It all happened so quickly. Tyana DeJesus was near the end of her shift at a local shoe store when she suddenly went down on one knee because she thought she was going to pass out. The 22-year-old noticed her hearing was muffled. She was seeing double and couldn’t move the left side of her body. While her coworkers tried to help her, Tyana’s manager called Tyana’s mom, Jacqueline, and said, “Something’s not right, something’s not right, her words are slurring.” Tyana’s mom arrived at the store and immediately drove Tyana to the Baystate Medical Center Harold Grinspoon & Diane Troderman Adult Emergency Department.
Arriving at the Emergency Department, Tyana remembers feeling so sick she vomited in her mask. She couldn’t speak correctly or walk. “I'm grateful that Baystate took action as fast as they could. I was the priority,” she said. Emergency Medicine physician Dr. Jessica Patel examined Tyana and ordered an immediate CT (Computed Tomography) scan of Tyana’s head.
The Director of Neurointerventional Surgery, neurologist Dr. Ennis J. Duffis, reviewed the scan which showed a blood clot in Tyana’s brain was blocking the main artery that carries blood to the back of the brain.
“Tyana had what we call a basilar artery occlusion, which is one of the most severe kind of strokes a person can have,” Dr. Duffis said. If left untreated, a stroke may leave a patient paralyzed, cause the patient to slip into a coma or even result in death.
“When they told me I was having a stroke,” Tyana said, “I looked at my mom and we were both crying. I asked my doctors to please not let me die. I haven't lived my life. I haven't achieved any of my goals.”
ACTING QUICKLY TO REMOVE THE CLOT
Dr. Duffis recommended that Tyana have a thrombectomy, a procedure in which a catheter is inserted through an artery in the groin allowing doctors to reach the clot and remove it. “Dr. Duffis told my mom, ‘If it was my daughter, I would want her to have the procedure as quickly as possible.’” This was all Tyana’s mom needed to hear, and she gave permission to have the procedure done.
There wasn’t time to wait for a patient transporter to arrive. “I wheeled Tyana to surgery myself because time is brain,” Dr. Duffis said. “Tyana’s mother deserves a lot of credit for taking action and getting Tyana to our ER right away. When it comes to strokes, the faster you act, the less damage is done.” Dr. Duffis urges everyone to learn the warning signs of a stroke and if you even suspect a stroke, get to the ER.
Tyana said lying on the gurney and being wheeled into surgery was like what you see in the movies. “They're pushing you and you're looking up and all you see is lights going by and nurses and doctors around you. I remember them telling me not to worry, that they would take care of me.”
The surgery team was able to remove the clot before it did any permanent damage. Because Baystate Health care teams can communicate quickly and coordinate care across departments, Tyana did not need to be transferred and the procedure was done right away. “I believe this ability to deliver advanced, coordinated care led to Tyana’s full recovery,” Dr. Duffis said.
LOVE AND CARING
The surgery went well and Tyana was moved to the ICU (Intensive Care Unit) to recover. “Dr Patel and Dr. Duffis came to visit me and see how I was feeling,” Tyana said. After surgery, her vision, speech and hearing were all normal again. Dr. Duffis remembers the look on her face and how amazed she was with her recovery. “Seeing that was very gratifying,” he said.
“I always put myself in the shoes of the patient and think of them as a I would a family member,” Dr. Duffis said. “I try to keep my patients informed every step of the way including how the procedure went and what to expect next. That’s what I would expect from my physician if I were in the patient's shoes.”
“At one point,” Tyana said, “my nurse answered my phone for me. I was on FaceTime and my whole family was outside in the parking lot because visitors weren’t allowed because of COVID. My family was waving and smiling and all I could hear was them all shouting, ‘We love you! We can't wait to see you! You did so good!’”
And it wasn’t just her family cheering her on. “Since I couldn’t have visitors, the staff were my visitors,” Tyana said. “My nurses really took care of me and were in and out of the room all the time. Everyone was just really nice. I felt like all the nurses and the PCTs took care of me as if I was their own.”
SO YOUNG TO HAVE A STROKE
“It's rare to see this kind of stroke in someone so young,” Dr. Duffis said. In hopes of finding the cause of Tyana’s stroke, several tests were done while she was in the hospital recovering. Doctors found that Tyana had a patent foramen ovale (PFO) which is an opening between the right and left sides of the heart. Although everyone is born with this opening, it closes on its own soon after birth for most people. For Tyana, it did not close.
Tyana’s doctors determined that this opening in her heart was the cause of her stroke. “We believe that a blood clot formed on the right side of the heart, then traveled across the opening to the left side of the heart and then up into the brain,” Dr. Duffis said. In a follow-up procedure, cardiologist Dr. Evan Lau and his cardiac surgery team, successfully closed this opening in her heart.
A FAMILY LEGACY AND NEW PERSPECTIVE
Tyana said she feels great and is back at work. “Having a stroke changed my perspective and it changed the type of person and the type of nurse that I want to be,” said Tyana who was in school with goals of becoming a nurse before her stroke.
Tyana comes from a family of nurses. Her mom, grandma and some of her cousins are all nurses. “Just being at Baystate, I knew that I wanted to help people like the Baystate Health caregivers helped me.” Tyana said.
“I think it's amazing that she wants to be a nurse and I'm just glad that I was able to play a small part in keeping her on track to becoming a healthcare provider,” Dr. Duffis said.
“Before my stroke,” Tyana said, “I thought I wanted to be a nurse, but now I know that I want to be a nurse.”
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