by Matt Batcheldor
Twenty years ago, then-Nashville Metro Councilman Adam Dread was behind the wheel of his Jeep Cherokee when he lost control, drove across all four lanes of Franklin Road and slammed into a stone wall and then a tree.
Dread, then 40 years old, had suffered a major stroke, the kind that kills a lot of people. He was rushed to Vanderbilt University Medical Center, where he credits the medical team with saving his life.
But Dread’s life wasn’t just saved that day — May 30, 2003. Shortly after recovering in Vanderbilt University Hospital for two days, Dread began receiving services from the Anticoagulation Clinic at Vanderbilt Heart and Vascular Institute (VHVI). He’s now been getting his blood tested every four to six weeks for two decades — easily more than 200 times — and he credits the clinic with keeping him alive.
The Anticoagulation Clinic is dedicated to ensuring patients are well educated about anticoagulant medications to keep them safe. In Dread’s case, that means regulating his dose of the blood thinner warfarin to keep him healthy and avoid another stroke.
Since the stroke, Dread was re-elected to the Metro Council for another term, graduated from the Nashville School of Law and has been a practicing attorney in Tennessee and then Massachusetts — and he’s never had another stroke.
“I’m just so thrilled with Vanderbilt taking care of me, and the service, and how nice all the staff are,” he said.
It was Vanderbilt University that brought Dread from Pittsburgh to Nashville, where he gained a degree and became a local celebrity. He spent seven years as a traveling stand-up comedian and three as a morning drive radio host on stations Thunder 94 and Lightning 100, then a stint as a feature producer for The Nashville Network, among other gigs. He was elected to the Nashville Council in 2002 with a flashy campaign and signs that said, “Dread This Election.”
Twenty years ago, Dread was just a year away from graduating law school, and he seemed to be on top of the world. He remembers having a headache the night before his accident and heading to the drug store for some aspirin. “I don’t usually get headaches, and it was in the back of my neck,” he said.
The next day, he remembers being at the post office in Green Hills “and I just started feeling really warm.” He went out to his Jeep and turned on the air conditioning for relief. He has no memory of what happened next.
“And the next thing you know, I’m four miles away, nowhere near my house, driving off a cliff on Franklin Road through a wall into a tree,” he said. “Ironically, thank God I was driving, because if I’d been in my bed asleep, I would’ve been dead.”
The next thing Dread says he remembers is being in the hospital and the Rev. Enoch Fuzz, longtime pastor of the Corinthian Baptist Church and a pillar of Nashville’s Black community, laying hands on him in prayer. A small army of media, politicos and concerned onlookers assembled outside.
Dread came out of his coma to learn that he carries a gene for lupus anticoagulant syndrome, a rare autoimmune disorder that causes blood clots. It can’t be cured, but it could be treated in Vanderbilt’s Anticoagulant Clinic, informally known as the Coumadin clinic, for the brand-name drug for warfarin.
At the time, the clinic was then just for patients with heart failure, not stroke. Dread became the clinic’s first stroke patient.
Vanderbilt’s Anticoagulation Clinic serves about 3,000 patients, primarily in a “virtual clinic” capacity that allows patients to have laboratory testing performed either at home or in their community.
After a patient has blood collected and Vanderbilt receives the results, an anticoagulant nurse dedicated to the patient will call to discuss how thick or thin their blood is, and if their dose of warfarin needs to be adjusted.
This virtual clinic cuts down on the number of clinic visits for patients, making it convenient. There are also three physical locations — Vanderbilt Health One Hundred Oaks, Murfreesboro and Franklin, Tennessee.
How often blood is drawn depends on the individual patient’s condition. Some may get their blood drawn every two weeks, others every two months. Dread has his blood drawn every six weeks at Vanderbilt Health One Hundred Oaks, and then gets a call from his anticoagulation nurse, Laura Devin, MSN, RN, to discuss results and warfarin dosing.
Like most other patients at the clinic, Dread will need to be seen indefinitely. That’s because the thickness of the blood in patients like Dread must be regulated very exactly with warfarin; if the blood is too thick, it can cause strokes, and if it’s too thin, it can cause dangerous bleeding.
Meanwhile, exercise and diet can greatly affect the consistency of the blood. Even something as simple as eating a lot of certain green vegetables, such as spinach or broccoli, can significantly change blood, Devin said.
Devin said anticoagulation nurses also do a lot of patient education — reminding patients to inform their nurse about any physical injuries, that something as simple as a fall could have serious consequences if they’re on blood thinners. Nurses are a phone call away if patients have questions.
Because patients tend to stay in the clinic for a lifetime, they form a close bond with their anticoagulation nurse. Dread has been working directly with Devin for the last five years.
“He’s friendly and approachable,” she said. “He takes his warfarin management very seriously as the majority of our patients do. And based upon what he’s been through, he has a strong working knowledge of why he’s on the medication and what he needs to do to keep himself healthy, so he’s proactive in his health care. We have a good partnership.”
Devin stressed that caring for Dread is not just about her; it takes a whole team. She is one of about 20 registered nurses in the clinic who work with patients, in addition to a dedicated pharmacist and other team members who partner with patients’ physicians to optimize their medications.
“We rely on each other for feedback and input,” she said. “The team is very cohesive. We’re in a good working environment. We have fun with what we do.”
The clinic was honored in 2021 as an Anticoagulation Center of Excellence by the Anticoagulation Forum and is one of only three clinics in Tennessee that have the honor.
It sure has meant a lot to Dread.
“Vanderbilt keeps me alive,” he said. “Thank God for Vanderbilt.”