By Leigh Farmer

Imagine watching your close friend and EMS surround you. Your eyes and ears take it all in, but you cannot move or speak.

This type of paralysis is called locked-in syndrome. It can happen when someone experiences a stroke.

“I will never forget the paramedic. I kept going out and I remember he kept saying ‘Chwanda look at me!’,” Chwanda Johnson recalled. She remembers everything – from start to finish.

Sitting down with Chwanda, you’ll notice how she always has a smile on her face. It takes mere moments from the start of a conversation to see why she calls herself “a jokester,” others just start laughing right along with her. She even smiles when telling you about the scariest day of her life. November 7, 2023.

“It was just like any other normal morning. I didn’t feel anything different,” the 49-year-old said, describing her early morning routine.

Chwanda usually hits the road at 6:30 a.m. to head to her job as a medical technician at a local senior living facility, where she has worked for more than 22 years. Usually, she’s enthusiastic about getting a jump start on her day. But on that November morning, Chwanda stumbled to the car.

“I got closer to the car, and it got worse. And I was like ‘oh my God what is going on?’” she recalled.

When she got to the car, Chwanda called her friend Calvin on the phone who was still inside the house. As soon as she pressed send, her body gave out. She couldn’t talk and her hands curled up into fists.

“I wasn’t able to say 9-1-1. I just said ugh, ugh, ugh.”

Calvin ran out of the house and immediately knew Chwanda was having a stroke, so he dialed 911.

According to doctors, Calvin’s quick thinking saved his friend’s life. EMS was there in minutes and knew exactly where to take Chwanda.

“Once I saw the VCU sign I was at ease because I knew I was in the right place. I didn’t want to go anywhere else,” Chwanda said.

Stroke experts say ‘time is brain,’ every second counts

About two million brain cells could be lost every minute a stroke goes untreated, according to VCU Health stroke specialists. A stroke happens when something blocks the blood supply to part of the brain or when a blood vessel in the brain bursts, rapidly decreasing the flow of oxygen to the brain. The more time that elapses, the worse the brain damage. After experiencing a stroke, an individual can have lasting brain damage, long-term disability or die.

Being prepared to react swiftly and appropriately, as Calvin did, can save a life. That is why it is important to recognize the symptoms.

“I think if he hadn’t called 911 when he did, I wouldn’t be here,” Chwanda recalled, her face changing quickly from a smile to a somber gaze.

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Because Chwanda Johnson’s close friend Calvin knew the signs of stroke, he immediately called 911. (Contributed photo)

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When Henrico Division of Fire answered the call, medical personnel knew exactly what to do – get Chwanda to the most equipped stroke care team in the area. They alerted VCU Medical Center. Thanks to this communication, emergency medicine physicians, nurses and a vascular neurologist were waiting at the door for Chwanda to arrive.

“Our personnel are accustomed to the immediate availability of a multi-disciplinary team of specialists in emergency medicine, radiology, and neurology to care for these patients as well as the ‘Direct to CT’ pathway that minimizes patient time to diagnosis and treatment,” said Jeff Ferguson, M.D., medical director of Henrico Fire. Ferguson is also an emergency medicine physician at VCU Medical Center and associate professor in VCU School of Medicine’s Department of Emergency Medicine.

VCU Health’s Comprehensive Stroke Center is one of only three centers of its kind in the region. Upon arrival, a patient suspected of having a stroke receives CT scans, labs, neurology assessments in one place. If surgery is needed, no time is wasted. They are waiting in a dedicated operating room that allows for the complete care of a stroke patient.

A quick CT scan at the hospital revealed a blood clot at the base of Chwanda’s brain. John Reavy-Cantwell, M.D., Chwanda’s neurosurgeon, removed that clot through a procedure called a mechanical thrombectomy less than an hour after Chwanda tripped in her driveway. The minimally invasive procedure is one of a few highly effective treatment options available when a patient is brought to the hospital soon after suffering from a stroke. If it takes longer for them to been seen by a medical team, the patient may be ineligible for the surgery.

That’s why it’s so critical for stroke patients to get medical treatment as soon as possible – more options are available to prevent long-term health problems.

A remarkable recovery

Recovery from a stroke is different for every person. Sometimes recovery can take weeks, months or even years. While some people fully recover, others live with lifelong disabilities such as problems with memory, speech or mobility. Rehabilitation can involve a variety of different therapists and support groups that help stroke survivors live with their new normal.

For Chwanda, it was a matter of hours before she was sitting up and laughing, back to her old self.

“I could hear voices saying, ‘move your feet, lift your leg.’ And anything they told me to do I did. And I heard them say ‘Oh, call the doctor! Call the doctor!’ They were so surprised,” said Chwanda. She describes it like she was performing a magic trick.

Reavey-Cantwell couldn’t believe his own eyes when he went to check up on Chwanda several hours after removing the blood clot from her brain.

“I thought that I had walked into the wrong patient's room because she was awake and talking and moving everything,” he said. “I was turning around to leave and then said, oh, no, this is her. Oh my gosh!”

Her daughter and two granddaughters were by her side. Reavey-Cantwell believes Chwanda’s remarkable recovery is part miracle and part perfect execution of emergency stroke protocol.

“She was probably as close to death as one can really come and then came back and made an incredible recovery, in my opinion,” Reavey-Cantwell said.

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Since Chwanda Johnson had a stroke, her 9-year-old granddaughter keeps stroke educational information with her so she can help if there’s an emergency. (Contributed photo)

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Everyone can be ‘Stroke Smart’

While the month of May is Stroke Awareness Month, VCU Health’s Comprehensive Stroke Center is dedicated to raising awareness all year long.

The center works with the academic health system, VCU, and the Richmond community to educate residents, students, faculty, and medical professionals alike on the signs, symptoms, and latest methods for treating stroke patients. This outreach includes an annual conference as well as the city-wide initiative Stroke Smart Richmond, which educates people on stroke symptoms to reduce treatment delays.

The co-leaders of the project, VCU Health stroke program manager Stacie Stevens, Ph.D., D.N.P., R.N., and emergency room physician Ramana Feeser, M.D., are driving home one important message: When you spot a stroke, call 911.

“The majority of patients with a confirmed diagnosis of stroke do not arrive by EMS,” Feeser said. “On top of this, most stroke patients arrive too late to be eligible for effective medication for a stroke. There is hope, if you come to us fast. We need everyone possible to spot a stroke and stop a stroke by calling 911.”

As part of the Stroke Smart campaign, the emergency department at VCU Medical Center is providing 6,000 pieces of educational material aiming to reach as many patients and visitors as possible during May.

You never know who will take it to heart.

Chwanda’s littlest advocate, her 9-year-old granddaughter, carries stroke information everywhere she goes.

“She keeps it in her purse just in case she is here with me and needs to know what to do,” said Chwanda with tears running down her face and a heart bursting with gratitude.

Learn the signs and symptoms of stroke