Last fall, Rocio Mendoza wondered whether she would ever hold her daughter again or go to work or even write her name.
A stroke left the 25-year-old White City nurse unable to talk or write. She spent three nights in intensive care, fully aware of the gravity of her injury. As a nurse, she was all too familiar with the devastating effects of a blood clot in the brain.
A stroke is like a heart attack, except it happens in the brain. And just like a heart attack, stroke should be treated as quickly as possible.
"Time is brain," said Jo Jacavone, stroke coordinator at Providence Medford Medical Center. "The more time that passes without getting treatment, the more brain function can be lost."
Depending on the severity of a stroke, victims may not even realize they're ill, so it's important for everyone to know the basic stroke symptoms, such as slurred speech or unusual mental confusion, Jacavone said. Stroke often affects just one side of the brain, so one side of the body may function normally when the other side doesn't.
An acronym called FAST helps ordinary people determine whether someone might be having a stroke:
Jacavone said stroke victims tend to be over age 50, but as Rocio Mendoza's experience indicates, anyone can have a stroke. She said about 6 percent of stroke patients are between the ages of 18 and 45.
She said people can reduce their chance of having a stroke by following many of the general guidelines for healthy living: keep blood pressure within a normal range, avoid tobacco and high-fat foods, limit use of alcohol and get regular physical exercise.
"I saw my symptoms," she recalled, "and how I wasn't getting any better.
"I was thinking I may never be able to do those things again."
Today in Portland, she will run her first half-marathon, living proof that a stroke can happen to anyone, and that it needn't mark the end of normal life.
Back in September, Rocio (pronounced ROW-see-oh) had just finished a five-mile run with her boyfriend, Benny Velez. They took turns pushing her daughter, Jimena, in her stroller. When they stopped at Benny's aunt's house in Eagle Point, Rocio felt strangely out of breath, but she thought she was just thirsty. She asked for a drink of water, but her words made no sense to Benny's aunt.
Rocio asked for water again.
"I listened to myself then, and I knew the words weren't coming out right," she recalled. Benny's aunt, herself a nurse, noticed that the right side of Rocio's face was drooping, and immediately recognized that Rocio was having a stroke.
"My whole right side went weak," Rocio said. "Then I couldn't talk."
Benny and his aunt loaded Rocio in a car and raced to Providence Medford Medical Center, where she worked on the medical/surgical floor.
"All the way there, Benny kept asking me how I was feeling," she recalled. "I just stared at him blankly, thinking 'What is going on? I'm 25 years old and on my way to the hospital. My god, I can't believe this.' "
Stroke was a mystery ailment for most of human history. Its very name suggests a punishment from some mysterious higher power that caused sudden death or left victims crippled or unable to speak. Only over the past 100 years have scientists and physicians begun to understand that a stroke happens when part of the brain loses its blood supply, either from a blood clot lodged somewhere in the brain or a burst blood vessel in the skull. Either way, the result is a blocked or reduced flow of blood to the brain.
Physicians treat stroke now with the same urgency that they respond to a heart attack, and for the same reason: the more time the heart or brain lacks fresh oxygen, the more cells die.
"Every second counts," said Dr. Corey Bergey, director of the emergency department at Providence Medford Medical Center.
When a stroke is clot-related, powerful clot-dissolving drugs can restore blood to the brain, but physicians must administer them with care, and as soon after a stroke as possible, to have the best effect. When a local neurologist can't evaluate a patient, some hospitals now use robot technology to allow on-call neurologists to examine a stroke patient to determine whether to administer anti-clotting drugs such as tissue plasminogen activator (known as "t-PA").
"Within a couple of minutes you can have a super-trained sub-specialist guide your care," Bergey said. "Right away they can make a decision to give t-PA."
While such drugs are invaluable in treating stroke, they are not without risk. Studies show that a small percentage of patients who receive t-PA suffer complications such as bleeding into the brain, which can be fatal. Rocio received t-PA and spent three nights in intensive care before being discharged.
She said the physicians who treated her never could determine why she had a stroke.
"All my labs came back negative," she said. "The doctors were shocked to see I'd had a stroke.
She takes one 81-milligram aspirin daily as a precaution to reduce the likelihood of another blood clot. It's a preventive measure familiar to many older people who may be at risk of heart attack.
As the immediate crisis passed, she started to retrain her brain. Fortunately, the brain can relearn lost skills (a phenomenon scientists call "plasticity") by building new neural pathways. For the 2005 graduate of South Medford High School, the process felt like going back to the classroom.
"I practiced my alphabet and numbers, just as though I were back in elementary school," she said. "It was frustrating at first, but Benny helped to make it a game and would challenge me."
Velez, her boyfriend, said he was determined to help Rocio regain control of her life because he'd seen his mother suffer after a stroke.
"I thought I'd lost her," he said, "and her life would never be the same. It was hard at first. She couldn't remember anything, and she's always been really good about remembering things."
Rocio's daughter, who was just learning to walk, provided inspiration, too. "Jimena fell many times, but she kept getting up and trying. So did I. My baby steps enabled me to regain the strength to hold Jimena, to walk again, and to have a coherent conversation."
Therapists helped her regain control of her limbs and recover her fine motor skills. She went back to work about six weeks after her stroke, taking up right where she'd left off.
"I was so happy to return to work and get back to my normal activities of life," she said.
She started running again too, although with some trepidation at first. She signed up for this spring's Pear Blossom Run, and she and Benny decided to do a longer run — today's Rock 'n' Roll Half Marathon in Portland.
"Every day I'm incredibly thankful," she said. "Life can change so fast."
Bill Kettler is a freelance writer living in Rogue River. Reach him at firstname.lastname@example.org.