole time as paramedics moved about checking vital signs, placing her on a monitor, asking many questions and performing other assessments. “I could not speak and my left side was paralyzed,” Marion says. “I could hear everything they were saying.

“I did not know what was going on, but I was not scared,” she continues. “It probably was scary for my husband, because of what he was dealing with. However, you yourself are not thinking about being scared when you are going through that.”

EMS rushed Marion to the University of Tennessee Medical Center. Once at the hospital, Marion’s stroke team, including Dr. Fred Wenger, Emergency Physician, and Dr. William Paulsen, Neurologist at UT Medical Center, checked for various neurologic, motor and sensory deficits. The exam shows changes in muscle weakness, decreased sensation, abnormal reflexes and changes in vision. Tests then were performed to determine the exact type, location and cause of the stroke.

It was determined that Marion was a good candidate for t-PA, a treatment for stroke that significantly can reduce the effects of stroke and reduce permanent disability. However, not everyone can be given this drug, because there is a chance that it will increase bleeding in the brain; it only can be used for strokes that are caused by blood clots. Doctors only use t-PA after carefully screening the patient.

“If you can have this medication before three hours is up, you really improve your chances,” Marion says. T-PA must be given within three hours of the first sign of stroke symptoms. Because of John’s ability to recognize the stroke warning signs and he could relay the information to the paramedics, Marion was able to receive her treatment in less than one hour and 15 minutes.

The drug worked.

Within six days, she was able to leave the hospital, begin her recovery and return to her life. I remembered everything, but I had problems when I spoke too fast,” Marion explains. “If I cannot think of a particular word, then I will cheat and substitute with something else. I worked with the speech therapist to improve that.”

Marion began seeing a speech therapist at UT Medical Center that entailed 12 sessions. She continues taking just one medication and has returned to her life in full with no further problems. Three to four times a week she attends her health club—where she has been a member for more than 25 years. “I really have not had to change my lifestyle at all,” she reports. “I go to the health club three to four times a week. I can do everything I used to. I was right back into my regular life. We even went on a cruise the month following the stroke.

“No one ever would have thought that someone in good condition like me would have a stroke,” she continued. “It is a miracle that I am in as good of shape as I am. When people see me, they forget anything ever happened.”

Marion and her husband currently are preparing a trip to California to visit their son, his wife and their two granddaughters. This October (2006), she departs on another cruise.

Marion thanks her husband, the paramedics and hospital for acting fast and treating her with the best possible care. “Dr. Paulsen was great,” she says. “I have been to other hospitals, but I now would never go to any other one than UT Medical Center.”

For more information on stroke, visit the Brain & Spine Institute.