Lisa Fitterman clearly remembers the Friday night 18 years ago when she woke up on the floor and had trouble dragging herself back to bed. The journalist, who was 26 years old and covering the legislature in Victoria at the time, felt out of sorts and couldn't move the right side of her body. She figured she had some sort of weird flu. By Sunday, she realized she wouldn't be able to make it to work the next day and went to call her office--but she couldn't remember the phone number. The next day, Fitterman got in her car and attempted to drive to the hospital. She didn't have the strength to put her foot on the brake pedal; she went through a stop sign and broadsided another vehicle. When police officers showed up, they were ready to take Fitterman to the drunk tank. Nobody, especially Fitterman herself, thought she had suffered a stroke.
"When you have a stroke, your mind isn't working properly," Fitterman says, "so it really didn't register. I remember telling the person in ER that I felt gibbled...that things weren't right. There is no pill to make you feel better."
A stroke occurs when either a blood clot or ruptured blood vessels interrupt the flow of blood to the brain. Because the brain needs a constant supply of blood, oxygen, and nutrients to survive, some of its cells die when that supply is cut off. Consequently, brain function becomes impaired. Stroke can lead to paralysis, dementia, speech problems, depression, and death. According to the Canadian Stroke Network, it's the leading cause of adult disability in Canada. Some people have trouble walking, dressing, and eating, among other after effects, and require long-term care.
Now 44, Fitterman went through a battery of tests and spent two weeks in hospital before getting discharged without a referral for a physiotherapist. Because she was so young, doctors estimated she could regain her physical strength on her own. She did. She quit smoking, started exercising regularly, and went back to work five weeks after her stroke.
Five months later came the emotional fallout. She had to take a leave of absence and spent months in counselling.
"Mentally, you really have no idea what kind of toll it can take until it happens to you," Fitterman explains. "People treat you like you're going to fall apart again....My message to researchers and doctors is, 'Don't forget the patient, especially when it's someone who's younger.' I felt like a bug under glass....We need to get better. And never forget that we are still people; we aren't victims. I hate the term stroke victim ."
The only physiotherapy Fitterman needs now is for the injuries she sustains occasionally from running marathons. She might have seemed an unlikely candidate to experience a stroke, but she did have at least one of the known risk factors in women: she started smoking when she was about 12, and was up to 60 cigarettes a day. Other risks include high blood pressure, the use of illicit drugs, being physically inactive, and having diabetes. In females, the chance of stroke goes up with pregnancy, childbirth, and menopause.
Stroke in women was one topic covered at the 5th World Stroke Congress, which took place at the Vancouver Convention and Exhibition Centre June 23 to 26.
Toronto General Hospital researcher Moira Kapral told the conference that medical professionals might not be inclined to test women for stroke, and consequently--as in the case of heart disease--the condition in women might be underdiagnosed.
Women are, on average, five to six years older than men when they experience stroke, Kapral said, and are more likely to remain disabled three months afterward. According to the Canadian Stroke Network ( www.canadianstrokenetwork.ca/ ), more women die as a result of stroke than men.
Symptoms for both genders include: sudden numbness or weakness, especially on one side of the body; trouble speaking, seeing, or walking; and dizziness, loss of balance, and headache.
The Canadian Stroke Network states that about 50,000 Canadians have a stroke every year and that 50 percent of people in the country over age 35 can't correctly explain what a stroke is. The risk doubles every 10 years after age 55. But as Fitterman's case proved, strokes don't just affect older people. In fact, five to six children per 100,000 experience stroke per year. As in women, the condition is often overlooked in kids; doctors might attribute weakness on one side of the body to common childhood neurological problems, like seizures or migraine headaches.
Medications are commonly used to treat stroke. Often doctors will administer the "clot-busting" drug known as tPA (for tissue plasminogen activator), which can reverse the effects of stroke if used within the first few hours after stroke onset. Surgery can repair vascular damage in and around the brain and can remove plaque in blood vessels that could lead to a clot. Poststroke rehabilitation usually includes occupational therapy, speech therapy, and physiotherapy.
Several seminars at the congress addressed prevention. Getting moderate exercise for at least 30 minutes a day, reducing high blood pressure, eating at least five servings of fruit and vegetables daily, limiting alcohol, and not using illicit drugs are among the ways to avoid stroke.
Fitterman's advice is more concise, as she makes clear on the phone: "Don't smoke."
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