For Patrick Petit, an economist, the first sign of trouble was nearly two weeks before his stroke. He woke up dizzy and sweaty, with a headache and upset stomach. “I could walk, but I’d lose my balance,” he says.
He slept through the day and felt better, but his headache and balance problems lingered. Eleven days later, his symptoms went from worrisome to life-threatening. He woke up to walk his dogs and immediately knew something was very wrong.
“I tried to get up, but I fell back on the bed,” recalls Petit, 50. “I was confused, and I lost my peripheral vision. Then I realized I couldn’t talk. My mouth didn’t move; the words didn’t come out. Instead of talking, some saliva started to drip from the left side of my mouth.”
Petit was experiencing a stroke, which occurs when blood flow to the brain is blocked. Signs of stroke include loss of balance, headache or dizziness, blurred vision, slurred speech, facial drooping and arm weakness. Because survival and functional outcomes are so time-sensitive, experts urge people with symptoms to seek care immediately.
Petit’s wife called 911, and an ambulance brought Petit to Suburban Hospital about a half-hour after his symptoms began.
Upon arrival, the 24-hour Stroke Team, a multidisciplinary stroke specialist group, took action to diagnose and immediately initiate a treatment plan involving emergency department doctors, neurologists, interventional radiologists and nurses.
“The Petit family acted quickly,” says vascular neurologist Malik Adil, M.B.B.S., medical director of the Stroke Program at Suburban Hospital. “The emergency department was ready to accept Patrick, and neurology specialist Omid Motabar, M.D., arrived in minutes. The interventional radiologist was ready. Everything was coordinated, allowing us to bring all the specialists together to get Mr. Petit immediate care for the best possible outcome.”
A CT scan in the emergency room showed that Petit’s stroke was among the 87% that are ischemic strokes, meaning they are caused by clots that block an artery. The remainder are hemorrhagic strokes caused by bleeding in the brain, which are deadlier.
Motabar gave Petit a medication called tPA (recombinant tissue plasminogen activator) to dissolve the clot. “The sooner you get it, the better,” says Adil of the medication. “It’s basically lifesaving.”
Petit recalls that his vision came back, and he was able to move his arms, but he couldn’t talk. “I was trying to talk to Dr. Motabar, and I couldn’t,” he says. “I remember being very frustrated.”
Motabar took Petit to the hospital’s 24-hour interventional radiology center for an angiogram — a diagnostic test in which a radiologist injects contrast dye then uses X-rays to view blood vessels — by interventional radiologist Abhishek Srinivas, M.D.
Srinivas found that the clot had blocked a large blood vessel in Petit’s brain. “That type of blockage, known as a large vessel occlusion, is associated with significant disability and normally does not respond well to tPA,” he says. “Thankfully, it did for him.”
Because tPA had dissolved the clot, there was no need for a thrombectomy, a minimally invasive surgical procedure that finds and removes blood clots.
Suburban’s stroke center is open 24/7, 365 days a year, and is ready to perform a thrombectomy at any time.
The procedure calls for inserting a catheter through a small incision in the femoral artery, and using X-ray cameras to guide the catheter to the brain and locate the clot. A suction or mechanical device is then introduced through the catheter to remove the clot and restore blood flow to the brain.
With Petit out of immediate danger, his next challenge was to regain his strength and speech.
“Once all the procedures are done, and a patient is stabilized, our physical therapists, occupational therapists and speech therapists conduct an evaluation and work to improve areas affected by the stroke,” says Adil.
According to the National Institutes of Health Stroke Scale, which assesses patients on factors including motor skills and speech, Petit’s stroke was deemed moderately severe. His most serious symptom was aphasia, the inability to retrieve and articulate words.
In intensive care and then a step-down unit, nurses and therapists cared for Petit and challenged him to regain his speech by identifying pictures on a sheet of paper.
At first, Petit, who is from Montreal and for whom English is a second language, could only count to 10 in his native French. “I couldn’t name the things I saw,” he said. “I would know what it was, but I couldn’t get the word.”
Over time, his aphasia improved. “The nurses took great interest in how I was doing, and were focused on making things better,” he says.
Two days after his stroke, Petit was discharged when he could stand without getting dizzy and eat and drink without difficulty. For the next few weeks, he sometimes struggled to recall words. “But that hasn’t happened since the end of January,” he says.
When a person has a stroke, every minute matters. That’s why doctors who treat them have a saying: “Time is brain.”
The Stroke Team’s quick action, plus Petit’s general good health and a dose of luck, helped the Bethesda resident recover fully. More than a dozen people cared for Petit during his hospital stay, including physicians, nurses, therapists, radiologists and patient care technicians.
“We work as a team, and our outcomes are great because of that,” says Adil.
“Right now, I’m feeling perfect,” Petit said in mid-March. “I’m back to taking walks with my dogs, and I’ve resumed jogging. I was very, very lucky. My wife was there, I was near the hospital and the care at the hospital was great.”
Suburban Hospital’s Stroke Program, launched in 1999, has achieved Advanced Certification by The Joint Commission as a Primary Stroke Center, reflecting its commitment to providing safe, quality care.
In 2020, Suburban Hospital’s Stroke Program was designated an American Heart Association and American Stroke Association Get with The Guidelines – Stroke GOLD PLUS with Target Type 2 Diabetes Honor Roll Achievement Award Hospital.
And in 2021, the hospital was named Best of Bethesda for heart and stroke care by Bethesda Magazine readers.
