Jessica Shirra is more than happy to be a statistical anomaly rather than a statistic.
Now in her early 30s, the Vancouverite suffered a series of strokes over a 10-day period in 2014. Getting that diagnosis was preceded by several frustrating hospital visits, misdiagnoses and mounting worry.
“In the hospital I remember thinking ‘I don’t even know what a stroke is. I’m young. How did I have a stroke?’” Shirra told the Courier. “I thought that happened to old men. It did take a while for it to sink in and understand what happened.”
Shirra’s story comes to light this week after statistics from the Heart and Stroke Foundation of Canada paint a horrific portrait of stroke prevalence among women in particular.
The stats suggest more women die of stroke than men, more women are living with the effects of stroke, they have worse outcomes and they face more challenges as they recover.
Stroke prevalence in women during pregnancy is three times higher than in non-pregnant women of similar age. Stroke risk increases in women after menopause and, in general, typically affect those over the age of 70.
None of that applied in Shirra’s case: she was 26 when her health turned, her family had no medical history to point to as a precursor, she was young and fit.
Shirra estimates she had 20 strokes varying in severity over the course of about 10 days. The first one she took note of happened while skipping rope at the gym.
“I dropped my rope and felt a snap in my neck,” she recalled. “And then all of a sudden my vision went really blurry in one of my eyes.”
Her hospital visit concluded with a misdiagnosis, the first of many over the following days. Shirra was repeatedly told she was experiencing anxiety or going through a bout of migraines.
Within 48 hours, another startling episode happened as Shirra was walking to her car.
“As I was walking my leg gave out,” she said. “I remember looking at my leg and it didn’t even look or feel like my leg. It was the weirdest thing ever. At this point, I really felt like something was wrong.”
Frustration and confusion were mounting after the second hospital trip. About a week later, the third major warning sign happened as Shirra got out of the shower. She went to tie her hair up in a ponytail, but her hands couldn’t do it.
A subsequent walk-in clinic visit ended with an anxiety diagnosis. While leaving, Shirra tried putting her jacket on, but couldn’t lift her hands above her shoulders.
She was back in the emergency room at Vancouver General Hospital within 10 minutes. The first MRI Shirra received suggested she may have multiple sclerosis. While waiting for further tests, and more than 10 hours after arriving, Shirra had another stroke in the E.R.
A second MRI confirmed multiple strokes had happened over several days. She was hospitalized for three weeks and required four months of recovery once discharged. It was later revealed that a tear in an artery in Shirra’s neck was the root cause, an incident that she can’t explain.
Her level of resentment has lessened over time, but questions remain.
“I cannot believe I had to go to the doctor so many times,” Shirra said. “For me, it was pretty eye opening. How did I go to the hospital so many times when I live in Vancouver, a city that has state-of-the-art facilities and some of the best doctors in the world? How did it take them so long to diagnose me?”
A neurologist with the Vancouver Stroke Program, Dr. Thalia Field said gender bias can play a role in stroke diagnosis, similar to the experience Shirra had.
“Sometimes if a young woman presents with weird symptoms, some would be more likely to think it’s a migraine than a stroke and the diagnosis may be missed,” Field said. “I think we have to be aware of those biases.”
Field acknowledged that while older people are most susceptible to strokes, cases like Shirra’s aren’t completely out of the ordinary. Problems related to blood clotting or congenital heart disease can affect younger people, while hormonal and blood flow changes can be problematic for pregnant women.
“It’s true that strokes proportionally affect older people, but young stroke is a problem and it’s becoming increasingly common for reasons we don’t entirely understand,” Field said.
When assessing the signs of stroke, remember the acronym F.A.S.T.
Face — is the face drooping?
Arms — can you raise both?
Speech — is it slurred or jumbled?
Time — to call 911.
For more info, see heartandstroke.ca.