Last year, Michelle Mick was driving, minutes away from Missouri Baptist Medical Center, when she encountered an odd and uncomfortable sensation.
“It felt like something shot up into my brain,” she says.
Her left arm fell off the steering wheel and landed in her lap.
Michelle, 56, a nurse practitioner hospitalist who was on her way to work at MoBap, used her right arm to pull her left arm back up.
It slipped off again.
Michelle says that’s when it hit her: She was having a stroke. Actually, she learned later, she was having two acute thrombotic strokes, which occur when blood clots form within brain arteries and interfere with blood flow to brain tissue.
For people experiencing stroke symptoms, it’s important to act fast to receive emergency care, because urgent, effective treatment is critical to saving lives and avoiding lifelong disabilities that result from the interruption of blood supply to the brain.
When she realized what was happening, Michelle was one stoplight away from MoBap, which U.S. News & World Report ranks as high performing in stroke care.
Instead of pulling into her usual parking place, she drove straight to the Emergency Department, handed her keys to a hospital security guard, walked inside, and told the first person she saw she believed she was having a stroke.
From provider to patient
At MoBap, members of the Primary Stroke Team took immediate action to help Michelle, showing why The Joint Commission awarded MoBap a Certificate of Distinction as a Primary Stroke Center.
Michelle was seen by an Emergency Department physician within three minutes. She quickly received a CT scan. Within 15 minutes of her arrival, thanks to stroke telemedicine technology, she met in real time through a two-way video/audio call with a WashU Medicine neurologist and stroke specialist at Barnes-Jewish Hospital, a comprehensive stroke center offering the most acute stroke care. Michelle was prescribed tenecteplase (TNK), an injectable drug used to help break up clots that can cause strokes.
“Since I don’t typically work in the Emergency Department, it was surprising, when they call a code stroke, how fast everything happens,” Michelle says. “When you are in the middle of it, it’s just amazing. I knew it was fast. I didn’t know it could be that fast.”
“Michelle’s story is remarkable in many ways," adds Charles Kircher, MD, WashU Medicine emergency medicine and neurology specialist and BJC HealthCare stroke network co-director. "It shows the teamwork required to provide the highest level of stroke care, and the benefits of a close relationship between the Emergency Department team and telestroke consultants. Michelle’s immediate recognition of her symptoms and the prompt care she received in the Emergency Department were crucial factors in her final outcome. Our WashU Medicine and BJC HealthCare team works every day to improve the care of acute stroke patients like Michelle throughout our hospital system and we are thrilled to see she has done so well after her stroke.”
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After receiving the TNK, Michelle was hospitalized for three nights and was fitted with an implantable loop recorder that monitors her heart’s electrical activity. Atrial fibrillation, or abnormal heart rhythm, is a risk factor for strokes, but Michelle did not have a-fib before her strokes and her loop recorder hasn’t detected any heart abnormalities. She still doesn’t know—and may never find out—why she experienced the strokes. She now takes a full-dose aspirin daily, which her doctors recommended as a precaution.
“I’m fairly young,” she says. “I’m fairly healthy. It came as a surprise. No high blood pressure. No diabetes.”
Without proper oxygen and nutrients, brain cells can begin to die in minutes after a stroke. The acronym BE FAST was created to help people know the signs of stroke and how to respond.
- Balance: Does the person have a loss of balance?
- Eyes: Has the person lost vision in one or both eyes?
- Face: Does the person’s face look uneven?
- Arms: Can the person raise both arms for 10 seconds?
- Speech: Is the person’s speech slurred?
- Time: Time is brain. Call 911 if you suspect a stroke.
Michelle’s rapid awareness of her symptoms—specifically her sudden trouble coordinating arm movement—along with the quick care she received at MoBap combined to produce an ideal stroke response.
Once she was ready to leave the hospital, a longer, slower, but equally important, process began.
Road to recovery
From her firsthand experience helping stroke survivors, Michelle knew the value of stroke rehabilitation. She was determined to maximize its benefits and wanted to start as soon as possible.
After selecting MoBap’s Center for Outpatient Therapy and Wellness for her recovery, Michelle poured effort and energy into multiple therapy sessions every week for months. Her primary focus was building back her left hand’s strength and control, along with cognitive exercises, like reading and comprehension activities.
The work didn’t stop there.
At home, Michelle sought out new tasks and challenges that would force her to learn new things, like creating word puzzles and learning how to shoot, edit, and post videos online. She even found apps on her phone that were made specifically for stroke rehabilitation.
“I tried to work my brain and do things outside of my comfort zone,” she says.
Now nearly fully recovered, Michelle believes the expert care she received along with a successful rehabilitation program are the reasons she’s fast approaching her one-year anniversary of returning to work following her strokes.
Learn more about strokes, including important signs to know
Voice of experience
Physical or cognitive problems that linger after a stroke are called deficits. Michelle sometimes notices small delays in moving her left hand and occasionally takes longer than she would like to locate a word she wants to say. But the examples are so few and far between, and so unnoticeable to others, that her patients who have survived strokes are often surprised to learn she recovered from two.
Michelle has decided to share her story with patients when she thinks it can help.
She’s found that she has a valuable starting place with fellow stroke survivors. She embraces shared common ground and witnesses it strengthen conversations. One thing Michelle stresses is the importance of rehabilitation.
“They may not realize how important it is right away to start working on that,” she says. “Getting back as much as possible in those first few months is important. It’s not that you can’t get back more later, but starting right away is beneficial.”
This encouragement comes not just from a professional but from a former patient, one who knows firsthand how acting quickly and receiving expert care can get life back on track following a frightening detour.
“I can put myself in their shoes and give them encouragement,” she says. “Coming from someone who had it, maybe they listen more? I can hope, anyway.”
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