Joco Opinion

Lori Allen: Stroke begins a journey of rehab, determination

Everything about that morning had been routine — except one thing. No one really paid much attention to it at the time, but during breakfast John Papazafiropoulos delivered one sentence to his son that was completely garbled.

His son asked him to repeat what he had said and everything came out just fine on the second delivery. Odd, but quickly forgotten.

It would only be a matter of moments and all of that routine would change. He remembers being hit by a feeling of a complete void on one side of his head. There was no pain. Almost immediately he began to lose function of his arms and legs and shouted for someone to call 911.

What happened after that is patchy in John’s memory. He recalled specifically telling the EMT’s that his health history was “unremarkable,” yet he can’t remember the trip to the hospital. When he awoke in the emergency room, he was told that he had had a stroke and may never walk again. That was September 8, 2013.

In basic terms, there are two types of strokes doctors recognize: Obstructive, where a clot obstructs the artery keeping blood from the brain. If treated immediately this type of stroke has a high survival rate.

A drug can be given that will thin the blood, eliminate the block and get blood flowing back to the brain instantly. The other type, the type John had, is hemorrhagic, where the brain is no longer being supplied blood because a vessel has broken and is bleeding into the brain.

In this case, medication would only increase the bleeding. Surgery was not an option because in John’s case the location of the hemorrhage was too deep within the brain to operate.

According to Don Milligan, a physician at the University of Kansas Hospital, one of the early symptoms of a stroke is a sudden change in sensory function. For example, changes in vision, hearing and motor function; if you can’t speak clearly, your tongue doesn’t seem to move normally or your face begins to droop, this could be an early sign. If you are inexplicably clumsy or have tingling in hands or feet this may be a warning. A severe headache is also a symptom.

If you suspect someone is having a stroke, check their pupils to see if they are equal in size. Ask questions about where they are or what time of day it is to determine whether they are having a brain event. With any of these signs or symptoms, call 911 or if it’s faster, drive them to the emergency room yourself.

“The biggest barrier to getting a stroke victim treatment is getting them to come in quickly,” Milligan said. “Some people are embarrassed to come in, thinking that their symptoms aren’t severe enough or that they might be wrong.”

While that may happen on occasion, in most cases it turns out to be a lifesaving action. “If you don’t check in, we don’t have a chance to find out” and more importantly can’t begin the process to treat the stroke. The key to surviving and retaining functions after a stroke depends on how quickly you get treatment. “It’s that first few hours after the stroke, where we have the best chance to intervene.”

Risks for stroke are obesity, high blood pressure, diabetes and heart disease. “Tobacco use, high cholesterol and your activity level are all risk factors. If you are very active or engage in moderate exercise you will not only lower your risk of a stroke but if you do have a stroke your chances of recovery are much higher,” Milligan said.

John’s background has served him well during the process of recovery as his education is in emergency medical sciences, bioscience, counseling education and neuropsychology.

When John began to experience depression and anger, he was able to recognize that his sense of hopelessness was normal and that treating the psychological issues were just as important as treating the physical ones.

“Many people are not comfortable with the mental issues that come with a stroke,” John notes. “It is vital to remain hopeful, make jokes, and most importantly, celebrate the smallest accomplishments during the slow recovery process. My physical therapist kept a big whiteboard with my accomplishments, and my wife would come in to help me celebrate every new advancement, no matter how small.”

The good news from Milligan is that there have been many advancements for stroke patients.

“We used to believe that cells would never regrow,” Milligan said. “We learned that the brain is capable of making new connections, new paths. Recently we’ve discovered that the brain can build and grow new cells.”

There have also been encouraging results with more aggressive rehab — it just depends on how much damage has been done. That’s another reason to seek help quickly.

There was no evidence in John’s strong stride or firm handshake of the difficult journey he has taken in the last year. John held the keys to his recovery: immediate medical intervention, awareness of the psychological burdens that could hamper his recovery, a determination and attitude to push himself beyond the confines of a wheelchair and the support of doctors, therapists and family to help him through it.

Freelance columnist Lori Allen writes in this space once a month.

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