Can a Cough Cause a Stroke? It Did for One Doctor Who is Sharing Her Story

Northwestern Medicine
Neurosciences May 24, 2021
In 2016, Shaiba Ansari-Ali, MD, a rheumatologist at Northwestern Medicine Delnor Hospital, survived a type of stroke that statistically has a less than 0.1% chance of survival and recovery. In her new book, When the Doctor Has a Stroke (How I Recovered and You Can Too)*, Dr. Ansari-Ali shares her personal account and humorous insight as a physician who became a patient. The mother of two describes what she learned during a functional and meaningful recovery.

For years, Dr. Ansari-Ali had experienced increasingly intense migraines and persistent coughing from asthma. One morning, she was finishing clinic notes at home when the room started to spin. Lying on her bathroom floor feeling hot, nauseated and dizzy, she could sense her husband’s alarm, but it was what she didn’t feel that was most concerning. Able to see and think, Dr. Ansari-Ali could not move, speak or swallow. At that moment, she knew she was having a stroke.

Dr. Ansari-Ali’s constant coughing had ripped the lining from a small artery that goes to the brain along the back of the neck. A blood clot formed and traveled up into the basilar artery, the major blood supply to the brain, restricting blood flow to her brain. She had suffered a vertebral artery dissection and basilar artery stroke.

Dr. Ansari-Ali had a flashback to reading The Diving Bell and the Butterfly by Jean-Dominque Bauby. Bauby had suffered a major stroke that led to locked-in syndrome — a rare condition in which a person is not able to move but can feel and process everything happening around them. Lying on the floor, Dr. Ansari-Ali knew she too had locked-in syndrome. She noticed emotions such as fear and worry were distant. It felt as if only the analytical portion of her brain was working.

At the hospital, the medical team administered tissue plasminogen activator (tPA) to dissolve the clot. Soon, Dr. Ansari-Ali felt a jolt go through her body. Suddenly she could move her right side again. Undergoing more medical procedures while intubated and seemingly sedated, she was able to observe and process everything. Relieved that she had survived, she focused on recovery.

However, about a week later Dr. Ansari-Ali experienced a rare complication and was transferred to Northwestern Medicine Central DuPage Hospital for surgery. The surgery was a success and Dr. Ansari-Ali was able to fully focus on regaining her mobility, strength and speech at Marianjoy Rehabilitation Hospital, part of Northwestern Medicine.

Dr. Ansari-Ali had days where she struggled both physically and emotionally. “One day I was upset about not being able to write,” she recalls. “The therapist turned to me and said, ‘Yes, some people do write beautifully, but they can’t walk.’ That wow moment made me focus on being appreciative for what I could do.” Seeing her husband and two young boys also touched her. “I thought, ‘I have to get better. They need me.’ ”

Dr. Ansari-Ali made tremendous progress in three weeks at Marianjoy and was soon able to continue her recovery at home. She continued practicing what she learned in rehab and even created her own speech exercises. Incredibly, three months after her stroke, she returned to clinical practice, where she’s able to look back and appreciate the positive changes in her life.

Now, with a few more years of recovery behind her, Dr. Ansari-Ali has written a book about it, When the Doctor Has a Stroke (How I Recovered and You Can Too). The book is geared toward patients and caregivers, as well as medical trainees, because she wants them to know how important it is to understand the perspective of the patient.

“I felt like the universe came together and saved me, and I had to give something back. I knew I wanted to write a book, but I didn’t want it to be long and overly serious,” said Dr. Dr. Ansari-Ali. “My inspiration was actually TED Talks. So, I wrote one line a day for six months during the pandemic.”

Dr. Ansari-Ali says she has gained new perspective from her role as a patient and it has made her a better physician. The experience of being aware of everything going on around her, but not being able to move or communicate was profound.

As she explains in her book, “Whenever a patient is sedated and intubated in the ICU, I talk to them as I do my physical exam as if they are awake and understand everything I’m doing. The nurses may think I’m crazy, but for me it’s just being polite.”

Due to lasting effects of the stroke, Dr. Ansari-Ali was forced to slow down and see fewer patients, but that gave her more time with each patient allowing for improved communication and connection. She takes time to explain more to patients and always tries to end the visit on a positive note.

“That’s something I kept with me from my time recovering at Marianjoy. The rehab team was very upbeat and encouraging, and I believe it helped my recovery. I want to be able to do the same for my patients. I want them to go home with a good feeling,” said Dr. Ansari-Ali.

Her advice for patients is to concentrate on being productive and focus on what you can do.

“Stroke survivors regain most of their function in the first few months after the event. So I made sure to work as much as I could for as long as I could. Practicing anything difficult until it was easier was key,” says Dr. Ansari-Ali. “Be in the moment to heal, but look ahead to a year from now, two years from now, and things will be better.”

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