My mom, Mary Jane, died 8 years ago. Dec. 25 would be her 86th birthday. Several years earlier she suffered a stroke. She certainly was a candidate for a stroke. She smoked since she was 15; she handled stress poorly, mostly by drinking much too much; and her dad had died of a stroke in his early 60s. Additionally, she didn’t have any kind of a handle on other possible risk factors. She rarely went to the doctor so she wasn’t aware if she had blood pressure or blood sugar issues. She didn’t exercise, and her eating habits included a summer sausage sandwich on buttered white bread with a pickle and piece of cheese at 2 a.m. She consumed lots of salt and not many fresh fruits or vegetables.
One morning mom woke up with a terrible headache. She never got headaches. She was alone. My dad left for church every morning long before she awoke. As she told it, she got up and was very imbalanced. She kept bumping into the walls. She waited but nothing improved. She didn’t understand that this was an urgent matter in which time was of the essence. Finally, when my dad got home, it was clear that mom was in trouble. 9-1-1 was called and she was taken to the hospital. Upon arrival her blood pressure was more than 200 over 110.
“Sudden” is a key word with stroke. Sudden changes in vision, speech and balance and sudden numbness are symptoms. “Time” is another key word. 2 million brain cells die every minute during a stroke. In the United States, stroke is the 4th leading cause of death and kills more than 133,000 people each year and is the No. 1 cause of serious, long-term adult disability.
The Stroke and Neurovascular Program at Froedtert & the Medical College of Wisconsin is a Primary Stroke Center as designated by The Joint Commission. It was the first such center in Wisconsin and one of the first in the nation. The Froedtert Acute Stroke Team (FAST) is ready 24 hours a day to respond to the needs of stroke patients, quickly, and if necessary, with new and emergent treatments that are not always available elsewhere. The physicians and other staff are unsurpassed. And the programs here for stroke rehabilitation include physical medicine and rehabilitation physiatrists, physical therapists, occupational therapists and speech therapists, psychologists, psychiatrists as well as patient and family support groups.
Mom did go to a rehab center. She did regain most of the physical losses she had experienced. She could walk and talk, but she couldn’t think nearly as well as she did before. She loved words and could no longer play scrabble. She watched "Jeopardy" and "Wheel of Fortune" but didn’t beat the contestants to the answers any more.
She really suffered the psychological effects that can come with stroke. About 50 percent of people who have had a stroke experience depression. Sometimes it can last for as long as three years. Her doctors tried any number of meds and even an in-patient stay for depression. Her primary care physician finally concluded that something in the area of her brain that affects mood and motivation was damaged. Her depression was intractable.
I miss my mom. I miss the way she was before the stroke: Cadillac-driving, cigarette-smoking, vodka-drinking, poker-playing, hard-driving, business-savvy woman. That was her identity and it did not include thinking about “risk factors.” It’s impossible to connect that Mary with the thin, weak, apathetic, frightened person she became.
Could it have been prevented? She could have addressed the risk factors and quit smoking, drinking and worrying. She could have stopped avoiding doctors. She could have started exercising, eating right and finding ways to reduce stress.
If she had the stroke anyway, would it have made a difference to recognize the signs of stroke and come directly to Froedtert (she went to a closer, community hospital)? YES! Quick treatment leads to better outcomes.
As I struggle with my own risk factors including, obviously, family history, I know that I will or my loved ones will respond FAST if this happens to me. I have a large refrigerator magnet that lists the steps to take:
Face – Does the face look suddenly asymmetrical, especially if the person tries to smile?
Arms – When asked to raise both arms, does one drift downward?
Speech – Is speech slurred or abnormal?
Time – Did this happen suddenly? Time is of the essence. Note the time that the symptoms first appear. There are some treatments only available soon after the symptoms appear.