After battling neck cancer, Shalini Chandra, M.D., an assistant professor of medicine and hospitalist at Johns Hopkins Bayview, thought she was
headed toward recovery.
Doctors had successfully removed the tumor located near her carotid artery. She began advising patients on how to move forward after a cancer diagnosis and was happily awaiting the arrival of her new baby boy.
But in April, while visiting a realtor friend’s open house, the 42-year-old internal medicine specialist suffered what she thought was a severe nose bleed. Emergency medical technicians took her to Johns Hopkins Bayview, where doctors discovered she had developed an aneurysm near her tumor site.
They treated her aneurysm, but soon after, Dr. Chandra developed a blood clot that traveled to her brain. This led to another setback: a stroke.
Luckily, Dr. Chandra was already at Johns Hopkins Bayview—one of only three Comprehensive Stroke Centers in Maryland. That means she had immediate access to advanced, life-saving stroke care.
Led by Elisabeth Marsh, M.D., associate professor of neurology, the Stroke Center embraces a multidisciplinary approach to care, with everyone from emergency medicine physicians, vascular neurosurgeons, interventional neuro-radiologists and neuro-intensivists and rehabilitation specialists working together to create comprehensive treatment plans.
Spotting the Signs
Moments after her stroke occurred, Dr. Chandra knew something was wrong.
“I couldn’t spell properly, and I noticed I had right-sided neglect,” she says. “My colleagues were pinching me on my right side, and I wasn’t responding.”
Doctors immediately began treating Dr. Chandra and moved her into the hospital’s Neuroscience Critical Care Unit. Quickly identifying the signs and location of the stroke are essential for patients to receive the best treatment, Dr. Marsh says.
“In the brain, it’s like real estate,” Dr. Marsh says. “It’s all about location. You can have a piece of a clot affecting a relatively large area of brain that doesn’t appear to cause problems. But you can have a small stroke in a critical area that leaves a patient devastated.”
At Johns Hopkins Bayview, stroke team members are experts in both acute treatment and recovery. They have access to the latest technology in stroke care, including new procedures like intra-arterial thrombectomy. With this minimally invasive procedure, doctors use a catheter (similar to when a patient is having a heart attack), but they bypass the heart to access and remove the clot from the brain.
Returning Home
Bayview’s Stroke Intervention Clinic (BaSIC) ensures patients receive continual care four to six weeks after they leave the hospital.
“The transition from rehabilitation back to work or home can be difficult,” Dr. Marsh says. “At the clinic, we help patients by making sure they are taking the correct medications, sharing research on the recovery process and guiding them so they can return to their prior level of function or find a new level of function.”
Dr. Chandra was “quite lucky,” Dr. Marsh says. Her stroke did not cause major damage. But she still has trouble multitasking, and her complex thinking is “one step” behind, Dr. Chandra says.
“If you look at me, you’ll think there’s nothing wrong,” she says. “Multitasking just takes me longer than it used to.”
Dr. Marsh expects most of Dr. Chandra’s higher level thinking will return within six months. To help move her recovery along, Dr. Chandra plays Sudoku or Scrabble at least once day, as well as challenging brain games online. She also enjoys spending any free time she has with her newborn son.
She credits Johns Hopkins Bayview and its quick-thinking staff for being where she is today.
“The level of experience that is available and accessible for stroke patients is bar none,” Dr. Chandra says. “I can’t say enough good things about my hospitalist team, the nursing staff, just everyone. I can’t thank them enough.”
Johns Hopkins Bayview recently received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award with Target: StrokeSM Honor Roll Elite. The award recognizes the Medical Center’s commitment to delivering advanced stroke treatments to patients quickly and safely.
Learn more about stroke care at hopkinsmedicine.org/jhbmc/strokecenter.