May 07, 2020
Robert Rountree, 59, from Orange, New Jersey, usually cooked meals for himself and his wife, Sheila. As a former in-house chef for a large supermarket chain, “I know my way around a kitchen,” he chuckles. But he admits that his meals for his family weren’t the healthiest. Anything that fit in a fryer got breaded and fried. And whenever he saw his grandchildren, they’d beg for their favorite breakfast of grits.
But on one particular morning in June 2019, Robert and Sheila needed to kill some time. Their car was being serviced, so they walked over to the nearest fast food restaurant for a bite to eat.
After the meal, Robert walked outside to smoke a cigarette, a habit he hadn’t been able to break, despite Sheila’s pleading. Through the window, Sheila watched a horrifying sight. Robert leaned against a pole, slid downward and landed with a thunk on the ground. Sheila ran outside, screaming, “Are you OK?” Robert lay there, unable to move or speak. “His right arm and leg started to turn in,” she says.
Sheila was terrified as she called 911 but did her best to stay strong. “I held it together long enough to answer all the paramedic’s questions,” she says. The West Essex First Aid squad transported Robert and Sheila to Mountainside Medical Center, where he was rushed to the Emergency Department.
Quick Action and Rapid Decisions
Doctors immediately suspected an ischemic stroke, the most common type of stroke. Blood vessels become narrow or blocked, causing severely reduced blood flow to the brain.
A CT scan confirmed their diagnosis. When Sheila heard the word “stroke,” she finally broke down and cried. But there was no time to wallow. Quick treatment for stroke is crucial because, without adequate blood supply, approximately 2 million neurons die per minute.
Doctors gave Robert Alteplase IV r-tPA, a drug that works by dissolving the clot and restoring blood flow to the brain, which is standard treatment for stroke. Unfortunately, because of the size and location of Robert’s clot, it couldn’t be dissolved completely with r-tPA, and his chances of a full recovery hovered around only 30 percent. Robert was still unable to move or talk.
The ER doctors called on Ahsan Sattar, M.D., director of neuro-endovascular surgery at Mountainside, for help. Robert’s doctors hoped he would be a candidate for a mechanical thrombectomy, a ground-breaking surgical stroke intervention that has been shown to dramatically improve outcomes and reduce long-term disability in stroke patients. Doctors did a more detailed CT scan to better pinpoint the blockage.
They discovered that a large blockage still remained in Robert’s left middle cerebral artery. Time was of the essence, so doctors described the procedure to Sheila and explained the risks. “My main concern was just getting him better,” Sheila says. So she agreed to the procedure.
The Right Place at the Right Time
Robert was brought into the new state-of-the-art Siemens Biplane Endovascular Suite, where he was put under light sedation. Dr. Sattar inserted a catheter in an artery into his groin. Then, using special wires and cameras, Dr. Sattar threaded the catheter through Robert’s body and, with exceeding precision, placed it into his brain. He then passed a device through the catheter and into the blood clot, capturing the clot and removing it from the artery.
When the procedure was finished, Dr. Sattar asked Robert to move his right side. He was able to do it immediately.
Robert was able to talk again, as well. The surgical suite breathed a collective sigh of relief. “It is pretty remarkable,” says Dr. Sattar. “This is a fairly new, very effective intervention, so it was absolutely exciting.”
Robert stayed in the intensive care unit for a few days before moving to a room, recuperating and receiving occupational therapy, physical therapy and speech therapy.
After about a week, he was discharged for rehabilitation at home. A physical therapist and a speech therapist came to his home a few times a week for about two months. “His voice was quiet at first, but he got better and better every day,” Sheila says.
Now Robert is back in the kitchen, but he’s focusing on cooking healthy meals like grilled chicken, fish, vegetables and fruit. He also takes a 30-minute walk every day.
Robert and Sheila are astounded at his progress, and they’re both so thankful that he ended up at Mountainside that morning. “If he’d gone anywhere else, I don’t think the outcome would have been as great as it was,” says Sheila. “We were at the right place at the right time.”
Learn how Hackensack Meridian Health is at the forefront of new innovation when it comes to stroke treatment and recovery.
Dr. Sattar practices in Montclair. To make an appointment, call 973-577-2883.
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