From crippling stroke to 14,000-foot summit

October 9th, 2017

Don and Kris Soltis at the top of a Colorado 14er.

It was 4:24 a.m. when Kris Soltis heard her husband struggling to get out of bed.

She had turned on the radio a little earlier as they began to wake up. And through the dim early light, she noticed a veil of fog outside, rare for an April morning in Timnath, east of Fort Collins.

Something else was off.

Don Soltis was talking like he had a mouthful of gauze from an oral surgery. And Don hadn’t had surgery. He was a healthy 55-year-old engineer who designed high-performance central processing units for Intel.

“Ra-room,” Kris heard her husband say as he rocked to try to stand up.

“Are you having a bad dream?” Kris asked him.

Then she looked over and saw that his left hand and leg were curled. She figured out he was trying to say bathroom. But his speech was garbled. He wasn’t making sense.

“Are you having a heart attack?” Kris asked.

Then she turned on a light and saw that the left side of his face was drooping and his left eye was bulging out.

Suddenly, she was wide awake.

“Oh my God. You’re having a stroke.”

Don tried to stand up. As he began to fall, Kris grabbed him and instinctively knew to protect his head from hitting the floor. Once Don was on the floor, she grabbed the phone beside her bed and dialed 911.

The countdown had begun to save Don’s brain.

On standby, poised for an emergency just like this, a doctor in Aurora was ready. Years earlier, he, too, had been a computer engineer. But, then, David Case’s father, a World War II veteran, had suffered a stroke that left him severely disabled for the rest of his life. So the son gave up engineering and went to medical school. He then specialized in complex brain procedures that could save stroke victims from the kind of damage his dad had suffered. On April 14, the Friday before Easter, Dr. Case and his team were ready to hunt down and grab a clot that had lodged in Don Soltis’ brain. As each minute passed, however, the clot threatened to destroy critical brain tissue.

Every second counts

As Kris spoke with the 911 dispatcher, Don was eerily calm. He struggled to stand up and wondered why such a simple thing had become so hard.

He tried to tell Kris that calling 911 for no reason was a felony. She ignored him and described Don’s symptoms. Her only exposure to strokes was what she’d seen on TV.

“See if he can say, ‘The early bird catches the worm,’” the dispatcher said.

Don said “the early bird,” then paused as his brain struggled to help him say this familiar word. Instead, he spelled out “c-a-t-c-h-e-s.”

“They’re en route,” the dispatcher said. “He’s having a stroke.”

In tears, Kris raced to open the front door and turn on lights for the paramedics. Terrible thoughts raced through her head. She worried Don would be permanently disabled or worse, that she was losing him forever.

But she didn’t want Don to see her fall apart, so she forced herself to stay calm

Suspect a stroke?

Act FAST – Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services

UCHealth’s Poudre Valley Hospital (PVH) was only about 8 miles away, but the ambulance crew had to be careful in the fog as they navigated around a pond with an inauspicious name: Deadman Lake.

As Don lay on the floor, he wondered what all the commotion was about. The clot in his brain had shifted all his experiences to slow motion.

He simply had to go to the bathroom and wondered why he couldn’t stand up. Usually, this was all so easy.

Then, a young woman was introducing herself.

“Hi, my name is Julie,” the paramedic said.

Don thought to himself, “No, you’re not.” He was thinking of Julie, his sister-in-law.

Outside, strapped into the gurney in the ambulance, he noticed the flashes of headlights bouncing off neighbor’s homes, then before he knew it, he was at Poudre Valley.

Nearby, he heard a doctor’s voice: “It’s confirmed. It’s a stroke.”

That’s when Don worried for the first time.

“Uh. Oh. This is bad,” he thought to himself.

Even in his compromised state, he knew that people who had strokes could become permanently disabled. Don had been a skier since 1971. He loved skiing, cycling, hiking and traveling. He loved using his brain to untangle complex challenges at work. And, he loved Kris, his wife of 7 years. Together, they had three sons and a daughter.

Doctors at PVH did a brain scan and knew immediately that they needed to get Don to a Comprehensive Stroke Center, a hospital rated to provide the highest level of care to stroke patients. There are only three Comprehensive Stroke Centers in the Rocky Mountain region and just over 100 in the nation.

‘Hold your head really still’

On a normal morning, PVH doctors would have flown Don to UCHealth’s University of Colorado Hospital, the nearest Comprehensive Center. But the fog had grounded all UCHealth LifeLine helicopters.

They’d have to race to Aurora by ambulance.

Kris had driven herself to Poudre Valley. This time, she jumped into the front seat of the ambulance. When the sirens started blaring, the weight of her new reality hit her and she began sobbing.

“It seemed so real. He could die. I didn’t even know if he would make it to Anschutz.”

Now, they were fighting rush hour traffic and drivers seemed oblivious to the sirens.

As the paramedics discussed the fastest way to get to University of Colorado Hospital, Kris begged drivers who couldn’t hear her to move over and let them pass. She knew every second counted.

Reality was hitting Don, too. As he lay in the ambulance, he thought about his left arm, lying limp by his side. Even with a fog filling his brain, he thought to himself, “I better not try to move that arm because if I can’t move it, that means I’m in trouble.”

Dr. David Case and his team at the University of Colorado Hospital Stroke and Brain Aneurysm Center were ready the moment Don arrived.

Kris grabbed Don’s hand as nurses wheeled him down the hallway to his room.

“The whole time, he knew who I was. It was almost like he was trying to reassure me as I was trying to reassure him,” Kris said.

The doctors introduced themselves. Dr. Case explained that he would be doing a procedure to try to remove the clot. If he couldn’t get it the first time, he might have to go in a second time and break up the clot.

Dr. Daniel Vela Duarte focused his attention on Kris.

“You look a little shook up. How are you feeling?” he asked.

“I remember that being very comforting,” Kris said.

The doctors told Kris they were going to take great care of Don.

By then, her son, Josh, had arrived. Coincidentally, he worked for the company that had built the hospital, Haselden Construction. To distract his mom, he started giving her a tour of the hospital and showing her his favorite features.

Inside the procedure room, Don heard Dr. Case say he was ready.

“You have to hold your head really still,” he told Don.

One of the attending physicians asked if Don would like to hear some music.

Don couldn’t say yes, but the young man said, “You look like a classic rock guy.”

With his right hand, Don gave a thumbs up and the thrumming sound of ZZ Top’s La Grange begin to fill the room.

Don remembers the procedure. He could tell that there were scans of his brain up on a giant screen over his head. He had a bad headache and he was tired of being strapped down. So he was squirming a bit.

Case kept reminding him to hold his head still. Then, in what seemed like just a few minutes, the procedure was over. That’s all Don remembered until two days later on Easter morning.

World-class care

David Case was only 23 when his dad had his stroke in 2002.

Case had been working as an electrical and computer engineer at the time, but as he spent time with his dad at a rehabilitation facility, he had his epiphany.

“This is what I want to do. I want to be in a profession where I’m helping people directly,” Case said.

Dr. David Case with his father.
Dr. David Case with his father. Case became a doctor and specialized in stroke care after his dad suffered a debilitating stroke.

His dad, who was in his 70s at the time, had suffered a stroke very similar to Don’s. But unfortunately the types of treatments available now weren’t available then.

“If he would have gotten to a hospital like ours today, he would have gotten treatment,” Case said.

Instead, his dad lived his final years with major disabilities. Case’s mom cared for him until he passed away. By then, Case was in his fourth year of medical school. And he was on a mission to learn the newest and best treatments for strokes.

Case learned that speed is everything when it comes to the brain.

“You can lose neurons very, very quickly,” Case said.

“If you’re able to treat people fast enough, you can help them survive,” Case said.

In Don’s case, Kris’ quick actions and those of the paramedics and medical team in Fort Collins made all the difference.

“Early recognition allowed him to survive,” Case said.

Don was due to head out of town for a work conference the following week. Had he been alone in a hotel room, unable to call for help, he might not have made it.

But Don was fortunate. He was in the hospital now. And Case was poised to perform an intricate and highly specialized procedure called a thrombectomy.

The blockage had taken place in the carotid artery on the right side of Don’s brain. It had halted blood flow to the right side of Don’s brain and, if left untreated, would kill more and more brain cells.

Using a CT scan for real-time visual guidance, Case threaded a catheter through an artery in Don’s leg. Little by little, he guided it up into the aorta and into the artery that supplies the neck with blood. He then navigated up through the carotid artery on the right side of the brain where he could see the offending clot. Slowly and carefully, Case fed a tiny grabbing tool called a stent retriever past the clot, then captured it. The tool has a tiny cage.

“You capture the clot and carefully pull it out. In Don’s case, it took about 20 minutes from the time I got into the artery. The faster we can remove the clot, the better the patient will do,” Case said.

“It’s a very profound treatment. You can have a huge impact,” Case said. “It’s changed the way we’re treating stroke, not only in our country, but also around the world.”

Case is a neurologist who also has specialized training in neuro-critical care and what’s called neuro-interventional and neuro-endovascular care. That means he’s able to perform the newest life-saving procedures, like the one Don received.

An independent non-profit agency called the Joint Commission certifies and rates hospitals that provide stroke treatment. The University of Colorado Hospital was one of just a handful of hospitals in the country to receive the highest rating in 2012 and in July, was recertified for the third time.

“They think we’re one of the best stroke centers in the country,” said Meredith Snyder, UCHealth’s stroke program manager. “We have the capability 24/7 to help patients.”

Stroke experts frequently use the phrase “time is brain.” By that, they mean the quicker a patient gets help, the more brain function doctors are likely to preserve.

Hospitals certified as Comprehensive Stroke Centers must offer:

  • Specialists trained in vascular neurology, neurosurgery and endovascular procedures.
  • Advanced imaging techniques.
  • 24/7 availability of experts, imaging, operating rooms and endovascular facilities.
  • A specialized neuroscience intensive care unit.
  • Experience and expertise treating patients with various kinds of strokes.

UCHealth’s Memorial Hospital Central in Colorado Springs is poised to become a Comprehensive Stroke Center by the end of this year, while Poudre Valley Hospital in Fort Collins and the Medical Center of the Rockies in Loveland both are certified as Primary Stroke Centers.

People like Don who need an interventional radiologist usually must be transferred to a Comprehensive Center.

The key for friends and family members is to get patients help as fast as possible.

“Call 911. Get family members to the closest place,” Snyder said. “Ideally, they’ll come to a Comprehensive Stroke Center, where we can do all the interventions. We get patients from all across the region: Wyoming, Montana, New Mexico, Arizona and Nebraska.”

Resurrection

Kris’ son was still showing her around the hospital when she heard someone saying, “Mrs. Soltis. Mrs. Soltis.”

The words echoed in her head and terrified her.

A nurse had something to tell her, but wanted to speak with her privately.

“It’s far too soon,” Kris thought to herself. She stopped breathing and prepared for the worst possible news.

Instead, she could hardly believe what she heard.

“They got the clot. They got it all out and he has 100 percent blood flow,” the nurse said. “You can see him in 20 minutes.”

Kris exhaled and tears of relief poured from her.

“He’s going to live,” she thought to herself. “Whatever it takes, I’m going to get him through this.”

Kris had no idea yet how much brain function her husband had lost. Aside from the clot, Don had been incredibly healthy. He had low blood pressure, had never smoked and he hadn’t suffered from an arrhythmia, an irregular heartbeat that can put people at higher risk for strokes.

As Don began healing, doctors hunted for a cause for his stroke, but they never found one.

Then, on Easter morning, something strange and remarkable happened.

Don woke up, tried to stand up, and announced that he had to go to the bathroom.

Everything seemed to be coming full circle.

Kris was sitting in the hospital room with Don.

Stroke support near you…

Having a stroke is a life-altering experience. Support groups are a great way to meet other stroke survivors or caregivers who understand what you are going through. Contact a local group today.

University of Colorado Hospital Stroke Support Group: 2:30-4 p.m. on the first Wednesday of each month, UCHelath University of Colorado Hospital Anschutz Outpatient Pavilion, room 2006 (second floor); contact Angela Vasilatos at 720.848.4467 for more information or email stroke@uchealth.org.

Neuro/Stroke/Brain Injury Support Group at Memorial Hospital: 5-7 p.m. on the second Tuesday of each month at UCHealth Memorial Hospital Central, 1400 E. Boulder St., Colorado Springs, in the basement level cafeteria/Pyramid Room; contact Colleen at 719.365.9841.

Fort Collins Life After Stroke Support Group: 12:30-2p.m. on the third Wednesday of each month at Our Saviors Lutheran Church, 200 S. Lemay Ave., Fort Collins; contact Christy Dittmar at 970.493.6667 or email cdittmar@brainrecov.com.

“I looked at him. His speech was pretty clear and his face was symmetrical again,” Kris said.

She was stunned and pulled the cord to get help from a nurse.

“Don’t stand up. Look, you have yellow socks (worn by patients who are at risk for falling). You’re not supposed to walk without help,” she said to Don as he looked at her like she was crazy.

“I’m so hungry,” he said. “I’m craving a breakfast burrito with chorizo.”

“Is this real?” Kris thought to herself.

Then the nurse came in and she, too, was stunned.

She started asking Don questions.

“Do you know where you are?”

“Yes,’’ he said. “I had a stroke and I’m in the ICU and I’ve got to go to the bathroom.”

His memory was clearly working. His speech was great. He wanted to walk. And, furthermore, it was Easter morning.

Don was apparently having his own resurrection and he started making jokes about it. He was officially labeled as an ESUS patient, an acronym that describes patients who have suffered “embolic strokes with an undetermined source.”

“I come in on Good Friday and go out on Easter. I’m kind of like Jesus,” Don joked, eliciting laughter from the stroke team.

Clearly the stroke had not affected Don’s sense of humor. It also didn’t seem to affect the part of his brain that could write computer code.

By Monday, as doctors continued to watch Don’s progress in amazement, he was pulling out his laptop and writing code. As a side hobby, he had created apps for Garmin watches that allowed users to change the watch face’s color and track heart rates while hiking, skiing and walking. He had been wanting to do an update to his app, so he wrote some code and ran some tests.

As Kris began to realize that she was getting her old Don back – the one who was healthy and fit and could never turn his brain off – she was overwhelmed with gratitude.

“He could walk. He could talk. His brain remembered how to swallow. He was never intubated,” Kris said. “He went up and down a flight of stairs on Sunday. It was like God was saying, ‘Not today. Give me 48 hours and I will fix this.’

“I am forever in debt to that stroke team: to the doctors, the ICU nurses. Everyone was wonderful. It was just flawless execution. Everybody knew their roles, knew what to do and could answer my questions,” Kris said.

As she handed out hug after hug, she kept asking herself, “How did we get this lucky?”

“I wasn’t even aware that we had this world-class stroke center,” Kris said.

Now, she is convinced that having a highly specialized team ready to act in an instant saved Don’s life and his brain. She tells everyone she knows to act fast if they suspect a stroke. And, if possible, get to a stroke center as quickly as possible.

Don’s brain had compressed the whole experience, giving him a blessedly abbreviated version of the worries Kris suffered.

“As far as I was concerned, I was fine the whole time. I had to take an ambulance trip and do some stuff, then I was fine,” Don said.

He, too, has been overwhelmed with gratitude as family and friends jumped in to help with meals and his recovery. Don spent two weeks at home, then went back to work.

“I was so unbelievably fortunate,” he said.

New summits

At first, when Don left the hospital, Dr. Vela Duarte advised him not to do any hikes, cycling or skiing over 10,000 feet for the first year after his stroke.

Don and Kris Soltis cycled up to the summit of Vail Pass months after his stroke.
Don and Kris Soltis cycled up to the summit of Vail Pass months after his stroke. His next accomplishment: climbing three fourtenners over Labor Day weekend.

But in June, at a follow-up appointment, during which Case did extensive scans, Don was having such a remarkable recovery that Case gave the couple the go-ahead to do a test bike ride up Vail Pass, which tops out at 12,200 feet.

“Let me know how it goes,” Case told them.

So they headed to the mountains with their bikes.

Kris rode behind Don the whole time, keeping a close eye on him. She was ready to call for help in an instant if they needed it.

But they got to the top and Don felt great. They posed for a picture and texted it to Case.

Since Don was doing so well, Case gave them a thumbs up to try hiking at high altitude as well. They decided to see how he felt climbing from the base of Vail Ski Area to the top. Once again, Don felt great.

So, they set a big goal for the end of the summer.

On Kris’ 45th birthday, they had climbed their first 14er together: Long’s Peak in Rocky Mountain National Park. Since then, they had hiked up a total of 20 of Colorado’s tallest peaks. Their goal had been to climb all 53 of Colorado’s tallest peaks, but they both knew that Don’s stroke might force them to alter that goal.

None of the 14ers are easy. They all require endurance and some people struggle as they get to higher and higher elevations. Over Labor Day weekend, the Soltises decided to pick a relatively easy 14er and give it a try.

They drove to Lake City and on Saturday morning, headed up Handies Peak. Once again, Kris followed Don to keep an eye on him.

The sky was crystal blue, perfect for a peak climb.

They made it to the top and took photos with signs to mark their achievement. Don’s said Handies Peak, 14,048. Kris’ sign showed a heart with a “this guy.”

Don cheered as Kris’ eyes filled with tears.

What’s wrong?” he asked.

“I was so concerned,” she confided.

During the hike, Kris made sure Don was drinking plenty of water to stay hydrated. She kept checking her phone to see if she had service in case she needed it. And she watched to be sure other climbers were nearby.

“You made it,” she said. “I just didn’t know. I was scared.”

The successful climb marked yet another turning point in Don’s recovery. It went so well that the couple climbed two more 14ers that weekend: Uncompahgre Peak on Sunday and Mt. Princeton on Monday.

Kris summed up a new feeling that guides them now.

Don Soltis attends a work event with his wife, Kris.
Only three weeks after his stroke, Don Soltis was able to attend a work event with his wife, Kris. By summer, they were cycling and hiking together in Colorado’s mountains.

“We don’t want to waste time.”

Each morning that Don wakes up and can move and think, he is grateful.

“I have a very different perspective now,” he said. “I’m happy every single day that I get to see the sun and be around all the people I love.

“Everything is a gift.”