Recognition and reversal of a stroke in a 31 year old woman who was 27 weeks pregnant with twins at the time of the stroke. Amazing sequence of events led to successful stroke reversal. One of the 15 stories from the book : 911Stroke
Visit our web page : 911stroke.org
AMY McCLURE 31 years old
Amy McClure, age 31 and 27 weeks pregnant with twins, was away from her home in Allen, Texas. She and her husband, Jason, were traveling to Lawrence, Kansas to visit Jason’s mother for Thanksgiving. They carried her medical records with them. They were prepared for most anything.
Two days after their nine hour car trip from Allen, Texas to Lawrence, Kansas, Amy went for her daily two mile walk. She always carried her cell phone in case she needed any help. It was snowing.
Amy: It was cold. My cell phone was in my jacket’s left pocket. My left hand started to feel numb and I thought it was just cold because I was not used to 30 degree weather. I had to help my left hand get into my pocket and hold on to my cell phone. I thought that if I had a grip on my cell phone and anything happened I would be able to pull it out and call for help. I walked a little farther and my left leg gave out – it’s almost like it went to sleep. I could not get it to work correctly. I fell to the ground. I was lying on the ground. I tried to get back up but I fell down and scraped my face on the sidewalk. I was back on the ground and I tried to find my cell phone but I couldn’t. I couldn’t see my cell phone. I couldn’t find it with my hand. I could not see off to my left side.
I was crying. That is when I saw the police drive up and an ambulance followed right behind. It turned out that I had fallen across from a fire station. They did a quick assessment of my status: I had no trouble remembering my name, no trouble remembering a phone number. My speech was slurred but my mouth was full of blood from the fall. As they loaded me up on a stretcher, Jason drove up.
Jason: When I got back from my run Amy was not yet back from her walk. Then my Mom and I heard the sirens and we were both worried. I jumped in the car and as I turned the first corner I saw Amy being loaded into an ambulance. I got there just in time. She could not move her left leg or her left arm. I ran back to the car and grabbed her medical records and gave them to the police officer as they loaded her in the ambulance.
Amy and Jason understood the value of traveling with her medical records. She had had some dizzy spells before she became pregnant but was seen by a neurologist who felt they might have been from her high blood pressure or possibly secondary to her migraines. So when she did become pregnant they were very alert to any medical symptoms.
Jason: Amy’s OB doctor laughed at us when we asked for a copy of her medical records. At the pregnancy class they said that if you go on a trip you should always take them with you in case something happens. We had already had one ER visit with her pregnancy when she had some bleeding. So we just wanted to make sure if anything like that happened again. We needed as much information as we could get.
After the initial assessment in front of the fire station she was rushed to the nearest emergency room. This was the beginning of a difficult time. They had arrived at the emergency room within 20-35 minutes of Amy’s fall. But then Amy’s evaluation seemed to stall.
Jason: Our time in the ER consisted of a lot of waiting and frustration. They cleaned her up but obviously she had left sided deficits. The ER doctor didn’t seem real confident in what was going on. They ordered a CAT scan and it was negative. I told my Mom that Amy had suffered a stroke. I recognized it as a stroke because my grandmother had had a stroke, and Amy’s weakness looked the same. In the ER they were saying that if it were a stroke warning, it should have resolved by now. There was a lot of debate about what should be done.
There was added confusion about what to do because of her pregnancy. Amy and the twins were all at significant risk. If the stroke had been allowed to run on to completion it might have caused total paralysis of Amy’s left arm and left leg. Dealing with left sided paralysis and newborn twins would be very difficult.
Jason: The ER doc made some other phone calls. He consulted with many physicians and pharmacists and the question was: “What effect would this (tPA) have on the babies?” The conclusion seemed to be,” Yes she needs tPA but we do not know what effect it might have on the babies”. The Saint Luke’s Stroke Center was consulted and they asked that she be transferred immediately.
As all these decisions were being made and the helicopter was on its way from the Saint Luke’s Stroke Center. Amy remembers that she was not able to help too much:
Amy: At this point I didn’t recognize that I had had a stroke. I was crying a lot: I was more concerned about the babies than me at that time.
Her memory of the events surrounding this part of her entry to stroke reversal is a good example of why stroke victims with left-sided weakness are not able to act in their own best interest – they cannot understand the problem. She did understand that her twins were at risk but she could not do much more than cry. Upon arrival at the Saint Luke’s Stroke Center things began to happen quickly:
Jason: The stroke neurologist on the Saint Luke’s Hospital Stroke Team met us in the ER and went over everything. I asked, “Well, what is the safest thing?” (They were considering using the Merci Retriever and/or intra-arterial tPA)
They explained the options in more detail: I signed the sheet and she went in. I waited.
Jason: After the procedure was over they told me that the
Merci® retriever didn’t work because the clot was too far back and the risk was too high if they were to go after it. I think they ended up injecting tPA into the clot and got most of it out.
Amy was taken to the ICU where they saw immediate improvement. She could move her left leg – she slid it up the inside of the right leg and she could extend the left leg and move her toes. They called in the obstetrician who examined the babies and told us everything was good with them. She said they looked great, told us how much they weighed and how long they were.
Amy did “perk up” when the OB doctor pronounced the children healthy. After Amy heard all the details about the kids she smiled. That was probably the only smile we saw from her that day. It was only one side of her mouth smiling but she was still smiling.
Amy began to improve but it was slow going.
After her stroke reversal the medical evaluation to determine the cause of her stroke ended in an unusual finding:
Jason: They determined that she has Sneddon’s Syndrome. One in a million people have it – roughly 200 cases in the US per year. Patients with this syndrome have what looks like a serious rash all over the body, the blood vessels in the kidneys narrow and they have high blood pressure. These patients may have a stroke. The theory is that the blood vessels narrow because the inner lining of the blood vessels are “rough” so the blood needs to be thin and smooth so no clots are allowed to form. The basic treatment is blood thinning forever. It was not what everyone thought at first – a pregnant lady in a car for eight hours driving to Kansas (a suspicious history for a clot to go through a PFO.)
Amy and Jason faced many questions in the aftermath of the stroke reversal therapy.
Amy: I wanted to know if things were going to get back to the way they were before I had the stroke. Was I going to be able to have the use of my arm and leg again?
At least one medical condition was resolved successfully and joyfully!
Jason: She went into labor 5 days before a scheduled C-Section. The babies were fine. The kids were ready to leave the nursery the next day and they had to wait for their Mom for two weeks.
Six months after Amy’s stroke her progress was good.
Amy: I have full range of motion of my left arm. The difficulty is in the fine motor things with my hands. My left leg has full range of motion as does my ankle which is still somewhat weak. But I’m walking with a
four-pronged cane and I’m doing some stuff in therapy without the cane and I am working on getting to where I can walk without the cane.
They looked back on their unscheduled visit to the Stroke Center.
Jason: We’ve always viewed the event as the best case of the worst possible scenario. She fell in front of a firehouse. In the ER they made the call that got her to the Saint Luke’s Stroke Center. Things just barely worked out. The blessing of it all is that the kids are perfectly healthy!
Amy: We just consider ourselves very lucky for where we were at the time it happened. It’s just one of those things where I got lucky to be at the right place at the right time.
We kept hearing the same thing from so many people in the hospital: “Well, we’ve never had a patient like you!” The OB ward did not know what to do with a lady who had had stroke reversal and who was 27 weeks pregnant with twins. In rehab they were surprised because they had never had to deal with a pregnant woman. They all kept saying: “Well, you are the most unique patient we have ever had.”
They are proudest of their twins.
Jason: Jack was small at birth. He was 4 pounds 2 ounces, so he’s now catching up. His brother is in the middle of the growth chart and catching quickly. Jack is now on the growth chart and he is over ten pounds now.
Comments:
Jason and Amy negotiated a complicated series of obstacles. Most strokes will not occur in front of a fire station with the knowledgeable first responders nearby. Their rapid and accurate assessment saved Amy. The ER physician was familiar with the problems presented and knew that the twins made things more difficult. The helicopter transfer to the Saint Luke’s Stroke Center was made quickly and in time for an attempt at stroke reversal. Jason and Amy were prepared for their emergency!
Read more true stories like this one in the book : 911Stroke!
Visit the web site for more information about strokes and stroke reversal at the St. Luke's Stroke Center in Kansas City , Missouri.
Re-Release! No longer back-listed. Return to the Olde Ways. The hustle and bustle of modern day life has brought many of us to a quick fix attitude.This book is for those of you who are fed up; have looked at your life and your loved ones and realize
Re-Release! No longer back-listed. Return to the Olde Ways. The hustle and bustle of modern day life has brought many of us to a quick fix attitude.This book is for those of you who are fed up; have looked at your life and your loved ones and realize
