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Published on December 17, 2019

Dr. Alex Linn and Stan Schmidt

Advanced Stroke Treatment, Lifesaving Result

Today, Norma Schmidt thankfully reflects that during All Saints ceremonies at her Sioux Falls church, the list of loved ones lost in the last year did not include her husband’s name.

Stanley and Norma Schmidt credit God’s “overwhelming grace” for this fact – along with some perfect timing that likely saved his life.

“Dr. Linn had just started with Avera, so it was a life-saving miracle that he was here to complete this procedure,” Norma said. “It was a godsend. We’re filled with so much complete joy, knowing we’ll have him with us through the holidays and we’ll be together and enjoy this time.”

The problems for Stan started in July 2019 when he just wasn’t himself.

“We stopped at the emergency room, but even MRIs and X-rays couldn’t pinpoint what it was,” Norma said. “The next morning, he could not recognize things on the breakfast table. He kept going to the fridge to get his yogurt and it was it sitting right there on the placemat. When he talked, it was all gibberish.”

She wasted not a moment and took her 83-year-old husband to Avera McKennan’s Emergency Department where he was admitted. The care team did more scans and collected more images, revealing a severely blocked blood vessel in Stan’s brain. Alex J. Linn, MD, a neurologist who specializes in neuro-endovascular procedures, proposed a possible intervention.

“He told us that it was something he knew really well – it was his area of expertise – but he also explained the risks,” Norma said. “We listened and we all agreed: let’s do it.”

Linn used high-tech operational equipment, including a biplane angiography system, which essentially is a pair of advanced X-ray cameras set in two synchronized areas. They let him “see” how a tiny wire was moving inside Stan’s body. Linn guided it into the area of the blockage to fix the problem.

To do that, he accessed the blood vessels through a large artery in Stan’s leg and used a set of progressively smaller catheters that then were worked carefully up his torso, into his neck and then into his brain. All the while, Linn observed the equipment from the X-ray cameras.

The vessel that was blocked in Stan’s brain was only about 2 millimeters in diameter in its normal state, while the area of blockage was only fractions of a millimeter in size which severely limited blood flow.

“Stan had a fairly uncommon type of stroke and the location for it was unusual,” said Linn. “It continued to cause problems despite an initial conservative treatment approach, so we needed to intervene before things became worse and permanent.”

During his first week as a member of the Avera Brain & Spine Institute, Linn completed the procedure, and even while Stan was heading to the recovery unit, he already was talking and feeling better. The images showed how the blood began to flow to this critical region of his brain, thanks to the tiny stent Linn and his team carefully put in place.

“It was my first interventional procedure at Avera, and it thankfully went perfectly,” he said. “Because this was an uncommon stroke with the blockage in an unusual location, I had actually consulted with my former mentors and some other colleagues prior to the procedure. Following its completion, I was happy to report that it was a success.”

Linn said initial conservative methods to treat the blockage using medication did not work; and traditional surgery also was not an option.

“I’m just thankful to have been in the right place at the right time, to be able to help Stan,” Linn said. “Stroke is an emergency, and thankfully his wife Norma did the right thing by noticing the symptoms and taking action immediately.”

Linn said everyone should try to remember the stroke memory tool, BE FAST, which stands for:

  • Balance – Sudden loss of balance or coordination with walking.
  • Eyes – Sudden loss of vision in one or half of both eyes.
  • Face – Sudden onset of weakness in one half of the face, with drooping when the person is asked to smile.
  • Arms – Sudden onset of arm or leg weakness on one side, in which the arm or leg on the affected side will drift downward or not move at all after both sides are lifted.
  • Speech – Sudden onset of slurred or garbled speech, or an inability to repeat simple phrases.
  • Time – Reminder to not waste time, and to call 911 if you notice one or more of these warning signs, or get emergency care right away.

After completing a short rehabilitation stay, Stan headed home, back to his busy life. The retired teacher, singer, composer and choral director – who also hosts a radio program featuring choral music – regained his speech and mobility.

Stan remains in awe of how things unfolded.

“Dr. Linn is so good at what he does and I feel I’m filled with overwhelming grace,” Stan said. “What I mean is that I understand what happened, but not exactly why or how. That’s the overwhelming grace of God that I experienced.”

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