Stroke at 30??

Stroke at 30-something: You Can Come Back.  The Right Attitude, Therapy and Caregiver Support is Vital to Successful Rehabilitation

Stroke survivor Jessica “Jess” McNair can joke about it now—one of the reasons, in fact, she is convinced that it’s her sense of humor that helped her recover from a series of strokes this year. At 32 years old, Jessica experienced what doctors described as “cascades of multiple strokes” resulting from irregularly formed arteries in her neck. The event left the San Rafael, Calif., resident unable to walk, talk or care for herself.  The prognosis was bleak and Jess’ team of doctors predicted she had a five percent chance of living.  Her road to recovery started with a grueling schedule of occupational, speech, and physical therapy.

“I had overwhelming amounts of denial from the very beginning,” said Jess describing her first reaction to the news given to her at the hospital. Although Jess was preparing to move to London and bartending to save money, she doesn’t see herself as a victim: “I consider myself strangely pessimistic in an optimistic way.”

This is where Jess’ older sister Kate comes in.

The Caregiver’s Life is Changed

No individual or family is ever prepared to fulfill the role of a full-time caregiver. Looking back, Kate recalls that both her and Jess were overwhelmed with emotion. “We were both crying, but immediately started joking,” says Kate who feels that maintaining a good sense of humor is a necessary coping skill for everyone – but especially for stroke survivors. “When I walked into the hospital I told her that there are other ways to get a day off – you don’t have to have a stroke!”

A fulltime sales professional, wife, and expectant mother at the time, Kate knew early on that she had to deal with the situation personally. The then 34 year-old recalls the vagueness of the doctors and nurses in answering her questions, which emphasized how important it was for her to take control of the situation. Shouldering the responsibility of work and the physical demands of pregnancy, Kate now had the added role of primary caregiver to her younger sister.

Thankfully, Kate was able to rely on her husband and friends who helped deal with insurance companies, meal preparation, and physical therapy.

“There was a lot of planning. We had to plan how to watch her. It was pretty scary and the frustrations were there,” Kate remembers.

When it came to working as a team, Kate recalls Jess’ determination, “She was really determined. We would make a diary and everyday have these little goals.” This helped support the efforts of her rehab.

A Great Rehab Team

For stroke survivors, rehabilitation options depend on the severity of their stroke, their level of disability, and the intensity of rehabilitation exercises they are able to endure. The goal of rehabilitation is to improve the survivor’s function so that they can regain independence and live life without relying on a caregiver.

Upon suffering a stroke and calling the ambulance herself, Jess was admitted to the Intensive Care Unit at Marin General Hospital where she had two more big strokes. She was then accepted to the rehabilitation program at California Pacific Medical Center (CPMC)—Davies Campus while she still had a tracheotomy. At the time, Jess couldn’t speak or make a noise. Through their sisterly-bond, Kate was the only person who could read her lips and understand her. “I guess you could refer to me as a vegetable at that point—I was not moving at all,” Jess points out. This marked the beginning of her three-month stay at CPMC’s inpatient rehabilitation facility, before being transferred to their outpatient program.

“I had three amazing people working with me—I call them my heroes,” referring to her occupational, physical, and speech therapists with whom she remains friends to this day. During her recovery, the skilled professionals got her standing up and walking again with assistive technology such as the EksoGT™, a wearable exoskeleton that helped train her body to walk with a proper gait, and an electronic stimulation machine that enabled her to relearn vocalization.  With these devices, both Jess and Kate noticed improvement, providing Jess the much needed confidence and motivation to continue her therapy.

A Time for Independence

Jess is still in recovery and has been able to regain some of her independence with the help of Kate and her army of “heroes.” The sisters, who will be separated in the upcoming months due to Kate relocating to Minneapolis, feel that this experience has brought them closer and made their relationship stronger.

“Before, we were close – we saw each other on an everyday basis, but now our bond has been reinforced. Silly arguments don’t seem to matter anymore,” mentions Jess.“I love her—she’s one of my most favorite people on earth. I feel like I’m abandoning her, so I’m going to miss her a lot, but I am confident in her progression,” Kate adds.

Jess is maintaining her positive attitude and currently focusing on regaining enough independence to be able to make the move to London.

To encourage others on their own personal comeback journeys, Jess and Kate recently participated in a podcast. The podcast is available through Connected Social Media, Ekso Bionics and iTunes.

To learn more about the advanced exoskeleton technology Jess used during rehab, visit Ekso Bionics.

Stroke patient gets second chance through new therapy

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Stroke Facts

The simple act of feeding the family cats suddenly became a struggle for Steve Benner, one Sunday morning in November 2014.

When the now-56-year-old Racine resident tried to open the bag of cat food, he dropped it. And when he tried to sweep up the contents, he noticed a strange numbing sensation in his arm.

“I thought maybe I was dreaming because it felt really weird,” said Benner.

Wondering if he wasn’t quite fully awake, he returned to the bedroom and tried to drink a glass of water, only to have it dribble down his face. When Benner’s wife, Steph, asked him a question, his response sounded like gibberish and — while he still wasn’t sure what was happening — Steph said she realized right away that her husband was having a stroke.

She called 911 and Steve was transported by ambulance to Wheaton Franciscan-All Saints hospital on Spring Street around 7 a.m. By 12:10 p.m. that same day, he was recovering in Froedtert & the Medical College of Wisconsin’s Neurosciences Intensive Care Unit and beginning to speak. And by Wednesday, he was back home in Racine in time to enjoy Thanksgiving with his family.

“It was remarkable to me how fast everything came back for him,” Steph said.

New Therapy

Steve Benner’s rapid and complete recovery, from what doctors describe as a massive stroke, came as the result of a novel stroke therapy being used at Froedtert & the Medical College of Wisconsin in Wauwatosa. Called a thrombectomy, the endovascular procedure allows doctors to remove a blood clot by sending a tiny device called a stent retriever through a patient’s blood vessels to the site of the blockage.

Dr. John Lynch, the interventional neurologist who performed the procedure on Benner, said he went in through an artery in Benner’s leg and used a very small catheter — about the size of a few human hairs — to send the stent retriever up into the patient’s brain.

This state-of-the-art procedure — made possible by recent advances in catheter and stent technology — makes it possible to retrieve a blood clot in a matter of minutes, rather than the hours it can take to dissolve a clot using more standard, pharmaceutical stroke therapy, such as IV tPA (intravenous, tissue-type plasminogen activator), Lynch explained.

“This is really a sea change in stroke therapy,” said Lynch, who is medical director of the Neurosciences Service Line at Froedtert & the Medical College of Wisconsin.

Profoundly effective

For Benner, the thrombectomy allowed blood flow to quickly be restored to the side of his brain being blocked by the clot, preventing what could have been devastating results to his physical and cognitive abilities.

“His stroke was massive at the front door and, with this acute stroke treatment, was reduced to a little dot of injury in the end,” said Dr. Diane Book, a neurologist and medical director of the Stroke Program at Froedtert.

A thrombectomy can be profoundly effective treatment in the right circumstances, Book said. And while it can be used for a variety of stroke patients, it can only be performed if a patient is seen quickly and if the right medical team is in place not only to perform the procedure, but to determine if the patient is a good candidate for it, she said.

The advanced stroke imaging methods used at Froedtert allowed doctors to better determine the timing of Benner’s stroke (which might have occurred in his sleep), and the stroke team’s 24-hours-a-day, seven-days-a-week staffing enabled Benner to receive the treatment and care right away. Every hospital has some version of a stroke team, but not many have it staffed around the clock, Book said.

Benner — who had also suffered a previous, mini stroke several years earlier, for which he was being treated with blood thinners — also received another novel catheter therapy at Froedtert to repair a PFO (patent foraman ovale), or hole in his heart, after recovering from his stroke.

Doctors discovered the PFO when looking for the cause of Benner’s strokes, and Book said they think it is what allowed the clot to get to his brain. While the minimally invasive PFO closure procedure is still technically experimental and awaiting FDA approval, Froedtert has been performing it on a study basis and is optimistic about the results, Book said. The PFO closure trial will be presented at the International Stroke Conference in February, she said.

New Life

For Benner, both novel therapies were life-saving procedures that have left him and Steph feeling very grateful.

Looking back on the day of his massive stroke, Benner said he is still amazed at how quickly everything happened and how lucky he was that he suffered the stroke at home, rather than after leaving for the solo hunting trip he had planned the next day.

“When they told me what they were going to do, I couldn’t believe they could go in through an artery in my leg and send something up to my brain and heart,” he said. “It still almost doesn’t feel real, even though I know it is.”

So real, in fact, that it wasn’t long before Benner was back at work at Poclain Hydraulics in Sturtevant. And he spent the summer of 2015 playing softball and riding his Harley, much like he’d done for many years before.

This time, though, the father and grandfather did so with the realization that he almost didn’t make it back to the ball field, the open road or to spend time with his family.

“If I would have left Monday morning to go hunting and been out in the woods by myself when the stroke happened, who knows if I’d have been able to make it back to my truck,” Benner said.

And the Benners aren’t the only ones benefiting from such novel stroke treatment, according to doctors at Froedtert.

“This kind of remarkable recovery has become a normal expectation,” Lynch said. “We’re doing it here every single day.”

Copyright 2015 Journal Times. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Dos and Don’ts While Waiting for an Ambulance

Posted by Lisa O’Neill Hil

Your friend is over for dinner. She’s sitting at the table, fork in hand. All of a sudden, she drops the fork and she looks scared. You ask her what’s wrong, but she’s having trouble talking. You notice that one side of her body appears to be weak, and her mouth is drooping. You know what that means; she’s had a stroke.

You immediately call 911. But you don’t know what you to do while the ambulance is on its way. Is there anything you can do to help your friend? Or should you just wait until the paramedics arrive?

It’s important to be prepared for a medical emergency. Read on to find out what you should and shouldn’t do while you’re waiting for help.

Do:

  1. Use the word “stroke” when you call 911.
  2. Tell the 911 operator where you are if you’re calling from a cell phone in case the call drops. You should also give the operator your cell phone number.
  3. Stay on the line with the 911 operator and follow his or her instructions.
  4. Keep the person safe. If she’s conscious, place her on her side. Her head should be slightly raised and supported.
  5. Loosen clothing that could get in the way of breathing.
  6. Note the time. This is important information for doctors.  Most strokes are caused by blood clots. The clot-busting medication tissue plasminogen activator (tPA) can only be given within a few hours of the start of symptoms.
  7. Tell emergency responders what you saw and heard. Describe your friend’s symptoms.
  8. Stay with her. Your friend will be scared.
  9. Remain calm.
  10. If your friend is unconscious, check her pulse and her breathing and start CPR. If you’re unsure how to do that, the 911 operator will walk you through it.
  11. Unlock the front door so paramedics can get in quickly. The 911 operator may tell you to do that or tell you to open the front door ahead of time. With stroke, the sooner the patient receives treatment, the better the chances of survival and recovery.

Don’t:

  1. Drive her to the hospital yourself. A stroke is a medical emergency. Paramedics will let doctors in the emergency room know they are on their way with someone who has had a stroke. The hospital will prepare for the arrival ahead of time.
  2. Give her anything to eat or drink. This could cause her to choke.
  3. Give her any medication, including aspirin.