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33-year-old stroke survivor recalls 1st symptoms he almost ignored

Those around him recognized the signs of a stroke and urged him to wait for an ambulance.
/ Source: TODAY

Just a month ago, Alex McKeown, 33, woke up feeling tired. But knowing that his go-to fitness studio charges him even when he doesn't show up — and he'd already skipped the last three classes — he pushed himself to get to his early morning workout.

During the first of three rounds of exercises, McKeown, an investor in Chicago, "started feeling a little lightheaded and dizzy," he tells TODAY.com. By the end of that first round, "I kind of had to sit down. And then as I was sitting, I was getting more dizzy and I ended up laying down."

The instructor noticed and asked if he was OK. McKeown gave her a thumbs down, he recalls, but he figured he was just dehydrated. When he reached out to grab her water bottle, however, he noticed how weak he felt.

McKeown sat and drank water and orange juice through the end of the class but still didn't feel any better. While McKeown wanted to sleep it off at home, he figured that if he was actually dehydrated, he'd have started to feel better by that point. So the staff around him convinced him to wait for an ambulance.

Once the paramedics arrived, "I couldn't stand on my own," McKeown recalls. "I couldn't get up or stand without assistance."

One of the staff members at the gym pointed out that it was McKeown's left side that felt weak. "She was spot on about that," McKeown says. "By the time I got to the hospital, I couldn't lift my left arm or my left leg and couldn't really see out of my left eye."

A speedy diagnosis and a "fairly extensive clot"

A stroke occurs when a blood clot in another part of the body, such as the heart, breaks off and makes its way to the brain. There, the clot can restrict blood flow, causing symptoms such as the weakness and loss of vision that McKeown experienced.

It's not unusual for people having a stroke to miss the first signs, like weakness on the left side of the body, Dr. Ali Shaibani, chief of neurointerventional radiology at Northwestern Medicine and part of McKeown's medical team, tells TODAY.com.

"Fortunately for McKeown, it was daytime in the gym. And there were some smart people around him," Shaibani says.

McKeown called a friend to bring him his ID and insurance card. “He thought I was overreacting until he spoke to me when I was in the ambulance,” McKeown says. “He said, ‘You’re really slurring your words. I couldn’t really understand you that well.’”

At the emergency department, staff evaluated McKeown for a possible stroke using what's called BE FAST criteria: balance, eyes (double vision or loss of vision), facial weakness, asymmetry (weakness or drooping on one side of the body), slurred speech and time.

"If somebody meets that criteria, then they move directly to imaging," Shaibani says. In McKeown's case, the stroke symptoms were clear — and he quickly underwent CT scans to look at the capillaries and arteries from his chest to the top of his head.

Luckily, one of McKeown's scans "showed that he had primarily salvageable tissue, meaning nothing seemed to have permanently died at that point," Shaibani explains. But a scan is just a snapshot in time, he adds. And in stroke patients, the situation can change in a matter of hours.

When doctors told McKeown he was having a stroke, he wasn't sure quite how to take the news. "It's kind of fantastical to get that news at 33," he says. "It defied belief." He even took a work call while at the hospital, but the staff quickly realized it wasn't urgent and told him to hang up.

McKeown was given tenecteplase, a medication that can help dissolve blood clots. But McKeown had what Shaibani calls a "fairly extensive clot" going all the way from the internal carotid artery at the base of his skull up to the middle cerebral artery behind his eye sockets.

The middle cerebral artery is "the main artery to the right hemisphere of the brain," Shaibani explains, and the clot was also blocking the blood supply to part of his visual cortex, causing visual symptoms. (At one point, McKeown heard his friend's voice but could see him — despite his friend being in the same room just a few feet away from him.)

So McKeown underwent a specific type of minimally invasive thrombectomy, during which Shaibani and his team inserted a series of increasingly small catheters into a blood vessel in the groin area. They then snaked the catheters all the way up to the clot in the brain and essentially suctioned and pulled the clot out, Shaibani explains.

In the vast majority of cases, this only takes one attempt, and that was true for McKeown, as well. Once the clot was out, he was transferred to the care of the neuro intensive care unit to recover.

After surviving a stroke at 33, Alex McKeown adjusted his eating habits and his relationship with work.
After surviving a stroke at 33, Alex McKeown adjusted his eating habits and his relationship with work.Courtesy Alex McKeown

Recovery and the road ahead

McKeown remembers getting the clot-busting medication, "and the next thing I know, I'm waking up and they're just saying, 'Hey, don't move,'" he says. "It was after the thrombectomy, and I was getting rolled up to the ICU."

He spent six days recovering in the hospital but showed significant improvement within a few hours, a rare phenomenon known as the Lazarus effect. "Within an hour or two, he was essentially at baseline," Shaibani says. "It's not common, but I think being young was in his favor."

These days, McKeown is taking it easy because he's required to keep his heart rate under 140 for the time being. He's adjusted his eating habits with portion control and incorporating more vegetables. Rather than going hard at the gym, he's making sure to get his steps in every day and taking leisurely bike rides along a nearby lakefront trail, he says.

And he’s more conscious about the amount of time he spends working and traveling for his job, trying not to overdo it.

He's also preparing to undergo elective open-heart surgery later this summer. Although doctors still aren't sure what caused McKeown to have a stroke, they did find something interesting in his heart: an aortic aneurysm.

The aneurysm is a "ballooning of the blood vessel," Dr. Chris Malaisrie, director of the comprehensive center for aortic disease at Northwestern’s Bluhm Cardiovascular Institute, tells TODAY.com.

McKeown's aneurysm is located right next to his heart at the aortic root, explains Malaisrie, who will perform the procedure. "And the bigger (aneurysms like this) get, the more likely they are to rupture or dissect, and those are both emergencies." 

Aortic aneurysms often go undiagnosed until they cause serious, life-threatening symptoms. Even though the surgery is not related to McKeown's stroke, it will help prevent “a second catastrophe,” Malaisrie says.

Although McKeown isn't an anxious person generally, he did recently experience his first panic attack.

"I've come to the conclusion that, subconsciously, this is just taking more emotional and mental space than I've given it credit for," he says. On a day-to-day basis, he's not necessarily thinking about his health issues, he explains, "but these are pretty major life milestones that I'm going through."

Looking back, McKeown wants other young, healthy guys out there not to dismiss any signs that something might be off. And he's grateful that those around him at the gym convinced him to take his symptoms seriously.

"The only reason I did is because I was surrounded by people who had the foresight to encourage me to do that," he says. "And, really, it did save my life."