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Face of F.A.S.T.

Posted on November 9, 2016 in Patient Stories

When Kathy Jennings looked in the mirror, the face looking back at her reminded her of the woman on the strokeKathy Jennings posters inside the elevators at Fort Sanders Regional Medical Center.

It was a face that frightened her because, like the lady in the poster, Jennings’ face was drooping – evidence that she too was in the midst of a stroke.

She knew this not only because she’s a 52-year-old licensed practical nurse, but also because she and her husband saw the F.A.S.T. (Face, Arm, Speech, Time) poster detailing symptoms on their frequent trips to Fort Sanders Regional to visit a sick friend.

It was June 1, her first day of vacation and a day she would later describe as “the best day I ever had.” Her daughter had delivered her first grandchild the day before, and she planned a couple of weeks off to enjoy the occasion.

But as she relaxed on her back patio, sipping wine while watching her husband mow the lawn, Jennings felt her left arm tingle.

“I thought that it must be falling asleep. So I didn’t think much about it and reached over to take a drink of my wine and it fell out of my mouth,” she said. “I knew about numbness, tingling and facial drooping being signs of a medical condition, so I came in to take a baby aspirin which I later found out you shouldn’t do. But when I saw my face in the mirror, I could picture the lady’s face in the elevator at Fort Sanders. I knew I needed to call 911 but I couldn’t – it just wasn’t working. So I went back outside, and my husband called 911.”

With her face, arms and speech affected, the only letter remaining in the F.A.S.T. checklist was “time” – how quickly one responds. That’s because time is critical when a stroke hits. While there is a four-hour window in which doctors can administer the life-saving, clot-busting drug tPA (tissue Plasmogenic Activator), brain cells are dying every second the brain is deprived of oxygen-rich blood. The result can mean permanent disability or even death.

Within 15 minutes of her attack, Jennings was in an ambulance on the way to Fort Sanders’ Comprehensive Stroke Center, a facility recognized by the Joint Commission, American Heart Association and the American Stroke Association as an industry leader in highly-specialized stroke care.

“Luckily I had enough brains left to say, ‘Take me to Fort Sanders,’” said Jennings, adding that her symptoms were mysteriously coming and going. “Certain hospitals have certain specialties and I just felt that Fort Sanders is where I needed to go. They took good care of me and I’m here because of it. They saved my life.”

Looking over her CT scan, Fort Sanders neurohospitalist Arthur Moore, MD says Jennings was “very lucky,” and surviving the ordeal without any lasting effects is nothing short of “amazing.”

That’s because Jennings’ stroke was classified as a “right-sided MCA ischemic stroke,” meaning the clot was blocking the middle cerebral artery to the brain. The MCA is by far the largest cerebral artery and is the vessel most commonly affected by strokes. Likewise, removing MCA clots via embolectomy has become almost routine at Fort Sanders Regional.

“We do that all the time,” said Dr. Moore, adding that FSRMC began performing middle coronary embolectomies more than a decade ago. “We did roughly 140 of them last year,” he said. “By far, we are the highest-volume stroke center around.”

While Dr. Moore has vast experience with this type of procedure, Jennings’ case was not routine.

“Hers was something we call an M3 distribution,” said Dr. Moore. “Imagine the MCA as a big artery that we can typically pull a clot out of. Like a tree, the blood vessels start to branch out, getting smaller with each branch. Kathy’s clot was located in an M3 level vessel making it too small for us to get because we do not have tools small enough to reach it.”

There was, however, good news – her blockage was only partial, which explained why her symptoms mysteriously came and went while waiting for the ambulance, again while riding in the ambulance, and once again in the CT room at Fort Sanders.

Once it was clear that the location of her clot wouldn’t permit removal by embolectomy, she was immediately given the clot-busting medicine. Within minutes, Jennings was her old self again.

Although Jennings felt fine and had no weaknesses, she would remain hospitalized for two more days. “It’s not just about treating somebody’s stroke – it’s about finding out why they had the stroke and what we can do to prevent the next one. That takes some time,” said Dr. Moore.

Testing during those two days revealed that Jennings, like 20 percent of the population, had a patent foramen ovale (PFO) or a congenital “hole” in the atrial septum of her heart. While a clot can potentially pass through that hole and into the middle cerebral artery, what caused Jennings’ stroke remains unknown. She did, however, have two risk factors – smoking and hypertension.

“You think you’re healthy, and then, all of a sudden, BAM!” said Jennings. “The Fort Sanders ED and the stroke team and the people in ICU were just phenomenal! They really were. They were wonderful! I’m thankful I was a nurse and knew enough to go because when it started and then eased off, I might have blown it off and it wouldn’t have been good. The posters work. When my husband saw my face, he said, ‘You looked just like that lady in the elevator.’ He knew enough to call 911 because of that. So, it worked for me.”

For more information about stroke services offered at Fort Sanders Regional Medical Center, visit