Facing recovery, following a stroke

Time is critical. Last year, many of the 795,000 Americans who suffered strokes did not get the right lifesaving treatment in time.

The American Heart Association /American Stroke Association encourages everyone to know the symptoms of stroke and to think FAST:

F: Face drooping.

A: Arm weakness.

S: Speech difficulty.

T: Time to call 911.

Beyond FAST, other symptoms of stroke include:

• Sudden numbness or weakness of the leg.

• Sudden confusion or trouble understanding.

• Sudden trouble seeing in one or both eyes.

• Sudden trouble walking, dizziness, loss of balance or loss of coordination.

• Sudden severe headache with no known cause.

For more information visit, www.strokeassociation.org/warningsigns or www.legacyhealth.org/stroke.

One minute, Rick Dobson was sitting on the couch in his Kalama home watching the sunrise. The next, he was slumped on the floor, slowly losing the ability to move his left hand. Then his arm. Then his leg.

“I figured out right away I was having a stroke,” he said.

On that May 18 morning, Rick had gotten out of bed early to watch the sunrise. He sat on the edge of the couch and suddenly lost his balance, falling to the floor.

When he fell, his left arm wrapped around his neck. Rick couldn’t feel his arm; he thought an intruder had come up from and tried to choke him.

He managed to crawl to nearby television remote controls and started to throw them, making enough noise to wake his wife, Cheryl.

Cheryl noticed her husband’s slurred speech immediately. She also noticed Rick couldn’t seem to focus his eyes.

As Cheryl called 911, the 57-year-old felt like he was watching his abilities fade away from him. He compared the feeling to waking from a dream. He tried to hold on to his abilities — moving his fingers, controlling his hand — just as a person tries to hold on to the faint memories of a dream.

When the Dobsons arrived at Legacy Salmon Creek Medical Center in Vancouver, doctors confirmed Rick had suffered an embolic stroke. Rick has atrial fibrillation, an irregular and often rapid heart rate that commonly causes poor blood flow. A blood clot caused by the condition made its way to Rick’s brain and caused the stroke, said Dr. Fatima Milfred, Rick’s neurologist at Legacy Medical Group.

As Rick lay in a hospital bed, doctors evaluated the severity of his stroke. Rick didn’t realize the damage the stroke had done to his body until later.

He couldn’t move his arm, hand, leg or foot on the left side of his body. His left hand was frozen into a claw shape. The left side of his face was numb. His vision was distorted, everything appeared splintered. His hearing seemed to be muffled by static. His head was pounding, as if he had eaten ice cream too quickly. He was confused.

“It’s kind of hard to make sense of it,” Rick said.

Rick practiced mindfulness meditation to distract himself from the pain and focus on the positives.

“I just wanted to survive and be mindful of recovery,” Rick said. “I just decided to not judge if it was good or bad.”

Mindfulness meditation helps people to become unconditionally present, maintaining a moment-by-moment awareness of thoughts, feelings, bodily sensations and surrounding environment. Mindfulness also involves acceptance, helping people to pay attention to their thoughts and feelings without judging them.

Studies have shown stroke patients who practice mindfulness have better outcomes, said Dr. Hoa Ly, director of Legacy Inpatient Medical Services at Salmon Creek. The essence of mindfulness is to focus and move on — precisely what doctors want to see patients in recovery do.

“We as a scientific community are starting to understand the spiritual connection to healing,” he said.

Rick embraced the practice and focused on recovery. He needed to relearn the most basic actions: brushing his teeth, washing himself, putting on pants, walking.

The first few days of physical therapy, Rick did exercises in bed and tried standing in short spurts. By the eighth day, he was walking again. He was giving his wife foot massages to get his hands and fingers moving. He watched TV with the closed captioning turned on and practiced reading — he had to teach himself to read from left to right, again — and speaking.

“Nobody told me I was going to be paralyzed for life, which was good,” Rick said. “I didn’t know any different, so I just started using things again.”

Rick’s positive attitude and commitment to his recovery impressed his entire team of providers.

“He has a very positive mental attitude as a patient,” Milfred said. “Stroke survivors aren’t generally. But this positive attitude helped him to overcome this obstacle in his life.”

Between 30 and 60 percent of stroke patients will suffer from depression as they go through recovery, Milfred said.

But Rick said his recovery hasn’t been without frustration.

Activities that were once easy — changing the TV channel, buttoning a shirt, dialing the phone — suddenly became difficult. Even now, after weeks of physical therapy, it’s not unusual for Rick to need six or seven attempts to get his shirt and pants on correctly.

But he’s still working on improving. Twice a week, Rick spends a few hours at Legacy Salmon Creek Medical Center for outpatient speech, occupational and physical therapy.

Rick’s fingertips are still somewhat numb, so he’s continuing to work on fine motor skills. He’s also working on his attention and concentration, as he’s easily distracted by things going on around him. Rick also hopes to regain some of the inflection in his voice.

Rick relies on Cheryl to help him with many tasks. Rick doesn’t get his own medication. He hasn’t picked up a knife since the stroke. And he can’t drive.

Despite the obvious bad in the situation, Rick said he sees the good.

“Through the worst of it, what I believe stood up,” Rick said. “That’s amazing.”