Sherrye McAnelly had just finished a day of swimming on July 4 when she sat down on the sofa at her Burnet home with a glass of wine. When she reached for her crochet project, her arm went limp.
She started thinking about it: She had a bit of a headache and some indigestion. Her speech was slurred, but she thought it was just the glass of wine. She decided to put herself to bed.
The retired hospital administrator didn’t want to go a hospital for fear that she might be at risk of being exposed to coronavirus or going to the hospital for what might be a pinched nerve.
At 1:45 a.m., she woke up and still wasn’t feeling right. She Googled the signs for stroke but thought that she would feel better in the morning.
She took a baby aspirin and went back to bed.
That next morning, with arms still numb and a headache, she texted a friend who is an emergency room nurse. She told McAnelly to go to the hospital right now.
McAnelly was then transferred from Ascension Seton Highland Lakes to Ascension Seton Williamson, where an MRI confirmed she had had a stroke.
"Oh, my gosh, I couldn’t believe it," McAnelly said.
She was lucky because her stroke was not as debilitating as it could have been, but she missed the four-hour window patients have to receive tissue plasminogen activator medication that can prevent some of the effects of the stroke from causing permanent damage.
She was treated with other medications while doctors tried to limit the chances of her having a second stroke or heart attack.
It was a wake-up call, she says. She now takes her medication regularly. "No matter how good I feel, I will always be a stroke victim."
Her best advice: "Instead of saying, ’I will feel better in the morning,’ don’t be scared of the hospital. They are doing all they can to keep it safe and clean."
When Haley Griffis first started hearing about the coronavirus, she was scared. She knew that people with diabetes and heart disease are at a greater risk.
Griffis, who lives in Waco, was diagnosed with heart failure in December after weeks of feeling tired, gaining unexpected weight and a bloated abdomen, and not being able to walk up the stairs without having to stop.
She was in denial that anything was happening to her and delayed care. "My biggest takeaway overall is listen to your body," she says. "Why didn’t I go to the emergency room in November? Why did I put up with all those symptoms?"
She now sees a doctor in Austin who specializes in heart failure and heart transplants.
When the coronavirus hit, her husband, one child and her mother-in-law ended up getting it in mid-March and quarantined at her mother-in-law’s house. Griffis, thankfully, did not get it.
She had been told "it would be very, very bad for you," she says.
Yet the virus made her worry about going to the hospital and having a defibrillator placed under her skin to be a backup if her heart stops. She had been wearing an external one in the form of a vest.
Her doctors assured her that she should not put off the surgery any longer.
"COVID is scary," she says, "but your heart is really important. You still need to seek medical health care when necessary."
Within the first months of COVID-19 hitting the United States, a small study at nine hospitals found that heart attack cases were down 38%.
Locally at Ascension Seton hospitals, the cases were down 44% in April 2020 from April 2019.
That trend has continued. It’s not that there are fewer heart attacks or strokes — it’s that patients are putting off care and not coming in. They are also coming in with much more serious cases after waiting.
Even patients who have heart failure, like the ones treated by Griffis’ specialist, Dr. Raymond Bietry, are hesitant to go to the hospital right now. Bietry, of advanced heart failure and transplant cardiology at the Seton Heart Institute in Austin, recalled one patient who was terrified to be admitted to the hospital. "He was feeling so poorly, yet he was so afraid and did not want to come into the hospital. I had to beg him. ... No one in their right mind would want to go home, but he was so terrified and scared."
Griffis’ cardiologist, Dr. Timothy Ball of Waco Cardiology Associates, says he has seen several patients come in with a late heart attack and chest pains that happened a week ago. "They got better, then they come in with heart failure symptoms," Ball says.
Or they now have permanent heart scars that could have been treated, he says.
The symptoms of heart attack and stroke are not normal, says Dr. Jeeathbell Balbastro, a hospitalist at Ascension Seton Williamson. "You need to go to the quickest emergency room."
"The outcome of your disease is very much in line with how long you wait to be treated," Balbastro says. "The better outcomes are those that come in right away."
Even if you don’t think the symptoms are severe enough, "ultimately we like to find the cause," she says. "If you have underlying heart conditions, you increase the risks if that goes undiagnosed. You’re setting up yourself for a bigger stroke."
If you delay care for a stroke and cannot get the TPA medications, then you only have physical therapy, occupational therapy and speech therapy to deal with the lasting effects, and medications to prevent another stroke event.
For heart attacks, Ball says, he wants to see patients within 90 minutes of the beginning of symptoms. "We want to get it fixed as fast as possible," he says.
Balbastro says "the hospital is safer than going to Walmart or any other place they are going right now. We have multiple things in place."
That includes increased cleaning protocols, screenings and universal masking. Plus, every patient who is admitted is tested for COVID-19.
Even with testing, because there have been so many asymptomatic patients coming in who later test positive, hospitals and staff members treat everyone as if they have it to keep everyone safe, Balbastro says.
"It’s rampant in our community," she says. "It’s what we have to deal with."