Caleb Schaffer was at swim practice on Sept. 22, working on kicks, when his coach noticed that something was off with the 9-year-old boy with the sprinkling of freckles across his nose.
His legs weren't working quite right.
When Caleb came out of the Pinnacle neighborhood pool, there was no doubt: His whole left side was drooping. He had an intense headache.
"I was trying to get through practice," Caleb recalled. "But I didn't feel good."
The coach called Caleb's parents, Matt and Cadena Schaffer. Matt, owner of Innovative Pest Management, was on his way to an appointment. Cadena was nearby.
Both parents raced to the pool. Cadena took her son to Central Baptist's facility at Brannon Crossing in Jessamine County, where a doctor immediately suspected a stroke.
"You've just got to get him to Central Baptist," he told them.
Stunned, Matt and Cadena decided not to wait for an ambulance to take Caleb to the main hospital.
It was rush hour on Nicholasville Road. And Cadena, a kindergarten teacher who is normally composed, was driving on sidewalks. Once at the emergency room, Caleb half limped and was half carried in.
Meanwhile, Dr. Curtis Given, director of neurointerventional services at Central Baptist, received a call at home. Neurology nurse Nicole Archer was on her way home when she got a similar call; she turned her car around and went back to the hospital.
A child's brain was at stake.
A racing clot
Stroke is most often linked with adults with high blood pressure and risk factors such as a history of smoking. Even though children are seldom thought of as stroke candidates, stroke and other cerebrovascular disorders are among the top 10 leading causes of death in children.
"Because we don't think of it as being in children, it often goes undiagnosed," Given said.
Given insists that when patients have heart attacks, they are more likely to recognize the well-known symptom of chest pain. But because the symptoms of impending stroke are less recognized — such as a headache — people often delay going to a hospital.
From Given's standpoint, that's the worst thing to do.
In children, stroke is often caused when a clot suddenly breaks loose and races to the brain, which is what Caleb's looked like, Given said.
The Colorado-based National Stroke Association says on its Web site that parents are on the lookout for croup and other sudden diseases of childhood, but not for stroke. They recommend using the FAST formula, advising parents to look for changes in Face droop, Arm movement and Speech difficulty. If so, it's Time to seek help.
In treating strokes, time equals brain preservation.
"We want to treat stroke like heart attacks, with the same urgency," Given said.
Pediatric stroke victims — about six kids out of 100,000 — have a good chance at recovery because their blood vessels are healthy. Given compares a child's brain to a new interstate, an older person's brain to a bumpy stretch of bad road.
A quick recovery
When Caleb arrived he was talking. He had a CT scan and then an MRI.
In less than two hours, he was given a clot-busting drug. Fifteen people were in the room, looking at his brain, asking him questions: What is your name? What hospital is this?
Caleb was soon moved to the University of Kentucky Children's Hospital for specialty treatment.
Given said the speed of Caleb's recovery has been remarkable and praises the Schaffers for their fast action.
On Sept. 23, Cadena wrote in her Facebook account: "Caleb woke up and asked for his mommy. Music to my ears!"
She was wary even after Caleb came home, watching him closely, assuring herself that he was well.
On Sept. 25, she wrote on Facebook: "I have followed him all over the house to the point that he asked me why I was always following him."
Back to swimming
Caleb had his stroke on Thursday. He was back at school, half-days, the following Monday. Two weeks later, he went back to swimming. He is able to play non-contact sports.
Matt and Cadena still don't know why Caleb had a stroke.
They accept that they may never know.
"The key to the whole case was getting him correctly diagnosed," Given said. "I'd like to tell you it was me, but it wasn't."
Caleb gave himself two weeks to recover. After that, said the Veterans Park Elementary fourth-grader, "I shut down the video games and started to go outside."
On a recent snow day, Caleb donned his green parka and started shoveling a neighbor's sidewalk. He said he was burning off energy.
He proudly talked about his favorite book, Jackie and Me by Dan Gutman, from a series about a boy who can time-travel via baseball cards and visits with Jackie Robinson. Then he slipped away into the dining room with a pile of Legos.
The tiny bricks could be anything, eventually. Caleb has plenty of time to think about it, now.
"We feel really blessed in the whole thing," Matt said. "It's almost a lesson not to take your kids for granted, not to take life for granted. It's our privilege."