At just 38 years of age, Joe had a completely unexpected, life-changing event. It was a cryptogenic ischemic stroke.
Joe was in the best shape of his life. Just 9% body fat, didn't smoke, and only drank alcohol occasionally. He had no family history of stroke. So, it's no surprise that he had never thought about strokes, let alone how to react to the signs and rapid onset.
In most cases, a stroke is caused by a blood clot that blocks blood flow to the brain. But in some instances, despite testing, the cause can't be determined. Strokes without a known cause are called cryptogenic1 and this is what Joe experienced.
Joe was a partner of a well-known digital advertising agency in New York. At the time of his stroke, he had relocated to Colorado for a new adventure at another advertising agency. One evening, he met a couple at the apartment he and his family were renting while they finalized the sale of their new house. The couple wanted to buy a rug Joe had in the rental. Joe helped carry up the rug from the basement to their truck. Halfway up the stairs, he felt a little headache come on. It was a long day, and he hadn't eaten that much. Almost to the truck now, he couldn't really have a conversation and didn't think anything of it. The couple handed him the money and he dropped it. They picked it up for him and handed it to him again. He crumpled it up and put it in his back pocket. He recalls he might have said thank you.
Joe decided that before he leaves, he should turn the lights off in the rental house. He walked back to the house but couldn't remember how to turn the lights off. He still did not suspect anything was amiss. He went back to the car to head home. He tried to call his wife and repeatedly dropped the phone. Finally, he dialed her but couldn't get out more than one or two words. It was then that he began to feel scared. Joe's wife didn't know he planned to visit the apartment, and Joe couldn't tell her where he was. With great effort he managed to utter the words "rug" and "rental."
Joe's wife drove to the rental and dialed 911 on her way. Emergency responders arrived before she did. Joe remembers lights and sirens and that it felt like time stopped. He remembers that the EMTs were talking about him – in front of him – in the ambulance ride to the hospital. They started to assume he had overdosed on drugs because of his age and good physical shape.
In the aftermath, Joe experienced weakness on his right side. He couldn't talk or write. Joe had receptive and expressive aphasia. It impairs one's ability to express or understand language. Reading and writing can be affected as well. Expressive language disorders cause difficulty in articulating or saying words, but there is often good comprehension and understanding of spoken language. Receptive language disorders, on the other hand, cause impairment in one's ability to understand language, so comprehension may be poor.2 Going from being a healthy 38-year-old in prime health to being affected by both forms of aphasia was devastating.
Joe was in the hospital for about ten days and then spent the next three months in speech therapy, relearning how to read and write. Joe remembers spending time on the floor with his youngest son as they both learned to read. At the end of his therapy, they said, "you are 100% now based on our scales and assessments."
At the time, Joe thought, "your scales and assessments are off. I'm not me." Their 100% was not Joe's 100%. Joe says, "One of the most frustrating things as a stroke survivor is to admit to others that I'm not what I used to be. I'm seen as healed when I'm continually healing. Those around me saw me as independent when I didn't understand what ‘paper or plastic' at the grocery store meant. People told me I was no different than before and I could do whatever I wanted. While it was all well intended, it made me question myself. But I wasn't me."
Aphasia can be a much slower recovery process compared to healing from weakness and regaining motor skill functions. According to the National Institute of Neurological Disorders and Stroke (NINDS), at least one-fourth of all stroke survivors experience language impairments, involving the ability to speak, write, and understand spoken and written language. 3 Significant progress can be made within two or three months in those who are impacted with aphasia; however, some might take longer to recover, others may experience life-long impairments or continue to improve for several years and even decades after their stroke.
A stroke survivor may appear to us as being back to their "normal self" after rehabilitation because we observe the external improvements. For those that also experience different types of aphasia, they need continued support from family and friends while they stay focused on working to get back to their sense of who they were before the event. Their "me".
Act FAST (Face, Arm Speech, Time) when you notice signs of stroke or suspect someone you are with is having a stroke. Even if symptoms come and go or go away completely. Immediate treatment can save a life, reduce long-term disabilities, and give the best chance for recovery. For more information about FAST, stroke facts and resources, visit the TheStrokeFoundation.org.
MMG is proud of the contribution we have made in clinical research for stroke prevention and treatment. Through clinical trial enrollment communications MMG has supported over 84,000 stroke study participants.
1 Cryptogenic Stroke or Stroke of Unknown Cause | American Stroke Association
2 Expressive and Receptive Aphasia After Stroke (stroke-rehab.com)
3 Post-Stroke Rehabilitation Fact Sheet | National Institute of Neurological Disorders and Stroke (nih.gov)