The numbness came on suddenly.
Kaitlin Holton was getting ready for dinner out on the eve of her 21st birthday when she lost feeling in her left extremity. She was putting on makeup, and it was almost like a stranger touching her face.
At first, she thought it was a pinched nerve, and after a few minutes, feeling came back. But then her face started to droop, and her speech slurred. She knew these were signs of a stroke, but she was in denial.
“Never in a million years did I think that was the case. I was too young for that,” she said.
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Holton had in fact suffered a stroke. A blood clot had formed in her heart and traveled to her brain, depriving a small part of her frontal lobe of oxygen.
After rushing to the emergency room, Holton received surgery and therapy, which helped mitigate the impact of her stroke and allowed her to suffer no lingering effects.
But the experience was traumatic, and she wants people of all ages — even those in their 20s — to understand that strokes can impact anyone.
“You can have a stroke at any age, and you should know the signs, not taking it lightly or blow it off,” she said.
Strokes, which occur when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts, are one of the most prevalent causes of death in Indiana. Nearly 3,000 Hoosiers died from strokes in 2015.
According to the U.S. Centers for Disease Control and Prevention, about 75 percent of stroke cases occur in adults ages 65 and older. But researchers concluded that in a nine-year span from 2003 to 2012 there was a 32 percent spike in strokes among 18- to 34-year-old women and a 15 percent increase for men in the same range.
The causes for strokes in young adults range from drug use, obesity and hypertension to congenital defects that lead blood clots to reach the brain. The cause of Holton’s stroke proved to be a tiny hole in her heart that had not closed as a fetus.
In normal child development, a small opening forms in the heart between the right and left upper chambers, said Dr. Abdelkader Almanfi, an interventional cardiologist for Fransican Physician Network’s Indiana Heart Physicians. Normally, that flap closes at birth.
But in roughly 25 percent of people, that hole never closes. The condition is called patent foramen ovale, and most people never know that they have it, Almanfi said.
“Luckily, a majority of those people will not have a problem. Most of them will be fine and never have an issue,” he said.
Holton had no idea she had a heart defect. The southside Indianapolis resident has always been healthy and never experienced any kind of heart problems or murmur, she said.
But on the night of Feb. 16, she started to see troubling symptoms. First the numbness in her left arm, then the inability to move part of her face. When she tried to call a friend, her words came out jumbled and slurred.
After 10 or 15 minutes, the symptoms went away. Holton cancelled her plans for the night and just went home.
“It all resolved, so I didn’t think much of it. I felt fine after that, but didn’t think I should do anything else. I even told the person I was with, ‘I think I just had a stroke,'” she said. “But when they asked if we needed to go the ER, I said I didn’t want to make a big deal about it. That was naive.”
The following day, Holton was at her mother’s house getting ready for a birthday party. She casually mentioned the odd symptoms she exhibited the night before.
Her mother, Kimberly Holton, looked at her with deadly seriousness. A former nurse with Franciscan Health, she knew that all of the signs pointed to a stroke, and they had no time to delay.
The family rushed to the emergency room. Kaitlin Holton still didn’t believe that she had anything wrong with her.
“I was in complete denial, even though I knew the symptoms, because I had relatives who had strokes. On your 21st birthday, the last thing you want to do is go to the ER. But I thought, in two or three hours I’d be done and then we could go to dinner or whatever,” she said. “I ended up not leaving for six days.”
Medical staff at Franciscan Health Indianapolis started tests and scans to determine what had caused the problem. MRI and CT scans revealed two minuscule areas on her frontal cortex where blood flow had been blocked.
She had suffered an ischemic stroke, meaning that a blood clot that had formed in her heart had traveled up to her brain and blocked blood flow to those two parts.
The medical team worked to try and discover the cause of the stroke.
“This is not the age population where this is a high prevalence of stroke happening. Normally, it happens in older people, people with risk factors like severe hypertension, diabetes, high cholesterol. This is a young, healthy woman,” Almanfi said.
One screening tool, known as a “bubble test,” featured aerated liquid injected into Holton’s veins. Doctors could track the tiny air bubbles through her heart using an ultrasound, and determine if any defects were present. The test, and then a follow-up scope of her heart, confirmed that she did have a hole in her heart.
To fix the problem, Almanfi recommended an non-invasive procedure known as transcatheterization. The medical team would insert a catheter into a vein near Holton’s groin and thread it to her heart.
Inside the catheter was a device known as a occluder. The small mesh piece resembles a pair of pinwheels, and once in place, it seals the leak in the heart, Almanfi said.
Over time, Holton’s heart tissue will grow over the mesh, naturally healing the defect.
“In the past, they said that only medication works to control this, by taking blood thinners,” Almanfi said. “Recently, there was a clinical trial that showed that if you close the holes, the patient will do much better than if they just take medication, in terms of preventing future stroke.”
Holton went through the surgery on Feb. 22. The procedure lasted about one hour, and the next day, she was released.
The stroke did not have any lasting impact on her mental or physical function. She did go through physical and speech therapy while in the hospital, but her abilities were impeccable. Her mother and grandmother, who Holton lives with, kept a watchful eye over her.
“They joked about baby monitors being used at one point, just because it is scary,” she said.
Following the surgery, Holton takes a low-end blood thinner to prevent future clots. But otherwise, she can live her life exactly as she did before her stroke. She resumed classes at the University of Indianapolis, where she is entering her senior year with the hopes of earning bachelor’s degrees in secondary education and history.
“They left it open to me when I wanted to go back. Missing a week of college isn’t ideal, and I missed two weeks. But the university was really great about working with me,” she said. “So my recovery was just rest, get back in a routine and lots of monitoring.”
Holton understands that she was lucky to have recovered so thoroughly from her stroke, particularly when she waited so long to get treatment after noticing the first symptoms.
She wants to use the experience to help others understand the risk that strokes pose to people of all ages. In addition, she wants people to be more aware of the defect that caused her stroke.
“The heart condition that I had is so common, I want people to understand the surgery that helped me and if they go through it, feel comfortable with it,” she said. “This surgery is a life changer, and you can go back to living a normal life.”
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Signs of a stroke
- Face drooping: One side of the face droops or is numb, and the person’s smile is uneven or lopsided.
- Arm weakness: One of the person’s arms seems weak or numb, and when the person raises their arms above their heads, one drifts downward.
- Speech difficulty: Speech is slurred or difficult to understand. When asked to repeat a simple sentence, they are unable to correctly repeat the words.
- Time to call 911: If someone shows any of these symptoms, even if the symptoms go away, call 911 and say that it’s a stroke to help get the person to the hospital immediately.
Stroke prevention
- Keep your blood pressure low
- Lower your cholesterol
- Eat healthy food
- Exercise regularly
- Treat sleep apnea
- Control blood sugar
- Drink in moderation
- Stop smoking
- Avoid stress
- Maintain a healthy weight
Source: American Stroke Association
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