After finishing work and returning home one day, Sten
Anderson was on his way to the gym — “dreading working out,
as most people do,” he recalls, as he sits at the front of a packed
lecture hall. The date was Oct. 10, 2016 and Sten was, at least
at that point, a healthy 24-year-old. After starting his run, he
developed the worst headache of his life and decided to return
to his apartment, but he never made it back. “I ended up on the
wrong floor, collapsed on the ground, just pounding against a
random door,” he remembers, before a passerby found him and
called EMS.
On March 9, 2018, Sten returned to the University of
Minnesota Medical School to share his experience of suffering
and recovering from a life-changing stroke for a captivated
audience of second-year medical students. Though Sten still
has some weakness on his left side, he was able to walk to his
seat unassisted, and he sat in front of the students telling his
story with clarity and frequent interjections of humor. The
following account is Sten’s story, told by Sten himself, along with
perspectives from his parents and caregivers.
Five months prior to his stroke, Sten had graduated from college
with a bachelor’s degree and had a job working in information
technology. He lived with a friend in an apartment in downtown
Minneapolis, had no prior medical conditions and exercised
regularly. But on Oct. 10, 2016, he found himself lying in a
hospital bed as it was whisked to the CT scanner as part of an
emergent stroke code activation. Dr. Christopher Streib, an
attending physician at the University of Minnesota who was part
of Sten’s medical team, remembers the case vividly. “I remember
being very hopeful initially … the senior resident had called
to tell me Sten had a complete right MCA middle cerebral
artery syndrome, but that he was only two hours from his last
known normal time. We were focused on getting IV tPA started
as quickly as possible, and the endovascular stroke team was
already in-house prepping for his case to perform an acute stroke
intervention.”
Those hopes were immediately dashed upon reviewing Sten’s
head CT. He already had early signs of stroke in almost the entire
right side of his brain, indicating that the damage was irreversible,
with essentially no viable ischemic penumbra or brain tissue that
could be saved. His CTA showed the culprit: a right ICA terminus
occlusion. Dr. Eddy Labin, a neurology resident who was also
part of Sten’s medical team, recalls feeling his heart sink when he
saw the scans. “He was so young and was surrounded by so many
people who loved him, all of whom were absolutely devastated.”
“The alteplase tPA was already mixed and was bedside and the
endovascular team was calling for him,” Dr. Streib remembers.
“I was emotionally torn. He was a young kid and we all wanted
to do everything to help him, but we knew he was unlikely to
benefit from alteplase or endovascular treatment, and given the
malignant profile of his imaging, was at high risk of harm from
the treatments. We knew then that it would be a large stroke and
a long recovery for him.”
Tubes Upon Tubes
When Sten’s family was first informed what happened, they
were in disbelief. His mother remembers the initial phone call
where she hung up on his doctors because she thought they were
telemarketers. “They said, ‘Your son has had a stroke,’ and I said,
‘Whose son? Not my son.’” But the severity of Sten’s injury was
immediately apparent to his family upon their arrival at Hennepin
County Medical Center. “Things weren’t looking real great,”
his mother recalls. “He couldn’t talk … but he could hear.”
They immediately established a “thumbs-up” and “thumbsdown”
system to communicate, and knowing she was able to
maintain a sense of what Sten was feeling put her at ease, at
least to some degree.
Post-craniectomy CT
After Sten was admitted to the ICU,
serial brain scans revealed that the
swelling in his brain was worsening.
Because his doctors were concerned
that this edema was life-threatening,
Sten underwent a decompressive
craniectomy — a procedure to
remove a large part of the skull to
allow his brain to swell without
causing additional damage — on the
second day of his hospitalization.
Sten’s mother recounts that as he
was leaving for the operating room,
she told him she would see him after
the surgery, to which Sten jokingly replied, “Maybe!” Despite his
neurologic deficits, Sten’s preserved personality and lighthearted
demeanor offered some relief to his family and caregivers in a
difficult time. “When you hear giant stroke you think, ‘Oh my
gosh, is he still in there? Is this still my kid?” Sten’s mother said.
His medical team was similarly moved. “Despite lying in bed with
the left-side of his body paralyzed, he was cracking jokes,” Dr.
Labin remembers. “And that’s how I remember him. He was the
victim of an unthinkable catastrophe and yet, still smiling.”
After the decompressive
craniectomy, Sten made a steady
recovery. When asked to reflect
on his time in the ICU, Sten
states, “I have very little memory
of my time in there, but what I
do have is not entirely pleasant,
as I’m sure you can imagine.”
Having a catheter in his bladder
and a feeding tube placed
through his nose were among
the low points of his stay. While
Sten’s memory of his
hospitalization is a blur, his
mother remembers things
vividly. She spent every single
night in the hospital by his side. She felt grateful not to have work
obligations, permitting her to focus entirely on Sten’s care. “I knew
I had to be there in the morning when the big teams came by. It
was very important to me.”
The Peaks and Valleys of Recovery
As Sten’s medical condition improved, he was able to participate
in physical and occupational therapy. He recalls a key turning
point during his hospitalization: “One of the first times I had
any really clear recovery is a couple of the OTs occupational
therapists came in ... and helped me sit up on the edge of the bed.
Which I know for both of my parents was a pretty amazing sight
to see.” Sten’s mother remembers having mixed feelings along the
way. “Everything is so frightening because you’re celebrating ‘Yay,
he’s up! He’s sitting up in bed!’ And then you go, ‘Why is sitting
up in bed so hard?’ I flip-flopped like that all the time.”
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