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About Medford mail tribune. (Medford, Or.) 1909-1989 | View Entire Issue (Sept. 8, 1963)
The victim of the nation's third largest killer tells what science and family can do to return an invalid to a normal life ten blamed, really don't have much to do with causing strokes. In a recent large-scale study at the New York University-Bellevue Medical Cen ter, only 3.5 percent of several hundred stroke victims were stricken under circumstances that might be described as acute stress. Many of them were asleep, just as 1 was, when the stroke oc curred. Typically, over four times as many house wives had strokes as did professional people. The word "stroke" has no precise meaning. It's just a way of indicating the symptoms of cerebro vascular accident obstruction of the circulation of the blood to or in the brain by hemorrhage, by narrowing of an arteriosclerotic blood vessel, or by clot If the stoppage of blood (which supplies vital oxygen to brain tissues) lasts even a few minutes, it is enough to kill the tissues affected and knock out the things they boss leg or arm movements, speech, and memory. If the damaged tissues are on the left side of the brain, the right side of the body is stricken. Injury on the right side of the brain knocks out the left side of the body. The extent of the injury depends on which and how large a region of the brain ia affected. Speech is controlled by a dime size piece of tissue called "Broca's Area." When it is only lightly damaged, there is just a slurring of words, which usually clears up in a few days, aa it did in my case. Why I Had a Strafe At the Northern Westchester Hospital in Mt Kisco, N.Y., where I was taken by ambulance from my home, specialists determined the cause of my stroke: the high blood pressure I have had for years had ruptured a weakened part of an artery in my brain, causing hemorrhage. Because I was not unconscious and because my speech, while Blurred, was not seriously affected, the doc tors reasoned that the bleeding was not extensive, that nature itself had already stepped in to start patching the hole. This was backed up by the lack of blood in my spinal fluid. Until just a few years ago, doctors generally thought that all strokes were caused by blood-vessel accidents inside the brain itself. But Dr. C. Miller Fisher of Montreal, among others, was baffled by consistent autopsy findings on stroke victims which showed no damage at all to blood vessels above the neck. In the early 1960s, Dr. Fisher, studying 432 autopsies, discovered that, in over a third, one or more of the four neck arter ies supplying blood to the brain were narrowed or clotted to such an extent that the tissues in the brain were cut off from nourishment This was quickly ruled out as a cause of my stroke by tests that showed the blood pressure in my neck arter ies to be normal. But in cases where the neck ar teries are involved, dramatic new procedures are now being developed. Then, shortly after Dr. Fisher's proof that not all strokes originated in the brain, a nontoxic radio-opaque dye, which could be injected into the circulatory system, was perfected. By using rapid-fire X-ray equipment, it became possible to follow the dye (injected into either arm or neck arteries), as it surged up through the neck to make its three-second trip to the brain. The dye shows up white on the X-ray film. Where there is a block, a dark shadow appears. This new diagnostic tool enabled Baylor Uni versity's Dr. Michael DeBakey, a noted vascular surgeon, to develop in 1964 a surgical method for correction of a clogged neck artery. Work ing through a small incision in the neck, Dr. De Bakey clamps off the artery on either side of the obstruction, installing a temporary "shunt" so that blood supply to the brain will be maintained during surgery. He removes the fatty clots which have narrowed the artery channel, and further enlarges the passage by means of a Dacron patch. Since then, Dr. DeBakey and his associates have performed blocked-artery surgery on several hundred stroke patients. This surgery is now be ing performed at 20 major medical centers in an evaluation study of its benefits in comparison with "natural" recovery of stroke patients. The most practical advances in general stroke treatment and prevention today are the new drugs those that retard blood clotting and those that lower and control high blood pressure. A recent report to the American Heart Association largely credits these drugs with a 22 percent drop in death from strokes among white males in the 45 64 age group. The anticoagulants, used to retard clot formation, boost a stroke patient's chances for survival by nearly one-third, according to a five-year study at the New York Hospital-Cornell and New York University-Bellevue medical cen ters. In a Mayo Clinic study, the drugs appear to reduce the incidence of second strokes by as much as 75 percent Tha High Priea af Nagtact Two years ago, when my blood pressure shot above the 200 mark and I had to be hospitalised briefly, I was given the new drugs to help lower and control it They worked fine but left me se verely depressed. Against my doctor's advice, I stopped them. My blood pressure shot back sky ward, and my stroke appears to have been the re sult Now, I'm taking them again two aspirin size tablets a day and I am determined to keep on doing so for the rest of life. Once you have suffered a stroke, you discover that rehabilitation is accomplishing near-miracles. Stroke no longer means the end of a person's useful life. But rehabilitation must begin early, whether in a hospital or at home. Exercise of seemingly useless muscles must begin at once, since inactivity can be more harmful than the original damage caused by the stroke. At first By JAMES WINCHESTER Perfectly mobile now, Jim visits daughter Nancy, 9, at day camp. the muscles and nerves in paralyzed parts of the body are as good as ever. It is just that their con trol centers in the brain are damaged. But deterioration of muscles and nerves sets in quickly and progresses rapidly when the stroke victim is bedfast or immobile. Other things hap pen, too. Circulation slows, calcium leaves the bones. Moreover, you can quickly acquire the atti tude that you're an invalid. Dr. Anita Isaac, a Kansas physician specializing in stroke rehabil itation, says, "I consider it an injustice to a stroke victim if he isn't standing within 24 hours, either alone or supported." I was sitting up in bed the first day after my stroke. On the second, I was standing, assisted, though my leg was completely paralyzed. That same day, the hospital's physical therapist began exercising my muscles with gentle massage every two or three hours although I still couldn't move them myself. Before the end of the week, with help, I was getting across to the bathroom. Every day I sat in a chair while my bed was being made. Comments Dr. Howard Rusk, who heads the New York University-Bellevue Institute for Phy sical Medicine and Rehabilitation in New York City, where I was transferred for intensive physi cal therapy just ten days after my attack, "If simple physical therapy begins within the first week after a stroke, most victims can be walking and taking care of themselves in six to eight weeks, sometimes sooner." Caring far tha Strata Pattant The best thing that family members can do for stroke patients, I think, is not to treat them as invalids. My wife, bless her, assumes I can do anything. Somehow or other, though, she always seems to be around when I'm dressing. It's just natural when she casually reaches out to help me with the cuff button on my left sleeve. I don't feel dependent Believe me, that's important Recovery for a stroke victim isn't easy for either the patient or his family. Physically, stroke victims may look and feel fine. But a part of the brain AM been destroyed. Only nature and time can train new tissues to take over. Until they do, there are bound to be emotional changes. These should be expected but recognized as temporary. For example, during their recovery periods, stroke victims, almost without exception, are ir ritable and snappish, often over trifles. When I first started back to work, I'd dictate letters to my wife, who'd take them down in long hand. She's not a secretary, and it was laborious work for her. Often, though, I'd have her in tears because she made a simple mistake, such as mis interpreting a word. I would become utterly out raged. Later, I would be bitterly ashamed. Another thing that stroke victims frequently do in the early stages of recovery is cry. You're not sad. Nothing has upset you. You just start ( Continued on page 15) PHOTOOIAMS T OUT OIUITTl TtmUy Weekly, frpUmbrrt.lMJ T
