Monday, March 7, 2011

About Them Strokes

On April 2, 2005 when Marty had a hemorrhagic stroke, 2000 other people had strokes. That year over 700,000 people were struck down by one of the two types of strokes, ischemic (blood clot) or hemorrhagic (bleeding in the brain). Stroke, in whatever form, is devastating and lethal, it is the 3rd leading cause of death in the United States today.
What I didn’t understand about strokes when Marty first went into the hospital is how permanent they are. What I didn’t understand about strokes was how many ways a stroke inculcates its way into your life and how many pieces of your body simply quit functioning or quit functioning well.

When you have a stroke, any kind of stroke there is a 25 percent chance you will die within 12 months and a 40% chance you will experience a significant impairment and a 10% chance you will move to a nursing home. And, if all of that is not good enough to get you to quit smoking, once you have a stroke the odds of you having another stroke are much higher.

Stroke kills but it is also the leading cause of disability in the United States. The effect of stroke absolutely robs people of their most precious resource, their brain, their mind, the ability to think with clarity, to communicate without thought, to move with ease. Those things we take for granted, swallowing, standing, scratching your head, getting dressed, or solitude are in the past, everything requires effort and assistance.

Marty’s first stroke, a subarachnoid hemorrhage, came very close to killing her. The majority of people who experience this kind of stroke either die or end up institutionalized. It was caused by the rupture of a congenital aneurysm in the left front of her brain. She, we, were lucky, the rupture clotted and stopped bleeding long enough for her to have surgery, it only started to bleed again once they entered her brain to repair the rupture.

My miraculous Marty largely recovered from this first stroke, but there were significant changes in her. The rupture was on the left side so she experienced significant weakness on her right side and struggled with short term memory loss and some cognitive functioning. Marty participated in physical, occupational and speech therapy and gradually recovered much of her strength but her personality and communication skills were markedly changed. The fiery, loquacious, raunchy Marty was just gone, replaced by a quiet, contemplative Marty. Pieces of her that made her the unique Marty were gone, Marty the educational psychologist would not teach again, she would not coach again, too many pieces were erased by the bleeding.

Statistically speaking, Marty’s second stroke should not have been that much of a surprise as about 25% of people who have one stroke will have another within five years. I was so full of gratitude and amazement at her recovery from the ruptured aneurysm I didn’t really think about it. I was still trying to adapt to the new Marty and trying to make sure we both maintained health insurance, I sure wasn’t thinking about a more devastating event.

Eight months after the first stroke Marty had an ischemic stroke, essentially a blood clot in her brain. This time it was on the right side, affecting her left side, this time the consequences were much worse and much more debilitating, this time she went into a wheelchair, this time she lost the function of her left side completely, this time she could no longer care for herself at all, in even the most basic functions, this time was much worse.

Marty is one of about 4 million stroke survivors in the United States. Like many she can no longer walk, stand on her own, move from one place to another without assistance, eat without supervision, bathe alone, get dressed, take her medicine or choose her clothes. Much of what was Marty is there, it’s in her eyes, her laughter, her humor, her enjoyment of simple things, but the strokes took a huge portion of her life, just as it does for so many. We are lucky to still have what we have; in spite of it all we have things for which we are grateful.

$62 billion is the cost of care and lost work for the four million stroke survivors. The medicine, the caregivers, the tools, the machines, the doctors and the hospitals all cost and all the costs mount up but all of that pales in comparison to the loss of identity, independence and self.

Stroke is one of those things that will affect most of us at some point in time in our lives. Four out of five families will somehow be affected by stroke. The best thing any of us can do is quit smoking, exercise, control our blood pressure and diabetes. The next thing you must do is if you exhibit any of the signs of stroke get medical help, right now, it can help . The consequences of doing anything else are simply devastating.
Data from American Heart Association, National Institute of Health, Center for Disease Control

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