The Picture of Stroke Survival
An Iraq War veteran wins the most important battle of his life
At just 48 years old, Daniel (Dan) DelaPeña had already experienced more than his share of danger and close calls. As a Blackhawk helicopter machine gunner and mechanic for the U.S. Army, he was deployed to Kuwait and then Iraq during the Iraq War in 2003, transporting army personnel, cargo and troops while “trying not to get shot down.”
Dan did not know then that the biggest threat to his life wasn’t overseas, but lurking deep within his body’s vascular system.
A long 18 months later, Dan came home from training and duty in Iraq without a scratch and went on to more deployments: El Salvador in 2006 and The Republic of Kosovo in 2007. Back home in Gurnee, Dan returned to his job in ground support at the Waukegan Regional Airport. He also served in the National Guard one weekend a month providing flight crew training.
A Strong and Sudden Change
In June of 2010, he was at work when his keys suddenly dropped out of his hand. He found himself struggling to pick them up, feeling numb on his left side and deeply fatigued. He chalked it up to being on the airport’s third shift, and he kept on working. A concerned co-worker searched online and discovered that Dan’s behavior matched symptoms of a stroke. He urged Dan to go home, but Dan kept on working.
“My army training tells me to keep going,” he says. “And I did what a lot of stroke victims do: I didn’t treat it as an emergency.”
That evening, Dan’s wife Judi took him to Northwestern Lake Forest Hospital’s Grayslake Emergency Center. The physicians performed a computed tomography (CT) scan and gave Dan the news: a blockage in his neck’s carotid artery had caused a full stroke.
Strokes occur when a blockage in an artery prevents blood flow to the brain tissue or when a hemorrhage causes bleeding in the brain. Without the oxygen carried by the blood, brain cells begin to die within minutes. This is why strokes often lead to death or serious brain damage and paralysis. In fact, strokes are the number one cause of long-term disability in the United States.
Stroke Center Handles an Unusual Case
An ambulance brought Dan to Northwestern Lake Forest Hospital’s Wood-Prince Family Stroke Center at the hospital’s main campus in Lake Forest. Under a new Illinois law, an ambulance may travel to a certified stroke center like Northwestern Lake Forest’s stroke center, even if it is not the closest medical center. The legislation established a special set of requirements for the certification intended to save more stroke patients’ lives and lessen the need for long-term, institutional care. (See "Importance of a Certified Stroke Center" for more information.)
“He had an unusual case in that a tear in the lining of the artery created a blockage,” explains Dan’s physician Mark Eskandari, MD, a board-certified vascular surgeon with the Northwestern Medical Faculty Foundation, associate professor of medicine at Northwestern University Feinberg School of Medicine, and chief of the Division of Vascular Surgery at Northwestern Memorial.
“The Stroke Center was key to reducing the severity of Dan’s stroke because it enabled immediate determination of what type of stroke has occurred and prompt administration of the right treatment. In his case, we discovered it was best to start him on blood thinners rather than the more typical tPA (tissue plasminogen activator), a clot-dissolving drug.”
Dan stayed in the Northwestern Lake Forest Intensive Care Unit (ICU) before being released to continue therapy through the hospital’s comprehensive Stroke Support Services. Unlike many stroke patients whose lives are irreparably changed due to paralysis and brain damage, Dan left the ICU on his own two feet. But it would take some time before his fine motor control, speech and emotional state would be fully restored.
“The first thing I asked was, ‘will this affect my military flying?’ I wanted to fight my way out of this thing. I just had a stroke, but I still thought I was Superman.”
A Rough Road, with More Bad News
The road to full recovery would test Dan’s can-do attitude. He began exercising with his physical therapist in the hospital and feeling great. But then, things went wrong again.
“I felt as if my whole body died; everything just gave way. My left side went dead, and my speech nearly disappeared. I was confused, frustrated and trying not to get down on myself. “
“A few days after the initial stroke, and after he began therapy, the severity of weakness increased significantly,” explains Charu Nagar, MD, a Northwestern Lake Forest board-certified neurologist who treated Dan. “This can occur about three to five days after the stroke, signifying that swelling has set in. It’s part of the natural evolution of a stroke and not a true setback. Thanks to Laura Meller, our valuable stroke services coordinator, and the entire team, ultimately Dan experienced a full and smooth recovery.“
But this after effect meant that it was back to square one for Dan, and in December he received more difficult news: the airport he had worked at for 15 years had to let him go. His wife worked at the same company, and she was laid off as well. Meanwhile, the possibility of a medical discharge from the U.S. Army loomed over him.
But support from his family helped him maintain his positive attitude and push through. His wife and his mother, Eva DelaPeña, both helped him, and even sons Tim, 14, and Sammy, 11, tried to help while Dan worked on rebuilding his motor control by bouncing and catching a ball.
“They’ve been helpful—they’ve tried, anyway,” he recalls. “While I was doing the ball exercises my son tossed his hacky sack at me, and it hit me in the head because I couldn’t reach my arm up to catch. We had a good laugh over that.”
Coordinated, Compassionate Expertise
Dan also credits his medical team and the Stroke Support Services at Northwestern Lake Forest for helping him to recover and avoid long-term disability.
“My physicians, nurses and therapists were all fantastic—positive, encouraging, and knowledgeable,” he says. “They were always communicating with each other; when I mentioned something that I did with my therapist, Dr. Nagar would say, ‘yes, I heard about that.’ And, I could see Northwestern experts right here. There’s no way I would get that kind of care otherwise— my 75-year-old mother was driving me to appointments, and she couldn’t travel far.”
Based at Northwestern Memorial Hospital in Chicago, Dr. Eskandari also has office hours in Lake Forest for precisely that reason.
“The whole idea of spending time here is to provide expertise onsite. A highly skilled clinician administering treatment and monitoring the patient makes all the difference for a stroke patient’s successful recovery.”
A New Attitude
Some of the stroke support services available to Dan, like a clinical psychologist and support groups, were not required as part of his treatment—and at first he resisted.
“I was completely against going. I thought, ‘why should I go to a clinical psychologist—I’m not crazy. And why would I want to sit and talk about this with other people?’ It was already a humbling experience.”
But after his wife and his medical team convinced him, Dan found that these services not only boosted his recovery, they made him a source of encouragement for others.
“The Life After Stroke group helped me realize I wasn’t the only one and seeing stroke survivors in wheelchairs made me appreciate my own health and good fortune,” he says. “At one seminar I met a woman whose husband was struggling with his therapy. We talked for a long time, and I told her what kinds of things I did, and how I knew it was up to me to do this. I was used to training people on technical things, and here I was talking about neurological medicine—I never thought I’d be in that kind of role.”
Dan is having a follow-up ultrasound over the summer to check on the status of his arteries. To hear him talk, you would never know that he was once close to having his voice silenced forever. He is still looking for full-time work, but has fully regained his motor skills. And after refusing many of Dan’s earlier requests, Dr. Eskandari has finally said he can return to flying. Thanks to his family and the excellent care he received, he is the same soldier he was before the stroke—only stronger.