Avoiding Strokes – When Stroke Strikes

One young father was in the prime of his life when a stroke changed his life forever. Monica Mercer tells us his story — and explains why we all need to know more about this leading cause of disability.

He heard a pop, and then — silence.

William Thomas, a successful businessman at the age of 42, had suffered a massive stroke.

As I talk to Veronica, his wife, nearly five and a half years later, we speculate about what true silence must feel like in a world of noise. Is it even possible to comprehend?

For William, it was. He says a sense of calmness washed over him. He was conscious. But there were no thoughts. There were no feelings.

“Half of his brain had completely shut down,” Veronica says. “It truly is just silence inside your head.”

All Veronica knew at the time was that something horrible had happened to her husband. It was on a brisk October night in 2007. They had just seen a production of 12 Angry Men at the Fisher Theatre in Detroit. As they cruised north on the Lodge Freeway toward their home in Birmingham, there was laughter. Veronica’s brother and her brother’s girlfriend were sitting in the back seat. Veronica remembers teasing her husband about something. They all thought he had a great sense of humor.

Normally, William also would have been driving home, as he usually did after nights out on the town. But Veronica had just gotten a new Cadillac. It was her “dream” car, she says — a reward for years of driving used ones. She wanted to enjoy it.

“I took the keys at the last minute and decided to drive home instead.”

It was a fateful decision. Once William felt the “pop,” the lighthearted night turned into a full-blown medical emergency. A blood vessel had ruptured in his brain. Suddenly, he exited the conversation. The only thing he could say over and over, Veronica recalls, was, “I’m fine.”

“I was in complete shock. I knew something was really wrong,” Veronica says.

By the time they got to the emergency room at William Beaumont Hospital in Royal Oak, William had begun to vomit. It was just one symptom of the stroke that would take him to the brink of death and change his life forever.

How Could this Happen?

A few days after talking to Veronica, I drive to Detroit Medical Center. I meet with Dr. Pratik Bhattacharya, a neurologist who specializes in young people who experience stroke. I have many questions. My biggest is the most obvious — and the one that fills me with dread. Stroke is preventable, we are told by experts, and it is critical to start living healthier lives to decrease our risk. Eat right. Exercise. Don’t smoke. Lose weight.

So how, exactly, could this happen to someone so young who was doing everything right?

William was indeed a very young victim. Statistically, most stroke patients are about 20 years older than he was. At the DMC, however, Bhattacharya sees people in William’s age group all the time. Many are in their early 20s or 30s who, despite not having any of the traditionally regarded risk factors like high blood pressure or being overweight, will succumb to stroke. This may be because of genetics, leading to various conditions that can cause thicker blood that more easily forms clots (a clot that blocks a blood vessel leading to the brain is the most common type of stroke).

It could also be because of recreational drug use. “One of the main causes we see at the DMC especially is cocaine abuse,” Bhattacharya says. “It causes a spasm or narrowing of the blood vessel walls, which can give rise to strokes. Even the first time you use (cocaine), it can happen.”

But William was no drug user, and he led a healthy life. He was a devoted husband to Veronica and their 5-year-old daughter, Violet. Professionally, he was at the top of his game. With an MBA from Yale, William was a principal at Gongos Research, a nationally recognized market research firm that he had helped build from the ground up 20 years earlier.

And yet William would eventually join a group of Americans making up about a third of all stroke victims every year for whom the violent assault on their blood vessel walls remains a mystery. “The doctors were baffled,” William says. “They told me it was just really bad luck.”

Such details can make a crippling stroke particularly hard to comprehend. Strokes are not discriminating. Seemingly out of nowhere, they can strike, and even the best doctors cannot explain why. These details are also what Bhattacharya finds so fascinating — and compelling — about studying stroke among the young.

“Think about it,” says Bhattacharya, director of the stroke program at Sinai-Grace Hospital. “A 65-year-old who has a stroke has just about 20 years to live life disabled. A 40-year-old has another 40 years to live life that way, so I think we need to be paying special attention.”

Disability, it turns out, is what many experts believe is the real toll of stroke, especially for younger victims who face a lifetime of coping with its effects. As in the case of heart disease and the other most dangerous health conditions in America, however, death statistics often take the spotlight. Stroke is No. 4 on the list of this country’s deadliest health conditions, having only recently been overtaken by chronic respiratory disease. That’s certainly an important number, says Dr. John Flack, chair of the Department of Medicine at Wayne State University and a nationally recognized expert on hypertension, or high blood pressure. But Flack believes that most people are unaware that stroke remains the No. 1 cause of disability — as well as the most expensive health problem in terms of healthcare dollars spent — in the country.

In most cases, “stroke is a devastating complication of hypertension and other chronic conditions,” Flack says. “And it is devastating because it typically doesn’t kill.”

The Go-To Guy

Veronica is at work. Violet, now 10, is at school. At their home in Birmingham, William is alone on a weekday. We sit down to talk about how life has changed after a two-month stint in the hospital and countless hours of rehab following William’s stroke. He doesn’t try to hide the reality of the situation. He tells me, almost apologetically, that he can’t really read, and he can’t type out an email. When I ask him to spell “Gongos,” it takes him a while. He has to spell it out with his left index finger on his leg. He admits that he gets bored — and he says he just doesn’t get the punch line anymore.

“I used to be funny. I used to be smart,” William says with a chuckle. “Now, not so much.”

Veronica disagrees as we talk about her husband the next day at her office in Troy. “He thinks he’s not funny anymore, but he is. It’s just a different kind of funny.”

Still, both are aware of just how drastically the stroke turned all of their lives around. William, after all, certainly had no idea what it was like to sit at home bored on a weekday.

Growing up in metro Detroit, he excelled at both statistics and writing, leading him to become extremely successful in the market research world. He would go on to lead his colleagues with an open- door policy at Gongos, believing in the strengths and individual assets of every employee. As a result, William was highly respected. His coworkers valued his opinions. They relied on his expertise.

“Bill (William) was a good boss,” Veronica says. “Instead of just telling you what you did wrong, he took the time to show you how you could be better.”

At the same time, Veronica remembers how much pressure this put on her husband. He would confide in her that while he relished the opportunity to collaborate on every project, he wasn’t sure he could keep up the pace.

“Bill was under a lot of stress (at work) when he had his stroke, which I personally feel contributed to the stroke. But we still don’t know why it happened,” Veronica says.

William’s disability — he will never work again and was eventually bought out of the company — is now the starkest consequence of the medical event that stopped him in his tracks. Doctors at Beaumont Hospital at first did not believe he would live. Next they said he would never walk. For two months, William simply held on to whatever fragile life he still had in him.

Then, things started to improve in rehabilitation. He would ultimately become successful at re-learning most everything — how to dress, how to brush his teeth, how to walk, how to talk. He has aphasia, a common side effect of stroke that interrupts the comprehension of language and the ability to speak, but it is mild; he is easy to understand. Curiously, William never lost his love for baseball. Even before he could speak, he turned on the TV one day, found the Tigers game, and uttered the name, “Renteria.”

“I looked at our friend (who was visiting him in the hospital) and said, ‘He can’t say my name, he can’t say Violet’s name, but he can say (Edgar) Renteria?’ ” Veronica remembers, in disbelief. (Renteria played for the Tigers for one season in 2008.)

Happily, some things had stayed the same. But clearly, everything was different.

Not being able to provide financially for his family by earning an income may not have even been the most devastating part. William has accepted that fact, and Veronica has always worked full-time. He knows they are lucky. He has met other stroke survivors since his own stroke, he says, whose long-term health costs have ruined them financially.

The small, daily things that people take for granted, it seems, are what William and Veronica sometimes mourn. William has been there to see his daughter grow up, but was unable to read to her at an age when those kinds of parental duties really mattered. He’s never been able to help her with her math homework, something he had expected to do easily. While he can do complicated math problems in his head, he just can’t explain the process. His brain won’t let him get the words out.

These small, but significant alterations to daily life were evident to those William and Veronica knew well, too. One of the hardest things, Veronica says, was to see people who they thought were friends walk away. “We’ve lost a lot of friends. Some people just couldn’t handle it, and that still makes me sad,” Veronica says.

But so what, says William, whose characteristic optimism, like his love for baseball, never left him either. “It’s kinda tragic what happened,” he tells me. “But I’m still alive and I’m happy. So what if I don’t get the jokes anymore?”

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