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Following a Near-Fatal Stroke, a Second Chance at Life: Liz's Story

11 minute read
Marathon runner mid-race in athletic gear including a hat and sunglasses.

Liz (Aquino) Boyd seemed to have everything going for her. At age 38, she enjoyed good health, loved her job as a surgical nurse, and was newly engaged.

It all changed the day, in her words, "my brain exploded." Liz was home alone when the right side of her body went numb and she dropped to the ground. She had suffered a massive stroke.

That day marked the onset of a journey that has taken Liz from the edge of death to a stunning recovery. It's a success story made possible by the efforts of countless committed healthcare professionals across the Mass General Brigham Neuroscience Institute.

Headaches were a warning sign

A long-time dancer and runner, Liz had few concerns about her health. But a couple months before the stroke, she began having headaches that got worse and worse. She went to the emergency room (ER) at a hospital near her home in Rhode Island three times. Doctors concluded she was having migraines and recommended going to a migraine clinic.

"I tried everything to prevent this from happening. No one listened to me," Liz said. "I'm a nurse, I know my body, and I knew these weren't migraines."

When Liz collapsed, she immediately feared she was having a stroke. Then came the seizures. "It was the most terrifying thing I've ever experienced," she recalled. "I lost all control of my body and had unstoppable shaking and tremors. It was sheer terror—I'm still going through therapy now because of it."

Liz managed to call her fiancé, Mike Boyd, who in turn called 911. Emergency medical technicians arrived and took her to a local hospital for evaluation. In the ER, she was found to have a subarachnoid hemorrhage (bleeding in the space between the brain and the membrane covering it). 

Realizing their hospital couldn't provide the advanced care she needed, the emergency doctors elected to have Liz transported to Brigham and Women's Hospital.

'Unworldly' pain in her head

A stroke usually happens due to a blood clot blocking blood flow in an artery within the brain. However, tests showed Liz had cerebral venous sinus thrombosis (CVST). This is a blood clot in a vein within the brain. The resulting pressure building up in Liz's brain caused significant bleeding.

The standard of care for CVST is heparin, a blood thinner. Her doctors hoped the medication would break up the clot and restore blood flow away from Liz's brain. But over her first few days in the intensive care unit (ICU), her brain continued to swell, creating pain she described as "unworldly."

During this period, Mike leaned heavily on neurologist Stelios Manolis Smirnakis, MD, PhD, who saw Liz often.

"Dr. Smirnakis was incredibly gracious and helpful," Mike said. "He'd sit with me for an hour or two, reviewing scans and answering every question I had about possible interventions and outcomes. It never felt like he was in a rush."

Undergoing a venous thrombectomy

After 10 days, the swelling in Liz's brain reached dangerous levels. Her inability to move had shifted from the right to the left side of her body. She was at great risk of falling into a coma, losing brain function, and dying.

Her care team, led by neurosurgeon Nirav Patel, MD, discussed her treatment options. They decided to proceed with a rare form of brain surgery called venous thrombectomy. It was her last chance at a healthy survival.

Liz remembered lying in the stretcher in the elevator on the way to the operating room.

Mike's looking down on me, and his eyes are welling up with tears, she said. I told him, 'It's going to be okay. I trust my team.'

Liz Boyd
Patient

Dr. Patel, who led the surgery, had a decade of experience conducting venous thrombectomy. During the four-hour procedure, he and his team used imaging guidance to thread a catheter (thin, flexible tube) from a vein in Liz's leg to the clogged vein in her brain. Then, the catheter broke up the clot and suctioned out the debris.

"The imaging showed we'd opened up the vein," Dr. Patel said. "At the same time, monitors in her brain showed the pressure had dropped as well. That told us the procedure had worked, and she could survive."

Recovery and rehabilitation

Patient and doctor smiling together in a clinic room. The patient wears everyday clothes, while the doctor stands beside her in a white coat. Medical equipment and exam table visible in the background.
Liz reunites with Dr. Patel, the provider who helped guide her recovery.

While recovering in the ICU, Liz began to regain movement in her left side. After about 10 days, she was moved to the neurologic step-down unit, which provides an intermediate level of care between the ICU and a general medical-surgical floor.

In the step-down unit, she experienced awful hallucinations and delirium (temporary state of confusion). Relief came after several days courtesy of the palliative care team, which adjusted her medications until her symptoms eased.

Liz spent just over a week in the step-down unit before being transferred to Spaulding Rehabilitation Hospital Boston. As she discovered, she had a long road ahead. 

"I was literally starting from the ground up," she said. "I had physical therapy and rehabilitation as well as occupational, cognitive, and speech therapy. I had to relearn how to do everything from walking to matching colors and shapes."

After two weeks at Spaulding, Liz finally returned home. Her recovery continued with assistance from the Spaulding outpatient team, who worked with her on things like making sandwiches, improving her balance, and walking on a treadmill. She experienced both breakthroughs and painful setbacks.

"I broke down so many times because I wanted my brain to work, and it wouldn't cooperate," she said. "I wish I could say I was happy just to be alive, but there was a lot of frustration and moments when I felt sorry for myself."

A question that stuck with her

Weeks in bed had sapped Liz of most of the muscle she had gained from dancing, running, and lifting weights over the years. However, she was determined to walk again on the bike path near her home. Over time, she managed to get out there, accompanied by Mike or friends at first.

Nearly three months after her surgery, Liz had a follow-up visit with Dr. Patel. She had no memory of him from her hospitalization and couldn't wait to meet him face to face.

"I wanted to give him a huge hug and thank him profusely," she said. "He's such a kind, empathetic, and compassionate provider and human being."

Dr. Patel was also looking forward to seeing Liz. "When I walked into the room, I remember thinking, 'Wow, what an amazing outcome,'" he said. "You can't even tell this woman had almost died."

Before the two had a chance to hug, Dr. Patel had a question for Liz: "What are you going to do with your second chance at life?" She's since put a lot of thought into that query.

Ongoing neurological care

Soon after Liz saw Dr. Patel, Dr. Smirnakis referred her to neurologist Samuel Snider, MD, for her ongoing care. During virtual and in-person visits, Dr. Snider performs tests to measure vision, cognition, strength, and more.

Dr. Snider describes his role as a "quarterback" who coordinates various aspects of Liz's treatment and recovery. Managing medications for issues like seizures, mood, and fatigue is a key responsibility.

"My job is to support her with what she needs to get back to a level of function that she's happy with," he said. "I'm trying to keep her safe without giving her any medications that will interfere with what she needs to do while reintegrating into her previous life."

"He's incredible. I've never experienced a provider like him," Liz said. "He'll answer the phone or reply to a text at any time of the day. He's dedicated and knowledgeable, and I feel very safe in his care."

A series of milestones capped by a marathon

Within six months of her surgery, Liz achieved a series of impressive milestones. First, she got back to running. Then she received clearance to drive again. She also returned to her job, slowly ramping up to full-time, on-site work.

The biggest milestone came just over a year post-surgery, when she and Mike were married in Providence, Rhode Island. But she wasn't done yet.

After completing a 10-mile road race, Liz set her sights on the 2025 Boston Marathon. She had long dreamed of running Boston. When she got a runner's bib via a local charity, she decided to go for it.

The day of the marathon featured gorgeous weather and an energetic, supportive crowd. Liz made it a point to soak it all in. Although her per-mile pace might not have impressed her younger self, the experience was unforgettable.

"When I crossed the finish line, it was a moment of disbelief and gratitude," she said. "And then I got the medal—that's when I straight out 'ugly cried.'"

'I know that I'm here for a reason'

Drs. Patel and Snider marveled at how far Liz had come in the two years since her stroke. "She has gotten so much better," Dr. Snider noted. "At this point, we're dealing with problems that only arise once you're functioning at a really high level."

Like many people who have had a stroke, Liz has struggled with her mental health. She sees a therapist to learn how to deal with her posttraumatic stress disorder, depression, anxiety, and mood swings. Dr. Snider factors in these considerations in managing her medications.

As Liz continues to heal, she is focused on making the most of her second chance at life. She plans to run the 2025 Philadelphia Marathon to raise funds for stroke care, awareness, and patient/family support. Eventually, she'd like to work full time with stroke survivors.

"I know that I'm here for a reason," she said. "Working with stroke patients, spreading awareness, educating and inspiring others: That's what I'm trying to do with my second chance."