Toledo mother recalls stroke while riding horse

This would be the first of many episodes for Kate Sippel. She had no idea she was battling a rare disease she was born with.

CLEVELAND — Kate Sippel of Toledo started riding horses at age 2, which led to her career as a veterinarian. She has been show jumping competitively since 2014 and last March added “mom” to her titles.

Two months after John David’s arrival, Kate and her horse, Norwin, returned to the ring. A beautiful ride, until a terrifying moment.

“All of a sudden I felt like someone punched me in the face,” Kate recalled. “I was heading straight for a jump and lost any type of movement or feeling on the left side of my body.”

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Norwin continued for three more jumps, then as suddenly as he started, it was over.

“It was gone,” Sippel says, “and I was kind of back to how I felt before.”

Kate thought she was out of shape because she had stopped riding while pregnant. At first it was easy to blame the time away from the ring, until the episodes kept happening and getting worse.

“I hit the ground and couldn’t get up,” she said of another incident. “I tried to get up, but I couldn’t, and it lasted probably 30 seconds.”

The day after this episode, it happened again, this time in front of Sippel’s husband, Fred, while they were in the car.

“I became completely paralyzed on the left side of my body,” Kate recalls, “and lost my ability to speak.”

Fred thought his wife had a stroke and took her straight to the ER. It was in the middle of COVID, and he couldn’t be with her in the hospital.

ER doctors told Kate the episodes were likely related to the stress of being a new mother, then discharged her. She was troubled by this diagnosis, and as she stood in the hospital parking lot waiting for Fred to pick her up, it happened again. Four more times.

As a veterinarian, Sippel didn’t need human medical training to tell him something was wrong. She immediately called her doctor.

“She said, ‘You’re 100% right,'” she said, her doctor told her. “‘It’s scary. Something’s wrong.’ and she had me do a neuro consultation.”

The neurologist diagnosed mini-strokes called transient ischemic attacks or TIAs. Kate also learned that she had an illness called moyamoya disease.

According to the National Institute of Neurological Disorders and Stroke, moyamoya is a rare but progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in an area called the basal ganglia. The term “moyamoya” is Japanese, which means “puff of smoke” and describes how the tangle of blood vessels seems to compensate for the blockage.

Sippel’s neurologist prescribed her blood thinners, but even with the meds, she continued to have nearly 15 TIAs a day and feared for her baby.

“Who was going to take care of this little guy, and who was going to raise him to do everything I wanted him to do?” Kate remembered thinking, fighting back tears all those months later. “I just lay in the hospital bed in tears. I wrote a letter to John David in case I couldn’t be there.”

In general, TIAs do not cause brain damage and usually go away in about 24 hours. However, they are a huge red flag: approximately 20% of patients experience a massive stroke within a week to 90 days.

Kate’s doctors told her it was okay to have two or three TIAs a day and that they would monitor her in six months. This plan did not suit him.

“If I let this continue, I’m going to have physical or mental deficits and I won’t be able to do any of this anymore,” she thought, “or I’m going to die.”

So she hopped on the internet and started looking for a second expert opinion. She didn’t need to look far: the Cleveland Clinic was only a few hours drive from Toledo.

“We see dozens and dozens of patients a year with this disease,” Dr. Andrew Russman, stroke program manager and medical director of the clinic’s Comprehensive Stroke Center, told us. “A lot of them will go for surgery; some of them don’t need surgery.”

Kate, however, would need surgery. Cleveland Clinic surgeons took his temporal artery and connected it to another artery in his brain, bypassing the declining carotid artery and saving his life.

“Moyamoya vasculopathy is a rare vascular disease that typically develops in childhood or early adulthood,” Russman explained. “This is a thickening that occurs in the carotid arteries that sit inside the brain, eventually causing these arteries to become completely blocked.

“We understand what happens to blood vessels, but what we don’t know is how to prevent it from happening.”

But Kate knew how to stop herself from becoming a statistic, becoming her own best health advocate and taking back the reins of her own life. The 38-year-old is now healthy, happy and stable, and ready to take many more ring jumps with Norwin.

Clyde P. Johnson