lmost two years ago, Bill Archibald thought he was having a bad dream.
Feeling dizzy and extremely tired, the paving contractor drove the few blocks to his Redwood City home shortly before noon, planning to grab a quick nap before dropping off a bid in Half Moon Bay.
Then he saw the bright, blinding light in his left eye. He tried to get out of bed, but the left side of his body resisted. "Maybe if I just sleep it off, I'll feel better later. Maybe this isn't really happening," he remembers thinking.
He almost didn't wake up at all. On July 9, 1998, Mr. Archibald suffered a stroke. According to the American Heart Association, nearly 600,000 people have a new or recurrent stroke every year, and about 160,000 of them die.
"I was lucky," Mr. Archibald says. His daughter Katrina stopped by the house that day to check on her father and found him. Luckier still, Katrina was able to recognize that something was seriously wrong with him. And though she didn't know what to tell the paramedics when they arrived, the fact that they did arrive -- and within five minutes of Katrina's call -- saved his life.
Many people don't fare as well. On average, most patients don't seek treatment until 22 hours after they first begin experiencing stroke symptoms, according to one study. By then, it's often too late for doctors to do much more than assess damage caused by the stroke.
Anne Jacobs directs the Peninsula Stroke Association, a support and outreach group headquartered at the VA Hospital in Palo Alto. She says people delay going to the hospital for a variety of reasons, but most often because they don't take their symptoms seriously.
"Most people know the symptoms of heart attack, and they know to go to the hospital right away," she says. "Stroke is a brain attack. But people don't know the symptoms. And they don't think a stroke can happen to them."
Quick action needed
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain bursts, or a blood clot blocks it. Starved for oxygen, tissue around the affected blood vessel begins to die.
Depending on where in the brain the stroke occurs, how much of an area is affected, and how quickly the patient gets medical help, a stroke can be survivable, catastrophic, or fatal.
Many neurologists say "time is brain" -- the more time lost before treatment can begin, the more likely the brain will be damaged, possibly forever.
That's why recognizing the warning signs of a possible stroke is crucial, Dr. Jacobs says. And that's why, along with a small army of volunteers, she plans programs to teach people to recognize the warning signs of stroke.
When the Peninsula Stroke Association opened its doors in June of last year, there were few local stroke-related groups. And while the YMCA and other service groups offered rehabilitation services geared toward people who had suffered a stroke, Dr. Jacobs believed that the Peninsula needed a clearinghouse to get that information out, she says.
"We're a new organization, still getting on our feet," says Marty Newlands, a volunteer who also helps edit the group's newsletter.
Volunteers and other members of PSA -- which is dedicated to reducing the incidence of stroke and to helping survivors and their families -- speak to civic groups and seniors' groups, make hospital visits, and staff a help line to answer common questions about stroke and its aftermath.
"We ll talk to any group that's interested, providing there are more than 10 people willing to come hear us," Dr. Jacobs says. "We've spoken to about 600 people so far, and we already have some success stories."
A woman who had attended a PSA lecture called Dr. Jacobs recently to tell her that the presentation saved her friend's life. "She was at a dinner party, and the friend developed a headache and was having trouble speaking clearly," Dr. Jacobs says.
"Unfortunately, quite often people, meaning well, suggest that the person should lie down, rest, and try to sleep off whatever's causing the distress. But she recognized that her friend was seriously ill, and she called the paramedics. And that was a life-saving decision on her part."
Offering support
PSA also provides a support network for stroke survivors and their families, a valuable resource for people struggling with an illness that can be isolating as well as debilitating.
"I think one of the hardest things about dealing with stroke is that it leaves you no time to grieve," Dr. Jacobs says. "As horrible as cancer is, for example, there's a diagnosis, and then at least a little bit of time to talk about treatment. But with stroke, you can literally wake up in the morning and find yourself almost like an infant again, having to relearn to walk and talk. That can be enormously difficult."
Kristin Archibald agrees. After her father's stroke, she says, she couldn't imagine anything more devastating. Her father had to relearn to do things he'd taken for granted for so many years, and the whole family had to pitch in.
"In the beginning, when he was dealing with the aphasia and having a hard time coming up with the right word for something simple, it was so hard," she says. "It was hard for him, and it was hard for us watching him get frustrated and upset. Some days we would guess and guess at what he was trying to say, and it felt like we'd never get it right."
For survivors, it's comforting to talk to other people who are facing similar challenges. And for the families, it's often a reminder that there is life after a stroke.
Allen Newlands, who survived a stroke nearly five years ago, is now the editor-in-chief of the PSA newsletter. A trim, quiet man, Mr. Newlands was a long-distance runner and devout vegetarian when, at 53, he suffered a stroke. "I often say a stroke is one thing I wouldn't wish on my worst enemy," he says. "It turns your whole life upside down, and you have to work to get back to where you were. But it is possible."
New drug therapies -- including administering tPA to dissolve blood clots in the brain and save tissue while a stroke is taking place -- are promising. But because the drug has to be administered within three hours of stroke, getting to the hospital quickly is all the more critical.
And new therapies or new variations on old therapies, including a promising study in which stroke survivors were forced to use the weaker limb, indicate that the brain can be retrained, even after an injury such as a stroke.
Depending on the severity of the stroke, retraining the brain can be an uphill battle. But acknowledging difficulties and celebrating accomplishments, Dr. Jacobs says, is important for patients' families, as well as for the patients themselves.
"It's a devastating thing to happen to a patient, to a family," she admits. "But seeing other people working with therapists, relearning old skills, reminds us all that there is life after a stroke."
It also reminds people how fragile that life is. "I hate that it happened this way, but my dad's stroke made me get closer to him," says Katrina Archibald. "It makes you realize how precious the people around you are. That's why it's so important to us to get out and talk to people, to remind them what can happen."
She looks over at her father, whose eyes have misted over. "It's a struggle," he says finally. "But you have to just keep trying to get better."
