Glen Ellyn patient's advice: When stroke symptoms set in, 'listen to your body' and get help now
A Glen Ellyn nurse who is safely managing her blood vessel disorder is the poster child for why it's vital to head to the nearest hospital as soon as symptoms of a stroke set in, even during the COVID-19 pandemic, her doctor says.
Sheila Sheppard, 49, was diagnosed in February 2019 with moyamoya disease, in which a network of tiny blood vessels forms to make up for a narrowing of the main vessels that bring blood to the brain.
When the main vessels become too constricted, patients can experience strokes or strokelike conditions, during which the brain is not getting enough of the nutrients and oxygen it needs, said Dr. Demetrius Lopes, a neurosurgeon and director of Advocate Health Care's stroke program at Advocate Lutheran General Hospital in Park Ridge.
Sheppard experienced this before her diagnosis in 2019. But she didn't immediately recognize the weakness in her right hand one day at the gym as a strokelike episode. She went to the doctor and was given blood pressure medications.
Three days later, the symptoms of what's called a TIA, or transient ischemic attack, were worse. Her entire right side went numb, from her face to her foot. She went to the emergency room, and doctors there told her of the moyamoya diagnosis.
Lopes then took over her care and performed a surgery to create a new pathway for blood to reach her brain to make up for the vessel that had narrowed.
“I was very blessed and lucky how it happened,” Sheppard said. “I went in right away and listened to my body.”
After surgery, she went about her normal life, working for Schaumburg-based Superior Pharmacy, providing IV medications in the home for patients with bleeding disorders and neuromuscular disorders, until April of this year.
That's when the now-familiar symptoms of constricted blood flow to the brain set in. The numbness began with Sheppard's fingers, then her hand. Her wrist and face went numb, too. She feared she was having another TIA.
“It lasted six or seven minutes. It was scary,” she said. “I went in right away.”
COVID-19 or no COVID-19, Sheppard knew, she needed care — her brain needed care — in order to survive.
“I'm not afraid of that. I just want to live,” she said about the virus. “I didn't even think twice about it. I knew I had to try to get to the hospital immediately.”
Doctors use the phrase “time is brain” when it comes to strokes and TIAs. By that, they mean these blood-flow constrictions can cause brain cell death and brain damage in minutes. That damage often is irreversible. The sooner the blockage causing the stroke can be cleared, the less brain function the patient stands to lose, Lopes said. Patients who delay end up suffering.
“If you miss that opportunity once the stroke is in place, you cannot recover from that anymore,” Lopes said. “It's permanent damage.”
Lopes praised Sheppard for her lack of hesitation. He recently conducted a telemedicine appointment with her to discuss the fact she may need another surgery to reroute blood around the blockage that caused her recent issues.
“She knew that when symptoms start to happen, that she had to come to the hospital,” he said. “Those things cannot wait.”
Lopes said hospitals, including those in the Advocate system, enforce careful separation of suspected and confirmed COVID-19 patients from everyone else to prevent transmission.
Still, Lopes said, Lutheran General is seeing 20% fewer stroke emergencies in the hospital. It's the short-lived episodes, TIAs like what Sheppard has suffered, for which patients are ignoring symptoms and not seeking care, he said.
The best route is for each person to be aware of what's normal for his or her body what isn't — and then to act accordingly, Sheppard said.
“People are causing irreversible damage or death because they're so afraid of COVID-19,” she said. “There's so much fear when you should be listening to your body.”