Team Sunnybrook saved Jenny Shin’s life after she suffered a severe stroke and broken neck
November 3rd, 2021 may have been both the unluckiest and luckiest day in Jenny’s life.
That morning, the 47-year-old Toronto public relations agency owner experienced a sudden, severe stroke. Jenny’s sister, Betty, was driving the two of them to work, and Jenny was using the morning commute to take a call with a client.
“I felt a bit dizzy, and I started seeing rainbow-coloured balls,” recalls Jenny. As she attempted to wrap up the call, she heard, “Jenny, are you OK?” on the other end. She tried to alert Betty, but her words came out garbled.
That’s when Jenny suspected she was having a stroke.
When they arrived at a nearby hospital, Jenny’s situation got even more complicated. She opened the car door and tumbled, head-first, to the ground.
Jenny would later find out that in addition to experiencing a life-threatening stroke, she had broken her neck.
Team Sunnybrook leaps into action
Lying on a stretcher with her neck in a brace, Jenny was rushed to Sunnybrook, which is one of nine regional stroke centres in Ontario.
It was like [the TV show] Grey’s Anatomy. It was like a well-oiled machine. I was so impressed,” remembers Jenny.
The team’s superlative efficiency was the result of several years of careful work and planning with a laser focus on quality improvement and patient safety in a joint collaborative effort between the stroke program, the emergency department, diagnostic imaging and neurovascular surgery.
Medical Director of the Inpatient Stroke Unit Dr. Houman Khosravani notes that Jenny’s case demonstrated “the power of what we call the chain of survival,” meaning that the neurosurgical and neurovascular teams had to work together to balance the complexities of two potentially life-threatening conditions – a significant neck fracture and a stroke.
On the leading edge of care
Minutes after imaging revealed the presence of a sizeable clot in one of the larger vessels in Jenny’s brain, she underwent a treatment at Sunnybrook called endovascular thrombectomy. This is the mechanical retrieval of a clot using a fine tube threaded up from a vessel in the groin into the brain. Sunnybrook was a site in the early clinical trials involving this treatment, which has now become a worldwide standard of care for certain patients.
That procedure is just one of the ways Sunnybrook is at the leading edge of research and care in stroke. In another example, Sunnybrook researchers recently led a pivotal study with colleagues in Calgary proving that tenecteplase, a clot-busting drug that is much faster and easier to administer, provides outcomes comparable to the previous industry standard (see sidebar).
Dr. Khosravani notes that Sunnybrook is “perfectly situated” to work on innovation in brain sciences because the stroke program “is nestled within a large body of expertise in neurosciences, including cognitive neurology, neuromuscular conditions, sleep medicine, neuromodulation and neurosurgery.”
It’s a philosophy of multidisciplinary collaboration that will be embodied in Sunnybrook’s under-construction Garry Hurvitz Brain Sciences Centre, a state-of-the-art facility that will be unprecedented in the field of brain sciences.
Philanthropy plays an essential role in pushing the boundaries of research and development in neuroscience at the Garry Hurvitz Brain Sciences Centre, says Dr. Khosravani. “Philanthropic support is able to provide a major inflow of resources to do advanced, cutting-edge studies.”
Back on her feet
Jenny spent the next few days in the ICU and then in the stroke unit, followed by occupational and physical therapy at Sunnybrook’s St. John’s Rehab.
Jenny opened up about her experience on social media a few days after arriving home, on what was coincidentally Giving Tuesday, an international day of generosity that encourages people to donate to their favourite charities.
“I used the day as an opportunity to genuinely thank Sunnybrook and inspire people to make a donation,” says Jenny. “Something good came out of what happened.”
Revolutionizing emergency stroke care
Inside Sunnybrook, stroke experts see first-hand the life-changing effects strokes have on patients and their families. They also bear witness to the opportunities for quality improvement made possible through research supported by donors.
Sunnybrook’s Dr. Richard Swartz and researchers at the University of Calgary have made a breakthrough discovery that is widely expected to change clinical practice for emergency stroke care. In the largest clinical stroke study of its kind in Canada, the team demonstrated that tenecteplase, a clot-busting medication that is commonly used to treat heart attacks, can effectively treat acute ischemic stroke.
This nationwide collaboration is the first time a novel treatment option has been introduced since 1995 – nearly 30 years.
While tenecteplase was proven equally effective to the current gold standard treatment alteplase, it offers the added benefits of being cheaper and faster to administer because it doesn’t require an infusion pump. “We could shave as much as 15 minutes off treatment time, further improving a patient’s chances of a good outcome,” explains Dr. Swartz, a staff neurologist and clinician-scientist at Sunnybrook’s Hurvitz Brain Sciences Research Program.
The findings have already led to new guidelines for emergency stroke care in Australia; Canada and the United States are currently in the process of updating their expert recommendations.