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Two Strokes, 10 Years Apart
Pharmacist gets life-saving care from Henry Ford Macomb’s Stroke Center
A pharmacist for more than a quarter century, Joseph Demsich, of Macomb, knows firsthand the value of timely, life-saving treatment for stroke. In fact, he has experienced it twice.
First stroke happens in the middle of the night
In 2013, the married father of three boys, who was 48 years old at the time, woke up in the middle of the night. He had difficulty speaking and his left arm was completely numb. His wife thought he had suffered a stroke, so she called EMS and Demsich was taken to Henry Ford Macomb Hospital in Clinton Township.
“Because I did not know when the stroke occurred and my symptoms had subsided, I did not receive tPA treatment,” says Demsich. Tissue plasminogen activator (tPA) is a type of clot-busting drug that is given to stroke patients at a hospital under the direction of a physician. When administered quickly after stroke onset (within 4.5 hours), clot-busting medication can help restore blood flow to brain to parts of the brain affected by a stroke, potentially limiting damage and functional impairment.
Demsich underwent physical therapy for several months to help with some of the long-lasting effects of his stroke, including numbness on his left side and trouble with fine motor skills. “For example, when I put on a shirt, I can’t feel the buttonholes and need to look into a mirror to see where my button is.”
Despite his setback, Demsich has continued living a relatively normal life, including pursuing his love of hiking.
A second stroke, 10 years later
Demsich had another medical scare in March of 2023. This time he was awake, and quick action and treatment made all the difference.
“I was in the shower getting ready for work and my left arm started to spasm, then my left leg went out,” he recalls. “I collapsed in the shower and couldn’t speak.” Demsich and his wife immediately recognized his stroke symptoms and called EMS, who had to assist to get him out of the shower. He was taken to Henry Ford Macomb Hospital, the first in the region to receive designation as a Primary Stroke Center by The Joint Commission. The designation is awarded to hospitals that have demonstrated a track record of following national standards and guidelines that can significantly improve outcomes for stroke patients.
Cause of stroke discovered
Demsich received tPA and underwent successful removal of a blood clot from his brain, using a catheter-based procedure called a thrombectomy. His symptoms promptly improved, and he was discharged home after a brief stay at Henry Ford Macomb.
He was treated by Mohammed Rehman, D.O., Henry Ford Macomb neurologist who diagnosed Demsich with “carotid web,” a rare carotid artery disease that can lead to additional strokes if not treated.
Dr. Rehman explains that carotid web is a thin, membrane-like shelf of tissue that extends from the wall of the carotid artery into the lumen (the space where the blood flows), usually at the origin of the internal carotid artery. “It’s thought that stagnant blood along the downstream surface of a web may lead to blood clot formation and stroke,” he says. “Carotid web has recently been recognized as a cause of stroke in young adults representing as many as 9.4% of cryptogenic strokes (stroke that was not caused by conventional causes). Prompt recognition and treatment is key to preventing recurrent strokes in these patients.”
Speedier recovery and back to doing what he loves after second stroke
Recovery after Demsich’s second stroke was much quicker than the first. He credits the quick and effective treatment provided by Dr. Rehman and the stroke team with his excellent outcome.
“With the first stroke, I had visual loss that I didn’t have this time,” Demsich explains. And with his first stroke, his hospital stay included 10 days in inpatient rehab, followed by months of physical therapy. “With this second stroke, I was in the ICU and then the stroke unit, and discharged after three days with minimal outpatient therapy to deal with.”
Demsich, who hopes to return to work at Henry Ford Medical Center-Troy later this year, says he is working on some minor issues with mental fuzziness, typing and multitasking, and goes to outpatient physical and occupational therapy to help with that. He still has issues with his left hand and numbness that he didn’t really recover from with his first stroke.
“It probably would have gotten worse after my second stroke if I did not have the rapid response from Henry Ford Macomb,” he says. “The care from Dr. Rehman and the stroke team was exceptional,” he adds. “My wife said it was like a light switch went on after I had treatment. I was able to speak without slurring my words and everything was coming back.”
Think FAST
Dr. Rehman says the good news when it comes to stroke treatment is there’s been tremendous growth in the last decade. “We are living in a phenomenal time during which stroke treatment has seen a tremendous growth, but we are still limited by the ability of the patient or immediate bystanders to recognize the symptoms and activate the EMS systems in an expedited manner,” he says. “When you suspect a stroke, the acronym to remember is “Think FAST” which stands for Facial droop, Arm weakness, Speech difficulty and last Time of onset and to call 9-1-1”.
Back to hiking less than two months after stroke
Demsich had a hiking trip planned in May before the second stroke happened and was grateful that he did not have to cancel his plans to hike in Zion National Park in Utah. He was able to hike 6-7 miles a day at 8,300 feet and would gain 1,200 feet in elevation during some of the hikes. “I doubt I would be able to do that if it weren’t for the rapid treatment I received at Henry Ford Macomb,” he says. “Not that I’d ever want to have a stroke again but if I do, I’d want to have treatment at Henry Ford Macomb.