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New stroke treatment at Southend saves Sylvia from ‘locked in’ syndrome

26 June 2015

Health Care

Friday 5 June 2015 was like any other for husband and wife, Sylvia and Doug Williams from Canewdon, but it would be a day that would change their lives and the lives of their family forever.

Sylvia, 63, was running a bath whilst Doug, 76, retired Merchant Navy, was putting up some shelves when he heard a muffled growl, at first he didn't recognise the noise and then released it was his wife. Dashing to the bathroom he saw her in the bath unable to move. Thinking quickly, he drained the bathwater but couldn't lift her wet, unmoving body from the slippery sides of the bath.

Mrs Williams had suffered a massive stroke and could only move her eyes, trying to communicate by blinking. The stroke had caused something known as 'locked in' syndrome, which renders its victim powerless to move and communicate through normal means.

Doug grabbed the phone and soon the ambulance service and a first responder were there. Next stop was Southend University Hospital and its renowned stroke unit. It was here that the enormity of the situation was explained, but in that darkness lay a glimmer hope.

Award-winning stroke consultant, Dr Devesh Sinha, warned the family that conventional stroke treatment with clot busting drugs would only have a four per cent chance of success in reopening the blocked vessel. However a new treatment called thrombectomy, where a clot is pulled directly from the brain could mean Sylvia's brain artery could be unblocked.

This new life saving operation is currently only performed in a number of hospitals around the world, but thanks to the foresight and investment of local commissioners and the hospital board Southend University Hospital is again leading the way by providing interventional stroke care.

Sylvia's occluded vessel needed to be opened immediately; if not, Sylvia would either die or face being in a persistent vegetative state.

Doug said: "It was all happening so quickly but the gravity of the situation was explained to us and that if we didn't do it we would regret not trying for the rest of our lives. As a family we decided that no matter what, win or lose, we had to take that chance."

Dr Sinha said: "When Sylvia arrived in A&E she was paralysed and voiceless. The only movement she had was the eyes, looking upward and eyelid opening."  

"Before we had an interventional stroke service at Southend, this would have most likely meant the worst outcome for Sylvia. But because we now have a stroke team that consists, amongst others, of an interventional neuroradiologist, an anaesthetist, stroke physician and fully trained catheter lab theatre staff we could offer this state-of-the art, specialist treatment to Sylvia."

The clot was removed by interventional neuroradiologist Professor Iris Grunwald, internationally renowned in her field, by utilising a minimally invasive technique which allowed the removal of the clot directly from the brain. Crucially for Sylvia and her family, Southend is the only hospital in Essex to offer this procedure and although there is "level 1A (highest level) evidence for this treatment, - due to the complexity and speed required- it is currently only offered in very few centres around the world.

During the procedure of the actual operation a small instrument like a vacuum cleaner is brought to the brain via a catheter and literally sucks out the clot, clearing the blockage so that blood can once again reach the brain's cells.

And the results can be amazing, just one day after the stroke Sylvia was talking and taking her first steps - a mere 72 hours after her attack. When she first came into the hospital she had a stroke score of 31, which means Sylvia had severe disablement, but left just with a score of one, which meant she was now able to walk, talk and swallow.

"We treat stroke as a resuscitation call" said Professor Grunwald. "Having instant access to an anaesthetic team for every stroke is, to the best of my knowledge, currently unmatched in the UK.

"With our fast service we are leading the way -not just in Essex- but in the whole of the UK. Our team has undergone excessive training and we have, over the last year, demonstrated that we can safely deliver this specialist service. This is shown by the amazing outcomes of the patients we treated so far." 

Sylvia and Doug's son, Mark, 39, also from Canewdon, said: "It's been like a dream and the change on a daily basis has been just incredible.  We've never seen so much human kindness than we have at Southend Hospital and it just restores your faith in humanity, especially in a world where all you hear is bad news.

"The grandkids are what are going to keep mum getting back to strength, you can see the change in her face when they enter the ward. It just lights up when she sees them. My daughter, Sophia aged 11, has been sat with her Nan listening to music and sat drawing picture letters for her until she fell asleep."

A chance meeting with Iris in the stroke ward corridor saw both Sophia and her brother Jack embrace Iris, spontaneously hugging her like an old friend, showing in that reaction the love for their Nan and gratitude both they and their whole family have. Jack,14, even telling Iris that she was his hero as she had saved his Nan's life.

"My heart melted" said Iris. "Worldwide there is a shortage of people who can perform this life saving treatment and we have so far been able to treat every suitable patient, day or night. Looking into those loving children's eyes makes all the voluntary effort of establishing an interventional service at Southend even more worth it. I only hope that, some day it will be possible to offer interventional stroke treatment 24/7 to everyone in the country." 

Sylvia was able to leave Southend Hospital and return home on Friday 19 June.

Mark concluded: "It's the amazingly long list of brilliant people involved from the ambulance crew to all those at the hospital that we'd like to thanks. It's mindboggling that so many people helped save my mum, and we can't thank each and every one of them enough. We are just so grateful and owe them all an eternal debt of gratitude. It's very humbling."

Doug concluded: "I'm a six foot guy who's been in the merchant navy and all that but during that crucial operation and the hours after I could have just sat down and cried. That woman means everything to me and she is such a fighter. I can't thank the team at Southend University Hospital enough."