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Stroke. Disoriented at church. Stroke. Lost on the way home. Stroke. "Will this happen to me again?"

As the world held its breath, watching whether global computer systems would crash due to the 4-digit year problem, my mother-in-law was transported from her small county hospital to a larger medical center. The computers were fine. She was not. She'd had a stroke, also known as a Cerebral Vascular Accident, or CVA.  

At age 87, she insisted she would go to New Year's Eve mass at the same church she'd attended all her life. My father-in-law wasn't feeling well enough to go, but well enough that she could leave him alone at home for a couple hours. Later we heard from others that she hadn't taken communion at church, which she certainly would have otherwise. It was a noticeable omission.

She headed for home afterward. She was a good driver, and I never felt unsafe when she was driving. But she got lost traveling the same route she'd driven for more than 20 years, since they'd moved into "town." Stopping in front of a shed on the dark country road, she tried to get in but it was locked. Confused, she set out into the cornfield in the cold night air. It was not frigid. There was no snow. We do not take this for granted in the Midwest, this time of year.

In a rural area, people notice the out-of-place, and someone noticed her car parked where no car should be parked. Dispatch to the county sheriff, license plate number reported, was overheard on scanner by one of her sons. A grandson was called by someone else. Forces were activated; she was found.

We were able to see her the next day as she spoke with a doctor, asking, "Will this happen to me again?" The doctor told her there was no way to predict it, but the fact she was lucid enough to ask the question was encouraging, and his prognosis for her recovery was optimistic.

Discharged to the nursing home back in her own county, she recovered substantially as the doctor predicted. There were a lot of problems, though, including physical and mental ones. She recognized family and friends, remembered events from long ago, though not recent ones. The brain attack had left her with aphasia, the inability to fully understand or express speech. Conversations with family members went on, but the aphasia always made us wonder if she understood more than she could convey. Her physical needs were too complex to care for her in her own little house, which she never lived in again.

The photo above shows her with her husband of almost 67 years at the time it was taken, in February 2000. She was well enough in the spring to enjoy the wedding shower for a beloved granddaughter, hosted in the family room at the home. But over the next five years, we lost her, pieces at a time. While at first she had good facial recognition, it wasn't long before she only could say my name if someone else said it first. That made me a little sad, but I was heartened that she always knew my son's name, always until the last time she called it, mistaking him for one of her own sons.

In May of 2005, her body gave in to its ongoing deterioration, and at age 93, she died. We miss her still, this remarkable woman who bore and reared nine healthy, fully functional children, who enjoyed without reservation all 21 of her grandchildren and many great-grandchildren, who accepted me into her family readily and lovingly. We miss her still.

Stroke. It can kill quickly or slowly. For the lucky ones, it is a temporary set-back. "Luck" often requires speed in diagnosis and treatment. We all need to know the signs of stroke and what to do if we suspect it.

To identify possible stroke in someone else, use the F.A.S.T. acronym.

Face: Ask the person to smile. Check to see if one side of the face droops.
Arms: Ask the person to raise both arms. See if one arm drifts downwards.
Speech: Ask the person to repeat a simple sentence. Check to see if the words are slurred and the sentence is repeated correctly.
Time: If the person exhibits any of these symptoms, time is essential. It is important to get to the hospital as quickly as possible. Call 9-1-1. Act FAST.

How can we prevent stroke? The National Institutes of Health provides stroke information that includes risk factors. These include
High blood pressure or hypertension
Cigarette smoking
Heart disease
Warning signs or history of TIA or stroke
Diabetes
Cholesterol imbalance
Physical inactivity or obesity

See your doctor for assessment of your risk.

My husband's cousin recently experienced a stroke, and his prognosis is quite good -- he is one of the lucky ones, although he did not get treatment quickly. He is in his mid-60s, overweight and inactive, has high blood pressure (diagnosed but he'd stopped taking medication), and smoked (he stopped upon entry to the hospital). Most of his risk factors were under his control, and he gets another chance.

A stroke is also known as a Cerebral Vascular Accident, but it is rarely an accident. The underlying conditions that contribute to risk may be present for years before a stroke. Know your risks and manage them where you can. Know the symptoms to help those around you, as well as yourself. Speed in diagnosis and treatment during or immediately after a stroke is essential.

     This diary is a repost of one I published a year ago. Thanks to Jim in IA for the photo of his parents and for encouraging me to write her story.

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