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As some people grow older, they occasionally notice little quirks about their bodies that weren’t there before. Whether it’s due to diet, stress or simply parenting children, we can’t always expect our bodies to fire on all cylinders. Such is life. However, it’s important for people to know the difference between temporary quirks and alarming symptoms — especially when the symptoms signal a life-threatening event that’s usually reserved for people twice their age.
While Doug Larsen, 32, hung out with his boys and sipped coffee at a shop in Red Wing last year, he slowly but surely began experiencing double vision, which he knew wasn’t a good sign based on his work as a physician assistant at Mayo Clinic Health System in Red Wing.
"After an hour, I realized I couldn’t text anymore,” says Larsen. “I was trying, but I couldn’t form the words. It was strange to see the letters coming out wrong — I work in the Emergency Department, so it became clear what was happening. I was having a stroke.”
Not the typical stroke patient
Larsen’s symptoms continued to progress. Fortunately, his wife was in a meeting two blocks away. After receiving Larsen’s texts, she ran over to the coffee shop and called an ambulance. By the time he arrived at Mayo Clinic Health System in Red Wing, he couldn’t speak or move the right side of his body. “My one-year-old and I were at the same level of speaking,” he says.
Although strokes are perceived as problems for older folks, several conditions can cause them. “I don’t look like the kind of person who would have a stroke,” Larsen says. “I’m in fairly decent health and shape."
Providers in Red Wing initiated a telestroke session, in which stroke experts at Mayo Clinic Hospital — Rochester examine patients remotely using a computer interface that allows them to see and speak with patients.
"I wanted to answer their questions, but I couldn’t at that point. Then I lost consciousness,” Larsen says.
According to Larsen, there is a highly standardized, evidence-based process to treat stroke patients across all Mayo Clinic Health System sites. Patients will always first receive a CT scan to determine if the stroke is hemorrhagic or not, followed by initiation of the telestroke service. Next, providers give the patient a set of questions that place the severity of the stroke on a scale of 0 to 42 (with 0 being nothing and 42 being the most severe) followed by an electrocardiogram (EKG) and lab tests, which are standardized across Mayo Clinic Health System and Mayo Clinic Hospital — Rochester, St. Marys Campus. The patient then typically receives a tissue plasminogen activator (tPA) — also known as a “clot-busting” medication — and is transported to Mayo Clinic Rochester – Saint Marys Hospital for ongoing care.
The specialist who remotely diagnosed Larsen recommended a helicopter flight to Mayo Clinic Hospital – Rochester, Saint Marys Campus for emergency treatment.
After a CT scan and EKG, Larsen was given tPA in Red Wing, and the treatment continued throughout the helicopter flight. According to Larsen, brain bleeding is a known side effect of tPA, so providers recommended helicopter transport to expedite arrival in Rochester in case that happened.
"I don’t remember the helicopter ride to Rochester, but I woke up in the CT scan room [after an additional scan there],” says Larsen. He says that within 30 to 40 minutes of the onset of his symptoms, he regained full movement of his body and could speak again, albeit slowly."
A paradoxical stroke
After overnight observation, Larsen learned that he had experienced a paradoxical stroke, which was caused by a blood clot slipping through a hole in his heart and entering his brain. The hole was news to him. “I had no idea that there was a hole in my heart before the stroke hit,” he says. “I hadn’t had any symptoms before that."
Larsen’s treatment required surgery, during which Mayo Clinic surgeons installed a permanent device into his heart. “[Surgeons] inserted a groin catheter to place the device, which is like two umbrellas side by side that clamp down on the hole,” he says. “It’s brilliant in its simplicity."
It took about a week for Larsen to regain semi-normal speech patterns, but he says to this day he has to concentrate on voice inflection and cadence, especially when he’s tired. He is doing well but has to take baby aspirin daily.
"I've had procedures and medications now that are typical of my 65-year-old patients,” he says.
Quick response, expertise the difference
Between Larsen’s vocational knowledge of stroke symptoms and extraordinarily quick response times from the ambulance, providers at Mayo Clinic Health System in Red Wing and specialists at Mayo Clinic, he was diagnosed and treated superbly, which he knows could have saved his life.
"I knew that if I wasn’t treated quickly but survived, there were so many things I wouldn’t be able to do anymore. This could have been a devastating stroke."
Aside from regular medication, Larsen is back to his 32-year-old lifestyle, enjoying his family and appreciating every day. He says the best speech therapy he has had is reading Dr. Suess to his kids every night.
"I've found myself being more conscious of what I do with each hour of the day, not letting them slip by and not dwelling on negative things,” he says.
Although Larsen describes his day-to-day life as somewhat ordinary, since his stroke he has been able to fully embrace his extraordinary hobbies, such as mountain biking, rock climbing and rappelling around Red Wing, canyoneering through Zion National Park in Utah, and bow hunting for elk in the mountains of Colorado.
"I enjoy the ordinary things just as much,” he says. “Because there was a good chance I’d be unable to do those things if that day hadn’t gone exactly like it did.”