Author David Schwab, left, and his tennis partner James
My friend recently had a stroke while we were playing tennis and didn’t know it.
This may seem hard to believe. But it was confirmed after a visit to the Emergency Room, hours after we had stopped running around the court and smashing tennis balls.
James, 62, is one of the fittest guys I know and one of the most intense competitors on the tennis court. Thanks to medical professionals, he is fine now. After spending three days in the hospital, where he was treated for a stroke and prescribed a blood thinner, he doesn’t have any lasting effects. Doctors are trying to figure out whether this might have been related to a pre-existing condition.
But the lesson is clear: Don’t ignore symptoms, and call 911 immediately if you suspect a stroke, which is the key to recovery and avoiding long-term damage, according to the American Stroke Association. A stroke is a medical emergency and, while those who are older and have existing conditions such as high blood pressure are more at risk, a stroke can happen to anyone, which is the point of Stroke Awareness Month in May.
“We see these kind of cases all the time. Strokes can happen for all kinds of reasons, including in people who are healthy and have minor symptoms,” says Laura Stein, MD, MPH, Associate Professor, Neurology, at the Icahn School of Medicine at Mount Sinai, who treats patients and is a researcher who focuses on improving the detection of strokes and the emergency services available to treat patients.
Laura Stein, MD, MPH
“Stroke can be very subtle, and patients need to take any sudden change in neurologic function seriously,” she says. In fact, if you suspect stroke you should call 911 and not drive to hospital. That’s because you can begin receiving treatment immediately in the ambulance and because the 911 response system is specifically set up to take you to the hospital best equipped to treat the type of stroke you may be having, according to Dr. Stein.
On the tennis court that morning, something did not seem right from the outset. When we walked on the indoor court as we normally do about 6:30 am, James told me he didn’t feel great. He asked if I had ever seen streaks of light in my eyes. He said something about “bumping into things” at his house that morning. He said he had trouble driving to the club. I was a bit alarmed. For most people, these signs might be discounted as early morning fog before you have your coffee. But not him. I suggested he sit down on the chair beside the net. He brushed me off and popped open a new can of balls.
Most people may associate strokes with obvious symptoms, such as a drooping face or slurring your words. But other key signs can be more subtle, such as balance loss, vision changes, and speech difficulty as James was experiencing.
So we began playing as if nothing were wrong. We are pretty strong players. We don’t sit around much. Our goal is to hit as many tennis balls, as hard as we can, for at least an hour and 15 minutes. I’m not in such great shape, so occasionally I try to stop early. But he normally won’t have it. We played for 90 minutes as we often do.
During this time, he seemed a bit off, not so much in how hard he was hitting the ball but in his manner on the court. He seemed at times a bit subdued, unfocused, agitated. You would notice things like this because this guy is normally so focused when we’re playing.
When we finally did stop, we stood by the net, pulling off our soaked tennis shirts for dry ones and packing our tennis bags. He said he still didn’t feel good. I suggested he sit down. He scoffed at that. But he looked a bit dazed. Some might have that look of exhaustion after an intense workout, but not him. Often he heads to the gym. I asked if he could drive himself home. He paused for a moment, and he seemed to think about that. So I offered to take him. Declined.
I urged him to make sure that he spoke with his wife when he got home; I knew she would know what to do. Unbeknownst to him, I drove behind him to make sure he got to his house, a 15-minute drive away in the northern New Jersey town where we both live.
“Stroke can be very subtle, and patients need to take any sudden change in neurologic function seriously.” — Laura Stein, MD, MPH
When I got home, I was still very concerned. About 20 minutes later I got a text: His wife was taking him to the nearby urgent care center. I was relieved.
The urgent care doctor would immediately send him to the Emergency Department at nearby Overlook Hospital in Summit, New Jersey. The doctor called ahead, so at the ED they were waiting for him at the door with a wheel chair. There were a series of tests. The next day, a neurologist confirmed he had had a stroke, which meant that a clot had blocked the blood supply to a part of his brain. And it probably was related to a pulmonary embolism (a clot in his lung) he had years earlier, something his doctors will be examining further.
Eleven days later, James and I were back on the tennis court. Since our last session, James had seen several specialists and his own primary care doctor. They told him there was no evidence of lasting damage from the stroke. He is taking a blood thinner and will be talking more with his doctors about what other treatments may be needed.
On the court, all seemed back to normal. But my friend is well aware of how lucky he was. Stroke is more treatable than ever thanks to recent innovations in care. But the fact remains, the sooner you can get care, the better. If you can get treatment for stroke within 4.5 hours of the first symptoms, you are more likely to recover with little or no disability, according to the American Stroke Association. James knows he missed that window, and the outcome could have been much worse.
And he’s not alone in missing potentially alarming symptoms. Days later, Sandra Lee, otherwise known as Dr. Pimple Popper, a dermatologist with her own popular show on Lifetime network, would tell People magazine how she overlooked the symptoms she was having a stroke while shooting an episode.
Fortunately, James now has much to look forward to. He and his wife recently retired. They just sold their New Jersey home of 20 years and are preparing to move to North Carolina and their dream retirement community, where there are plenty of tennis courts. James expects to play every day.
David Schwab is a writer and editor in the Mount Sinai Marketing and Communications Department who oversees the Mount Sinai Today digital news site. He has been playing tennis since he was in elementary school, starting with a wood racquet.