Thread by @drliamhealy

"Mammy's not well"

5 year old Priya has FaceTimed her Dad, Damian, using the family iPad. Damian is on his way to work. It's been a busy few weeks for the family. His wife Mary, 35, is at home with their daughter and new 2 week old baby, Noah.

It's two days before Christmas.

Horrified, Damian sees from the iPad that his daughter is holding, that his wife Mary has collapsed to the ground. She is not moving. She can't speak. He quickly calls family members who live next door. They race to the house, calling an ambulance along the way.

An ambulance arrives. The paramedics suspect Mary has suffered a stroke. Within 15 minutes they are on the way to CUH. They pre-alert the Emergency Department and the CUH stroke team, who are waiting at the door as the ambulance arrives.

Mary is seen immediately by the Emergency Medicine and Stroke Teams together. She has suffered a catastrophic stroke. She can't speak. She can't swallow. She can't see properly. She is paralysed down her right hand side.

Advanced imaging shows that Mary has torn her left carotid artery, the main blood vessel bringing blood from her heart, through her neck to her brain. Worse still, she has also blocked the left middle cerebral artery - the main blood vessel with the brain itself.

Mary is critically ill. There is no blood getting to the left hand side of her brain. At just 35, this stroke will either kill her or leave her with severe disability, requiring nursing home care. The chances of her returning back home to her young family are no more than 5%.

But, Mary has come to CUH - the busiest inpatient stroke centre in Ireland and 1 of just 2 hospitals in the country, that can provide stroke thrombectomy - the ability to acutely remove the blood clot causing the stroke. Mary is immediately prepped for an emergency thrombectomy.

Consultant Interventional NeuroRadiologists Dr. Gerry Wyse and Dr. Noel Fanning, along with their team, quickly rebuild Mary's torn carotid artery using 3 special stents. They then remove the blood clot further up in her brain. She has been in hospital less than 1 hour.

Mary is transferred to the Stroke Unit under Consultant Neurologist, Dr. Aine Merwick. The team, and Mary's family wait to see if the procedure has been clinically successful. Within 24 hours, Mary can speak again. Within a few days she can wash and dress herself.

Within a week, Mary has no discernible stroke deficits. She can walk and talk, eat and drink, laugh and cry. She leaves hospital a little over a week later, stopping on the way with her husband Damian, to again meet the team that saved her life.

I was't directly involved in Mary's care but I am enormously proud of the skill and dedication of my colleagues here in CUH who were able to save her life. She came to our hospital, our stroke service, at the most critical time in her life and received emergency care that is

comparable to any hospital in the world. There hasn't been any clinical intervention in medicine within the last decade as effective as stroke thrombectomy. Uniquely, for medical advances, it is also hugely cost effective, with large reductions in rehab and social care costs.

We have performed 77 thrombectomies in CUH in 2019, a 50% increase on previous years. We have treated patients from Cork, Kerry, Tipperary, Limerick, Waterford and Clare. We have had many outcomes as good as Mary's, albeit few as dramatic.

We still have work to do to further develop CUH as a comprehensive stroke service with a properly equipped and staffed stroke unit that can provide comprehensive stroke care to the people of Cork and Munster, every hour of every day, every day of the year. We are making progress.

Mary is back at home with her husband Damian and her now 5 week old son, Noah.

Her daughter Priya is back playing on her iPad.

(An enormous thank you to Mary and her family for giving us permission to tell her story).