When Nestor Montalvo woke up last September, he knew something was wrong. He had a headache, and his vision was blurred. The symptoms felt like a “really bad hangover,” but he hadn’t been drinking the day before. When he tried to stand, the right side of his body was numb.
“Everything started spinning. I went to stand up, and I fell,” Montalvo, 61, recalled. “I just didn’t understand what was going on. I couldn’t understand it. I didn’t know why I was feeling that way.”
His wife helped him up and immediately called 911. Paramedics gave him alarming news: He was having a stroke. They rushed him to the emergency room at Catholic Health’s Mercy Hospital in Nassau, Long Island. The situation was dire: Montalves said he overheard a doctor telling his daughter, a registered nurse, that he only had a 15% chance of survival.
“I was like ‘Oh my God, I’m going to die. I don’t even have a chance to say goodbye to anybody,'” Montalvo, a retired New York City police officer, recalled.
Nestor Montalvo 
“Time is brain”
Doctors who treat strokes have a saying: “Time is brain,” said Dr. Taylor Kimberly, the chief of neurocritical care at Massachusetts General Hospital. Kimberly was not involved in Montalvo’s treatment. Strokes are caused when blood flow to the brain is interrupted by either a blocked or ruptured blood vessel, Kimberly explained.
Montalvo had a blockage, or an ischemic stroke. In these types of strokes, cells in the brain lose access to nutrients and oxygen, causing damage. The longer a stroke goes untreated, the worse the damage can be, Kimberly said. No one knew how long Montalvo had been having a stroke, since the symptoms had been present when he woke up.
Dr. Cini Thayil, an emergency medicine attending at Mercy Hospital, was the first doctor to see Montalvo. He was having “very prominent” neurological deficits, she said.
“You could see that something was awry,” Thayil said.
The symptoms triggered Mercy Hospital’s stroke protocol. Within 10 minutes of arriving at the ER, Montalvo had been assessed as a potential stroke patient. Fifteen minutes later, he was undergoing a CAT scan. Shortly after doctors reviewed the scans and conferred, Montalvo received a clot-busting medication called TNK, Thayil said. Later, he underwent another minor procedure to ensure the clot was gone.
“I could have been a vegetable, I could have died,” said Montalves. “But they saved my life.”
A complicated road to recovery
Even though the stroke had been treated, Montalvo’s situation remained critical. His vocal cords collapsed, and he needed a tracheotomy to allow him to breathe. He couldn’t talk or swallow because of the tubes, and aftereffects from the stroke itself made it difficult for him to speak and eat. When he met Aileen Fairchild, an acute care speech pathologist at Mercy Hospital, he couldn’t even swallow a quarter-teaspoon of applesauce unaided.
“It was a mess. I couldn’t swallow, I couldn’t talk, I couldn’t eat,” Montalvo recalled.
Nestor Montalvo 
For six weeks, Fairchild worked with Montalvo. He received about an hour of speech therapy a day, as well as exercises that targeted the muscles in his throat that contribute to eating and swallowing. He underwent regular scans to make sure the treatments were working.
After that month and a half, the tracheotomy tube was removed, allowing Fairchild and Montalvo to work more on his ability to eat and speak. He underwent three procedures to help the muscles in his throat. By Thanksgiving, he was able to eat a regular meal with his family.
Nestor Montalvo 
Now, about a year after his stroke, Montalvo is doing better. He can speak and eat like before, and is enjoying retirement by spending time with his wife, their children, grandchildren, and their dog, Paris. He still uses a cane to walk and is continuing to receive outpatient physical therapy. Montalvo said that he hopes to continue his recovery, which he said has been even tougher than surviving the stroke itself.
“You take life for granted, and then when something like this happens, it wakes you up,” Montalvo said. “You hear people talk about it, and it just sounds like it’s not going to happen to you. All of a sudden, it happens to you.”
