Patient’s husband pushed to get to heart of what caused her stroke
What started for Laura Sammons and her family in 2017 as a routine weekend drive in the Houston area took a treacherous turn. As she approached an intersection with a stoplight, she blanked out and had no idea how to drive.
Not understanding what was happening, Sammons kept driving into the intersection despite the red light.
“Pull over! Pull over!” her husband, Nick, yelled as cars swerved around them.
Nick Sammons grabbed the steering wheel and managed to pull their minivan into a parking lot, where he asked his wife what was wrong. She struggled to explain how she felt, though she did say her arm was numb. Laura, a lawyer and Air Force veteran, protested when her husband suggested going to a hospital, but he insisted.
At the hospital emergency department, the MRI machine was malfunctioning. Because Sammons was young and healthy, doctors chalked up the episode to paralytic migraines, which came as a surprise because Sammons had never experienced one before. She and her husband weren’t satisfied with that explanation, so that week, Laura went to a cardiologist and back to the hospital neurologist for further testing.
She got devastating news: Not only had she had a stroke during that traffic episode, but she also had a hole in her heart due to a patent foramen ovale, or PFO, and she had a type of irregular heartbeat known as atrial fibrillation, or AFib. AFib can cause a blood clot that travels to the brain, resulting in a stroke. PFO, a hole between the right and left atria, can cause a stroke if blood flowing from one atrium to the other contains a clot that then goes to the brain.
“Of course, these two conditions were the perfect recipe for a stroke,” said Sammons, 42 at the time of her stroke. “So many things were not right.”
A year and a half before that stroke, Sammons had experienced a transient ischemic attack, or TIA,— also known as a “warning stroke.” She received emergency treatment but said she didn’t take the episode seriously. On top of that, both of her parents had AFib and had heart attacks, so Sammons wishes she would have been more diligent in monitoring her health.
After the 2017 stroke, Sammons — a mother of five, whose kids range in age from preteen to young adult — couldn’t remember what she’d read, even just one page in a book. When she spoke, words flowed out of order, and she would call objects the wrong word. Sammons jokes about how her friends would recognize her “Yoda speak” and help translate for others.
In addition to her own children, she was fostering a baby girl, and Sammons couldn’t lift her out of the crib because of lingering weakness. She tried to do limited legal work, but it mostly amounted to administrative tasks because she experienced difficulty with written language and a colleague had to review everything she did. While Sammons knew who her loved ones were, she lost a lot of her memories about the relationships and this, combined with changes in Sammons’ personality during her recovery, strained emotional connections.
“My initial response was: ‘Everything I am, I can’t be anymore. … So who does that make me?’” Sammons said. “I can’t be anything that I trained to be. I spent years training to be who I am. … It was a challenge.”
Sammons’ Houston-area cardiologist referred her to an electrophysiologist, who performed an ablation on her heart for the AFib. But the procedure made matters worse: Sammons’ heart went from beating about 70 times a minute before the procedure to about 140 times per minute after it. The doctor said the problem would probably fix itself, but months passed and it didn’t.
She decided to get a second opinion from Dr. Andrea Natale, an electrophysiologist at St. David’s HealthCare in Austin. That’s when her recovery really started to accelerate, she said. Sammons underwent another ablation, with Dr. Natale. But after discussing the pros and cons with Dr. Natale and Dr. Francisco Otero, an Austin cardiologist, she decided to hold off — at least for now — on getting surgery to repair her heart’s hole.
After about a year of recovery, Sammons said, she was fully functional – “it was if all the tumblers just fell back into place.” She got a new wardrobe and joined a new law firm.
Since the successful ablation, Sammons stopped taking blood thinners. She no longer needs any cardiovascular medications, and she maintains her cardiovascular fitness with regular exercise such as working out on a rowing machine, walking and biking.
Sammons gives a lot of credit to the collaboration among her physicians — Dr. Natale; Dr. Ortero; and Dr. John J. Volpi, a Houston-area neurologist she switched to after her initial care — for her successful recovery, and for guiding her on lifestyle choices that will prevent a future stroke.
“I think it was really important that they were all on the same page,” Sammons said. “My health care team continues to evaluate my condition together. They have allowed me to have a significant voice in my own care and keep doing the things I love.”
Sammons also is grateful to the doctors who initially recognized the stroke and what caused it.
“They all understood that women, first of all, can be stroke victims and victims of heart disease, and that we are an under-identified category of victims. And young people can also have these problems,” she said.
“When I wasn’t satisfied with the answers I had been given, they took my concerns seriously and put in the effort to identify the real problem and provide the treatment I needed.”