Brian Hultman had raced the grueling 206-mile LOTOJA course (from Logan, Utah to Jackson Hole, Wyoming) nine times prior to what was to be his tenth and final outing on September 7, 2013. Hultman loved competitive cycling but it was time to give it up. He wanted to spend more time with his growing children, ages 3, 8, and 11, and get off the training treadmill and into another stage of life. On that day in September, he was feeling good. He'd completed all three of the course's toughest climbs. The worst behind him, all that was left was a comparatively easy 70-mile cruise through some of the most scenic parts of Wyoming.

"My vision went really loose on the left side," Hultman says of the moments before his memory fades to black. "Then my hands were stuck on my bars and my right leg was really stiff. I had to stop. The highway patrol guy was telling me it was going to be OK and that an ambulance was on its way. I don't remember much after that." 

Found on the side of the course by a Wyoming State Trooper, the then-45-year-old had suffered a major stroke caused by a blood clot in his brain. And, were it not for a high level of medical collaboration, Hultman would not be able to tell his tale. The process began in Afton, Wyoming and ended on an operating table at University of Utah Health.

"This is cutting-edge stuff, only really offered at a few centers," says Hultman's interventional neurologist, Michael Wilder, MD. "There were a lot of things that went right for him. We got him attention at the first hospital very fast and had him brought down to U of U Health quickly where we had a team assembled and waiting."

Wilder consulted with the hospital in Wyoming and was able to quickly ask the doctors there to administer intravenous "clot-busting medicine" which helped mitigate the damage in the brain. Once in Salt Lake City, the medical team used advanced imaging technology to determine Hultman's candidacy for a surgical option. Then they employed a cutting-edge and minimally invasive x-ray-guided procedure to extract the remaining clot from his brain. 

"Being able to consult with hospitals in areas that may not have the training or equipment to handle a stroke allows us to streamline the treatment and opens up a lot more options," Wilder says. "In Brian's case, the clot busters we ordered bought us time and we were then able to remove much of the clot from the clogged vessel in his brain. It led us to a much more successful outcome." 

Calling Hultman's recovery "dramatic," the neurologist ultimately gives credit to the cyclist's athletic and competitive nature for how far he's come. 

"Brian is a very determined and motivated guy," Wilder says. "He is expressing frustration that he's not getting better faster while everybody on our team is blown away at his recovery pace. He's a fighter."

And, although Hultman knows he has a long way to go, he says he's just taking it one pedal stroke, one climb at a time.

"I promised myself early on in this that each day is going to be a new day," he says. "I don't want to think about how much better everybody says I am. I want to prove to them that I am truly better."

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