MADISON. Wis. – At 40 years old, for many, a headache may not seem like anything out of the ordinary, and that certainly was the case for Sarah Wade, of Lyndon, Ill., in 2015.
But it persisted for more than a week.
She tried to continue with her life at first. She would rest, take naps and prepare for an upcoming camping trip with friends. However, an observant friend noticed her eye was drooping.
“I had no idea there was anything wrong with my eye, and I see myself in the mirror every day,” Sarah said.
She went to the local emergency department and the doctor caring for her noticed that one of her pupils was not dilated when a light was shined in her eye, and ordered a CT scan. The test revealed her carotid artery near the brain was more than 99% blocked, and she was rushed to UW Health SwedishAmerican Hospital in Rockford. There, the care team quickly realized Sarah was in need of more advanced care at University Hospital in Madison and was transported by ambulance.
“I felt so much better when I arrived there,” she said. “They were just so good at explaining everything to us and how it works, even drawing us diagrams.”
There, Sarah was in the hands of Dr. David Niemann, neurosurgeon, UW Health, and associate professor of neurosurgery, University of Wisconsin School of Medicine and Public Health.
What Sarah experienced is called a dissection, where a tear in the wall of the carotid artery formed a little flap of tissue, which over time was pushed up by the constant pumping of blood through the vessel. The flap acted like a cap or plug, stopping the flow of blood.
“They can actually happen to any of the four pipes that go to your brain,” he said. “I’m a plumber for the brain, so whether I fix them from the inside or outside, I like to talk about ‘pipes’ and ‘rivers.’”
To fix the flap of tissue causing the blockage, Niemann and his team inserted a tube called a catheter into the artery that had a stent inside it, which is an expandable tube that would push the flap down allowing blood to flow and blood vessel cells to grow over the stent adhering it to the artery wall.
“Sarah, fortunately, completely recovered,” he said. “She didn’t really have any significant brain damage because she got to the hospital in time.”
While this condition is often associated with trauma injuries where there is damage to the neck, it can happen for no reason at all. Sarah even had genetic testing done, which did not show a disposition to dissection, Niemann said.
Within days, Sarah was back home in Lyndon and after a few months of recovery, life continued normally. Soon, her life would reach another milestone. About two years later, she had a daughter, Harper Taylor. However, one month after Harper’s birth, in 2016, Sarah started feeling dizzy and headaches returned.
“Obviously, when I get a headache, I get a little nervous at this point,” Sarah said.
Out of caution, she went to the local emergency department, and a CT scan was performed, which revealed, yet again, she had another dissection.
“They must have been a little more concerned this time, because they sent a helicopter down from Madison,” Sarah said.
The concerns of the emergency room doctors were well-founded, according to Niemann. The dissection this time was even more closed.
“The second dissection was really tight, and she actually had stroke symptoms,” he said.
Now, almost 150 miles away from her newborn daughter, Sarah lay in a hospital bed preparing for an emergency procedure to again place a stent and heal her artery wall.
“That was awful,” she said. “I had a really hard time.”
Much like her friends recognizing her symptoms two years earlier, Sarah’s friends were there for her again.
“Thank goodness for all of my friends because we do live two hours from Madison,” she said. “A friend drove Harper up to see me, and she stayed the night with me; I broke down in tears.”
Sarah returned home again, and following another few months of recovery, was back to being able to teach Harper how to garden and play. Sarah could also enjoy being a grandmother, as her oldest daughter and her son now both have children.
This almost didn’t happen, of course, because time is of the essence when stroke symptoms present, like slurred speech, weakness on one side of the body, vision changes or droopy eyelids, Niemann said.
“We have a phrase called ‘time is brain,’” he said. “Brain cells, or neurons, can only survive for about five minutes if they don’t have a blood supply.”
Blood cells can remain dormant before dying when a stroke occurs, but it is extremely important to call 911 and get to a medical facility that can treat strokes, Niemann said, because those cells can be revived when the blood supply, or “river,” is flowing again.
Sarah has a message for people who think strokes can’t happen to them, even if they are young and healthy.
“You typically hear of older people having strokes, but it can happen to anybody at any age,” she said. “Listen to your body, when your body doesn’t feel the same as it normally does – like a headache that lasts a week – go to your doctor.”
She goes back to Madison every couple of years to have a scan, and sees a doctor for chronic pain following the surgery. Sarah is extremely grateful for all the care she received and fully understands the gifts of friends and family who helped her through this ordeal.
“It is a blessing; I am thankful to wake up every morning,” she said. “When this happened the first time, I didn’t think I was going to make it, but now when I go see my doctors, they call me the walking miracle.”
