Surviving Stroke

Aear ago, then-39- year-old Michelle Reitz was in her athletic prime. A working mother of twins, Reitz counted dozens of half- and full marathons, triathlons and an Ironman among her accomplishments. She ate unprocessed, healthy foods. She had enviably low cholesterol and blood pressure. But one day, she realized she was falling with regular frequency during her runs – something highly unusual for a runner. At times, she would suddenly feel nauseous. Something was off, but she couldn’t put her finger on it.

“For me to fall consistently, something was up,” Reitz said. “It should have been a red flag, but it wasn’t.”

Weeks later, she was working at home. She had the strange sensation of feeling like her voice sounded far away, almost muffled. When she met up with her training partner, he immediately noticed it. “What’s wrong with your mouth?” he said. “You’re slurring your words.” As soon as he said that, she knew it was a stroke. Whisked to an emergency room, hospital tests confirmed that at age 39, Reitz was now a stroke survivor.

Doctors speculated her recent bouts of poor coordination may have been a result of an earlier transient ischemic attack (TIA), a phenomenon that pro – duces similar symptoms to a stroke but lasts briefly. The attack may have been a precursor to the actual stroke. The news was shocking. Reitz was healthy and had no risk factors for stroke. How could this have happened, especially when she was not even 40?

“I never would have believed it if someone told me I would have a stroke,” she said. “If it could happen to me, it could happen to anybody.”

STROKE ON THE RISE

Experts say the prevalence of stroke is rising among younger wom – en. A 2012 Centers for Disease Control and Prevention study showed an alarming rise among younger adults in the number of acute ischemic strokes, the most common kind of stroke in which blood supply to part of the brain is cut off due to a blockage. From 1995 to 2008, the number of women ages 15-34 hospitalized for this type of stroke rose about 23 percent. For women ages 35-44, stroke hospitalizations jumped 29 percent. A second study found that strokes among 20-to 44-year-old Caucasians (who are generally at lesser risk than African Americans) has more than doubled since 1993.

Complicating the situation for younger women is misdiagnosis. A study conducted by the Wayne State University-Detroit Medical Center Stroke Program revealed that younger adults showing signs of suffering a stroke are sometimes misdiagnosed in hospital emergency rooms, preventing them from receiving early treatment that can prevent serious damage.

Effectively, the younger a woman is, the longer it likely takes to receive a stroke diagnosis – and the longer it takes for her to receive the time-sensitive treatment that mitigates stroke’s effects. “Part of the problem is that the emergency room staff may not be thinking ‘stroke’ when the patient is younger,” said Dr. Seemant Chaturvedi, director of the stroke program.

In Reitz’ case, emergency room doctors diagnosed the stroke after performing an MRI. Unfortunately for Reitz, too much time had already passed that day to mitigate the stroke’s effects

Interestingly, Reitz said she still dealt with doctors’ disbelief that she could have a stroke – even after it was diagnosed. Stroke risk factors include high blood pressure, high cholesterol, diabetes, tobacco use, alcohol use, physical inactivity and obesity. Reitz had none of those risk factors. Her unusual stroke is something she and her team of doc – tors are still trying to wrap their heads around and figure out why.

ROAD TO RECOVERY

A year after that fateful emergency room trip, Reitz appears to be the same athletic, beautiful and energetic person she was before. But Reitz says each day brings its challenges. Her brain fatigues quickly, and she has scaled back her business technology consulting work to give her more time to rest. Her speech is much improved, but she still finds herself grasping for words. She tells her kids phrases like, “Go put the milk in the car door,” – the type of word-finding difficulty typical after a stroke. For Reitz, recovery has been long and often without medical support. Perhaps because of her age, her doctors didn’t make her aware of all the physical and speech therapy options that might have sped up her recovery and eased some of her frustrations. Without experienc – ing the more severe physical effects of stroke, it was as if people were telling her she didn’t need to worry about her new limitations. But at 40, Reitz wanted to be more than merely functional. “I want to get back to where I was,” she said

Before the stroke, Reitz qualified and competed in elite USA Triathlon competitions and the Half Ironman World Championships. After the stroke, Reitz knows her abilities have changed, and she is also cautious about pushing herself too hard. But for this Pennsylvania native, giving up fitness – and the social support network she has found in the racing community – is not an option. “I don’t want [stroke] to define me,” she said. One difference: Today, all her running buddies and training partners are aware of the signs and symptoms of stroke. Helping people understand how to interpret symptoms is critical for Reitz, who realizes a future stroke is possible. But she also knows that the more she can spread the word about stroke, the more others will be aware of stroke in their own lives and among their loved ones.

THE RACE AHEAD

This November, Reitz will travel with a group of Nebraskans to Tempe, Ariz., to tackle her second Ironman. She will com – plete three long-distance races: a 2.4-mile swim, a 112-mile bike ride and a 26.2-mile marathon run – all in succession without a break. Her 10-year- old twins will be there to cheer her on.

“My kids and my faith in God are my inspi – ration,” she said. “He gave me this body and the opportunity and ability to do this. It’s a challenge, and it’s beautiful.”

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