Lauren Brown, an emergency physician at Centra found herself in the most unexpected situation of becoming a patient herself. In this episode she shares her personal narrative of experiencing a stroke that forever altered her life. Through Lauren's story, we discuss the vital importance of stroke awareness and early intervention, and how she navigated the surreal reality of recognizing her own symptoms while drawing from her medical expertise. Her experience offers unparalleled insight into the unpredictable nature of strokes and the resilience needed for recovery.
As we mark World Stroke Day, the episode highlights the importance of gratitude, proactive health measures, and awareness in preventing strokes, ensuring that listeners walk away with a heightened understanding of these critical issues.
Cami Smith:
Hi and welcome to, and so Much More. My name is Cami Smith and I am your host and I'm here with Lauren Brown, who is an emergency physician here at Centra, and we are going to be talking about and recognizing World Stroke Day, which is coming up here in October I believe it's the 29th it's coming up and there's so many ways that you all can get involved and we're going to put that in the description but to kind of like set the pace and to help you better understand why we celebrate World Stroke Day, why we have awareness around a stroke month, why it's so important for education and awareness, and so we're going to have Lauren share her story, and I don't want to get too far ahead of myself or you, so why don't you tell us a little bit first about what it is you do at Centra as an emergency physician?
Lauren Brown:
So I am one of the emergency medicine physicians. I work in the emergency department and I am ready for whatever emergency you throw at me that day. So every day is a little bit different.
Cami Smith:
They're all different which is probably nice, which is exciting and interesting and fun and challenging.
Lauren Brown:
And we see, you know, two day olds and 99 year olds and everywhere in between, um, and we see things that you know somebody just isn't sure where else to go and needs help. Somebody that clearly is having like an acute life-threatening emergency. Um, and so it's. It's fun, like it's. It's a little bit of everything. It changes all the time.
Cami Smith:
You can't get bored, um, so so you have to be ready to go at any moment for anything, right, yeah? And so I mean, and I I want you to share your story, um surrounding stroke and what you went through. But even thinking about, like what you've shared about recovery and and, as you guys can see, like we're standing where where we wanted to to show, um, how your life has kind of been able to come back to um a semi well, a norm I don't want to speak for you a normal, uh place, a normal state, because there are a lot of things that stroke survivors um have to change or adjust after an episode like that. So so I want you to tell your story, just to kind of help us better understand why you being able to, at any point in time during the day, meet someone else's need and the way it needs to be met, or even just stand here and have a conversation, yeah, so tell us your story.
Lauren Brown:
So I am used to seeing people having strokes coming into the emergency department where we activate the stroke team.
Lauren Brown:
However, on February 29th leap day, very memorable I was the patient.
Lauren Brown:
I had completed an hour-long session of physical therapy for a meniscus tear in my knee, had been completely active and fine during that entire session, got incredibly lucky that I decided to go to the restroom instead of getting in my car to do the next thing on the day's list and went down in the bathroom because the left side of my body completely stopped working.
Lauren Brown:
So I had a pretty large and significant and profound stroke and it's interesting because the type of stroke I have you have something called hemi-neglect. So the left side of my body did not work, I could not feel it, my face was drooping, my gaze was deviated to the right, I could not look left and I was unaware of the left side of my body. Wow, so even though I'm a trained emergency medicine physician and can recognize a stroke in others pretty quickly, if it's that profound, I thought I had glanced down and saw my toes wiggle on both sides. I thought I had function on both sides. I did not realize I had had a stroke and I was on the floor in the restroom trying to sort through. Like I'm awake, I didn't pass out, it wasn't syncope.
Lauren Brown:
I don't have blood sugar issues. I felt a little off balance, but I'm not spinning or dizzy or having a vertigo attack, and so I'm doing my emergency medicine thing and trying to work through, like what is going on. Meanwhile I cannot roll over or get myself up off of the floor, even though I am an otherwise pretty healthy 45 year old. I also got incredibly lucky and if the person that was in the other stall is watching this by chance, thank you so much. I got incredibly lucky that there was somebody else in the restroom. They recognized that I was having trouble getting off the floor. They went and got help. They came in immediately. I also want to thank the physical therapist that dived under the stall door because I could not open it.
Lauren Brown:
So I got. I was found immediately because I wasn't able to get to my phone or roll over or help myself because this entire side of my brain was not getting almost this entire side of my brain was not getting very good blood flow and so super fortunate that this person got help, that they immediately assessed me. They immediately called EMS, shout out to Station 6, who is located just a few minutes from OrthoVirginia. Luckily it was OrthoVirginia here, within a mile of the hospital. So I was at the ER super quickly after the onset of my symptoms, but profound symptoms. Also super lucky that you know EMS calls in with pre-arrival information. They knew there was a stroke coming.
Lauren Brown:
I was pretty much met at the charge desk as we tried to meet all of our strokes pretty immediately assessed, rapidly, had my CT scan immediately. They knew that there was a clot. Pretty quickly we were able to give them clot busting medicine because I was within the allowable timeline. We only have that option in the first three or four and a half hours, depending on your age. So the fact that everything just happened the way it was was so fortuitous. We also got me to the, to the lab and got the clot taken out and before it all sunk in, I think there was a. It felt like 30 seconds of my life that I realized like I am not functioning on an entire side of my body. I have a two-year-old, I have a five-year-old and I didn't even get a chance to like fully panic because I woke up in the ICU and I could move again.
Lauren Brown:
Wow, and so I'm incredibly grateful to everybody that day.
Cami Smith:
Yeah, you sent in an email and, as a mom I can't even wrap my mind around it. Like you were holding your now three and six-year-old Three tomorrow, three tomorrow. Oh, I love that and you were just kind of hit with that moment of gratitude, like I can do this, like I can still do this and being able to hold your children is a big deal, yeah, especially a six-year-old.
Lauren Brown:
I was, oh, I know Well, and there, yes, I was like I, I, yeah, I, I may or may not have sent a thank you note that was like I'm so grateful for changing poopy diapers. Didn't think I would appreciate changing poopy diapers, but I really do Just that perspective switch, yeah, and you can have such a wide range of symptoms. So, you know, in the ICU, like because of my training, because of having seen people in the ICU when I was a med student and a resident, I know kind of like am I going to be able to safely swallow? Am I going to be able to safely eat? Am I going?
Lauren Brown:
to be able to move Am I going to like be able to function cognitively, and so you know, passing the swallow screen and being able to have water and regular food is a victory, and having you know function back and being able to like, walk to the restroom and sit and stand is a victory.
Cami Smith:
Every stage of recovery.
Lauren Brown:
Yeah, and so and there are people that have intervention, maybe not as quickly or have some underlying medical conditions and it may take longer, but with rehab you can get back some function. It's not always this easy and I I recovered motor function Like I could move, I could feel. I kind of had a heavy sensation for a couple months. That's gone away now, but it rung my bell. I was exhausted. I slept 12 hours a night, when I'm used to like five or six. I couldn't do paperwork or be on the computer for more than like 20 or 30 minutes without a horrible headache for the first couple months. So there's definitely, even though outwardly everything was pretty back to normal quickly, there is definitely still a recovery window, even when you do well as far as outward appearances go. And so for any family members like they may seem a whole lot better, but they may still have a ton of subtle things or things they notice that maybe you don't, that they may be working through. So have a little patience with your family member.
Cami Smith:
Yeah, so as not even just a clinical professional, but as someone who is an emergency clinical professional, the knowledge that you must have had I would even imagine it was probably a little bit scarier the things that you had to filter through in your head in that moment, like could it be this, could it be this, could it be this, could it be this? That that to me feels overwhelming. And I think that sometimes, when you're in, like the healthcare industry or or anything kind of related, you, you think you know, like for me, like having had so many conversations now, like I would hope that I would be able to recognize you know a stroke or or some type of health related episode in my body.
Cami Smith:
But you know, some you find yourself so vulnerable in those moments and, and I like what you said, there were people there. Like that is amazing that there were people there who jumped in and who got you where you needed to go. And even with such a fast response time, it your journey to recovery was still a difficult journey, like it is hard to recover from a stroke. Um, and and I think, addressing that and I love that you said, on the outside I looked, you know, like things were progressing well and um, but there's so much more to it, um, like the looking at the computer screen and the grace that really you have to give people grace because recovery is a process and you were probably exhausted because your body was just making up the difference, which is insane. And so thank you for, first of all, sharing your story and being so transparent about it. Sharing your story and being so transparent about it, and and and what message would you have to people who would think I'm a healthy person?
Lauren Brown:
You know like you were.
Cami Smith:
you were just doing, you know physical movement and physical therapy, and would never imagine that you would be in that situation. But you know like and I'm a I'm a pretty healthy person I would never think X could happen at any moment, but you have to be ready. So what would be your message to those who are?
Lauren Brown:
listening A few things. So as far as I'm trained in emergency medicine and did not recognize my own stroke because of the amount of brain not functioning in that moment, and so if your family member is saying, oh, I'm okay, I'm okay and you recognize they are clearly not, please ignore them and get them help. The faster that you call 911, the faster that they're at the emergency department, the faster we can intervene and have options and try to get that clot out of there. If it's a clot, if it's a bleeding stroke, it's a little bit different. But we can do blood pressure control and positioning of the bed and minimize additional bleeding and damage. But time really is brain and so I got super lucky. I say that I cashed in all of the good karma points I had in the universe, so I'm now trying to do nice things again to build back my karma bank.
Lauren Brown:
But time matters. So please get your family member to us, please get them to the ER, please give us the option of medications and procedures to try to, you know, restore blood flow, reverse damage and start the recovery process as soon as possible. And then, on the health front, I, it was discovered, have a tiny hole at the top of my heart called a patent foramen ovale or a PFO. It is supposed to. It's. It's needed when you're in mom's womb. It is not needed once you are delivered and it should close after birth. But for a decent number of the population it does not.
Lauren Brown:
And we often don't know. It doesn't really create a murmur unless you happen to have had an echo for some reason and they caught it. It's usually unknown, unless you have a completely unexpected stroke on a Thursday late morning and then in the aftermath they go looking for it. It is now closed, so hopefully we are done with strokes. For me, that one's kind of a tough one to to preventatively look for.
Lauren Brown:
There's not a guideline that says that you should be screened, but there's a bunch of other things that are risk factors. There's things like hypertension, diabetes, obesity, smoking. Those things can be controlled. I carry some extra weight. Hi, I'm Lauren. I'm obese. I'm working on it. Um, so I have lost about 19 pounds since the stroke, continuing to try to be more active, make better food choices and get more active and more healthy. Um, cause I'm incredibly lucky to have this time with my kids and my husband and my family. Um, so taking care of yourselves, cause you don't know what tomorrow brings. Um, taking care of your loved ones, being there for each other and then being lucky that you're in a community where people see a complete stranger down and get help, where EMS is fantastic, where we have an incredible emergency department and neurointervention department, so being thankful for all that.
Cami Smith:
So did they know it was you coming in.
Lauren Brown:
The ambulance, I think, recognized me. I think the medics recognized me and said where do you work? And I said Lynchburg General. And they said where? And I said the emergency department when we're going.
Lauren Brown:
And then part of the emergency. So the funny thing is, I was incredibly cautious during COVID and wore my N95 longer than anyone else and then switched to a surgical mask and was still wearing a surgical mask three years into COVID. To be cautious and try to be conscientious and keep you know, the people I'm seeing and our community safe. Yeah, so people are used to seeing me with my hair up in a ponytail, a surgical mask or an N95 for three years in scrubs in the emergency department. Yeah, and I'm like a normal human being. That day, I think my hair ended up down somehow. I was in regular clothes. I had actually just, with everything going on, gotten sick and so I had some vomit in my hair.
Lauren Brown:
The left side of my face was drooping and so some of the staff recognized me. The physician that picked up my case actually goes, told me after the fact hey, you look kind of familiar. I thought you were, you know, somebody that I had just seen like as a patient in the ER pretty frequently and I was like well, you do see me in the ER pretty frequently. We work together multiple times a month.
Lauren Brown:
But it took a while, like she, didn't even recognize me when I first came in. Some people did, and it's interesting talking to people afterwards that were there and like their, what they were thinking in them. Yeah.
Cami Smith:
We're like family, you know. So it's just, it's weird, yeah, but also to think that some of them didn't recognize you and that did not change the level of care or intention that was provided. Yeah, because when someone comes through those doors, I mean that stroke team, it's, it's unbelievable. And you said something that I want you to break down a little bit and you kind of did. But time is brain. We say that a lot when we talk about stroke. Can you just very granularly break that down for?
Lauren Brown:
us your brain. So there's two types of strokes. Most people have an ischemic stroke, where you're not getting blood flow to a section of your brain. That was the type I had. Your brain needs blood, which carries oxygen and sugar and important things to keep your brain functioning, and so the longer you go without that blood supply, the more kind of the damaged area spreads, and so there's usually a certain amount of injury when you have a stroke that doesn't resolve pretty quickly. But the longer there's no blood supply, the more kind of time for those brain cells to fully not have what they need and die off and not recover.
Lauren Brown:
And then your recovery process becomes more trying to train other parts of your brain to take over for what was lost. So if we can catch you early and there's an area that's affected but can be reversed, and we don't completely kill off all of those brain cells we injure them but it gets blood flow back and allow them to recover, that's huge Um, and that's why I can carry my six year old Um, it's why I can, you know, go run around gymnastics with my almost three year old. It's why I can dance with my husband. You know, go run around gymnastics with my almost three-year-old is why I can dance with my husband and why, after a little time in recovery, I can go back to a quite mentally challenging job. Yeah. So yeah, time matters and I just got lucky.
Cami Smith:
It does. I also want to talk through BFest, because we talk about BFest a lot. Now do you know, like all the things that it breaks down to?
Lauren Brown:
You said it and I was like, oh God, she's going to quiz me Top quiz. I was like so the funny thing is that I'm familiar with the mnemonic. I'm used to coming at it slightly differently. Correct me if I'm wrong. Do we have?
Cami Smith:
balance. Yes, so balance, if you're feeling slightly off balance.
Lauren Brown:
Which balance? Yes, so balance. If you're feeling slightly off balance which I did because it turns out one side was not functioning it's hard to keep your balance.
Cami Smith:
Funny thing about not having access to one side of your body is you cannot stand.
Lauren Brown:
I know Good to know, I want to say, like eyes, it is eyes. Yeah, and I had that, I had the gaze.
Cami Smith:
Yeah, the gaze was was hard to to maintain control of.
Lauren Brown:
Yeah, I could not look left of midline with the stroke I had. So if somebody is just staring in one direction and even if you try to get their attention, like they move their head or body but not their eyes. Oh, okay, that can be an indicator, so that's it's what freaked my husband out the most, actually about my stroke.
Cami Smith:
Really.
Lauren Brown:
Yeah, Even though I was like droopy and not for whatever reason, that really caught his attention.
Cami Smith:
Yeah, which is the?
Lauren Brown:
next one face Facial droop. Yeah, had that one too. So yeah, if one side of your face looks droopy, a lot of stroke is one-sided, so if all of a sudden things are not matching up. So if you've got the facial droop, I think it's arms. Now this one Weakness or drift.
Cami Smith:
Yeah, so is that like help me understand that one. I've never quite understood the arms of BFAST.
Lauren Brown:
So a lot of times, if we are like if I'm out in triage and you come in with some weakness a lot of times, one of our first questions is are you weak all over Are? A lot of times, one of our first questions is are you weak all over? Are you weak on one side? If you're weak on one side, then we're probably going to have you start smiling to see if there's any subtle facial droop.
Lauren Brown:
We're going to have you lift and hold your arms and see if, over time, we get a little bit of drift or weakness okay or sometimes it's just like we, we pull your hands up and one falls down, one falls down okay, and so arms and kind of like that asymmetry.
Cami Smith:
So S would be.
Lauren Brown:
So speech, so slurred speech.
Cami Smith:
I mean, what was that like when you experienced your stroke? Were you able to call out for help?
Lauren Brown:
I was talking because this side was not functioning and so you know, facial muscles and everything wasn't working the way they're supposed to. I did sound a little slurred. Yeah, usually I just talk fast and mumble, according to my mom, but actually actually slurred that day and so that can happen because of kind of strength and tone changes.
Cami Smith:
Yeah, yeah. And then time, which we talked about. We talked about, yeah, which you know having this in front of you and knowing what be fast means it's, it can be so important. But I think it's also very important to mention like you are alone in a bathroom stall, Like BeFest Luckily two stalls.
Lauren Brown:
Luckily two stalls. Oh, there you go, and there's somebody next to me.
Cami Smith:
So you know there was no one in the stall with you who could have been like let me see your arms, you know, in that moment, and so just being aware and taking care of yourself and so many of our podcasts come back to this, and so I do want to mention this is pay attention to your body and stop trying to be the strongest person in the room If something is off, if you are not feeling 100%, you know, look into it. Give yourself that moment and that grace of you know it's okay if I'm not okay right now and let's figure out what's going on. So many people push through. They just want to push through. We're all busy, but there's a lot to be said for paying attention to what's happening inside your body and then paying attention to the people around you because, like you said, that person in that stall, that's amazing.
Lauren Brown:
Yeah, I was in like, oh, I just need to roll over. If I could just get to my knees I'll get up. I guess, like I told her, pt must have just really like been more like. It must have been more tiring than I thought, like no.
Cami Smith:
No, that was not. It Like I was not okay and we've had other.
Lauren Brown:
I've seen other podcasts with a fellow provider in the ER and we are nurses, physicians, pas, like you name. It are historically pretty bad about trying to minimize yes, and it's often people around Don't do that them that are like no no, no, like, no, no, no, let's, let's go get this checked out.
Lauren Brown:
No, let's go do this like, and so, yeah, if people that know you encourage you strongly to go get checked, they go get checked. Um, if your spidey sense is just like something's not right, then a lot of times there is something to that. So yeah, yeah that. Yeah.
Cami Smith:
That's incredible. So I hope you're taking notes.
Lauren Brown:
I also assure you that I can actually recognize a stroke if you come to me in the emergency department. I just haven't been through the mnemonic in a while.
Cami Smith:
Oh gosh Well, and you know it's interesting, I always have to stop and really think about the mnemonic and, and I think it's important to go over it.
Cami Smith:
I mean we put it on a billboard even during stroke month, because when you don't think about it as often, then it just goes in one ear and out the other, unfortunately. And so just having those timely reminders, like this conversation and and so I love that, because I think stroke month is at the beginning of the year when we have a lot of these conversations but then having something like this later on in the year to just keep it in front of us, yeah, because these are things that are happening to people every day. I mean, people don't just get strokes on stroke month. No, there's so much that we have to do to take care of ourselves and take care of people around us, and so being aware of the ways you can detect, I think is good. And so, yes, I have to like rack my brain to remember okay, be fast, I know, be fast, but what does it stand for? And so now you know, and so no quiz, but um, but yeah thank you, thank you so much and thank you for it.
Lauren Brown:
So I do want to share. So Lauren encouraged us to stand today and we've never done like a state. We've done, I think, a walking podcast before, but we've never just done like a standing podcast. But the reason why don't you share the reason Because I think there's kind of a silent message of like I am physically capable of standing, which unfortunately not, you know, some stroke survivors are not capable of. Sometimes there's circumstances, sometimes they're not found for hours or days. But just one more thing that I'm lucky and grateful for is standing and, you know, being able to function on a day-to-day basis. The one other thing I will say is a lot of the some of the mnemonic, like the balance, speaks more towards a posterior stroke or a stroke of the back of the brain.
Lauren Brown:
And those can sometimes be a little bit harder to pick up on, but any stroke increases your risk for additional stroke in the next 30 days. Any TIA or transient ischemic attack symptoms that come and go within 24 hours increases your risk of stroke in the next 30 days. And you know, if you're lucky enough to get through a TIA, that's kind of the time to investigate and to either get to your primary care doctor or get to the emergency department and try to do some of the screenings and see if there are modifiable risk factors so that you don't end up having a stroke with permanent disability. So I'm a big fan of preventive medicine when we can.
Cami Smith:
Absolutely.
Lauren Brown:
So keep those things in mind too.
Cami Smith:
Yeah, and I just really appreciate your gratitude oh my gosh.
Cami Smith:
I mean it like is exuding from you and I think a lot of times again, you don't put yourself in your. If you don't have a mindset of, like, all of the things you have to be thankful for and just really being aware of stories like yours, then it's easier to forget to do the things to take care of yourself, to go and get the screenings, to have very important and transparent conversations with your primary care. So thank you for just being willing to be here and have this conversation.
Lauren Brown:
Thank you, thank you for bringing attention to it and, again, thank you to everyone, and there was so many, there's so many people involved from the start to the end. Just thank you all.
Cami Smith:
Yeah, and thank you guys for joining us on and so Much More