04/20/2008
Blethen Maine Newspapers
The morning that changed Lucie Hannigan's life started with her waking up exhausted. Not one to let that slow her down, she drove to her job as a vice president at Bangor Savings Bank in Portland.
There things got really strange. She couldn't understand her co-workers' greetings, and when she talked to them, her speech was slurred, her sentences were jumbled.
Once seated at her desk, she struggled to remember how to check her voicemail, then was confused by the messages. The people calling sounded familiar. But who were they and what were they saying?
Hannigan was 38 and having a stroke -- one of an estimated 700,000 people each year who suffer brain damage when blood flow is suddenly disrupted by a clot or a burst vessel. She would have a hard time believing that it happened to her. "I don't know if I had even thought about it," she said.
Hannigan was 38 and having a stroke -- one of an estimated 700,000 people each year who suffer brain damage when blood flow is suddenly disrupted by a clot or a burst vessel. She would have a hard time believing that it happened to her. "I don't know if I had even thought about it," she said.
But doctors say that more women should: Women account for more than 60 percent of overall deaths from "brain attacks" nationally and in Maine. And the incidence of stroke, a leading cause of disability and nursing home admissions, is growing fastest among women ages 35 to 54, according to new research.
"Strokes have been associated with unhealthy, overweight, smoking men," said Dr. John Southall, chief of emergency medicine at Mercy Hospital, and a member of the advisory board of the American Heart Association in Maine, which provides stroke education. "But the reality is that women need to be concerned about the disease as well."
Because age is a major risk factor, it is not surprising that women, who outlive men, have higher mortality rates from strokes. In Maine, women accounted for 432 stroke-related deaths out of 694 in 2005, according to the state Center for Disease Control and Prevention.
But women, as a group, also have a wider range of risk factors for stroke. On top of risks such as diabetes and smoking, the chances for stroke are increased by birth control pills - the hormones can lead to blood clotting -- and pregnancy, which can increase blood pressure.
Migraines, which are more common in women, also have been linked to strokes. Getting these painful headaches can increase a woman's risk of stroke by as much as six times, according to the National Stroke Association.
More recently, attention has fallen on the link between women's waist size and stroke risk.
The stroke rate among women ages 35 to 54 nearly tripled to 2 percent in a comparison of a federal health survey from 1999 to 2004, and a previous survey, from 1988 to 1994.
At the same time, the average waist circumference increased nearly 4 centimeters, according to research presented at an American Stroke Association conference earlier this year.
Looking back, Linda Morin of Biddeford can see multiple factors that may have contributed to her stroke. She had smoked for 20 years, was stressed out by her job as a supervisor at a Wal-Mart Supercenter, and counted physical activity as lifting boxes and stocking the shelves of accessory aisles.
Since her January stroke, though, she has cut out cigarettes and makes an effort to walk to the store and the bank. Until her physician gives her the OK to go back to work, she goes to New England Rehabilitation Hospital of Portland twice a week to see occupational and speech therapists.
"My memory is better than what it was (immediately after the stroke)," Morin, 59, said. "My balance is a little bit off and I have a few numb spots on my left-hand side. Otherwise, I'm not too bad."
Morin said she was lucky that she was treated soon after her co-workers found her crumpled outside the doors of Wal-Mart before her shift started.
Dr. Syed Kazmi, Morin's doctor and the director of the stroke rehabilitation program at the hospital, said that often, people wait to seek treatment too long after the warning signs of stroke appear -- such as sudden weakness in the body and trouble seeing. Those with clot-caused stroke, for example, should take a clot-busting drug within three hours of the first symptoms. "They don't pay attention to their symptoms and they think it's minor and will go away," Kazmi said.
That was the case with Hannigan who first received signs in the form of severe migraines around the time she said she started a new birth control pill last April to regulate her period.
But as a banking executive and the mother of a boy and girl, 12 and 10, whom she shuttles to and from sports practice, she said she didn't have time to dwell on her discomfort. Besides, she felt otherwise healthy: she didn't smoke, and was always full of energy.
Even last May, when she was feeling so disoriented from a migraine that she couldn't understand a conversation with her mother -- doctors later thought it was a "mini-stroke" that resolved itself and left no permanent damage -- Hannigan didn't seek help. She thought she would wait to ask about her condition at her next doctor's appointment in several weeks.
The stroke came first on June 15. Hannigan left work to go to the emergency room within several hours of the first symptoms. Her children and husband watched stricken after she underwent a battery of tests in the emergency room and insisted her doctor's name was something it was not.
A couple months of speech therapy, appointments with neurologists and drug regimens followed. So did gradual recovery. Nearly a year later, Hannigan's speech has improved to the point where she can speak without having to mentally edit herself first. Other than feeling easily tired, Hannigan, now 39, has not had any physical problems and was able to start working again in September. She is amazed that her stroke wasn't more debilitating.
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