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After dinner at home with his wife Tisha on Feb. 17, 2019, avid cyclist and fitness enthusiast, 58-year-old David Lannes began cleaning up the kitchen. Suddenly overcome with a feeling of weakness, Lannes slumped to the floor. Within moments, his wife entered the room and called 911. Even though he was paralyzed down the left side, Lannes told his wife he was fine and believed it – this seeming bizarre denial of the obvious is actually a common sign of the type of stroke that he was experiencing.
Lannes arrived at Edward Hospital within minutes. A thorough exam and CT imaging confirmed he was having a stroke due to a large blood clot that had formed in his heart, broken off, randomly moved up his right carotid artery in his neck and finally became wedged in the artery in his head supplying blood to the right half of his brain. He was given tPA, or tissue plasminogen activator, a drug that helps dissolve blood clots that lead to a stroke. tPA can be extremely effective in limiting or reversing symptoms, but must be given within a 4.5-hour window of symptom onset. Unfortunately, his clot was so large the tPA could not break it down, so a more advanced procedure was necessary.
“David had a right-sided blockage of his carotid artery which commonly causes a syndrome called ‘neglect’ in some patients, where they can’t understand they’re having a stroke,” says Michael Hurley, M.D., a neurointerventional surgeon with the Edward Neurosciences Institute. “He also experienced left-side paralysis because each side of the brain controls the opposite side of the body and face, but did not have the speech and cognition problems typically seen with strokes affecting the left side of the brain.” Even though Lannes is left-handed, his speech was unaffected as it was controlled by the left side of his brain, as it is in the overwhelming majority of people.
Because Lannes’ scan didn’t show a large area of brain damage, doctors knew they had brain to save. They quickly determined that he was a candidate for a surgery called a thrombectomy.
“In the interventional suite, we took a catheter up from top of the right leg and through the aorta to the right-side carotid artery,” says Dr. Hurley. “At this stage, I could see the clot had moved another half-inch further downstream from the carotid artery into the main stem of the right middle cerebral artery. We know with this type of blockage, about 80 percent of people will have severe long-term disability, meaning they will not be able to look after themselves.”
Next, Dr. Hurley delivered a stent retriever through the catheter and was able to mechanically remove the clot from Lannes’ artery and into the catheter.
Following his procedure, Lannes’ progress was impressive, but on his fourth day in the hospital while working with the physical therapist, Lannes experienced a second stroke, this time on the opposite side, and was once again rushed to the surgery suite where they prepped him for a second procedure. However, just as the procedure began, Lannes improved significantly because the blood clot was more benign and resolved on its own.
“I remember looking up and seeing four people hovering over me, it felt like an out of body experience,” says Lannes. “I asked them if they were going for another clot and they said “not anymore,” since I was talking to them.”
By this time, he was diagnosed with an irregular heart beat due to atrial fibrillation, a common cause of repeated strokes due to blood pooling in the irregularly beating heart chamber and forming clots. He started blood thinning medication to prevent new clots from forming.
Following his second stroke, Lannes was moved to a rehabilitation facility, but progressed so quickly that he was home within a couple of days. He then set out to build back up to his preferred state of physical fitness and a regular routine that includes high-mileage cycling.
“I started riding stationary bikes for 45 minutes a day and soon, doctors cleared me to fly home to Virginia,” says Lannes. “My physical therapy was working in my yard for six hours a day and using all my limbs and extremities.”
Lannes soon worked up to 20-mile rides and within a month, completed a weekend of rides that totaled 160 miles, to complete his participation in the 2019 BP MS 150, a fundraising cycling event hosted by the National Multiple Sclerosis Society. The event connects participants across the country in their common goal to raise funds for multiple sclerosis research.
According to Dr. Hurley, before the recent development of advanced treatments, on average 80 percent of patients who suffered strokes like Lannes’ would be severely disabled when assessed three months after the stroke. Thirty percent would not survive untreated. Even with treatment, Lannes’ quick recovery after two strokes was remarkable.
“David’s previous excellent physical condition and his motivation helped his recovery tremendously,” says Dr. Hurley. “We tend to underestimate how much recovery is dependent on mental as well as physical rehabilitation. Some patients have to relearn skills they took for granted for many decades – that takes hard, frustrating work and commitment, and it’s important they get all the support to maximize their potential.”
As for Lannes, he’s making the most of every moment. He continues to support fundraising for MS research as well as serve as a Boy Scout camp aquatics director. He lives in Virginia and spends as much time as he can with his family, most notably his grandchildren.
“Doctors and nurses say I’m a walking miracle and I have to believe them,” says Lannes. “I’m here not because of me but because of God. I’m just doing my part to keep myself physically fit, but He gave me the opportunity.”
Lannes has also adopted a theme song for his experience, called “Good to be Alive” by Christian rock artist Jason Gray.
“I’m a very positive person and it makes you appreciate your entire life when you go through something like this,” says Lannes. “Every day you wake up, you feel like it’s good to be alive.”
Learn about our stroke and vascular services.
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