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Learn the signs of stroke

How one woman's story is raising stroke awareness

Meghan Robinson, age 31, and her then-boyfriend, Steven McKee, came home from a late Saturday lunch in Winston-Salem. As they were about to settle in for the night with a movie, Robinson reached for a water bottle, but her hand missed and she stumbled to her right side. She realized that her balance was off, but she thought everything was fine.

When McKee walked into the room, he quickly realized that something was wrong. The left side of Robinson’s face had fallen, and McKee quickly realized what was happening. Robinson was experiencing a stroke. He called 911 and EMS quickly arrived.

Robinson, a physical therapist by trade, could name the tests that were being performed on her while in transport to Novant Health Forsyth Medical Center. However, she could not recognize her own symptoms, due to the part of her brain that was affected by the stroke. “I work with stroke patients frequently,” Robinson said. “But I could not recognize the signs and symptoms in myself. It’s called neglect; you do not acknowledge one side of your body. I didn’t realize what was going on.”

When Robinson was in high school, she found out that she had an atrial septal defect (ASD), a birth defect that causes a hole in the wall between the heart's upper chambers. She sought out medical advice from various providers, but was given the unanimous vote of, “If it’s not broke, don’t fix it,” Robinson said. She continued her life and participated in triathlons and marathons, and she was often thought of as “one of the healthiest people my friends know,” she said.

Dr. Mateo Calderon, vascular neurologist at Novant Health Forsyth Stroke & Neurosciences, assessed Robinson’s situation as soon as she arrived to Forsyth Medical Center, made the diagnosis of a clot in the right middle cerebral artery and administered the clot-busting medication t-PA within minutes. Calderon simultaneously consulted Dr. Donald Heck, the director of interventional neuroradiology.

“Dr. Heck was the most calming person during what was the scariest event thus far in my life,” Robinson said.

Heck performed a thrombectomy, an emergency surgical removal of blood clots in Robinson’s brain. “Because Steven and Novant Health acted so quickly and got Dr. Heck in there immediately, everything happened perfectly,” Robinson said.

Heck says that Robinson is a reminder that young people do have strokes. “I think the key thing in Robinson’s case is that her boyfriend recognized that she was having the stroke and called EMS and that the EMS providers recognized that she was having a stroke and treated this as an emergency situation,” Heck said. “The recognition that she was having a stroke was the key component to her full recovery.”

He continued on to say that stroke is a time-sensitive disease. “We really only have a very brief period, a few hours, to make an impact in terms of the patient’s recovery,” Heck said. “EMS providers do a fantastic job, but people have to know to call them.”

Robinson, an unlikely candidate for stroke, found out afterward through tests that she had a PFO (patent foramen ovale) with an atrial septal aneurysm, which is a slightly different hole than she was originally told she had. Robinson said that due to her congenital heart defect, deoxygenated and oxygenated blood mixed together and entered the brain. “Younger people are having strokes more often, because they are unaware they have similar risk factors,” Robinson said.

Robinson had surgery to close the hole in her heart and returned back to work two weeks later. She experienced firsthand, the importance of the saying, ‘time is brain.’

“When you’re having a stroke, the clot prevents the perfusion of blood to brain tissue, which deprives the tissue of oxygen and cells begin to die,” she said. “That translates to impairments in your gross and fine motor ability, as well as cognitive and visual impairments.

“The faster you can act during a stroke, the less tissue damage occurs and the greater chance you have to prevent functional impairments.”

Robinson stresses the importance of everyone understanding the signs and symptoms of stroke. “FAST is an acronym to help detect stroke,” she said.

The acronym stands for: Facial drooping, Arm weakness, Speech difficulties and Time.

“Knowledge is power,” she added.

When reflecting on her experience, Robinson said that McKee, now her fiancé, is the initial person who saved her life. “His grandfather had sadly passed away the week before this all happened, and he had experienced a stroke while he was in the hospital,” Robinson said. “It was so fresh in his mind that he knew exactly what was happening to me.” 

Robinson’s experience with the acute care rehabilitation team including physical therapy, occupational therapy and speech language pathology, was very positive, she said. “They treated me with respect as a patient, clinician, and most importantly as a young person whose life had just been turned upside down,” Robinson said.

As part of her recovery, Robinson said she’s still working on strengthening her left foot and left hand, but she realizes that it is a process. “I’m running again, taking spin classes and doing strength training,” she said. Her goal is to run in marathons and triathlons again.

Heck recently asked Robinson if she would like to attend a two-day event to raise stroke awareness on Sept. 28 and 29 in New York, hosted by Penumbra Inc. in partnership with the Joe Niekro Foundation. One person from each state attends to help raise awareness of stroke signs and symptoms. “The purpose of the event is to raise awareness in Congress and the public that stroke is a treatable disease and can happen to anyone,” said Heck.

Robinson said she was very touched that Heck thought of her to attend the event, and she’s excited to share her story. “I cannot think of a better way to turn my experience into something positive. I want to help others recognize that stroke can occur in anyone, regardless of age and to understand the signs and symptoms to be able to act quickly.”

Heck said Robinson is a great fit to attend the event. “She is not the typical patient you think of having a stroke. She is a reminder that this is a disease that can affect anyone and she’s a fantastic example of what can be accomplished if the problem is recognized and treated as an emergency,” he said.

“This is a situation where you could have had a 31-year-old woman who is disabled for the rest of her life, and instead what you have is a 31-year-old physical therapist who’s engaged to be married next spring,” Heck said. He remembers visiting her hospital room in the intensive care unit the day after surgery. “She was recovering remarkably well and her boyfriend was in the hospital room with her and I said, ‘You don’t have to marry him, but he did save your life.’”

Robinson’s testimony is timely, given that National Rehabilitation Awareness Celebration, led by the National Rehabilitation Awareness Foundation (NRAF), is Sept. 18 to 24 this year. The group’s mission is to educate people about the benefits and impact of rehabilitation and develops programs that create opportunities for Americans with disabilities.

Heck is a seven-year board member of the Society of Neurointerventional Surgery (SNIS), and a co-author of published multisocietal guidelines for the treatment of cerebrovascular diseases, including stroke and brain aneurysms. He is active in cerebrovascular research trials and has published multiple peer-reviewed journal articles.

For more information about Forsyth Medical Center’s stroke and neurosciences unit, call 336-718-5000.

Published: 9/26/2016