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Ashanti Coleman, a nurse and a survivor of a stroke, was discharged with what doctors call a migraine.
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She really had a torn and blocked artery and could die if she did not go to another institution.
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The way doctors reject her pain, she says, is common among black female patients.
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Ashanti Coleman wishes she could tear off her head. Over the past week, the onset of pain on the right side has become increasingly persistent and intense. As a stroke survivor and nurse working in a pain clinic, Coleman knew she did not have a headache.
But in the emergency room in May 2019, Coleman said she waited a few hours before she was seen. Eventually, she was admitted with a ‘mini-stroke’ diagnosis, but waited for days for the attention of a neurologist to determine the source of her now severe headache.
When the doctor did see her, he did not ask about her pain or do a neurological examination, Coleman said. He rather dismissed it as a migraine and discharged her – despite the fact that he had treated her first stroke and thus knew her health history and occupation. “It did nothing to me,” said Coleman, who lives with her husband and two children in Memphis.
That night, Coleman wakes up with pain in her neck. “It felt like something was tearing,” she said. Therefore, she was taken to another hospital, where her right carotid artery – one of the two main sources of blood in the brain – was broken and 50% blocked, and she had to undergo emergency surgery immediately.
It turns out when doctors tried to remove a blood clot after her first stroke in 2017, they damaged that artery. It did not fully repair itself, causing the tear, clogging, and Coleman’s symptoms.
“The entire right side of my brain did not get any oxygen or blood, which caused the headache,” Coleman (now 41) told Insider. “Eventually that tear could have gotten worse, and I could have died.”
Through a partnership with the American Heart Association, Coleman spoke to Insider about her experience as a dual survivor of stroke and a black woman navigating the health care system. Even as a nurse at PhD level, she is subject to systemic racism that negatively affects care.
Coleman was 38 years old and healthy when she had her first stroke
When Coleman woke up one morning in 2017 with a pain on the right side of her head and body, she brushed it off and went to Starbucks. Back home, “the headache just kept bouncing, but just kept going,” she said. Then her husband noticed that her speech was confused.
Looking back, Coleman says the symptoms were a stroke in the “textbook”. But she was 38 years old, had a healthy weight and good blood pressure, exercised regularly and did not drink, smoke or eat red meat. “I was just a little denied when the symptoms started because I’m like, ‘I have nothing wrong with me,'” Coleman said.
But then there was a sharp pain in her left side, the left side of her arm felt numb and tingling and she lost coordination. “Then I knew I was having a stroke,” she said. Her medicine for race and birth control was her only risk factor.
In the hospital, she was immediately diagnosed with a stroke caused by a blood clot on the right side of her brain. Doctors first gave her a “clot-buster” medication and then tried to remove it, but at that point it was small enough to stay in place.
After that, she started with physiotherapy, occupational therapy and speech therapy to repair her lost functioning. Early on, for example, Coleman could not open and close her left hand herself. “My mind said my hand had to do it, but it wouldn’t do it, so it was so frustrating,” she said. “I could not do my daughter’s hair, my hair or my clothes.”
As some survivors of a stroke do, she also developed an accent that lasted about six months. She sounded Jamaican. “My speech therapist actually asked me where I came from,” Coleman said. “I was like ‘I from Chicago.'”
But after more than two months of rehabilitation, Coleman was back at work as a nursing professor at the University of Memphis. “I was determined to be able to function again as quickly as possible,” she said.
Coleman feels relieved during her second stroke
Coleman does not know why her second experience in the same hospital and at the same provider went so differently. But she does know that it feels ignored and that pain is overlooked by health professionals, too common among black women.
“I hear a lot,” she said, “that African Americans, and women in particular, are just being fired with their pain.”
One study from 2016, for example, found that about half of white medical students and residents endorse false beliefs about biological differences between black and white people, such as that black people’s nerve endings are less sensitive and their skin thicker. In turn, they rated the pain of black patients as lower and made less accurate treatment recommendations.
Coleman said her pain was initially untreated as she, as the neurologist told the primary care physician, “does not appear to be in pain”.
“They assume that individuals are not in pain because we are not presenting as they think we should,” Coleman said. “I did not wriggle on the ground. I did not use blasphemy. But everyone’s pain is different. ‘
Coleman, who is currently administering COVID-19 vaccines and is publishing research on women and cardiovascular disease, wants her nursing students to learn just that. “I hope to train them where they are not looking at a person like this skin color,” she said. “I hope they look at a person as a whole.”
She hopes that patients also do not keep themselves in a category, such as thinking that because they are young and healthy, they can not have a stroke. “I use my strength to keep going and moving forward and pleading for other people,” Coleman said, “so that another young lady does not have to go through what I went through.”
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