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Dr. Sarah Parker

Sarah Parker, M.D.
Sarah Parker, M.D.

Healthcare Professional

It was the first warm week of spring. Just chilly enough to need a jacket, but wonderfully refreshing after a cold winter. It was Sunday and like every Sunday my Mom and I were spending it with my grandparents. We enjoyed my grandma's amazing home cooking at lunch and then my grandpa settled in to his recliner to watch TV and my Mom and i started using the gorgeous weather to do some yard work. There was one thing odd about the day, my Grandma wasn't feeling quite right. She was tired and had a headache and went to lay down. This was unusual. She was generally so healthy other than arthritis she never had any complaints. I remember thinking to myself "she is getting older. We will probably have to doing more to help her out."

After we had been working for about an hour my Grandma came out to check in on us. She had the cat in her arms as she came out. A trip outdoors was a special treat for the spoiled house cat! Just few minutes later it happened. I was standing about 20 feet away when I looked over and saw the cat jump out of my Grandma's arms. I started toward her to help her catch the cat that was running off when suddenly the cat didn't matter. My grandma had fallen, slumped down actually, sliding down the side of the house. As soon as I got to her I knew what had happened. She had had a stroke. Her left arm hung useless by her side, her face seemed contorted as the left side was motionless, like it was a wax mask that had started to melt. She didn't say anything, she just grunted. I grabbed the cat who had stopped running and seemed to be standing watching in awe the change in get beloved owner.

My mom yelled "call 9-1-1!" She didn't have to tell me, I was already rushing to the phone that was right inside the door, just feet from where my grandma lay.

I remember saying to the operator "my grandma just had a stroke!" The 9-1-1 operator asked me why I thought that and I remember thinking, "What do you mean why? Because she's having a stroke!" I managed to relay that she couldn't move her left side. They asked me how old she was. I paused, "was she 79 or 80?" I thought, "How old?" I said out loud and to my surprise I got the answer from my Grandma. "80!" Her voice was so slurred but at least she was talking and knew what was going on! I don't remember the rest of the conversation with the 9-1-1 operator. I'm sure I told her the address and some other info but those details are a blur. It seemed to take forever for the ambulance to get there. In reality it was only about 15 minutes. When they got there I was surprised. "Why weren't their sirens and lights? This was an emergency right?!"

They loaded her into the ambulance and my mom and I got into our car to follow. Sometime during that rush my Mom had gone in to tell my Grandpa - a stroke victim himself - what had happened. I'm glad I didn't have to be there for that.

I remember sitting in the car waiting to follow the ambulance. Another 15 minutes went by before the ambulance started moving. I remember questioning myself "what's going on in there? Is she OK? Why aren't they GOING!!!" When they finally did get moving I was still expecting sirens and lights. There were none.

The ED room. In my memory it was bright and shiny and everything gleamed as if it was chrome. There were monitors and a computer screen and soooo many people there.

They asked about her medical history. "Does she have high blood pressure?" "No. She has hypotension. It has always been low." "What medicine does she take?" "Something for her thyroid." "Is she on any medication for high blood pressure?" "No. She has low blood pressure. Hypotension."

Then my mom asked about that new drug for stroke. "Yea," I thought. "That was on the news awhile back!"

Looking back I can still see the emergency room doctor's face and the surprise at the thought. "We don't have that drug here. Only a few big hospitals have it right now."

I have some vague memory of her getting a CT scan and then she was admitted. I don't know exactly when she was transferred to the slightly larger hospital about an hour away. Those days right after the stroke are such a blurr. I remember her getting an EEG and MRI and I remember the Neurologist saying a few days later "I've never seen someone with a stroke that big look so good." This wasn't much of a comfort. His idea of "looking good" was complete paralysis of her left arm, some small movement of her left leg, her face drooping, her speech slurred, and worse - the neglect!

It was so strange to me. My grandma, so obviously devastated didn't believe she had had a stroke and she seemed completely oblivious to her left side and the left side of the world. I remember her adamantly refusing to believe that that lifeless, swollen arm was hers. She hadn't had a stroke, she was fine, that wasn't HER arm. One day my mom and I visited her and I sat on the left side and my mom on her right side. I didn't say much toward the end of the visit and to my surprise, when I got up to leave and walked into the right side of the room she said "Sarah! When did you get here?"

I was devastated to realize that the hour I had just spent by her side, she didn't even know I was there. As soon as I had walked into the left side of the room I was gone.

She was transferred to an inpatient rehab unit where she stayed for a few weeks. She learned to walk with a walker, her speech became less slurred, but that left arm did nothing, maybe a slight movement at the shoulder, but basically nothing. The neglect was the hardest. It did improve some. She still wouldn't dress the left side of her body, her shirt sleeve empty and limp by her side, her arm under the shirt, shirt not pulled down on the left, yet she was oblivious to anything wrong. I remember watching a therapy session, watching the therapist try again and again to draw attention to the left side of the world with little improvement.

Eventually she came home. That's when things really changed. To understand how much first you will need to know a bit about my grandma.

She was the rock the family relied on. She was the one who took care of everything and everyone. She was a remarkable woman. She only completed an eighth grade education - no need for a girl to learn anything else at the time- but she was one of the smartest people I have ever met. She could figure out how things worked, how to fix things and she was so creative. No she couldn't help me with calculus homework or help me learn the process of DNA replication but if you wanted to build an award winning mouse trap racer she was the one to go too! She could do anything in my mind. She ran the finances and my grandpa which was no small feat since he thought he ran everything! She could fix anything; rewire a lamp, refinish furniture, darn socks. She was the best cook. I still remember her home made tamales. It was an all-day event when she made those from scratch and they were unbelievable! She was our rock and now that rock was gone.

Her life had changed and so had all of ours. I was a junior in high school. I finished my extracurricular activities and then went to my grandparents where I met with my mom when she got off work. Together we got dinner made, medications given, did dishes, started laundry, and got breakfast and lunch set up so they could easily fix them. Then I headed home to do homework. They did have help from home health services but still there was so much to do.

I don't know exactly how or when I made the decision. It really wasn't much of a decision. It was obvious..... I couldn't go away to college. Yes, community college had always been in the back of my mind knowing that my mom could not afford to send me to a four year university but I could get scholarships. I had straight A's, too many extracurricular activities to list, leadership roles, awards, volunteer work, I was the complete package! But I didn't apply to anyplace other than my local community college. My mom and I suddenly had so much more to do. My mom had a full time job, two households to take care of, two sets of bills to pay and so many more worries. Me, I had school, homework, never ending extracurricular activities and of course helping out as much as I could. I remember when my grandma died - 5 years after her stroke - my mom and I thought back and decided that it was almost as if she had died twice. On the day of the stroke out rock died and all of our lives changed in an instant.

When I first became interested in Neurology I had no interest in stroke. I didn't want to see people that reminded me of what I'd lost and how my life had changed. During my time in medical school I saw a total of two patients in the hospital with strokes. I wasn't taught about stroke treatment. The first time I heard of tPa was when I was interviewing for residency. On my second interview one of the residents, Dr. Nair, was talking about how much it was used at that facility. Still I had no interest in stroke. I was going to be a sleep neurologist, read sleep studies, and see some patients in clinic -- no sleep emergencies. It was going to be a good life!

I approached my first stroke rotation with dread. I remember the pit in my stomach the night before I started.

I wish I could remember my first tPa case. I wish I could say that I saw a patient make a full recovery in front of my eyes the first time I saw tPa given and I was hooked from that moment. Instead it was a slower process. Patients still reminded me of my grandma and family members reminded me of myself in that life changing moment but I realized I could help these people. Stroke doesn't have to be always devastating. It could be treated. Soon my dread of stroke became a love.

I call my mom almost every day on my way home from work. One day she asked me, "you're on stroke again, aren't you?" "Yes" I said, "how did you know?" "I can hear it in your voice, you're happy, you're excited." Yes, I'm excited. Stroke changes a person's life, but it doesn't have to change it in the way it changed my grandma's and my family's.

A few months ago I saw a gentleman with almost identical stroke symptoms as my grandma's roll though the door of the emergency department. The ambulance had its lights on. We rolled him into CT, mixed tPa and within 5 minutes Dr. Nair and I were giving him the treatment that would change his life. When he walked out of the hospital you could barely tell he had had a stroke. I cried. Someone still had their rock.

I want to make clear, I didn't go into stroke because of my grandma. I didn't go into stroke because of the thrill of giving tPa. I didn't go into stroke to break records. I can't put in words exactly why I did it but I know that every patient I care for, every family I talk to, are in the middle of a life changing event. Every time I can treat a patient, educate a patient or even just comfort a family when the time for treatment has past, I am rewarded. My heart warms. I am so great full that I happened upon a team that showed me what could be done, taught me, embraced me, and led me into this wonderful field.

 

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Display of the Faces of Stroke stories does not imply National Stroke Association's endorsement of any product, treatment, service or entity. National Stroke Association strongly recommends that people ask a healthcare professional about diagnosis and treatment questions before using any product, treatment or service. The views expressed through the stories reflect those of the authors and do not reflect the opinion of National Stroke Association.

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