World Stroke Day: Minutes Can Save Lives

Justin McKellar, 41, felt guilty for going to the pharmacy so late on June 20, 2022. Arriving at the Rexall on St. Paul Avenue just 15 minutes before they closed, he remembers trying to get out of there as quickly as possible so as not to delay the pharmacist too much.

This late visit probably saved his life. While waiting for his prescription, Justin was hit with a sudden, crippling headache. He tried to tell the pharmacist that he was going outside to sit in his truck, but the pharmacist wouldn’t let him leave. They immediately called 911, and the next thing Justin knew, he was on a stretcher heading to the Emergency Department at Brantford General Hospital.

When Justin was assessed in the Emergency Department (ED), the pharmacist’s suspicions were proven correct: Justin was experiencing a stroke. He was met in the ED by Dr. Somaiah Ahmed, and Physician Assistant Valerie Derbecker (physician assistants support all emergent stroke patients in the emergency department). They video conferenced in a neurologist from the Muskoka area. According to Dr. Ahmed, “this relationship with tele-stroke neurologists across the province allows us to quickly have CAT scan images of the brain reviewed by the neurologist in real time and support decisions around giving clot busting medications to patients or transferring them to Hamilton for a surgical procedure that removes a large clot.”

 While all of this was going on, Justin was losing function – movement on the left side of his body, his sight, his ability to speak. Justin was told he would need surgery. The ambulance ride to Hamilton General Hospital was bumpy, and the paramedics and ED nurse who accompanied him were comforting. They kept telling Justin to “be still,” which he thought was funny as he literally couldn’t move.

Then, Justin’s wife Allison was there, waking him up to say “We got it!” It had been 3 hours since his headache started in the pharmacy.

Justin’s memories of the entire night are hazy, so Allison fills things in.

When Justin was unusually late coming home from the pharmacy, she used location sharing to find out he was in the ED. She started frantically calling him, and because Justin couldn’t pick up the phone it was eventually answered by Dr. Ahmed, who told her to get to the hospital as quickly as possible.

Justin had arrived at the hospital alone and the intake team had no way of knowing anything about him, except for a medication list that the pharmacist had printed out. This was a life-saving measure as some of his existing medications would have had adverse reactions with the drugs used to treat stroke. When Allison got to Justin in the ED, just 10 minutes after the phone call, she found him with very little movement on his left side, a pronounced facial droop and eyes that were wildly darting back and forth without actually focusing on anything. Justin would later describe this feeling like he was drunk; he was aware of his surroundings but not quite present.

Dr. Ahmed immediately asked Allison if she could get her kids in to see Justin or talk to him on the phone.  

“They might never hear him say ‘I love you’ again,” she said, a phrase that has haunted Allison for months, both because it reinforced the severity of Justin’s situation, and because of the compassion it showed. Dr. Ahmed wanted to make sure that Justin’s children remembered his voice. Justin didn’t want their two daughters – 10 and 13 at the time – to see him like that, and Allison respected his wishes. Both say now they are glad that the children and Justin’s parents didn’t have the memory of seeing him so sick.

After the video call diagnosis, Justin was transferred to Hamilton General Hospital, where the doctor from Muskoka had arranged a team ready to perform surgery. A stroke is caused when blood supply is cut off to part of the brain; in Justin’s case, the result of a blood clot. The surgical team accessed the clot through Justin’s femoral artery, in his upper thigh. They removed the clot on the first try, and then came the waiting. Would Justin have any lasting deficiencies? Difficulties with speaking, mobility, sight, and memory are common after a stroke, and there’s no way to know if a patient will experience them ahead of time.

Justin was speaking and moving 20 minutes after his surgery. About half an hour after that, Allison was allowed in to see him, and his first words to her were, “Who won the hockey game?” He had a bet with their oldest daughter on the results of the Stanley Cup playoffs. This is when Allison knew that her husband would be just fine.

After Justin’s surgery, Allison made sure to call BGH and share the news with the care team here. She’s a nurse on the Labour & Delivery floor, and she knows that healthcare providers often don’t get the end of the story. She wanted to make sure that everyone knew that their quick action had saved a life that day.

Dr. Ahmed, having met them last week for the first time since that day, highlights that “the care Justin received on the day he came in and his recovery is because of the team’s success. So many people rally quickly around a potential stroke patient with the triage nurse, lab technician, and resuscitation nurse quickly getting intravenous access and labs and arranging an immediate CT of the brain with the radiology team. Simultaneously, the Physician Assistant and physician quickly do an assessment to ensure the right parameters are present to proceed. Knowing that Justin has had such an amazing recovery reminds me of my purpose as a physician, to help patients in their time of greatest need.”

Justin has made a remarkable recovery. He was an inpatient at Hamilton General Hospital for five days, and after his discharge he started outpatient therapy at Brantford General. His only lasting side effects are some minor muscle memory lapses and feeling more fatigue than he previously did.

“I’m suddenly a nap person,” he says. “It’s not so much physical exhaustion as mental.”

Justin started back to work the first week of October, working on a modified schedule as he rebuilds his stamina. He intends to gradually add more hours and days until he is back to full-time.

He and Allison are full of gratitude to the many members of the care team that looked after Justin – nurses and physicians, the radiology team, phlebotomists, paramedics, and more who treated them with professionalism and compassion. They’re grateful to the pharmacist who was so attentive to Justin’s initial symptoms, too, because Justin knows he was about to brush his headache off, because he’s tough - and that could’ve altered the course of his entire life.

“We’re lucky to live where we do, with central access to so many healthcare services,” says Justin. “If we lived in Northern Ontario, I don’t know that we would’ve gotten the level of care at the speed that we did. The regional partnership [between BCHS and Hamilton Health Sciences] is so important.”

Four months on, Justin has had plenty of time to reflect on his experiences. He is now more in tune with his body and more willing to complain when things don’t feel quite right. He is also making the most of every healthy day he has, and encouraging his family to do the same thing. Justin and Allison have been candid with their daughters and used this as an opportunity to teach them about strokes and what the signs are, and they say that it has made their daughters more sensitive and aware.

Justin’s ongoing goals for recovery are simple: have patience, and take it one day at a time. He knows how lucky he is, and isn’t going to waste that for anything.

When it comes to stroke, minutes can save lives. We applaud the team at BCHS and Rexall for recognizing the signs and reacting quickly. Stay alert for the key signs of stroke:

• Facial Drooping
• Arm weakness on one side
• Speech difficulties – slurring or not making sense

People may also experience changes in their vision and loss of balance/dizziness. Learn more from the World Stroke Organization.