Facing strokes head on

By Michaela Morris/NEMS Daily Journal

The brain normally hums along quietly managing thousands of tasks. Walking down a street, opening a bottle of water, saying hello to a neighbor and breathing don’t require a second thought.
A stroke caused by a tiny clot blocking a key artery or bleed in that same artery can turn those normal tasks into Herculean feats.
“The best thing is trying to prevent them,” said Dr. Brian Condit of Tupelo, who specializes in physical medicine and rehabilitation.
The acute care for strokes focuses on limiting the damage. Long term, the goal is helping the brain overcome the damage through physical, occupational and speech therapy.
With intense rehabilitation therapies, the brain often can relearn and rewire around the damaged sections. That isn’t true in all cases. If even a small stroke hits the parts of the brain that deal with speech, vision or other complex functions, there may not be any way for the brain to rewire, Condit said.
“The whole world has fallen apart,” for people with strokes, Condit said. “But there is life, hope and dreams. You can have life beyond all this.”

Coming back
Quick response made all the difference for Jane Carruth.
The Tupelo woman was having her morning cup of coffee on March 15, 2009, when a stroke struck in her right brain.
“My entire left side gave out and I fell over,” Carruth said. “My speech started getting slurred.”
Her husband was able to call for help and get her quickly to the hospital, where they diagnosed her with an ischemic stroke caused by a blood clot.
Because she and her family acted quickly, she was a candidate to receive tPA, a clot-busting stroke treatment that has to be given within three hours of the stroke.
But that didn’t mean Carruth was all better the next day. The first week after the stroke was frightening and frustrating.
“I couldn’t bathe myself, I couldn’t feed myself, I couldn’t brush my teeth or wash my face,” Carruth said.
She spent four weeks in the NMMC Rehabilitation Institute. She made up her mind right away she was going to reclaim every bit of her life that was possible.
“You have to stay focused no matter how hard it is,” Carruth said. “If you feel defeated, you will not make progress.”
She made a point of getting up, dressing and putting make up on every day. Instead of going back to her room after rehab sessions, she ate in the dining room.
“The first day I walked, everybody in there clapped for me,” Carruth said.
At night, she’d work on trying to wiggle her hands and feet.
“I remember the first night my toes moved,” Carruth said. “I cried.”
After she got out of the hospital, she continued therapy through outpatient rehab. Slowly, basic tasks like spreading mustard on a sandwich, blow drying her hair and folding clothes became less daunting.
Carruth still walks with a cane, but she’s able to keep her 7-month-old grandson three days a week and help her husband, who is recovering from surgery.
“I’m still working on writing and my vision is impaired, but that has improved,” she said. “You have to keep trying.”
Recoveries like Carruth’s depend on where and how badly the brain was damaged and the attitude of the stroke survivor, Condit said.
“A positive mental attitude is very helpful,” Condit said. “But sometimes the spirit is willing, but the body is weak. … Our approach is we’re going to help people get the best recovery they can. But often times, getting all better is not on the agenda.”

Support
The impact of Peggy Markley’s January 2006 stroke didn’t stop with her brain.
“It was pretty devastating, not just to an individual, but the whole family,” said her husband, Bruce Markley.
The Markleys, who at the time lived in Biloxi, had just gotten off an airplane in Vancouver, B.C., on their way to an Alaskan cruise when the stroke, caused by a tiny bleed in her brain, hit.
“If we had been out on the boat or in the air, she wouldn’t have made it,” Bruce Markley said. “We were able to get care immediately.”
The stroke left Peggy with left-side paralysis, vision problems and cognitive deficits. She spent 22 days in the hospital in Canada and then weeks in inpatient and outpatient rehabilitation therapy.
“Your active life is just jerked away,” said Bruce Markley, who in the aftermath of the stroke, moved with his wife to Tupelo to be close to their children who live in Saltillo, Oxford and Starkville.
Despite efforts to keep Peggy at home, it eventually became clear she needed more help and she moved to The Greenhouses at Traceway.
After the move to Tupelo, daughter Lisa Abstein found a stroke support group in Memphis and encouraged her father to go.
“The biggest thing is to interact with other stroke survivors and their caregivers,” he said. “Unfortunately, there’s a lot of families with the same struggles.”
Because of his experiences, Bruce Markley convinced Stacy Suggs, an occupational therapist at the NMMC Rehabilitation Institute, to start a group locally.
The support group is a great source of encouragement for stroke survivors and their families to keep pushing and not give up on living life to its fullest.
“We go to church, to restaurants and around town,” Bruce Markley said. “You’ve got to stay as active as you can.”
Peggy will sometimes chime in during Sunday school and surprised her husband recently by reminding him to pay up for the Wednesday night supper.
“It does good things for her mind,” he said.

Prevention
Angela Bobo, a school bus driver and assistant at Parkway Elementary, had no clue her blood pressure was out of control.
“I didn’t feel anything,” Bobo said. “I felt fine.”
At her required physical in the fall, Bobo’s blood pressure was slightly elevated, but not to the point medication was recommended.
But during a Parkway community health fair sponsored by North Mississippi Medical Center in February, Bobo got a scary surprise.
Her blood pressure registered 222/114. Normal is 120/80. If the diastolic blood pressure – the lower number – reaches 120, it’s consider a medical emergency. The health fair crew checked it twice with the automatic blood pressure cuff before sending her to school nurse Leslie Backstrom, who took her blood pressure manually.
“I was scared,” Backstrom said, because of the high risk of Bobo having a stroke. “I asked her, ‘Where do you want to go, because we’re going to a doctor now.’”
Backstrom took Bobo to Med-Serve and waited with her to see the doctor. Bobo went home with medicine and orders to rest and monitor her blood pressure.
After three months of taking medication and regularly monitoring, Bobo’s blood pressure is a more manageable 138/80.
“It’s been as low as 128/72,” said Backstrom, who regularly monitors Bobo, and anyone else who requests it.
Bobo has seen what undiagnosed high blood pressure can do. Her father died from a stroke following prostate cancer surgery.
“Seriously, I could be dead,” Bobo said.
“We are so very thankful for the health fair,” Backstrom added.
Regular check-ups, especially after age 40, are an essential component for good stroke prevention, Condit said.
Three key risk factors for stroke – high blood pressure, diabetes and high cholesterol – can be symptomless for years, but can lead to fatty build-up in the arteries, Condit said.
“If you can treat those things up front,” Condit said. “You’re treating the atherosclerotic disease that leads to most strokes.”