Thursday, Jan. 19, 2017

Mildred Thomas was taking a break from visiting a friend in the hospital when she ordered a junior hamburger, fries and a drink at the Wendy’s inside Virginia Commonwealth University Medical Center on Labor Day. Then, her thoughts became eerily inaudible.  

“The young lady [behind the counter] was asking me questions. The thoughts were forming, but no words were coming out,” said Thomas, 59. “At the time I didn’t think anything was going on. I collected my food and went to sit down and get myself together. I walked out into the main lobby and when I looked down I saw my purse on the floor. I picked it up. I dropped it again. I picked it up. I dropped it a third time and then I saw people running to my assistance.”

Thomas was having a stroke. She didn’t realize it. But employees in the hospital’s busy lobby thoroughfare did. VCU Health employees are trained to recognize stroke using the F.A.S.T. acronym, which stands for facial drooping, arm weakness, speech difficulties and time.

“An environmental services employee said to me Thomas was showing signs of a stroke,” said Ranjeeta Sanyal, the information assistant working at the hospital’s information kiosk near Wendy’s. “I approached [Thomas] and asked if she was OK and her name, and she couldn’t answer any of it. She looked confused. She had a blank stare. I put her in a wheelchair and pushed her outside and to the emergency room. All I could think was I needed to get her to the emergency room as quick as possible if she was having a stroke. I didn’t want to take any chances.”

The VCU Medical Center emergency room is less than five minutes away from its gateway lobby. Once there, Sanyal told medical personnel she thought Thomas was having a stroke.

Because of concerned onlookers and quick care, Thomas made a full recovery. She is thankful to the compassionate strangers and medical team who rushed to her aid.

“I am just blown away that people identified the stroke symptoms I had. [At the time], it still hadn’t dawned on me that I was having a stroke,” she said. “I tell people all the time, by the grace of God I was in the right place at the right time with the right people."

Time is of the essence

Blurred or blackened vision, loss of balance or coordination, and difficulty speaking and understanding are typical signs of a stroke. In Thomas’ case, there was a blockage in the middle cerebral artery from a blood clot. It was cutting off blood supply to the portion of the brain that controls her ability to speak, understand language, and move the right side of her body, said VCU Health neurosurgeon Dennis Rivet, M.D.

Rivet was the doctor on call on Labor Day, and he rushed from his home to the hospital to treat Thomas. Because bystanders so quickly detected she was in trouble, her outcome is phenomenal, but rare, Rivet said.

“We know from multiple published studies that the ability to prevent stroke or limit the severity of one depends on how fast someone gets medical attention, how fast the diagnosis is made and when treatment begins,” he said. “Every day we see cases where although we might have been able to do something, it is already too late.”

In the U.S., nearly 800,000 people each year suffer a stroke, which kills almost 129,000 people annually. Some stroke risk factors are hereditary while others are linked to lifestyle issues like poor diet and cigarette smoking. The effects of a stroke range from paralysis to memory loss.

Thomas suffered a heart attack in 2000, but since then she assumed she was governing her health well.  Yet at the time of her stroke, medical tests revealed her cholesterol was nearing 300. A healthy cholesterol level is between 100 and 129.

“I wasn't doing as good a job as I thought,” Thomas said, adding that she loves cheese, which can be high in saturated fat and contribute to elevated cholesterol levels.

‘The man of the hour’

The procedure performed on Thomas is called a mechanical thrombectomy, during which a device is used to extract the blood clot, or thrombus, causing the stroke. Thomas was conscious up until her surgery, and refers to Rivet as “the man of the hour” for his bedside manner and concern for her even after her operation.

“After surgery he told me he heard I got sick outside of Chick-fil-A. I told him, ‘No, it was Wendy’s,’” Thomas said. “At that time he said he knew I was doing great.”

Rivet insists, however, that her care was a team effort. The operating team included an endovascular neurosurgeon, an anesthesia team, operating room nurses and a radiologic technologist. All involved deserve credit for reacting quickly, particularly on a holiday weekend, to deliver lifesaving care, he said.

“A complex and advanced procedure like this provided in emergency fashion is obviously an evolution which requires many people all doing their job in order to help one person,” Rivet said.  

With regard to stroke care, VCU Health is a pioneer in the state. VCU Medical Center was the first comprehensive stroke center in Virginia. In May, it received the Gold Plus Achievement Award and was designated as a Target: Stroke Honor Roll-Elite Plus hospital for its participation in the Get With The Guidelines-Stroke® program. The award was given by the American Heart Association/American Stroke Association, and is the AHA/ASA’s hospital-based quality improvement program, which provides hospitals with tools and resources to save lives and accelerate recovery.

“When you become older and wiser, when you know better, you do better.”

Thomas said she is thankful to have been in a place that could provide speedy and excellent care. Today, she is even more conscious of her daily meals and the need for exercise.

“I have been trying to pay attention to everything across the board,” Thomas aid. “I don't intend to be in the hospital for medical care anymore. When you become older and wiser, when you know better, you do better. That’s what I'm trying to do as far as my health is concerned.”

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