When stroke strikes young

UF freshman suffers stroke while driving, leading her to UF's Stroke Program team.

By Shayna Brouker

Nov. 17 had been as normal as any other day for 18-year-old University of Florida freshman Barbie Diaz. After spending the day at the Oaks Mall with her dad, the Gainesville native dropped him off at their house at 7 p.m. and drove toward her dorm on campus.

But just 15 minutes later, her left side suddenly went numb. She scratched her face with her left hand, which felt like it was asleep — she thought it was a spider.

She felt hot and rolled the window down. Her Jeep bumped against the median until she hit a car turning onto 34th Street from Archer Road. Bystanders at the scene helped her up as she fell out of the car, but told her to “sober up” because the police were coming, thinking she was drunk.

Diaz could not move her left arm or left leg, and her left face was drooping. But recalling her pre-medical program classes during high school, Diaz knew exactly what was wrong.

Despite her youth, active lifestyle and healthy diet, she was suffering a stroke. Having worked as a respiratory care assistant at Shands at UF, she also knew to tell the EMS personnel to put her on stroke precaution and treat her accordingly. Paramedics issued a stroke alert en route to Shands where the acute stroke team was awaiting her arrival.

From there, she was in the care of the Stroke Program team at Shands, thankfully just a few minutes down the road.

“Everything good that could have happened, happened,” Diaz said. “All the right doctors were there, like Dr. (Michael) Waters, and I couldn’t have been any luckier. They were the best team I’ve ever seen.”

Waters, a vascular neurologist and director of the Stroke Program, and Brian Hoh, MD, a UF endovascular neurosurgeon, quickly diagnosed Diaz by performing a CT scan followed by an angiogram, threading a catheter up through her right groin to take pictures of her brain using a contrast dye. What they found was a blood clot that had completely shut down her right carotid artery and right middle cerebral artery. To gain access to the arteries inside Diaz’s brain, Hoh performed balloon angioplasty to mechanically open the right ICA. With access to the arteries, Hoh then used a new cutting-edge suction-like device called the Penumbra clot aspiration catheter to suction out the one-inch clot and restore blood flow to her brain.

Diaz was awake and very afraid during the procedure, but doctors calmed her as they worked to open up her artery. After they opened the artery, she began moving her left arm and left leg, which were paralyzed before the operation. By the end of the procedure, she had regained almost full strength on her left side.

The next thing she knew, she woke up in a hospital bed at 3 a.m., crying and feeling very cold — but not alone.

“I knew my dad would show up. I woke up and he was there,” Diaz said. “He’s been there every day since.”

She mustered the strength to walk out of the hospital on her own after just four days. With the help of her family, friends, Sigma Kappa sorority sisters and aunt and uncle, who are both physical therapists, she was able to walk again normally within two months.

But her journey was far from over. The question remained: Why did a teenage girl with a passion for dancing and eating healthy suffer a stroke?

At Waters’ urging, Diaz checked into Shands at UF for a week, so physicians within UF’s neurosciences could run tests to determine what caused the stroke. The result was surprising. Doctors diagnosed Diaz with a rare disease called Takayasu’s arteritis, which affects just two in 1 million people. It’s more common in people with Asian and Indian descent, but Diaz is Puerto Rican.

The disease causes arteries to become so inflamed they shut down and block blood flow, causing a stroke. Today, the balloon angioplasty and a daily regimen of six different medications keep the inflammation in check, and Diaz avoids foods that will limit their effectiveness.

She will have to continue close follow-up with Waters and Hoh to monitor treatment of her blood vessels. But until then, it’s business as usual: classes, gym, friends and family.

“Ms. Diaz is wise beyond her years, sanguine regarding her condition, reflective and aware of its seriousness, though refusing to allow it to own her,” Waters said. “As a patient she is a pleasure to treat. Receptive and informed, we are as lucky to have her as the converse.”

The stroke changed some aspects of her life, though, both negatively and positively.

“They say something dies in you after having a stroke,” she said. “Before, I lived my emotions, but now, I have trouble connecting my emotions and expressing them. I also used to stress about being two minutes late to class, but I’m more mellow now. I know I have to keep my stress in check.”

She also knows that it’s common for stroke patients to have another stroke within five years, but she’s not letting that hold her back from her dream of becoming a veterinarian. She switched her major from animal science to zoology and got a dog for Christmas, her first request after waking up from surgery.

“So be it if I have another stroke — I’m going to live my life. I want to finish my education. My outlook now is about enjoying the process and the memories,” she said. “For two months, all I had were memories, lying in bed thinking of what I hadn’t done yet. Now I’m catching up.”