Anita Fish
Patient survives deadliest form of stroke, thanks to team approach
After smoking for more than 30 years, Anita Fish decided that she would quit for good on April 1, 2009. She said she kicked the habit because she wanted to improve her health.
"I knew it was bad for me, but the habit was stronger than my will to quit at the time," Fish said. "I had quit off and on in the past, but this time I knew it was going to be for good."
Four days later, Fish was getting ready for bed when she started feeling dizzy. Dismissing the sensation as nicotine withdrawal, she went to bed. The following morning she awoke on the floor unable to move.
"One of my coworkers called the house because she noticed that I was more than an hour late for work," said Fish, who had worked as a waitress in Macclenny, Fla. for 13 years. "When I answered the phone from the floor, she heard my plea for help and called 911."
Within minutes, paramedics arrived and the stroke team at Shands Jacksonville was activated. Fish was taken to a second location where the TraumaOne air ambulance flew her to the Shands Jacksonville trauma center. Upon arrival, she was immediately treated with anticoagulants, medications that stop blood clots.
"When Ms. Fish was presented to us with a reduced level of consciousness, several tests had to be performed quickly to determine where the stroke had taken place," said Scott Silliman, MD, a University of Florida College of Medicine – Jacksonville associate professor of neurology.
A brain stem stroke
Fish's stroke occurred at the stem of the brain, the area responsible for consciousness, breathing, heart rate and other life-support functions. Due to the location where the clot occurred, Silliman said these types of strokes are the most devastating because the patient experiences difficulty breathing and loses consciousness, often resulting in death. Patients who survive this type of stroke in an irreversible state are usually left paralyzed in all four extremities. They can sense stimuli but are unable to respond to them.
"Strokes like this have a high mortality rate. About 60 to 70 percent of patients don't survive in these instances," said Silliman.
A multidisciplinary approach
Fish remained hospitalized for two weeks at Shands Jacksonville and received around-the-clock care by more than 30 healthcare professionals, including UF neurologists, gastroenterologists, Shands nurses and rehabilitation specialists. Following her discharge, she underwent several weeks of occupational, speech and physical therapy.
"Ms. Fish is a prime example of our multidisciplinary approach to treating stroke," Silliman said. "She received outstanding care by leading neurologists as well as those working in the intensive care unit."
Silliman said there are 100 different types of stroke. It is the No. 3 killer in the United States, the leading cause of acquired physical disabilities in adults and the No. 2 cause of dementia.
Know the signs and symptoms
The symptoms of stroke vary depending on where in the brain the stroke is located. Physicians use symptoms to pinpoint the site of the stroke. Symptoms may include sudden feelings of weakness, numbness or loss of functionality in a leg, arm or face. These symptoms are usually experienced on one side of the body. Confusion, sudden headaches, blurred vision, dizziness, loss of balance and difficulty speaking or understanding speech, are also among the signs and symptoms of a stroke.
The good news is that strokes can be prevented by treating the most common risk factors such as high blood pressure, diabetes and high cholesterol. Silliman recommends that patients receive routine checkups with their primary care physician, watch for irregular heartbeats, quit smoking and maintain a healthy diet and exercise.
Enjoying life again
Today, Fish is home with her two dogs. She hasn't returned to work, but she gets out and exercises on a regular basis. She said she is thankful for the care and support that she received at Shands Jacksonville and from her family and friends.
"I'm a little slower than I used to be, but at least I'm back in the game and trying to enjoy life again," Fish said.
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