La Croix Calloo
La Croix Calloo – teaching student, artist, poet – was in disbelief when first told she had suffered a severe ischemic stroke. (Photo: UHN)

Hearing the words, "you suffered a stroke" would come as a shock to anyone. For La Croix Calloo, learning that her abdominal pain, constant fatigue, and dizziness were the result of a severe ischemic stroke, her natural first response was to laugh.

However, laughter quickly turned into disbelief. After all, La Croix was only 22 years old at the time of her diagnosis.

Now 25, the Toronto-born Niagara University teaching student wants to tell her story, and raise awareness for World Stroke Day, which is Monday, Oct. 29.

It was after returning home from a trip to Jamaica in 2014 that La Croix began experiencing severe symptoms. With each day, they intensified, showing no signs of improvement. She was young and healthy – a student, an artist, and a poet.

What could be the source of her unexplained pain?

La Croix ventured to a local clinic with the hope of uncovering answers. She was told that the symptoms likely resulted from a virus or parasite transmitted abroad; a by-product of her visit to Jamaica months earlier.

But, this was no virus. Instead, La Croix was experiencing the beginning stages of something much more complicated. The symptoms persisted, and her need for an answer intensified.

"I ended up seeing a cardiologist, two family doctors, a rheumatologist and a disease specialist," she recalls. "But a consensus was never reached."

In the end, her condition remained undiagnosed throughout her multiple visits, and the severe pain continued. Exhausted, hurting, and incredibly confused by the situation, La Croix says she was told to "go home, get some rest, and hope for the pain to subside."

Handed a prescription for morphine and sent on her way, La Croix was left to her own devices.

Exterior of TW and Krembil Brain Institute
The Toronto Western Hospital and Krembil Brain Institute, the location of La Croix’s ischemic stroke diagnosis. (Photo: UHN)

After visiting a variety of doctors across the Greater Toronto Area (GTA), each with different specialties, La Croix was finally taken to the Toronto Western Hospital (TW), a comprehensive provincial stroke centre, specializing in prevention, acute care, rehabilitation and home care.

At TW, she was treated by Dr. Aleksandra Pikula, a stroke neurologist and clinical lead at the Combined CNS Vasculitis/Stroke in Young Clinic within the Krembil Neuroscience Centre, and Dr. Christian Pagnoux, Associate Professor and Vasculitis Specialist at Mount Sinai Hospital.

In addition, she received crucial brain imaging that would change the course of her story.

Dr. David Mikulis, a Senior Scientist at the Krembil Research Institute, explains the importance of the imaging: "In patients who have sudden loss of neurological function such an inability to speak or move, brain imaging must be performed urgently to determine the cause.

"Under these circumstances if a clot is found blocking a large brain artery, then the faster you get the clot removed, the more brain you can save."

Time is something Dr. Mikulis does not look upon lightly.

"There is an estimate that 1.9 million neurons are dying per minute if you do not clear out the blood clot in the artery that caused the stroke," he says.

 Dr. David Mikulis
Dr. David Mikulis, a Senior Scientist at the Krembil Research Institute, was recently selected to head an international study on arterial wall imaging, which allows stroke specialists to ability to image the wall of the blood vessel inside the brain. (Photo: UHN)

Upon receiving a series of brain imaging, La Croix presented with a medical condition called eosinophilic vasculitis—inflammation in the walls of her blood vessels, which carry blood throughout the body. When blood in the inflamed vessel clots, a condition called thrombosis, it can block blood flow, causing an ischemic stroke.

TW is where suspicions were confirmed – La Croix was finally diagnosed with an ischemic stroke.

"An ischemic stroke is caused either by a clot that travels from the heart to the brain, or a clot that forms within the vessel that, in some instances, can arise from the inflammation of arteries within the brain," explains Dr. Pikula. "This type of stroke can happen secondary to vasculitis, which is the inflammation of arteries that can happen within any organ, including the brain."

It is one of the most common types of stroke, but only 10 to 12 per cent of patients are under 50.

"I laughed at first," La Croix says of the diagnosis. "Once I stopped laughing, I was in disbelief.

"There were words forming in my head about what I was experiencing, but no matter how hard I tried, I just could not say them out loud."

A stroke was simply unfathomable.

"Being a young female going through life changes, especially at that age, it really affected me mentally and physically," she says. "Life is daunting enough, but understanding that I had a stroke was incredibly difficult."

Stroke in younger patients is on the rise. According to Dr. Pikula, approximately 150 patients within the same age group (under 50) are assessed annually at TW.

"While stroke risk factors, such as poor diet, lack of physical activity, hyperlipidemia (high cholesterol levels), and high blood pressure are on the rise, we are also seeing young patients with other unusual and undetermined causes for stroke," she says.

In other words, stroke does not discriminate against age, something La Croix knows too well.

"Before my diagnosis, I did not think it could happen to someone my age," she says. "Unfortunately, it can happen to anyone."

La Croix’s poem
A poem by La Croix entitled “When Lightning Strikes.” A line in it reads, “With one stroke, you caused a thousand storms.” (Photo: UHN)

Nevertheless, La Croix remains optimistic about her condition.

"I took the stroke as a positive, even though it was very much a negative," she says. "It is difficult, but you try to take whatever good out of the situation, and you just run with it.

"This is the reality of life – I'm still dealing with the responsibilities associated with having a stroke, but I'm still progressing."

The scientific community is learning from La Croix's experience – trying to understand what happens in both young stroke patients and survivors.

At the Krembil Research Institute and TW, scientists are starting a new research project to assess the psychosocial needs and occupational functioning of post-stroke patients. As the research progresses, scientists, including Dr. Pikula, hope to develop interventions in collaboration with patients, to help those who suffer a stroke re-integrate back into their personal and professional lives.

In addition, Dr. Mikulis was recently selected to head an international study on arterial wall imaging. This type of imaging allows stroke specialists the ability to image the wall of the blood vessel inside the brain.

"If we did not have medical imaging and innovations within the field, we would have tremendous difficulty in diagnosing a stroke," he says. "All current and future stroke treatment (including the diagnosis, treatment, and recovery) depend on imaging."

In La Croix's case, this type of arterial wall imaging allowed the accurate depiction of the vasculitis that ultimately lead to her stroke diagnosis.

Experiencing a stroke inevitably changed her life in more ways than she could have ever imagined.

However, the condition that caused such pain and confusion also made La Croix a stronger and more determined person. She has found a variety of creative outlets to express her thoughts and feelings about what happened.

"I did have a stroke," she says. "But, I'm also an artist, a writer, and a life-long learner. I'm also incredibly family oriented."

It has also given her strength to overcome unexpected challenges.

"Having to relearn how to draw and paint over again was incredibly difficult," La Croix says "When I was at the hospital recovering from the stroke, everyone thought I would not be able to return to school.

"But, here I am."​

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