Advanced Stroke Care Saves Groom to Be

Stroke patient Travis Mattox.
Stroke delays Travis Mattox's wedding, but advanced care puts plans back on track

An avid hiker, traveler and golfer, Travis Mattox is active and enjoys the outdoors. In April 2017, he was more active than ever, frequently hitting the gym with his fiancée, Amy Gattermeir, as the 2 prepared to look and feel their best for their wedding, just 5 weeks away.

But a health crisis struck that threatened to take it all.

With Amy out of state enjoying a pre-wedding girls' weekend, Travis, then 41, relaxed at home with the couple's Great Dane, Matty. Travis turned in late that Friday night and woke early Saturday to let the dog out.

"As soon as I got up, I felt something was wrong," Travis says. "My legs felt funny, almost like they were asleep. It's hard to explain, but I just didn't feel normal."

At the front door, Travis struggled to punch the home security system code into the keypad. After finally managing to disengage the alarm and let Matty out, Travis decided to return to bed and sleep off the strange sensations. But when he awoke 2 hours later, the symptoms hadn't abated. He decided to go to the hospital.

"I don't know why I didn't call 911," Travis says. He made it to his car, where pressing the button on the garage door opener clipped to his visor proved almost impossible. He finally did it and somehow drove to the nearest emergency room.

"I was so lucky," Travis says. "The doctor on duty had done his residency at The University of Kansas Health System. He recognized I was having a stroke and transferred me immediately."

Advanced, comprehensive care

Less than an hour later, stroke neurologist Colleen Lechtenberg, MD, director of the stroke program at The University of Kansas Health System's Advanced Comprehensive Stroke Center, met Travis' ambulance upon its arrival. She and neuro-interventionalist John Madarang, MD, together reviewed Travis' CT angiogram and CT perfusion images to determine the best course of action.

Dr. Madarang recommended removing the clot causing the stroke.

"Travis' waxing and waning symptoms indicated we had the opportunity to stop the damage the stroke was causing and reduce its effects," Dr. Madarang says. "As Travis was a young, strong person, we decided to take aggressive action. Allowing the clot to remain was to allow the stroke to continue causing damage, risking complete paralysis on one side or the inability to speak."

Dr. Madarang used state-of-the-art stent retrieval devices, maneuvering the technology up to the brain through a small puncture in the groin. The surgical procedure was successful, yet could not undo all of the stroke's effects. In the immediate aftermath, Travis was unable to speak and experienced limited mobility on his right side.

Once Travis was stabilized, neurologist Michael Rippee, MD, stepped in to oversee ongoing care.

Stroke patient Travis Mattox.

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A focus on rehab

Travis refused to let frustration hold him back. He saw therapists during his 5-day hospital stay who helped him begin his recovery.

"It was the most frustrating thing to be unable to talk," Travis says. "I remember things like wanting to ask Amy or the nurse to turn down the temperature in the room. I knew what I wanted to say, but I just couldn't say it. My physical therapist was wonderful. She was cheerful and encouraging, and that demeanor made such a huge difference."

Travis brought a fighting spirit and tremendous support from Amy, friends and family to an intensive regimen of speech, occupational and physical therapies. First as an inpatient for a month and then on an outpatient basis, Travis worked with unwavering determination to recover the capabilities he had lost. He remains in an outpatient rehabilitation program, receiving several hours of therapy daily. He is focused especially on improving the use of his right hand and arm and has made impressive strides with speech, strength, daily living and mobility.

"Speech isn't 100% back to normal, but I feel like I can carry on a conversation," Travis says. "I walk with a limp, but I don't need a cane. I'm walking about 2 miles a day. I'm almost there."

Stroke awareness

Act FAST

Would you be able to recognize the signs of stroke? Try this simple test:

  • Face – Does one side of the face droop when smiling?
  • Arms – Does one arm drift downward when raised?
  • Speech – Are the words of a simple sentence slurred?
  • Time – Call 911 immediately if you see any of these symptoms.

The right care team

Travis and Amy both praise the care team that saved Travis' life and supported them through a frightening time and onward to a new normal.

"I had a wonderful experience at The University of Kansas Health System," Travis says. "You hope to never be in that situation, but if you are, that's the place you want to be. The doctors are wonderful, and the nurses – God bless them. Everyone is top-notch."

"I 100% second those comments," Amy says. "The doctors and nurses are excellent. They were extremely respectful and patient with us. They explained everything thoroughly and always asked if I had questions. I always answered that I didn't even know the questions I should be asking. They helped us every step of the way and went above and beyond every day."

The health system's multidisciplinary team approach appealed to Travis and Amy as Travis received complex care.

"Our approach to comprehensive stroke care entails involvement from a number of specialties," Dr. Madarang says. "We work collaboratively across specialties including emergency care, stroke care, interventional care, neuro ICU care and rehab to give every patient the best chance at an optimal recovery. Upon Travis' arrival, we worked quickly, obtained imaging, mobilized the team and began treatment. That made every difference in Travis' outcome."

Both for convenience and to ensure all of Travis' providers continue to work together and benefit from a shared big picture, Travis transferred all of his ongoing care to doctors at the health system. This includes his neurologist, rehabilitation specialist and primary care provider. It also includes a cardiologist, as it was determined that Travis has atrial fibrillation, an irregular heart rhythm that increases stroke risk.

"Our neurology stroke team and heart rhythm team have an excellent relationship with great communication," says cardiologist Martin Emert, MD. "Together, we can help reduce stroke risk for patients who may have heart rhythm problems. Many patients have cryptogenic strokes – strokes caused by a blood clot, but with the source of the blood clot unknown. In these patients, atrial fibrillation is a very common source of that blood clot."

Dr. Emert placed an implantable loop recorder – a heart monitoring device – just under the skin of Travis' chest. In contrast to external monitors, once a care standard that monitored heart rhythm for about a month, the new internal technology will track Travis' heart rhythms 24/7 for up to 4 years.

"Advancements like this help us collect more data to make better decisions," Dr. Emert says. "The data confirmed atrial fibrillation and informed our decision to prescribe a more aggressive blood thinner, dramatically reducing his risk of a recurrent stroke in the future." "Travis was a good candidate for the clot retrieval, an advanced procedure we are among just a handful of programs in the region to perform," Dr. Rippee adds. "The specialized care available across our team allowed us to retrieve the clot, provide expert neurological intensive care, discover the atrial fibrillation and tailor a preventive regimen to reduce the risk of future stroke."

Thankful

Reflecting back, Amy shares details she only discovered later and that makes her all the more thankful for Travis' well-being.

"We learned that Travis drove to the local hospital without his contacts or glasses, and he never put on shoes," she says. "He parked in a regular parking space and walked the length of a football field to the emergency department. He told us later that he felt his words were making sense at the time, but the staff told us they weren't. We are very lucky he made it there safely."

Travis and Amy stress the importance of stroke education and awareness to reduce the risk of stroke and improve the likelihood of a positive outcome when it does occur.

"I knew something was off that morning, but the possibility that I was having a stroke never entered my mind," Travis says. "This can happen to anyone. Getting help right away was so important, and we are lucky to have the best help right here in Kansas City."

"We were just 5 weeks out from our wedding and had been working out every day to get into dress and tuxedo shape," Amy adds. "It didn't matter. It doesn't matter what kind of shape you're in or how old you are. If something doesn't feel right, go get checked out. Hopefully, it will be nothing. But if it's something – you have to be your own advocate."

Though Travis is still hard at work in therapy, the worst of this experience is behind him. Travis and Amy have rescheduled their wedding and look forward to celebrating with friends and family in June.

"I want to make as much progress as I can before the wedding," Travis says. "That's the goal I'm reaching for."

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