Stroke ... minimize your risk
A quick response and a dedicated team of therapists helped this central Wisconsin father fulfill a day of promises
A promise fulfilled: Ed Horgan and daughter Mary Ellen dance at her wedding, just over 3 weeks after his stroke.
Preparations for their youngest daughter's June wedding had been underway for months. With the wedding just over 3 weeks away, the Horgans decided to take some time for themselves and spend a weekend in Door County. As they got ready to leave, Ed Horgan, 72, suddenly felt nauseous and lightheaded.
“I knew that something was going on,” recalls Ed. Within a short time, Ed was on his way to Ministry Saint Michael’s Hospital in Stevens Point, where he was seen by neurologist Paul Atkinson, MD.
Ed didn’t have the traditional signs of weakness, numbness or slurred speech, yet he had suffered an ischemic stroke – caused when a blood clot stopped the vital flow of blood and oxygen to a part of his brain.
Many stroke survivors are left with mental and physical disabilities. With his left side paralyzed, Ed wondered who would walk his daughter down the aisle.
During a stroke, brain cells die at a rate of 2 million per minute, so quick response is crucial to minimize brain loss and improve the outlook for recovery. Many of the long-lasting effects of stroke may be minimized if treatment is administered within 3 hours of the onset of symptoms.
There are two types of stroke.
Hemorrhagic stroke is rarer and occurs when a blood vessel in the brain breaks and leaks blood into the brain.
Ischemic stroke occurs when arteries are blocked by blood clots, plaque or other fatty deposits. Strokes that have symptoms that last less than 24 hours may be referred to as transient ischemic strokes (TIAs). These are sometimes called mini-strokes. They are usually caused when the blockage of the blood vessel has not yet reached 100 percent.
For an ischemic stroke, the normal course of treatment is to administer tissue plasminogen activator (tPA), a potent drug which helps break up the clots that block blood flow to the brain during a stroke.
However, due to the type of stroke Ed was experiencing, administering tPA would have posed a greater risk, so Ed was given heavy doses of aspirin instead. The next morning, Ed had difficulty swallowing and had lost the ability to move his left side.
Ed realized he was fortunate to be alive. According to the American Stroke Association, (www.strokeassociation.org) stroke is the #3 killer in the US. It’s also a leading cause of serious, long-term disability.
Four days after his stroke, it was time for Ed to look toward rehabilitation. Ed chose Ministry Saint Joseph’s Rehabilitation Center in Marshfield for 10 days of intense patient rehabilitation therapy.
Knowing that Ed wanted to not only walk his daughter down the aisle, but also dance the father-daughter dance at her wedding, the therapists set out to help Ed meet his aggressive goals. Ed’s therapists practiced walking and dancing with him so that he would be ready for his daughter’s big day.
While most progress in a person’s ability to function in the first 30 days after stroke are due to spontaneous recovery, rehabilitation is an important part of the process.
Successful rehabilitation depends on:
- how early rehabilitation begins
- the extent of the brain injury
- the survivor’s attitude
- the rehabilitation team’s skill
- the cooperation of family and friends
“At Ministry Saint Joseph’s you have intense therapy – 4 hours each day,” said Ed. “Thanks to the dedication of my medical team of physicians, nurses and therapists, on June 12, I walked my daughter down the aisle and danced our ‘father-daughter’ dance.
“I think goal-setting is extremely important,” said Ed. “I have not felt depression over the changes in my life. I’m still in occupational and physical therapy at Ministry Saint Michael’s Rehab Services. I am walking unassisted and my balance is good.”
Ed continues to play golf and tennis. “Therapy is an extreme amount of work,” said Ed. “I know that I may never be the way I was, but I will be as close to that as possible. I will find a regimen of exercises that will keep me on track and growing.
“You get to know people in the rehabilitation program. Most of them had suffered stroke. Some of them handled it better than others. I started encouraging people. There were always things that I could compliment. It was a neat dynamic to work together and encourage one another,” added Ed.
Because of public awareness, the incidence of stroke has fallen by 18 percent and stroke-related death by 33.5 percent. Recognizing symptoms and acting fast to get medical attention can save a life and limit disabilities.
One in four people who have had a stroke will have another (recurrent) stroke within their lifetime. Within 5 years of a stroke, 24 percent of women and 42 percent of men will experience a recurrent stroke.
Recurrent strokes often have a higher death and disability rate because parts of the brain already injured by the original stroke may not be as resilient. Whether you have had a stroke or not, you can reduce your risks with simple lifestyle changes.
Are you at risk for a stroke?
While there are risk factors that we cannot control, such as age, race, hereditary conditions and personal history, the National Stroke Association states that up to 80 percent of strokes can be prevented with lifestyle changes.
“The key to stroke prevention is focusing on modifiable risks, including high blood pressure, high cholesterol, smoking and tight glucose control in diabetes. Your primary medical provider may suggest medications to help prevent stroke,” said Paul Atkinson, MD, a neurologist at Ministry Medical Group in Stevens Point.
Maintain a healthy blood pressure. “High blood pressure (over 120/80), also known as hypertension, is the leading risk factor for stroke,” says Charles Wirtz, MD, an internal medicine physician with Ministry Victory Medical Group’s Thorp Clinic. “When detected early and treated with medications and lifestyle changes, it can be controlled indefinitely with no ill effects.”
Exercise. Just 30 minutes of exercise every day can help you regulate blood pressure and cholesterol. Take a walk, dance or swim. Just get yourself moving; you’ll feel better and improve your health.
Eat a healthy diet. A low-fat, low-sodium diet will help you maintain or lose weight and lower your cholesterol and your blood pressure.
Lower your cholesterol. High cholesterol increases the risk for stroke and transient ischemic stroke (TIA). Total cholesterol should be less than 200 mg/dL; LDL (bad cholesterol) should be less than 100 mg/dL; and HDL (good cholesterol) should be at least 40 mg/dL; 60 mg/dL is optimal.
If you smoke, STOP! Smoking doubles your risk for stroke.
The National Stroke Association states that up to 80 percent of strokes can be prevented.
Face – ask the person to smile. If one side of the face appears crooked or drooping, this person may be having a stroke. Arms – ask the person to lift both of his or her arms in the air – if he or she has difficulty with one arm, this too might be a sign of stroke. Speech – ask the person to speak. If his or her words are slurred or he or she is unable to speak, this person might be having a stroke. Time – if any of the above symptoms are present, you must call 911 immediately to make sure this person reaches the hospital FAST.
STROKE by the numbers 6,000,000 people living in America today are stroke survivors. 2,000,000 brain cells die each minute during a stroke. 795,000 strokes will occur this year. 185,000 recurrent strokes occur per year. 137,000 people die from stroke each year. 55,000 more women than men have a stroke each year. 87 percent of strokes are ischemic. 80 percent of strokes are preventable.