{"id":35096,"date":"2020-10-12T15:22:03","date_gmt":"2020-10-12T21:22:03","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=35096"},"modified":"2020-10-21T14:24:24","modified_gmt":"2020-10-21T20:24:24","slug":"recovering-from-a-stroke-provides-new-and-surprising-perspective","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/recovering-from-a-stroke-provides-new-and-surprising-perspective\/","title":{"rendered":"Stroke gives 40-year-old father a new, surprising, perspective"},"content":{"rendered":"
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Edgar Fuentes has had a tough stroke recovery but he hasn’t stopped living, it just looks different. And it’s provided him with a much different perspective on life. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

At the tender age of 15, Edgar Fuentes immigrated with his family from Mexico to the United States. He learned a new language, immersed himself in the American way of life and at the age of 19, moved to Fort Collins in 1999.<\/p>\n

\"Edgar,
Jessi Fuentes, right, struggled to watch her husband recovering from his stroke but she also knew his strength would help him persevere. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

When terrorists attacked the United States on Sept. 11, 2001, Fuentes went to an Army recruiting station that day and joined the military. His wife was seven months pregnant at the time with their daughter. He served three tours in Iraq, missing out on a lot of time with his family, including the birth of their second child.<\/p>\n

Eight years in the Army changed him, and when he returned for good to his wife and children in Fort Collins, he carried the burdens of war. He fought depression and memories of combat. A decade later, he\u2019d again face an enemy that would try to take his life. With help from a squadron of family members and caregivers from UCHealth, he would again narrowly escape death.<\/p>\n

A lifelong weightlifter who stands 6-foot-2, Edgar is an imposing figure. He\u2019s a man\u2019s man, a warrior who values family above all. For 20 years, he slept alongside his wife, but on that Halloween morning 2019, his wife, Jessi, became alarmed when she felt his absence.<\/p>\n

Her husband had a bad spell of nausea and had staggered out of the bedroom. Edgar usually didn\u2019t get up before his wife and three kids, so Jessi went to check on him.<\/p>\n

\u201cHe wasn\u2019t feeling good and was wondering when urgent care opened,\u201d Jessi said. \u00a0\u201cI was more annoyed than anything that this was going to distract us from the day.\u201d<\/p>\n

Edgar laid back down.<\/p>\n

\"Jessi
Jessi, right, was relieved to know that her husband of 20 years didn’t lose his sense of humor after his stroke. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

\u201cThe next thing I know, he was throwing up uncontrollably by the bed not even able to get to the bathroom,\u201d Jessi said. \u201cThe next thing I know Edgar was talking to our son, telling him he hoped he\u2019d been a good dad. I was like, ‘Why is he talking about this now? We are going to the ER.’\u201d<\/p>\n

Jessi knew they need to get to UCHealth Poudre Valley Hospital. Edgar knew too. He thought he was telling Jessi how he was feeling but nothing was coming out.

Know the signs and symptoms of a stroke. Watch this video<\/a>.<\/div>\n

\u201cIt was the first time I could hear his speech slurring, and he couldn\u2019t keep his balance. Everything was little off,\u201d she said. Jessi called 911.<\/p>\n

Recognizing a stroke<\/strong><\/h3>\n

At the hospital, an MRI showed vertebral artery dissection<\/a> (VAD), a tear of the inner lining of the vertebral artery, which is located in the back of the neck and supplies blood to the brain. After a tear, blood enters the arterial wall and forms a blood clot, impeding blood flow.<\/p>\n

Edgar went to the ICU, where he was monitored while more tests were done. \u00a0About 2% of all ischemic strokes are caused by VAD, though it is increasingly becoming a leading cause of ischemic stroke in young and otherwise healthy patients, as was the case for Edgar.<\/p>\n

\"Edgar
Edgar with two of his children a few months after his stroke. Photo courtesy of Jessi Fuentes.<\/figcaption><\/figure>\n

Too young and too healthy for a stroke<\/strong><\/h3>\n

After his years in the military, the family moved from a military base in Colorado Springs to Fort Collins. They had their third baby and Jessi got a job with Colorado State University and her husband worked as a tech in the surgical unit at PVH before he began delivering orthopedic and neurosurgery supplies for DePuy, a Johnson & Johnson Co.<\/p>\n

With a growing family, going to the gym and working out became a favorite activity for Edgar and Jessi.<\/p>\n

\u201cWe date at the gym,\u201d Jessi said. \u201cWe really love going together, and it helped Edgar with his depression. It was a way to reset his mind.\u201d<\/p>\n

The spontaneous nature of a vertebral dissection<\/strong><\/h3>\n

The same place that gave him peace and kept him happy, though, may have contributed to his stroke.<\/p>\n

\u201cA lot of these (vertebral dissections) happen spontaneously,\u201d said Dr. Sean Pauzauskie<\/a>, a neurologist at UCHealth who helped treat him. \u201cThe only thing in Edgar\u2019s history is that he worked out in the gym a lot.\u201d<\/p>\n

\"Edgar
The gym has always been an escape for Edgar and where he and his wife, Jessi, would “date” before he had his stroke and the coronavirus pandemic shut everything down. He’s glad to be able to be back in the gym recovering from his stroke. Photo courtesy of Jessi Fuentes.<\/figcaption><\/figure>\n

A majority of vertebral dissections are caused by trauma, but there is evidence<\/a> that they can be caused by hyperextension or rotation of the neck during events such as yoga, chiropractic manipulation, or even painting a ceiling when neck movement, most often sudden, causes an injury to the neck\u2019s artery.<\/p>\n

\u201cArteries in the neck are vulnerable to tear,\u201d Pauzauskie said. \u201cIt appeared that one in (Edgar\u2019s) neck had developed a tear and a clot, and part of that clot traveled up into the back part of the brain area that\u2019s important for maintaining consciousness, which is why we needed to do whatever we could to get that clot out of the area.\u201d<\/p>\n

Treating a vertebral dissection<\/strong><\/h3>\n
\"edgar
Stroke survivor Edgar Fuentes at the gym. Photo courtesy of Jessi Fuentes.<\/figcaption><\/figure>\n

Pauzauskie cared for Edgar, who had been intubated and sedated, after he arrived at the hospital on that Halloween morning. Scans showed that his basilar artery in the back part of the brain was blocked. Pauzauskie started him on Heparin, a heavy blood thinner that could help shrink the clot.<\/p>\n

\u201cThe basilar travels up the brain stem and is part of the nervous system that keeps us awake,\u201d Pauzauskie said. \u201cSo a stroke in that area makes the person appear sleepy and they struggle to maintain consciousness. It\u2019s very debilitating \u2014 there are a lot of important things going on there.<\/p>\n

\u201cIt could have been fatal honestly,\u201d he said. \u201cIt could have stroked that entire brainstem and he would have not woken up from that. He would have been able to breathe but not be able to wake.\u201d<\/p>\n

If the clot didn\u2019t shrink, Pauzauskie knew, Edgar may need a thrombectomy, a well-established and highly effective treatment<\/a> for acute ischemic strokes. He called his colleagues at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus.<\/p>\n

\"Edgar
With help from physical and occupational therapists, Edgar can walk again after his stroke and attended his daughter’s high school graduation this past summer. Photo courtesy of Jessi Fuentes.<\/figcaption><\/figure>\n

\u201cOur system is great,\u201d Pauzauskie said of UCHealth. \u201cIt\u2019s all streamlined with stroke coordinators and directors, and a developed process where we have a chain of communication that begins with the identifying providers and neurology service, then DocLine getting us connected with the stroke and vascular neurologists at Anschutz.<\/p>\n

\u201cWhen there is enough possibility that this procedure could help the patient \u2014 typically when there is still salvageable tissue but the patient is clinically deteriorating, which was the case with Edgar, then we are greenlighted for transport. It\u2019s very seamless and efficient.\u201d<\/p>\n

Stroke care at Anschutz Medical Campus<\/strong><\/h3>\n

Edgar was flown to Anschutz. When he got there, the clot had dissipated and a thrombectomy wasn\u2019t necessary. Doctors continued to watch for swelling in his brain, and Jessi educated herself on her husband\u2019s new condition.<\/p>\n

\u201cI spent a lot of time learning from all the doctors there,\u201d she said.<\/p>\n

Sedated, Fuentes still managed to write a few words \u2014 a smirk comment toward Jessi after she insensitively enjoyed her morning coffee in front of her intubated husband.<\/p>\n

\u201cI still knew his sense of humor was still there,\u201d Jessi said, describing it as a bit ornery yet playful humor. \u201cHe was able to give signs that he was still there. I didn\u2019t know what was going to happen, where we were going to go from there, but I knew he was still him.\u201d<\/p>\n

\"Edgar
During a recent camping trip to Horsetooth Reservoir, Edgar jokes to his wife, Jessi, about his “ball and chain.” It’s his humor that she’s always loved about her husband and had worried he’d lose when the stroke occurred last year. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Stroke rehabilitation program at PVH<\/strong><\/h3>\n

Four days later, doctors began talking with Jessi about the next steps.<\/p>\n

\u201cPVH had just opened its rehab,\u201d Jessi said. \u201cWe have three kids, if we can go back to Fort Collins, that\u2019s by far the best for us \u2014 it was a complete blessing for us.\u201d<\/p>\n

Back at PVH, Edgar began inpatient physical, occupational and speech therapy.<\/p>\n