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Tracy Nelson woke up on a cold January morning in 2007 to find that her arm had gone limp during the night. Thinking she had just slept on it wrong she attempted to get out of bed. Moments later she went crashing to the floor.
Nelson didn't know it yet, but she was experiencing a left brain stroke that most likely resulted from a heart condition known as patent foramen ovale (PFO).
"I didn't know what was happening," said Nelson, "It never occurred to me that I was having a stroke."
Strokes Can Occur Even in the Young
At 42, Nelson said, "I defy people's perception, even my own, of what a stroke victim looks like. I always thought, stroke is something I'll worry about when I'm older. It's just the perfect example of, it really can and does happen. It's so important that you know the signs and symptoms of stroke."
Nelson was left lying on the floor, unable to move, for about ten minutes.
"Every few minutes I'd try really hard to get up. I probably tried ten times and all of a sudden the eleventh time I was able to get up. My arm was still hanging but I thought, 'gosh, I have no idea what just happened to me but whatever it was it seems to be over."'
Once Nelson was able to get up she attempted to brush off the incident and continue with her daily activities.
Recognizing Something is Wrong
"I was able to make my way downstairs and I was a little shaken up but I thought, 'at this point it seems to be done.' I went to let my dogs outside and I said to them something like 'time to go outside' and I knew what I was trying to say but it came out complete nonsense words," continued Nelson.
"I really got scared because I thought; I know something is wrong with me now. I don't know what it is but I need to call 911."
Nelson attempted to call 911 but experienced difficulty.
"I went over to my phone and picked it up. My brain was telling me to dial 911 and I looked at the phone and had no idea how it worked. It was this incredible feeling of disconnect, where your mind is telling you what to do but you can't understand what to do, you can't make your body do what your mind is telling you."
Nelson continued, "I played with the phone for another 20 minutes screaming to myself in my head, 'dial 911' and looking at all the buttons not knowing what to do."
About 20 minutes later Nelson was able to dial 911. Nelson had trouble remembering and communicating her address. She was also disconnected from the operator during the call. Eventually, the operator was able to find Nelson's address and confirmed that help was on the way. In the meantime, Nelson tried to contact a friend for help.
"I remember sitting on the floor in my entryway on the rug thinking I have to remember a phone number and I couldn't think of a single phone number that I knew," said Nelson.
Getting the Help She Needs
Once help arrived, Nelson was taken to UW Hospital and Clinics where she saw Justin Sattin, MD, Medical Director of the UW Health Comprehensive Stroke Program, and was diagnosed with a left brain stroke most likely caused by PFO.
PFO is a heart condition caused by a hole in the heart. Everyone is born with this hole but about 30 days after birth this hole closes in most people. If the hole doesn't close blood that pumps through the heart may not go to the lungs where clots are broken up and instead the clot may be sent straight to the brain causing a stroke.
"By that time they had figured out that it was very serious; Dr. Sattin told me that there was a portion of my brain tissue that was dead and there was another much bigger area at risk. He said that we had missed the three hour window for administering tPA and that the only option for me at that point was a endovascular intervention where they go up through your femoral artery to your brain and actually physically break up the clot and shoot tPA in."
David Niemann, MD, Assistant Professor of Neurological Surgery, performed the endovascular intervention called intra-arterial thrombolysis which was successful in breaking up the clot in Nelson's brain, then once the stroke emergency was over, she had to deal with recovery.
Today, Nelson has recuperated very well.
"I still have some problems with my right hand," said Nelson, "I have trouble with things like the clasp on a necklace, but for the most part, I am able to do all the activities that I was doing prior to my stroke. I know that if I hadn't received care quickly, I might not be so lucky. We are very fortunate, here in Madison, to have such an amazing healthcare system."