When to Worry About a Headache?

Maike Blaya, MD, had been having intense headaches for two weeks. The pain extended from behind her left ear down her neck. And it was getting worse day by day.

“If a patient came to me with the same symptoms, I immediately would have sent them to the imaging department for a scan,” says Dr. Blaya, a neurologist at Memorial Neuroscience Institute, who specializes in headaches and migraines. “When someone has a new onset headache that doesn’t go away, and it is always on the same area, it’s a warning sign or red flag for a secondary headache, and it could be a hemorrhagic stroke. But I just didn’t think that my headaches were serious. I attributed them to stress and tiredness. I was busy and I kept going, not listening to my body.”

Anyone could have made the same mistake. Dr. Blaya was fortunate — her stroke happened when she was at home with her three teenage sons.

"Call 911 right away.”

September 1, 2021, began like any other Wednesday for Dr. Blaya. After dropping her kids off at school, she worked out at the gym. Then it was off to work for a busy day of seeing patients at the Institute.

By late that afternoon, Dr. Blaya’s headache was terrible. Instead of making dinner as usual for her kids after returning home, she went to her bedroom.

“We had just moved into our new place, and I was excited to organize and color-code my closet,” she says. “I remember getting started and then a few minutes later realizing I couldn’t tell the difference between a pair of pants and a shirt. And I didn’t know what color either one was.”

Then, for reasons she can’t explain, Dr. Blaya walked over to her laptop computer and opened it. But she couldn’t remember the password. Frustrated, she went to her 17-year-old son’s room for help. When Felipe opened the door, Dr. Blaya couldn’t remember his name. The words coming out of her mouth didn’t make sense.

Felipe immediately called Anita, a nurse practitioner in Dr. Blaya’s office. Anita said, “Felipe, your mom is having a stroke. Call 911 right away.”

Do You Know the Warning Signs of a Stroke?

Anita’s instructions likely saved Dr. Blaya’s life.

A stroke is a life-threatening emergency condition where every second counts. The longer it takes to receive care, the more likely a stroke will cause permanent brain damage or death.

But you don’t have to be a neurology nurse practitioner to recognize the warning signs of a stroke. You can heed the advice of the American Heart Association and BE F.A.S.T.:

• Balance problems – Feeling unsteady when you walk.
• Eye problem: Loss of vision or double vision.
• Face drooping – Look for a droop on one or both sides of the face.
• Arm weakness – Ask the person to raise their arms. If one arm sags downward, they may be having a stroke.
• Speech difficulty – The person may slur their words or struggle to find the right word.
• Time to call 911 – There’s no time to waste.

Additional signs of stroke can include:

• A new, severe headache in one location that persists and gets worse
• Confusion
• Sudden loss of balance
• Sudden loss of vision in one or both eyes
• Trouble walking

Remember, every minute counts in stroke treatment and can mean the difference between losing and saving critical brain function.

Emergency Surgery to Restore Blood Flow

Within minutes of Felipe’s call, paramedics arrived and rushed Dr. Blaya to the nearest emergency room. Doctors diagnosed her with a hemorrhagic stroke, sometimes called a brain bleed. This type of stroke occurs when a weakened blood vessel ruptures. Dr. Blaya would later learn that a blood clot in one of the veins in the brain had bleeding in her brain.

When medication didn’t restore blood flow in her brain, the medical team transferred Dr. Blaya to Memorial Regional Hospital  in Hollywood – a Joint Commission Comprehensive Certified Stroke Center, and one of Memorial’s four certified stroke centers in Broward County with round-the-clock neurosurgical services.

That day, a colleague and friend of Dr. Blaya’s, Norman Ajiboye, MD, performed a delicate surgery to remove the blood clot, restore blood flow and allow the brain to heal.

Struggling to Find the Right Words

Days later, Dr. Blaya woke up in the intensive care unit surrounded by doctors and nurses she knew well. But instead of discussing patients with them, she was the patient.

“I was so confused at first,” says Dr. Blaya, who was in the hospital for two weeks. “The stroke had damaged my brain’s language center and caused a disorder called aphasia. I couldn’t always find the right words or understand what people were saying to me. When I tried hard to think of a word, like ‘pizza’ or ‘shoes,’ I’d get an intense headache. And the right side of my body was very weak. It was hard to walk even a few feet to the bathroom.”

Dr. Blaya was determined to get better. Four months after her stroke, Dr. Blaya returned to work part-time at the Memorial Neuroscience Institute.

“I had always been the loud, energetic one in our office, but when I returned to work, I was fatigued and quieter,” she remembers. “I took a nap every day in my office and needed a nurse practitioner to record my notes after patient visits. But my family, friends and colleagues were incredibly supportive.”

Over the next few years, she had three additional surgeries to treat abnormal connections between arteries and veins and subsequently improve blood flow in her brain. Inpatient and outpatient physical therapy helped her regain the use of her right side. Speech therapists worked with her in English and her native language, Portuguese, to address aphasia symptoms.

The Journey Continues

Now, more than two and a half years after her stroke, Dr. Blaya’s brain continues to heal. That’s not unusual — some people need years to fully recover from a stroke. Many others have permanent disabilities.

Dr. Blaya was fortunate. She is back to practicing medicine full-time thanks to excellent medical care, months of speech therapy, a strong support network, and hard work. Always physically active, Dr. Blaya does yoga and works out with a personal trainer. Fatigue is still an issue; sometimes, she still needs a moment to think of the right word to say.

Reflecting on her recovery, Dr. Blaya says she is grateful.

“Before my stroke, I think I was trying to do too much and achieve too much,” she says. “Now, I take things slower and try not to be hard on myself. I appreciate the person I have become.”

Remember, a stroke can happen to anyone, any time. So it’s important to know the signs and act BE F.A.S.T. by calling 911.

Do you have concerns or questions about your risk for stroke? Search for a primary care doctor to help you find out.