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Stroke of Fate For most victims of strokes, there is hope both in prevention and immediate treatment. Traci Miller, a young mother of two, is living proof 
Her three-year-old daughter woke up Traci Miller, York, Penn., at 6 a.m. on Saturday, April 8, 2006. She remembers it vividly. After putting her back to bed, Miller decided to jump in the shower as a busy day lay ahead. Her parents were coming to visit and she and her husband, Mike, were going house hunting. It all sounds like a perfectly normal start to the day for a 35-year-old busy mother of two. Moments later, Traci collapsed in the bathroom and Mike ran in to find her on the floor, unable to speak or move. He wasn't sure what had happened but wondered if she suffered some trauma in the fall itself. Results of a CT scan and tests performed at the hospital yielded the unthinkable: This young, perfectly healthy woman had suffered a massive stroke and the clock was now ticking away the time needed to save her. According to the American Stroke Association, about 795,000 Americans suffer a new or recurrent stroke each year and that more than 143,000 of those die as a result. It's the number three cause of death behind heart disease and cancer. Risk factors for stroke are age, high blood pressure, obesity, diabetes, family history, heart disease and smoking. Another risk factor is if a patient has what's known as a TIA or transient ischemic attack - also known as a mini-stroke. An ischemic stroke is one in which a blood clot forms and cuts off blood flow, which is what occurred in Traci's brain. But she had none of these associated risk factors. In fact, her blood pressure was and still is low. So what happened? Upon further testing, doctors determined that Traci had a PFO or patent foramen ovale, which is a flap-like opening in the heart that closes after birth for most of us. For about one in five Americans, it doesn't and it can allow a blood clot from one part of the body to travel through the flap and up to the brain, causing stroke. According to Mike Miller, the PFO was thought to be the catalyst for Traci's stroke but the root cause was not determined. However, she was advised to stop taking birth control pills, which she'd been on at the time of stroke as there is a known risk associated with "the pill" and stroke. Key for stroke patients is time, which many do not realize. Tissue plasminogen activator (tPA) is a clot-busting drug that has shown to be effective in treating ischemic stroke and reducing the damage caused but it must be administered within three hours of the stroke to be effective. For Traci, tPA wasn't an option, says her husband Mike, because her clot was so large. Her best option was a procedure using something called the Merci Retrieval Device, in which a cork-screw-like device would be threaded through a catheter inserted through the femoral artery in the groin. The device "ensnares" the clot and pulls it out. At the time of Traci's stroke, Overlook Hospital in Summit, N.J., where she was being treated, was the only hospital in the state offering the procedure and she would be only the second patient to undergo it. According to Dr. Ron Benitez, Traci's surgeon and the chief of endovascular neurosurgery at Overlook Hospital, this procedure must be done within eight hours of the stroke, so again, time is of the essence, which is why if you think you or someone you know may be experiencing a stroke, don't call first, just go to the hospital. Dr. Benitez says symptoms may include loss of vision in one eye, the feeling of a "black shade" coming down over the eye, numbness or weakness on one side of the body, loss of speech, inability to get certain words out. Sometimes, he says, the symptoms may come on for a couple of minutes and then go away (as in a mini stroke) but it's still reason for concern and a visit to the doctor. Within a few hours of her stroke, Traci Miller was under anesthesia and Dr. Benitez was working on removing her clot. First he injected tPA onto the clot to break it up and after two attempts to get the full clot, he was able to restore almost all of her blood flow to the area. Amazingly, Mike says, about an hour after the procedure she could whisper words. She spent four days in intensive care, three days in a regular room in the hospital, a week at an in-patient rehab facility and two months doing outpatient rehab, both speech and occupational therapy, which ironically was more for a shoulder injury she received as a result of the fall. In the moments after her stroke, Traci Miller couldn't speak and her entire right side was paralyzed and 13 weeks later, she was back to work. "I can't see out of my left eye and I can't write like I used to," Traci says, "but that's it." Her eye was most likely damaged from a small piece of clot that got into one of the vessels leading to her eye. In a case like Traci Miller's, prevention was something she could only think about after the fact, but for people that have any of the known risk factors, making lifestyle changes early is key. Adjust diet and incorporate exercise, which can reduce several of the risk factors, along with regular checkups. Dr. Jeremy Payne, medical director of the Banner Good Samaritan Stroke Center in Phoenix, says that salt is like poison and recommends the Dash Diet for lowering blood pressure. "We know that by and large, reducing your salt intake in conjunction with more exercise and lowering your body mass index is equal in worth to the blood pressure medication," he says. He also notes that the popular Mediterranean diet is associated with lower heart attack and stroke rates. For Traci, the recovery was frustrating but her lifestyle has not changed much since the stroke. She's still a healthy woman running around as a financial analyst and mother of two daughters. But it's important to her to share her story. "It can happen to anybody, no matter what age, no matter what," she says. "I had no warnings." |
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