She demonstrated it most recently on March 1, 2023, when she flew from Missouri to Raleigh-Durham International Airport, and then drove to Cary, North Carolina to care for her sister who had recently fallen and suffered multiple fractures.

“My sister was in bad shape, so I came into town to help care for her after she got out of inpatient rehab,” explains Polly. “She fractured her hip and elbow in three places and was taken to a nearby hospital by ambulance. There, they discovered she had some trouble with her heart as well, so she remained in the hospital for a few weeks to address her heart issues, fractures and rehab needs.”

All was going smoothly once her sister was discharged home. Polly, her niece and her great niece were available to care for her, providing meals and helping her with activities of daily living until she could resume these essentials for herself.

Subsequently, on March 11, 2023, as Polly was standing in the kitchen preparing to clean breakfast dishes while her niece helped her sister bathe, Polly felt disoriented.

“I grabbed my cup, and I set it on her island. When I turned around to put it into the sink, I kinda just went ‘ohh’ and leaned forward. The cup fell out of my hand. I stubbled to the sink, holding my head in my hands. When I raised back up, I tried to talk, but I was not making any sense.”

Polly began yelling gibberish in an effort to gain her sister and niece’s attention. They made it back into the kitchen where they found Polly struggling with sudden onset aphasia. Polly’s sister told her daughter she recognized the bizarre symptoms as signs of a stroke.

“My sister told me to sit down. Then my niece had her daughter call 911,” remembers Polly.

BEFAST

The signs of stroke may be subtle and wide-ranging, but using the acronym BEFAST can help.

B – Balance: Sudden loss of balance or coordination
E – Eyes: Sudden vision change/trouble seeing
F – Face: One side of the face droops when the person smiles
A – Arm: One arm drifts down when the person raises arms
S – Speech: Person’s speech in slurred, slow or strange
T – Time: If you or someone around you is experiencing one, some or all of these symptoms, BEFAST and call 911 immediately for emergency medical assistance.

Arrival of Emergency Medical Services

Polly recalls, “Emergency medical services (EMS) arrived in less than 10 minutes. A technician took my blood pressure, and he listened to my heart.”

Following an evaluation, the team determined that Polly needed to go to the hospital as they, too, feared she was having a stroke.

“I kept trying to tell them I had to go to the bathroom, but no one understood me. So, I bolted up, used the bathroom and then went to lie down on the gurney. The EMS team hoisted me into the ambulance. I had no symptoms of stroke other than the inability to speak clearly.”

Polly was taken to WakeMed Cary Hospital. Upon arrival, the team transported Polly to imaging where they conducted a computed tomography (CT) scan of her brain and chest. The team discovered that Polly had, indeed, had an ischemic stroke, but an auxiliary blood vessel was supplying some blood to her brain. As such, she did not have the full spectrum of stroke symptoms. She was also diagnosed with a collapsed lung and pneumonia.

Polly shares, “I was coherent throughout this process. I knew what they were doing. I understood everything they said. I just couldn’t speak to them. When I tried to respond ‘yes’ or ‘no,’ words such as ‘tree’ or ‘house’ would come out instead.”

One particularly frightening moment happened for Polly when the team determined they would consider using contrast for Polly’s scan. Polly, who was severely allergic to the contrast, tried to explain, but her words were intelligible. Eventually, she just began shaking her head with great fervor to get the physician’s attention. In this way, they were able to determine very quickly (before receipt of any medical records from Missouri) that Polly was allergic to the contrast.

“The doctor asked me, ‘Do you break out in hives or go into anaphylactic shock?’ I nodded my head up and down for each question. So, then they knew about my allergy. Looking back, it was funny, but at the time, I felt extremely frustrated that I couldn’t communicate properly,” notes Polly.

Once certain of the diagnosis, the Cary Hospital Emergency Department team transferred Polly to the Stroke team, and WakeMed CT scan technologist, Brooke Story, noted Polly’s allergy to contrast in her medical chart.

Polly was next seen by highly skilled neurointerventionalist Michael Chen, MD, through WakeMed’s Telestroke Program, employing virtual observation. This doctor, in collaboration with community emergency medicine physician Joseph Wiater, MD, determined that Polly was a candidate for thrombolytics and tissue plasminogen activator (t-PA).

Thrombolytics (t-PA) & Mechanical Thrombectomy

Karah Lanier, MD, a WakeMed community doctor and Raleigh Radiology neurointerventional radiologist, performed her intra-arterial mechanical thrombectomy in the WakeMed Cary Hospital cath lab. Tracey Mueller, RN with a dual sign off from Katie Snyder, RN administered alteplase. Thrombectomy is a minimally invasive procedure that, when performed in conjunction with Alteplase administration, can remove clots and stop a stroke in its tracks.

During a mechanical thrombectomy, a neurosurgeon uses an innovative, catheter-based technology to capture the clot and pull it out of the artery, which immediately restores blood flow to the brain. This procedure is enhanced by biplane technology, an advanced imaging system that helps the physician guide instruments through the patient’s artery to the clot.

Because Polly had multiple medical issues, the team used a muscle relaxant and intubated her to give her body time to recover in a restful state.

By the next morning, Polly felt great and was able to speak again. Speech, physical and occupational therapists came by to test her functionality and determined she needed no rehabilitation.

Yet, the stroke team kept her in the intensive care unit (ICU) to monitor her since she had pre-existing high blood pressure and atrial fibrillation (an arrhythmia), but needed to come off of her blood pressure medication temporarily to assist in her recovery from the stroke.

Polly says, “The team discussed shocking my heart to bring it back into sinus rhythm, but WakeMed cardiologist Saleen Khan, MD, felt it was ill advised to put me back under so soon after the stroke and while on blood thinners. Instead, I was put on medication to stabilize my atrial fibrillation and told to see my cardiologist once I returned to Missouri.”

Soon, she was transferred to 1E Clinical Evaluation. By Wednesday, March 15, 2023, with her physical health stable and temporary measures in place to address her arrhythmia, Polly was discharged to her sister’s home in Cary.

A Return to Missouri with Gratitude for WakeMed

Within days of her return to her sister’s house, Polly headed back home to Missouri on March 27, 2023. She required immediate follow-up care, including an electrical cardioversion to address her arrhythmia.

Polly shares, “After I returned home, I visited my family doctor. He said, ‘Do you know that if you would have been here and had your stroke, we would not have been able to give you the care you received at WakeMed? We don’t offer thrombectomy and t-PA, so I’m not sure what shape you would be in today if you hadn’t gone to help care for your sister.'”

Clearly, doing for family paid off for Polly. Because she was in Cary, North Carolina when she had her stroke, she was taken to WakeMed Cary Hospital and received state-of-the-art care in the award-winning Joint Commission-Certified Primary Stroke Center. The serendipitous reality of the situation was not lost on Polly.