‘Minutes Matter When You’re Dealing With a Stroke’

Darcie Belisle doesn’t remember struggling on the treadmill at cardiac rehab last October.

“One minute I’m walking on the treadmill – going through my new rehab routine – and the next I’m sitting in a chair, listening to someone tell me that an ambulance is on the way,” Belisle recalls. “I didn’t know what was happening, but I knew something was wrong.”

At 45-years old, Belisle wouldn’t strike you as a person at high risk of stroke. But today, the mother of two considers herself lucky to be alive after a blood clot nearly took her life.

“It was a scary and emotional time for me, but thankfully a lot of people acted fast and got me the care I needed.”

A Textbook Response to Stroke

As a neurologist and director of stroke care at The University of Vermont Medical Center, Chris Commichau, MD, says Belisle’s case offers a textbook example of how people should respond to a potential stroke situation.

“It’s critical to learn to spot the symptoms and quickly get a person to the hospital if you think they’re having a stroke,” Dr. Commichau says. “Our best chance of returning them to full health comes in the first several hours. In Darcie’s case, this led to the best possible outcome – a complete recovery.”

Tony Shaw, a physical therapist with UVM Medical Center’s Cardiac Rehabilitation center, played a big role in that. He was working with Belisle at the time and was by her side when she suffered her stroke.

“I just thought she was getting a little tired, but it quickly became apparent that something else was going on,” Shaw says. “As physical therapists, we are trained to identify the signs of a possible stroke – drooping of the face, weakness on one side of the body, slurred speech, confusion, loss of balance – and basically all of these were suddenly present. I knew it was time to get help.”

As staff called for an ambulance, Shaw activated the center’s emergency call system, which brought cardiologists and nurses from across the hall to assist. One of the cardiologists then immediately called the stroke team at UVM Medical Center to alert them of an incoming patient.

“In all my years as a physical therapist, I’d never encountered a situation like this,” Shaw admits. “But our training worked and I’m really grateful, for Darcie’s sake, that we were prepared.”

A Rare Stroke After Surgery

Strokes are extremely rare in the aftermath of surgery, though heart valve replacements like Belisle’s come with a slightly higher risk. Still, the risk of stroke after heart surgery is less than 1% for most people.

Belisle’s path to heart surgery was a long time in the making. She was born with a heart defect that over time damaged her aorta – the body’s largest artery – and the aortic valve that links it to the heart’s left ventricle. She lived without complications until age 45, when problems started to arise: shortness of breath, fatigue and chest discomfort – and a heart murmur became more pronounced. In September 2021, Belisle had her aortic valve replaced with a new, mechanical valve at the UVM Medical Center. The surgery went off without a hitch, and she began cardiac rehabilitation not long after.

Sherrie Khadanga, MD, Belisle’s cardiologist and assistant director of cardiac rehabilitation, says that all signs pointed to Belisle being ready to start her rehab program: her vitals looked good; her stress test went well; she was on a medication to mitigate the risk of blood clots.

“Unfortunately, this was one of those extremely rare incidents,” Dr. Khadanga says. “But as strange as it sounds, she couldn’t have been in a better place when her stroke hit. We were ready.”

With Stroke, ‘BE FAST’

Dr. Khadanga was one of the first people to respond to Shaw’s emergency call. Looking back, Dr. Khadanga says she knew that time was of the essence. The best thing she could do was alert emergency department physicians and stroke neurologists at UVM Medical Center to Belisle’s condition and need for immediate care.

“Minutes matter when you’re dealing with a stroke,” Dr. Khandanga says. “The more we could do to help our colleagues at the Medical Center prepare, the better chance we were giving Darcie to get the best possible treatment.”

This collaboration paid off. Dr. Commichau and his team were waiting for Belisle, with a plan in place, when she arrived at the UVM Medical Center. They rushed her for a CT scan, which showed that a blood clot was obstructing the flow of blood and oxygen in her brain.

Within an hour, interventional neuroradiologists performed surgery to remove the clot, a procedure that would’ve otherwise been difficult, if not impossible, had Belisle arrived much later. All told, less than four hours passed between Belisle’s episode on the treadmill and her arrival in the post-operative recovery room.

“The whole process couldn’t have worked any better,” Dr. Commichau says. “And we’re so pleased to see Darcie back to good health.”

‘Back to Doing What I Love’

Surveying her road to recovery, Belisle is still in awe at the speed with which she found her feet again.

“It’s hard to imagine that just three days later I was in the comfort of my own home again,” Belisle says. “I couldn't have asked for a better experience. The care I received was absolutely amazing – everybody was so helpful and willing to talk to me and make sure that I understood what was going on. I know that they probably had a ton of patients to deal with, but I always felt like I was a priority.”

Belisle completed her cardiac rehab program last month, and she says she’s getting stronger every day.

“I’m finally back to doing what I love: going for walks, spending time with my family, taking my kids to basketball practice and theater rehearsals,” Belisle says. “I’m really proud of myself for getting here.”