George Bishop’s daughter was the one who found her father unresponsive on a couch.
A severe headache had forced Bishop to lie down in an apartment his company provided close to his construction job in Bradenton. He hadn’t returned to work two hours later.
Kadance Bishop video-called her mom, Samantha Pankow. In the grainy video feed Pankow could make out vomit in hisbeard. She heard him groaning.
“Call 911,” she told her daughter.
It was the start of a 12-day ordeal during which doctors at three different hospitals worked to save Bishop’s life. On top of suffering a stroke, vomit clogged his lungs, leading to infection and then pneumonia.
When more intensive care was needed, one hospital refused to admit him because he was too high risk. It was only Bishop’s age — 33 — that persuaded doctors at HCA Florida Largo Regional to take the chance.
Doctors there kept him alive on an advanced life-support system that functions as the heart and lungs for nearly two weeks.
Even that seemed like a HailMary move. No one knew how much the stroke had damaged his brain and if he would ever be able to breathe independently again.
A rising number of younger people are suffering strokes, medical studies show. Bishop’s case serves as one example of a trend that has experts alarmed.
The number of U.S. residents ages 45 to 64 having strokes in a three-year period through 2022jumped almost 16% compared to a decade earlier, a Centers for Disease Control and Prevention report found. The number of strokes in those ages 18 to 44 rose almost by the same rate.
Roughly three-quarters of stroke patients are over 60. But AdventHealth Tampa’s Comprehensive Stroke Center is treating younger stroke patientsmore frequently, said Dr. James Lefler, a neuro-interventional radiologist.
The increased risk of stroke among younger patients can be attributed topoor health choices including bad diet, smoking and a sedentary lifestyle, Lefler said. Those can lead to health conditions that make a stroke more likely, including obesity, high blood pressure, diabetes and high levels of cholesterol. Use of illegal drugs like cocaine and methamphetamine also increase the risk of strokes.
“If you look at the younger population, I think more people are obese or overweight and that promotes bad heart attacks,” Lefler said.
The worldwide spread of COVID-19 also has raised the risk of stroke, a study published in the American Heart Association’s Arteriosclerosis, Thrombosis, and Vascular Biology journal found.
The research showed elevated numbers of heart attacks and strokes in more than 10,000 people infected with COVID-19 in 2020. The risk was more pronounced in people with non-O blood types like A, B and AB.
Strokes are caused when blood flow to the brain is interrupted. It typically occurs from ruptured blood vessels or because plaque or blood clots have blocked an artery.
“Basically COVID-19 makes you clot more than your average person,” Lefler said.
Few choices, little hope
Bishop was intubated by the time he arrived at Manatee Memorial Hospital in Bradenton after his stroke last summer.
A CT scan showed bleeding in his brain. His blood pressure was 250over180, the highest the neurosurgeon treating him had ever seen. Pankow, Bishop’s partner, rushed from her Dade City jobto be with him.
Bishop was placed in intensive care. The neurosurgeon told Pankow that when he drilled into Bishop’s brain to relieve the pressure, blood shot out like a bullet.
His lung infection was likely the result of him vomiting while intubated and sedated. It worsened over the next two days and his lungs stopped supplying oxygen to his body. Nurses had to flip him onto his stomach to improve his breathing but his oxygen levels were fluctuating dangerously low.
His prognosis was so bleak that a palliative care doctor was called to speak with Bishop’s family.
“They were doing everything they could for him medically — he was not responding,” Pankow said.
Doctors said his best option was to be put on extracorporeal membrane oxygenation, a life support machine that constantly pumps blood out of the body through devices that add oxygen and remove carbon dioxide before it’s pumped back into the patient.
To get that level of care Bishop needed to be transferred.
“He had a 50/50 chance or we just gave him medicine to make him comfortable and let him go,” Pankow said.
There was also no guarantee another hospital would take him.
Tampa General Hospital denied him admission, saying he was too high risk, Pankow said.
But Christiano Caldeira, a thoracic surgeon at HCA Florida Largo Regional, felt that a patient that young deserved a chance.
Doctors wanted Bishop airlifted but that was ruled out because he weighed 368 pounds at the time, Pankow said. Nine days after he was admitted, an ambulance took him on the 43-mile journey to the Largo hospital.
His life was still in the balance.
The silent killer
Pankow was able to see Bishop the next morning after he arrived in Largo.
A half-inch hose was carrying blood out of his leg and into the machine. Another tube returned it into an artery in his neck. Gauze was placed in his nostrils to stem bleeding. His mouth was bleeding too.
It took almost eight days before doctors saw any improvement in Bishop’s lungs. When they reduced his level of sedation, they were able to detect brain waves for the first time.
After 12 days on life support, he was revived. He awoke with no idea where he was or who was with him. His brain was not capable of regulating his temperature, which quickly spiked to 103 degrees.
“He was awake, his eyes were open but there was nobody there,” Pankow said.
When he was finally stable, he was transferred to a third hospital, AdventHealth Connerton, a long-term acute care facility in Pasco County where he was weaned off intubation and began a physical and occupational therapy regimen.
Although now fully consciousness, he struggled to follow basic commands.
“There was no medicine to give him and we were just waiting,” Pankow said. “Then he started to show more signs of recognition; he would purse his lips and blow his mom a kiss.”
There were still short-term memory lapses, and Pankow had to tell him four or five times a day why he was in hospital.
Almost two months after his stroke, Bishop transferred to the Brooks Rehabilitation Neuro Recovery Center in Jacksonville for more therapy.
By the time he was discharged from Brooks roughly a month later, Bishop was 160 pounds lighter than when he had his stroke.
It would be another nine months of in-home therapy before he felt able to resume working as a construction site superintendent.
His near-death experience has forced some lifestyle changes. He regularly gets medical checkups for his high blood pressure. He exercises more and has improved his diet.
“I used to work seven days a week,” he said. “I refuse to do that anymore. Time is valuable and spending time with your family is very important to me.”
Pankow now encourages everyone she knows to get regular checkups.
“They call high blood pressure the silent killer — I didn’t know that,” she said. “Had I known how serious it was, I would have been dragging George to the doctor.”
