A stroke of luck
When Yvonne Reynolds is out running errands in her hometown of Exeter, Ont., she sees many familiar faces. If they haven’t heard her news yet, she’s quick to tell them that she is a “walking, talking miracle.” It’s not an understatement considering what Yvonne went through on a cold morning this past February. She knows how lucky she is.
Yvonne awoke that Monday morning and commenced with her regular routine – coffee, a nutritious breakfast, solving the word jumble and playing Sudoku. But as she suddenly felt numbness down the entire right side of her body, it became obvious that it wasn’t going to be an ordinary morning.
“As soon as I felt the sensation I thought to myself, ‘This must be a stroke,’” Yvonne recalls with a calm certainty. “I felt dizzy and had a hard time walking as I stumbled to the phone to call my neighbour.”
Yvonne’s quick wit and sense of humour are palpable as she describes how she made light of the harrowing experience.
“I wasn’t in a panic,” she recalls. “I took the time to apply make-up before leaving the house. After all, I have my priorities!” What Yvonne didn’t realize at the time was how crucial it is for people to call 9-1-1 as soon as they begin exhibiting stroke symptoms.
A neighbour drove Yvonne to the local hospital in Exeter. Following an assessment by the Emergency Department doctor, Yvonne was transferred to London Health Sciences Centre’s (LHSC) University Hospital which serves patients across southwestern Ontario in the regional Hyper-Acute Stroke Unit. Dr. Jennifer Mandzia and a team were waiting for Yvonne to arrive in the ambulance.
“Fast action is vital in patients presenting with stroke symptoms to determine whether they have a clot obstructing blood flow or a hemorrhage in the brain,” says Dr. Mandzia. “This allows us to determine which treatment options are available to potentially limit the amount of damage that could have a severe impact on quality of life.”
The first step was confirming through a CT scan that Yvonne was not experiencing a hemorrhage. Dr. Mandzia explained to Yvonne that she was eligible to receive a powerful clot busting medication called a tissue Plasminogen Activator (tPA). Dr. Mandzia also explained that while there are risks involved with the medication, it can drastically limit the amount of brain damage from a stroke and increase the chances of a good recovery.
“Administering the tPA needs to be done within a four-and-a-half-hour window from the onset of stroke symptoms in order to be effective, which is the reason why patients need to seek timely care,” says Dr. Mandzia.
For the hour after she received the tPA, Yvonne’s health-care team checked on her cognitive functions every 15 minutes, as well as her blood pressure and strength and control of limbs. As they checked the feeling in her face, arms, and legs, the numbness on the right side of her body gradually began to disappear. As Yvonne demonstrated positive assessments, the team extended her checkups to every half-hour, and eventually every hour throughout the night.
Stroke care involves a multidisciplinary team. Throughout her stay, Yvonne received the attention of a physiotherapist, an occupational therapist, a nurse practitioner, a speech-language pathologist, as well as Dr. Mandzia.
“I received constant monitoring,” says Yvonne. “They asked me questions like what was my name, where was I, did I have to peel a banana before I ate it, how many animals could I name in a minute, and countless others. I also used the biggest words I could during tests to prove how well I was doing.”
To ensure that she did not have issues with swallowing, Yvonne wasn’t able to eat or drink anything for the first 12 hours in the hospital.
“I hadn’t eaten since breakfast. A kind nurse got me a turkey sandwich and a package of cookies at one o’clock in the morning once I was able to eat again. They tasted good,” she says.
Remarkably, Yvonne returned home the day after her stroke with prescriptions for blood thinners and a cholesterol reducing drug. She did not need to return for physiotherapy, occupational therapy, or speech-language therapy; an excellent outcome considering the potential for stroke patients to require subsequent care.
“I feel incredibly blessed considering how severe it could have been,” she says.
There are between 40,000 to 50,000 strokes in Canada each year. Devastatingly, there is the potential for people to lose a variety of physical and cognitive capabilities depending on the amount of brain damage that occurs during and following a stroke.
“Strokes vary greatly by case from mild to severe,” says Dr. Mandzia. “Stroke is a major cause of disability in Canada, and in certain people, largely preventable. Probably around 60 per cent of people with stroke are left with some degree of disability.”
The risk factors for a stroke are varied and can include family history, high blood pressure, heart problems, smoking, diet and other lifestyle choices. Yvonne, who quips that she “reluctantly admits to being in her eighties – not saying how far in!” has kept active and healthy over the years, with the exception of the occasional serving of heavenly hash ice cream.
After seeing the impact that a stroke has had on friends in her community, Yvonne knows that taking care of herself is important. This is especially true as a mother to three sons, as well as a grandmother and great-grandmother. She believes it is her mission to tell others about her positive experience. She has spoken at local clubs, her Bible group, and even receives phone calls from people in her community who are curious about what happened that morning.
“This is a small town, so the news has spread like wildfire!” she says. “I firmly believe my good outcome is the result of the stellar care I received at London Health Sciences Centre, as well as all the prayers and positive thoughts amongst my friends, family and the community.”
Yvonne also stresses the importance of recognizing the symptoms of a stroke and receiving timely care at the right place and at the right time.
“My symptoms were classic,” she says. “If you think you’re having a stroke, call 9-1-1. The ambulance attendants will check you out and assess whether you should go to your local hospital or the regional stroke care facility. If you’re wrong about your symptoms – so what? But if you’re right, you will get the help you need.”