Barbara's Story: A Stroke Patient's Family is Faced with Difficult Decisions at a Critical Time
After Barbara Collard suffered a massive stroke, she missed the window of opportunity to benefit from clot-dissolving drugs. When she arrived by helicopter at Massachusetts General Hospital, her family had to make decisions quickly.
July 29, 2008 started as a normal day at work for Barbara Collard, a mother of five and grandmother of nine from New Bedford, MA. However, that morning a co-worker recognized signs of a stroke, and EMTs rushed her to a local hospital. From there, she was immediately airlifted to the largest stroke center in the state, Mass General.
When Barbara arrived in the emergency room at Mass General, a CT angiogram (CTA) showed a life-threatening blood clot at the base of her brainstem. The clot needed to be removed immediately or risk becoming fatal. Despite arriving by helicopter, Barbara could no longer benefit from tPA, a clot-dissolving drug, because too much time had elapsed.
The acute stroke team and interventional radiologist James D. Rabinov, MD met with Barbara's family to explain her medical situation. They discussed the possibility of an intra-arterial thrombolysis procedure that uses an image-guided catheter to open an artery and restore blood flow to her brainstem.
I see people of all capabilities in my stroke support group, and it makes me so much more grateful for what Mass General has done for me.
"When Dr. Rabinov met with us, he laid the cards right out on the table and told us there was a good chance she would be incapacitated or might not make it," recalls her husband Richard. "He explained the treatment options, and we made a choice as a family."
According to Dr. Rabinov, the area of Barbara's brain that controls motor function and awareness was severely compromised. "Barbara had experienced one of the most severe strokes that we encounter in our practice. The damage was extensive, and we had to move quickly but the situation was not hopeless," he said.
When Barbara woke up in intensive care, she was not able to walk or talk. During surgery, blood flow had been restored to her injured brain tissue, but she was facing months of slow rehabilitation.
In the following weeks, Barbara and her family were in constant communication with her doctors, including stroke neurologist Natalia Rost, MD who monitored her closely for signs of neurological improvement. Small gains such as squeezing Dr. Rabinov's hand or lifting her leg motivated her to recover, and her healthcare team was soon able to coordinate her transfer to a rehabilitation hospital.
Richard appreciates the close communication with Barbara's doctors and the hospital staff. "They gave us information daily and were really good about explaining things to me and my daughters, putting things in layman’s terms,” he says.
Now, six years later, Barbara reports that she is almost fully recovered. “I am forever doing puzzles to challenge my brain," she says. "I read books, craft and make quilts with my daughters. I can tackle just about anything."
Her team at Mass General continues to follow up with her, which Barbara says is worth the drive to Boston. "I see people of all capabilities in my stroke support group, and it makes me so much more grateful for what Mass General has done for me," she added.
"Without Dr. Rabinov and his team, Barbara wouldn’t be here today," Richard said. "We made the right decision."
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