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Too young for a stroke? Not if you have risk factors

Blake Gordon of Santa Fe is back running her psychotherapy practice after UNMH surgeons performed a procedure to retrieve the clot that was starving her brain of oxygen-rich blood. (Courtesy of UNMH)

At age 40, it would never have occurred to Blake Gordon that she might be having a stroke. But her mother, Claudia Standish knew better – and dialed 911.

“I had difficulty speaking,” Gordon recalls. “The words that were coming out did not make sense and definitely were not what I was thinking I was saying, so I could hear that. I also had weakness on the left side. I was trying to sit on a chair and I kind of slumped down. There was also a little bit of facial drooping.”

Doctors in the emergency room at Santa Fe’s Christus St. Vincent Regional Medical Center consulted with a neurologist in Denver, who advised them to send her to UNM Hospital for a procedure to retrieve the clot that was starving her brain of oxygen-rich blood.

It was Tuesday, January 22, and a snowstorm prevented helicopters from flying, so Gordon was taken to Albuquerque by ambulance. Within a few hours, a UNMH neurosurgeon had successfully performed a thrombectomy and Gordon was sent to intensive care to recover.

Six months later, Gordon is back running her psychotherapy practice, having completed months of physical and occupational therapy to fully regain her mobility.

“Having had this traumatic experience, I have a better understanding of what my clients who have experienced trauma – any kind of trauma – have gone through,” she says. “And I think that that provides more empathy and patience.”

Meanwhile, Gordon is still puzzling over how someone without the usual risk factors could have had a stroke.

“There is consensus that oral contraceptives definitely played a factor,” she says. “I was on it for 22 years.” Long-term oral contraceptive use can cause blood clots, and a powerful antibiotic Gordon had been taking to fight off pneumonia is known to weaken blood vessel linings.

“One hypothesis is that this combination of medications created a vulnerability in the artery, which in combination with pretty significant coughing created a lesion,” she says. “And instead of the blood going and patching it up, a clot formed … and then a piece broke off and went into the brain.”

The other possibility is that, like many people, Gordon has a small hole between the upper two chambers of the heart that could have allowed a clot to pass from her veins into the arterial system – and on into the brain.

“Outside of those factors, I’m not sure how else to understand it, because I did not actually have any of the risk factors,” she says. “I’m not a smoker. I don’t have high blood pressure. It doesn’t run in my family.”

Gordon was just getting over her flu-related pneumonia and her husband was out of town on the evening of Jan. 21. “I started feeling very strange – I didn’t feel like myself,” she says. “I couldn’t put a finger on exactly what I was experiencing, but I just knew I wasn’t feeling right.”

She called her mother and asked her to spend the night. The stroke symptoms came on the next morning as they were cleaning up after breakfast.

When she got to UNMH, she was met at the door by the stroke team. “I just remember being quite frightened at that moment in time,” she says, “but they were very generous with their patience and their support, and encouraging me and saying, ‘You’re going to be OK.’ ”

All told, Gordon spent about two weeks at UNMH and at a Santa Fe inpatient rehabilitation hospital before returning home for outpatient therapy. On her first follow-up visit to UNMH, she paid a visit to the Neurological ICU, where she had been treated.

“It was important to thank those people,” she says. “My entire experience was completely positive – from the night nurses, to the physical therapist, to the doctors to the surgeon – every level of care that I received was superior.”

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