Carly Schroeder with her husband Allan and their children William, 6, and Georgie, 6 months. Photo by Joe Howell
It was a hot August afternoon in 2009 when 29-year-old Carly Schroeder left a coffee shop on Hillsboro Road and noticed that her left arm was tingling.
“I was thinking, ‘This is so weird. What is happening?’,” Schroeder remembered. Her arm went from tingling to numb and then she noticed it wouldn’t bend. She thought it was falling asleep.
Schroeder, now 39, pulled her Volvo SUV out of the parking lot.
“My car was moving forward, and my brain was thinking, ’Hit the brakes!’” Schroeder said. “I could not make my arm turn or my foot hit the brake. My whole brain and body were failing me. My brain was trying to tell my body what to do but nothing was working.”
In the emergency room, it became apparent that something serious was occurring when she couldn’t wiggle her toes. “I kept looking at everyone saying, ‘I’m wiggling them,” she said. “My husband, Allan, said, ‘Babe, no, they aren’t moving.’ I knew I was in trouble.”
As Schroeder watched powerlessly from her immobile body, her car drifted into the path of oncoming traffic. She was unable to brace herself as her car slammed head on into another car. Her airbags deployed. The coffee that she had purchased minutes before when everything seemed normal splashed on her legs.
Then she remembers noise. Sirens approaching, loud frantic voices; lots of movement all around. Schroeder was wedged in the car, confused and immobile, but, amazingly, not seriously injured.
The driver of the other vehicle was not injured either — it was a very low-impact collision — but told police Schroeder had been driving erratically.
“I wanted to scream, ‘I’m not driving erratically. Help me!’,” Schroeder said. “I was helpless.”
Schroeder’s speech was slurred as she tried to tell paramedics her husband’s phone number.
“It hit me so hard when I realized that doctors thought I could’ve died. I was bawling thinking of my mother, brothers, family, my friends and my life. Since then, I have really tried to be optimistic, present and live a life full of gratitude.”
In the emergency room, it became apparent that something serious was occurring when she couldn’t wiggle her toes.
“I kept looking at everyone saying, ‘I’m wiggling them,” she said. “My husband, Allan, said, ‘Babe, no, they aren’t moving.’ I knew I was in trouble.”
Schroeder received tissue plasminogen activator (tPA), a “clot buster” drug that can cause a clot to break up and improve the outcome after a stroke, said Howard Kirshner, MD, professor of Neurology, one of Schroeder’s physicians.
After that treatment in the emergency department, Schroeder had interventional stroke treatment by a neurosurgeon. She had blockages in an internal carotid artery and middle cerebral artery but responded well to the surgery.
“Ms. Schroeder did exceptionally well,” Kirshner said. “She underwent three stents in the internal carotid artery and a clot removal, via suctioning, in the middle cerebral artery in the brain.”
Missed Signals
The crisis in the coffee shop did not come out of nowhere; there had been warning signs. Fourteen days before her stroke, Schroeder was wakeboarding on a lake with her husband and some friends. While wakeboarding, Schroeder had fallen and crashed head and neck first into the water.
“I swam back to the boat and I had the worst headache of my life,” she said. “An hour or two later, I was crying hysterically because my head was hurting so bad.”
Schroeder went to a local hospital and was diagnosed with a concussion, and for days afterward she still had symptoms, including her pupils fluctuating in size. Because she had had migraines for years, she tried to ignore how she was feeling.
“At the time [2009], this type of recovery from a stroke involving the carotid and middle cerebral artery with complete [blockage] of the arteries was indeed miraculous,” her doctor said. “It absolutely seemed like a miracle.”
“I went to work. I decided to grin and bear it and somehow get through life. I was 29 years old. I was a normal healthy person,” she said. “I did on occasion smoke socially, but I stayed very active and was energetic.”
What was going on in her body, though, was dangerous and potentially deadly: a cutoff in the right middle cerebral artery in her brain and a complete carotid dissection in her neck.
“A carotid dissection is a tear in the lining of the artery, which allows blood to enter a false channel within the wall of the artery and can lead to total blocking of the artery,” Kirshner said.
Carotid dissection does not show up on a CT or MRI. The only way to detect this type of injury is specialized vascular imaging.
Recovery
Bob Singer, MD, at that time a VUMC neurologist, performed surgery on Schroeder to insert three stints to open her blocked arteries.
There was no guarantee this would work. She could have been completely paralyzed, or suffered other neurological deficits — sensory loss, visual field loss, or cognitive impairment.
However, after surgery she was able to speak, and later moved her left arm, left leg and her left eye (since the stroke had occurred on the right side of her brain, the left part of her body was affected).
“At the time [2009], this type of recovery from a stroke involving the carotid and middle cerebral artery with complete [blockage] of the arteries was indeed miraculous,” Kirshner said. “It absolutely seemed like a miracle. She has some minor motor impairment but leads a normal life.”
After four days in the hospital, Schroeder was transferred to Stallworth Rehabilitation Hospital.
“The recovery was the hardest,” she said. “I couldn’t tie my shoes any more. I couldn’t stand up in the shower. It was like I was more tired than I’ve ever been in my entire life. The exhaustion after a brain injury was so hard. I took a nap three times a day. It was like being a toddler and regressing.”
She underwent months of physical therapy. With support from her husband, mother, family and her friends, she continued to work through therapy and eventually returned to her job.
“I’m a doer, so for me to be stuck for that long was really hard,” she said.
Despite the hardships during her healing, Schroeder felt immense gratitude knowing that she’d survived.
“It hit me so hard when I realized that doctors thought I could’ve died. I was bawling thinking of my mother, brothers, family, my friends and my life,” she said. “Since then, I have really tried to be optimistic, present and live a life full of gratitude. I’m eternally grateful to all the people that helped me through that dark time — my previous employer, friends and family, doctors and therapists.”
The only remaining physical reminder of her stroke is unusual movements, called hemidystonia, in her left hand and foot. But it took a while for her to feel normal. The risk of having a blood clot or another stroke stayed in her mind for some time.
Kirshner had some advice for her that helped.
“Dr. Kirshner said, ‘You have to live your life. You can’t let this stroke dictate the rest of your life. You have to keep living.’ I took that to heart and remind myself on a monthly basis.”
Living Life
Carly and Allan will celebrate 15 years of marriage this year and since that traumatic injury have had two children. She is now a stay-at-home mom to 6-year-old boy and 6-month-old girl, enjoying life to the fullest.
“I really can’t say enough how I try to have gratitude and grace,” she said. “I tell my husband twice a week how grateful I am to stay home with our daughter and be in the carpool at 3 p.m. picking up my son.”
She still thinks about the day that her life changed.
“It’s in the forefront of my mind,” she said. “Life is so precious, and you never know what could happen.”
To learn more about stroke, go to https://www.stroke.org/understand-stroke/recognizing-stroke/act-fast/
