Tuesday, September 4, 2007

After stroke, life is one step at a time

Fast action when it occurs might help limit lasting effects.

Last update: August 31, 2007 – 5:58 PM

Halloween was only a few days away, and it was the last game of the World Series. David Whitehead and his wife, Pam Bailey, had just gone to bed when Whitehead woke up to find his wife trying to crawl to the bathroom.

"She was real confused, real lethargic. Her mouth was drooped, and she had a totally confused look on her face, and her arm was like this," Whitehead said, hanging his arm lifelessly by his side.

Whitehead rushed her to a hospital near their home in Mobile, Ala. "Of course, I knew before we got her to the hospital that she had a stroke, and when I got her there, they acted like, well no she didn't," Whitehead said.

He had described his wife to the ER staff: healthy, vibrant and only 44. Not the normal profile of a stroke victim.

Then they went to help her out of the car. "The nurse -- excuse my language -- said, 'Oh sh--,' and threw her in a wheelchair," Whitehead said.

One of the most dangerous misconceptions about stroke is that it's something that only older people have to worry about, said Dr. William Hewitt, a neurologist with the Diagnostic and Medical Clinic in Mobile.

"Stroke gets more common as you get older, but we do see young people with strokes," Hewitt said.

At the hospital, Whitehead didn't see his wife for almost two hours, and when the doctors finally got back to him, Whitehead learned that his intuition was correct: Bailey had suffered a massive stroke.

There are several types of stroke, but all occur when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. When either happens, brain cells begin to die, and the physical and mental abilities controlled by those areas are damaged or lost.

Bailey's outlook wasn't good.

The effects of stroke are many and varied, depending on the severity and location of the blockage. They can include aphasia -- speech and language problems -- along with problems with memory, partial or full paralysis and problems with spatial and perceptual abilities, among a host of other lasting and life-changing effects.

While Bailey has recovered remarkably well, the aphasia remains.

"The paralysis went away within a week or two," Whitehead said. "Within a week she had her strength back, and within a month, she was walking pretty close to normal again. But it's been nine months, and her speech is still ..." Whitehead trailed off.

"But they told us she would never talk again."

Today, Bailey is talking again, but words come out a bit jumbled, and pronouns are often switched -- "he" for "she,"him" for "her." She also uses the word "him" for several other words, especially when she means to say "stroke."

But after sitting and talking with her for a while, her speech patterns emerge, and it's easy to understand what she's saying. Humor and emotion aren't lost. She knows what she means to say, but the wiring from her brain to her mouth just won't let her do it.

"Every day's different," Whitehead said.

Bailey nodded emphatically.

"Because I feel like I could do, but I can't, and I get mad," Bailey said.

The couple attend an aphasia support group at Mobile Infirmary's PRO Health Fitness and Rehabilitation Center.

The group is designed for individuals who have aphasia -- as well as their family members, friends and caregivers -- and provides education about the disorder, encourages socialization among members and provides an opportunity to practice speech and language skills.

"At the beginning, Pam was unable to say her name, even just the simple name of Pam," said Jennifer Pettis, a speech language therapist who organized the support group and works with Bailey.

With intense speech therapy, combined with practice at home with Whitehead and special speech therapy software, Bailey's improvement has been dramatic.

Frustration is one of the major hurdles in patients with aphasia, Pettis said.

"They want you to treat them like a regular adult, like a normal person," she said. "More than likely, they can understand everything you're saying, and they don't want to be talked to like a child."

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