The Handicapped in America: The ADA Has Your Back

My mother-in-law used to always have a lawsuit going on. But, alas, they were frivolous suits, mostly slips and falls in the market, on someone else's sidewalk, or falls in the street, all when barriers were in her way, where she just bruised herself almost every time. And she wasn't handicapped. She was clumsy. In all that time, around 30 years, I thought about when would be the next time for her, and I didn't give one thought, not a single one, to handicapped people who really had to be worried about barriers.

I am now handicapped from the stroke, but the government protects you--sort of. The Americans with Disabilities Act (ADA) was signed into law July 26, 1990 by George H. W. Bush, so don't say Bush was a bad president. Oh. My bad. That was his son.
 

Anyway, the ADA was later amended with changes on January 1, 2009. The ADA is really a civil rights law that prohibits, in most cases, discrimination based on disability. Disability, as defined by the ADA, is "a physical or mental impairment that substantially limits a major life activity." Excluded are those with vision impairment, fixable by lenses, and drug users because those conditions can be repaired. (Are you listening, drug users? There's hope for you yet, but not through the ADA).

Look at some of the lawsuits filed recently in the past and the winners from them:

Barden v. The City of Sacramento
The City of Sacramento failed to bring its sidewalks into compliance with the ADA. Certain factors were resolved in Federal Court. One issue, whether sidewalks were covered by the ADA, was appealed to the 9th Circuit Court of Appeals  of Appeals, which ruled that sidewalks were a "program" under ADA and must be made accessible to persons with disabilities. The ruling was later appealed to the U.S. Supreme Court, which refused to hear the case, letting stand the ruling of the 9th Circuit Court.
Winner: Barden

Class action suit v. Expedia.com and Hotel.com 
Customers with disabilities could not book hotel rooms, through their websites, without substantial  efforts that persons without disabilities were not required to perform.
Winner: Class action
 
Bates on behalf of Deaf/Hard of Hearing v. UPS
UPS failed to address communication barriers and to guarantee equal conditions and opportunities for deaf employees; Deaf employees were mostly excluded from workplace information, denied opportunities for promotion, and in harm's way due to 
unsafe conditions due to lack of accommodations by UPS
Winner: Bates on behalf of Deaf/Hard of Hearing
 
National Federation of the Blind v. Target Corporation
Target Corp. was sued because their web designers failed to design its website to enable persons with low or no vision to use it.
Winner: National Federation of the Blind
 
Michigan Paralyzed Veterans of America v. The University of Michigan 
Michigan Stadium violated the Americans with Disabilities Act in its $226-million renovation by failing to add enough seats for disabled fans or accommodate the needs for disabled restrooms, concessions and parking. In addition, the distribution of the accessible seating was at issue, with nearly all the seats being provided in the end-zone areas. The settlement required the stadium to add 329 wheelchair seats throughout the stadium by 2010, and an additional 135 accessible seats in clubhouses to go along with the existing 88 wheelchair seats.
Winner: Michigan Paralyzed Veterans of America
 
Spector v. Norwegian Cruise Line Ltd. 
The defendant argued that as a vessel flying the flag of a foreign nation was exempt from the requirements of the ADA. This argument was accepted by a federal court in Florida and, subsequently, the Fifth Circuit Court of Appeals. However, the U.S. Supreme Cout reversed the ruling of the lower courts on the basis that Norwegian Cruise Lines was a business headquartered in the United States whose clients were predominantly Americans and, more importantly, operated out of port facilities throughout the United States.
Winner: Spector
 
Access Now v. Southwest Airlines 
The District Court decided that the website of Southwest Airlines was not in violation of the Americans with Disability Act because the ADA is concerned with items with a physical existence and thus cannot be applied to cyberspace. But Judge Patricia A. Seitz found that the "virtual ticket counter" of the website was a virtual construct, and hence not a "public place of accommodation."
Winner: Access Now


Don't think the court is up to its neck with ADA lawsuits. The ADA had yielded a unusually miniscule number of lawsuits on employment issues--only about 1,200 across America in the first seven years of the statute. But as with all statutes, once people know them and what they include, many disabled people file worthless actions, thus, every ruling does not benefit the handicapped. For example, an qualified job applicant or employee with a disability can claim employment discrimination under the ADA, but job applicants must meet all the necessary requirements of the job with or without reasonable accommodation. Small businesses with fewer than 15 employees are not covered by the ADA.

The ADA covers individuals with psychiatric and neurological impairments that mostly limit essential life activities because individuals with such impairments have traditionally been subjected to ongoing employment discrimination, not because they are unable to successfully perform job duties, but because of fears and stereotypes associated with such impairments. Psychiatric impairments involve social, biological,or psychological dysfunction. Neurological impairments are conditions or diseases involving the nervous system, like the brain, spinal cord, and nerve centers.

The ADA, at the heart of it, is all common sense. For example, with the ADA excluding people with interim physical problems, it also excludes people with short-term mental health problems, too. The law recognizes that modifying existing structures is more expensive than making new construction accessible. The law only requires that public accommodations, like restaurants, stores, banks, and hotels, remove barriers in existing facilities when it is readily achievable. 

Inexpensive, easy steps that can be taken to help the disabled include, for instance, a ramp to cover five steps, a bathroom grab bar to help with balance, special hinges to widen a doorway, a paper towel dispenser that's low enough to reach, and an accessible parking space.

The ADA requires all government programs to be accessible, not all government buildings. The ADA only insists that clear communication not exclude people with disabilities, like providing them with written materials instead of watching a PowerPoint that they can't easily see or hear. But the law does not require any measure that would cause extreme financial or administrative difficulty to the employers. Remember in the beginning when I said "sort of"? That judgement, right there, is arbitrary. In other words, how much difficulty is too much?

While people have the right to file lawsuits, not all suits are winners for the handicapped. On its website, http://www.eeoc.gov, the U.S. Equal Employment Opportunity Commission (EEOC) is responsible for 

"enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information. It is also illegal to discriminate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit." But Human Resources departments everywhere don't abide by that ruling. If they want to get you for filing a discrimination suit, they'll figure out a way.

The EEOC has authority to dismiss the complaint. Trivial complaints do not make it through the system. EEOC investigators are taught to scrutinize whether one person or a party, like class action suits, has an actual ADA disability. Go to https://egov.eeoc.gov/eas/ if you think a charge should be filed.

So there you have it, everything I know about the ADA. Hmmm. It's too late to file a complaint against my former manager, J, and her boss, stupid D, for making cracks about my lack of hearing when I asked them to repeat themselves. Actually, it was D's fault. My hearing went south because the work environment in which I was located initially, with observable roaches and vermin, affected my ability to hear clearly.

"You don't hear anyway," was doltish J's remark.  D used to roll his eyes and twitch his jaw if the remark had to be uttered again.

I didn't know about the EEOC back then, but I surely wish I had.

"The Tales of a Stroke Patient"....YES!

“The Tales of a Stroke Patient” is making its way into the limelight.

I am a stroke survivor, and I’ve written a book that tells of my expedition. If a stroke could happen to  me, with low cholesterol, low blood pressure, no diabetes or obesity, it could happen to ANYBODY!

If you’re a stroke survivor, caregiver, have stroke in your genes, an avid reader of memoirs, or just curious if a stroke could happen to you, please read my book that will educate and inspire to make stroke awareness so much bigger than it currently is. 

Warning: Not intended for the faint of heart or politically correct crowd.

Click the link to buy it:

from the publisher, http://bookstore.xlibris.com/Products/SKU-0115053049/The-Tales-of-a-Stroke-Patient.aspx,

or for Amazon’s Kindle, http://www.amazon.com/The-Tales-Stroke-Patient-ebook/dp/B009J9QC64/ref=sr_1_1?ie=UTF8&qid=1373898600&sr=8-1&keywords=tales+stroke+patient

or for Barnes & Noble’s Nook, http://www.barnesandnoble.com/w/the-tales-of-a-stroke-patient-joyce-hoffman/1113052852?ean=9781479712496.

Don’t have a credit card? Message me by email--hcwriter@gmail.com--or Facebook to see how you can get a copy!

The 5 W’s and the H of Getting Up and Moving Your Ass

I was playing a game with myself. I recalled a famous personality of the past to test my memory. The topic of the day was who died from blood clots that went to the heart or brain or lungs. There were many.

David, David, what-his-name. Of course, I got it after a while. I was thinking about David Bloom, the weekend anchor of the Today show.

Although David is dead now--he died at 39 years old, I read that his heart and thoughts belonged to his family. In David’s final communication with his wife, Melanie, he wrote on April 5, 2003, "When the moment comes in my life when you are talking about my last days, I am determined that you and others will say 'he was devoted to his wife and children, he was admired, he gave every ounce of his being for those whom he cared most about… not himself, but God and his family.'

He continued, "My legs have been cramping up, and I really have to stretch them out tonight."
 
A day later, on April 6, Bloom died from a pulmonary embolism caused by a condition called deep-vein thrombosis (DVT). DVTs can occur when people have certain risk factors like clotting disorders and restricted mobility, like when Bloom was broadcasting from Iraq in the Army tank in which he was traveling.

(I’m going to tie this in soon. Wait a minute, will ya?)

In journalism class, decades ago, we were taught about the 5 W’s and the H: Where, Who, Why, What, When, and How.

“Always include them in the top one or two graphs [paragraphs] at the beginning of an article,” the professor said. 

The professor was right on, but journalism has gotten more creative since then and some journalists start off with an intriguing statement or question like “It was all about the water” or “Two plus equals four, right?” 

But I was a creature of habit when it came to journalism and I mostly started with the 5 W’s and the H, which made me think of sitting in one position as Bloom was, at length vs. standing.

Where: This information comes from one of the best in the world, the Mayo Clinic.  

Who: A group of researchers studied the problem of sitting too long.

Why: They discovered that sitting too long could cause health problems.

What: Sitting too long in one spot in excess of 2 hours could lead to high blood sugar, blood pressure and cholesterol, and/or an excess of fat around the stomach.

When: The research was done in June 2012.

How: Sitting too much could increase the risk for cardiovascular diseases and cancer.

The organized paragraph would go something like this:

Researchers at the Mayo Clinic discovered in June 2012 that sitting too long could cause health problems like a spike in blood sugar, high blood pressure, increased cholesterol, and an abundance of belly fat leading to cardiovascular disease and cancer.

Stroke survivors, if they can stand at all, should stand more. But most survivors, at least the ones I know, seek out the comfort of a chair or sofa.
 

That’s why I’m going to the gym three times a week—to get off my a** and do something. 


As a writer, I  do a lot of sitting. But I know I should be standing more. So at most every two hours, I go for a break. I don’t mean a potty break because that would involve sitting, too, for women all the time and men half the time. I mean, men don’t have to sit to pee, but women…. You get my drift.

What I meant was, I stand sometimes to take a lengthy phone call. Or I go for a walk, up to the corner and back. Sometimes I stand to watch television if I’m sitting on the sofa too long. If you’re working, get the powers to be to buy a standing desk, or improvise with a high counter.

Bloom needed to stand more and stretch his legs. Maybe he didn't know about DVTs. Even if he did, he didn't think he could die from it. This situation reinforces my mantra, "You never know what's around the corner." Plus, the Army was on a mission. So was Bloom. Rest in peace, David Bloom.

An Accident Waiting to Happen, aka The Dangerous Treadmill Throws Me for a Loop

2009 was a rotten year for me, and brutish Mike Tyson as well. That was the year I had my stroke. That was also the year Mike Tyson's 4-year-old daughter, Exodus, died from a treadmill cord wrapped around her neck, strangulation style. (Her mother was busy, cleaning in the next room because they couldn't afford a housekeeper. All of Tyson's money now belongs to the IRS, but I digress). The point that Laura Cox made in '09, as a medical writer for ABC news, who informed us of Exodus' death, was that exercise equipment is dangerous.

Take treadmills, for example. Treadmills are risky pieces of equipment. Health club owners have an obligation to inspect their machines and tell members who use them if the treadmill is not in condition to work properly. Typical injuries connected to defective treadmills include back problems, spinal cord injuries, fractured bones, torn ligament and knee injuries, electric shock, facial fractures and lacerations, and traumatic brain damage. If placed too close to a wall or other equipment, a treadmill user may become trapped and the moving treadmill belt can access exposed skin which, in some cases, can require expensive skin grafts and rehabilitation. The problem with the treadmills has gotten so dire, there's attorneys out there who only represent treadmill injuries.

The U.S. Consumer Product Safety Commission (CPSC) documents cases, like the 86-year-old woman in Chicago who sued a health club after a treadmill malfunction threw her from the machine and then severed her right foot. How about this one? A 2-year-old boy was brought to the emergency, and he received treatment for a friction burn to his right hand after he got it stuck in a moving home treadmill. His mother, who had been running on the treadmill at the time of the accident, pulled the safety strap, but not in time to prevent the injury. The treadmill in question had safety instructions underneath the machine and were not visible to her.

West Bend Mutual Insurance Company says that adult injuries are "typically caused by deficient knowledge of the functions of the particular machine. From heart monitors to programmable routines, treadmills have become increasingly complex, and several advanced features can make operation overwhelming. When televisions, headphones, and magazines are added to the equation, it’s shocking more accidents don’t occur. Distractions, complexity, and exertion combine to set the stage for a potentially devastating trip and fall exposure." So true.
 

Here's where I come in. It was yet another day at the gym which, as a stroke survivor, was questionable anyway. But I always have someone nearby while I'm working out on the safe machines. This is my current regimen: The elliptical (safe), the inclined plates for stretching my hamstrings (safe), the treadmill (not so much), and the leg press machine (not safe at all). All my exercises are for the legs because I can't lift my hand independently. I hired a trainer at the gym, whom I liked, but he quit after two weeks of training me, and I got a new one to replace him.

Anyway, after the elliptical for 15 minutes and the inclined plates for 2, which I accomplished by myself because I safely could, I motioned to the trainer for what was supposed to be a 30-minute session including the treadmill, the leg press machine, and some body exercises he thought would be helpful. He was there in an instant because most trainers are usually bored at the gym with nothing to do unless they train somebody. I mean, my trainer was on a 6-hour shift and how long could he occupy himself by doing show-offs things like sit-ups and weight stuff.

I approached the treadmill, with the trainer right next to me, and got onto it by stepping up and transferring my hand from the cane to the side bar. The trainer took the cane off the treadmill pressed the appropriate buttons and I was off at 0.5 miles an hour. Then a few seconds later, I stopped the machine.

I said, "My safety strap isn't on. The last trainer said my safety strap has to be on in order to shut off the treadmill immediately in case I'm in trouble," quoting the last trainer exactly.

"But I've got you," he replied. "And anyway, that safety strap doesn't work sometimes. It pulls away from the treadmill. I've got you," he repeated again. Then he turned the treadmill on again.

I was going for about three minutes with my one hand holding onto the side bar, when I decided the front bar might be better. So I moved my left hand right under the treadmill's console. After thirty seconds, I realized the side bar was more comfortable, and when I moved my hand back again to the side bar, with the "I've got you" trainer right along side of me, something happened.

My feet did a turn around in which they were now facing the wall behind me. The treadmill was still running. And worst of all, I cracked my head on the cross bar. I began to cry. In that defining moment, I wasn't a jock anymore.

"Stop the treadmill," I screamed. "It's still going."

Everybody in the gym came running. Somebody, maybe the trainer, turned off the treadmill after about 15 seconds.

"You should have told me what you were going to do before you did it. It's the first time that I worked with you," remarked the trainer, as if the accident was my fault.

"Gwyneth," who brought me to the gym, showed up at the very moment. She said, "If I was there when it happened, the trainer would lose his [censored] when he made that remark." Gwyneth is a hard ass.

The trainer dragged a chair over to me and asked me to sit in it. He gave me a cup of water and I gave him the worst news.

"Every time I have a fall," I said between sobs, "I need to go to the hospital to have a CT scan, to make sure I'm not bleeding internally. My head is starting to swell up."

The trainer  looked like he was going to throw up. And the owner asked me if I required an ambulance. All I wanted to do was to leave there ASAP, worrying that my brain would burst yet another blood vessel.

I got up from the chair and sat of the bench near the elevator while Gwyneth made a call to the hospital, indicating I was coming soon.

The 10-minute ride to the hospital passed quickly, and I didn't have to wait long before I saw a triage nurse. She took my blood pressure and my temperature and said, "We are kind of crowded so you'll have to wait for the doctor in the hallway. In a gurney, of course." Gwyneth was brought a chair at my request. 

Another nurse came by to check my vitals--again--and a doctor agreed that the CT scan was the best way to tell if there was any internal bleeding. After the CT scan, I returned to the hallway and Gwyneth, and within a half hour, the doctor came over to my gurney and said that there was no bleeding and that my discharge papers would be coming momentarily.

Two hours and I was out. But some questions remain: There are three treadmills at the gym. Why did he have me on the treadmill with a defective strap? Why wasn't the owner told of the defective strap? And why wasn't the trainer's first instinct to turn off the treadmill? I'll never know the answers, and I don't care. Bottom line: the trainer failed. But I'm going back to the gym where I'll use the elliptical and the inclined plates. And the treadmill? Not yet. Not even with a safety strap that works. It's too soon.
______________________

After-the-incident note: The owner of the gym, who wasn't told the treadmill safety strap pulled away at times, told me after the fact, even if it did, the treadmill would stop running anyway. Why didn't the trainer know that? And was he not listening to the owner if she said the safety strap stops the treadmill if it pulls out of its socket? Maybe the owner didn't tell the trainer. 

I got lucky.

The Cane: It's Not Just an Aid for Walking

My cane is a lifeline. Yet, it’s humbling at times. I still often think of my cane as a third leg—cane, right leg, left leg, cane, right leg, left leg. I would rather be safe than sorry with a fall. But my thinking has changed in my four years post-stroke. I’ll tell you what I do with my cane if you promise not to guffaw!

First, a little background which you probably know already. Among the many types of canes, there is the straight cane with little support, an adjustable cane with two shaft segments, and a quad cane with four tips, or ferrules, offering the most stability. The most important thing with canes is that they be set at the right height for the users. But all canes can do something besides helping you walk. That’s where the guffawing might come into play.

I’ve gotten shorter now, as all people do when they age. At about age 40, folks are prone to lose almost a half inch every decade. I used to be 5 feet, 5 inches tall. Now, I’m 5 feet, 4 inches in measurement. The height changes, not only as part of the aging process. Gravity plays a role, too. The vertebrae of the spine might thin and dry out, making the vertebrae more compressed. And the arches of the feet are more likely to flatten out, and diseases such as osteoporosis don’t help the height situation either.

All on these physical realities may mean you’re having trouble with getting things on the top shelves of the cabinets as I do. That’s where the cane comes in. You can move boxes (glass containers break and cans dent) to the very edge of the cabinet. But wait a minute! If only one hand is working, how do you hold the cane and catch the box at the same time? You may have to let them just fall to the ground. Then if you’re able to bend at the waist or from your knees, the box is yours to pick up. If you can’t bend, bring a chair which is nearby (preparation comes first on my list) to where the item has fallen, sit down, and pick it up.

Everybody, friends and family alike, walks ahead of me because at some point, they feel like they’re walking too slowly. I’m left in tow. But I feel confident in using my cane as a weapon if need be. 

And one time, there was a need. My friend was walking ahead, as was customary for her. A thin, middle-aged man rounded the corner we were approaching, bumped into me, like the mugger that he turned out to be, and my instinct took over. When he tried to grab my pocketbook, I hit him square in the “balls” and he took off, albeit injured. Mission accomplished!

Additionally, you can use the cane to close a drawer or door that you can’t reach. I tend to leave the door wide open in the bathroom if nobody’s home and I’m doing “my business.” But my friend left the door unlocked and his workman entered. My trusty cane helped me shut the door so fast it looked like a blur. Come to think of it, I haven’t moved that fast ever!

A cane can also be useful for pushing things along the floor in order to get them to their destination. For example, the toilet tissue is stored in the back hallway. I get three or four rolls on the floor and push them to the bathroom like a herder navigating sheep. Then I sit on the toilet and get them lined up.  Easy, breezy!

And you thought the cane was only for walking. Balderdash!

Note: Write to me at hcwriter@gmail.com and tell me what YOU use your cane for besides walking. I might mention it in an article later on.

Wishes and Hopes: Do They Amount to a Hill of Beans?

It was a famous line in the film Casablanca that gave "hill of beans" its notoriety. Humphrey Bogart says to Ingrid Bergman, who's married to another man, “Ilsa, I’m no good at being noble, but it doesn’t take much to see that the problems of three little people don’t amount to a hill of beans in this crazy world."

I'm having one of "those days" because I wish there was something to do about my stroke. And like Bogart says, the stroke "don't amount to a hill of beans in this crazy world."

Right now, I'd have an operation on my brain if there could be some improvement in my speech, my arm, my leg, any one of the above. Maybe some neurosurgeon could close the hole in my brain with stitches. But I take the blood thinner called Coumadin, and there's the likelihood of complications like significant bleeding into my brain, especially with stitches. Alas, I have a hole in my head. Please. No LOLs.

In reality, no doctors in their right minds would want to try "it," i.e. close the hole in my brain caused by dead brain cells that couldn't regenerate. Cells in the brain just don't do that once they die. The bleeding causes them to die and I had a hemorrhagic stroke when the clot caused my blood vessel to burst. My stroke anniversary just passed. I had a stroke in April 2009 and I'm tired from it. On the surface, I'm generally pleasing and happy. Below the surface, not so much. Still. Even now.

I'm angry though it never shows, at least to the general public. The bitter side says, "Why me?" The euphoric side says, "Why me?" also. Weren't you listening? I already told you. I'm having one of those days where floods of memories come back to me even though I attempt to shun them.

A memory of my mother appears right before my eyes. She had a stroke, too, but there were signs years before. Everyone--my mother, her family, her friends--ignored them. She fell every so often when she would become anxious over one thing or another. She probably had a  transient ischemic attack (TIA) which is like a mini stroke, producing like symptoms of a stroke: weaknesses on one side of the body, blurry vision, trouble talking. 

About 1 in 3 people who have a TIA ultimately have a stroke. Then she had the big one, a name that should be only reserved for California earthquakes. But that is what a stroke amounts to--an earthquake in your brain. I feel happier now, for the moment, that I just invented a new phrase for strokes. But then again, happier is relative.

I fell every so often, too, walking along the corridor or on the street. But I'm not a complainer; neither was my mother. So we didn't do anything about our falling. I attributed my mother's falling to anxiety; I attributed mine to clumsiness or tight shoes. My mother instilled a fear of doctors in me that was so strong, I screamed when the doctor would touch me in appropriate places so we didn't take any action on our falling. Or maybe it was the shoes. My mother had enormous bunions. So do I. But I believe the falling was a precursor of the stroke that damaged our lives forever. My mother was in her eighties, but I was 61, the new 41.

That's enough for memories. I don't want to spend any more time on them. I can't; I shouldn't. I am in the present now. I looked, examined, and researched many ideas--stem cell therapy to make me, even more, mostly whole once again (all the doctors that I researched were fraudulently going after people's money), the Walkaide and the Bioness to enable people walk more efficiently (I wasn't a candidate because of my hyper-extended knee), slings that reduce subluxation in my shoulder (I got one from my "friend" on Facebook, but after three months, I didn't improve any further). I just got the name of a doc who does Hyperbaric Oxygen Therapy. I'll try that next.

The definition of crazy is when you do the same thing over and over, expecting different results. Maybe I'm crazy. Or maybe I'm hopeful. I'm always searching, and I always reach dead ends. But I still try to find magic in the medical community. Perhaps I'll blow a hole in that definition of "crazy" yet. 

The weather is heating up, and summer is about 30 days away. But all the seasons the same for me, and just the temperatures are different. The days are consumed by the stroke, searching to find the silver bullet that will make it all, or most of it, or part of it, go away. I'll take any improvement. My friend calls me Pollyanna, a character in a 1913 novel that turned into a popular term for someone with an optimistic outlook. I say, "How can I NOT be." Hope and wishes are both traits of Pollyanna.

Today, I'm going to do research on Amazon for pomegranate and chocolate. That's to take my mind off of the stroke, but only momentarily. I am obsessed with the stroke and who it's going to hit next. "On average, one American dies from stroke every 4 minutes," say the Centers for Disease Control, (CDC), and it is a fact. How can I not be obsessed, I scream silently to myself.

Hey! Can Fast Foods in Abundance Really Cause a Stroke? No Kidding!

Here's news from across the pond. For all my foreign readers, "across the pond" is a standing idiom, or expression, between the United States and Great Britain. We laugh harder because we won the American Revolutionary War lasting from 1775 to 1783. For Britain, that's a touchy subject--still. But back to the news.

Late last year, the American Academy of Neurology published a study about an increasing number of younger people having strokes. I don't want you to get all nuts, my dear reader. But while the stroke rate has declined among all age groups, the average age of stroke survivors--and non-survivors--is also diminishing. And do you know what that means? The elderly aren't the only ones who could have strokes.

The researchers, Dr. Brett Kissela from the University of Cincinnati and his collaborators, conducted a study of a sample population that examined the number of new stroke cases at three intervals: only 12.9 percent of all new cases of stroke in 1993 were found to be in people under 55, in 1999, using the same under-55 criteria, this percentage elevated to 13.3 percent, and  2005, 18.6 percent of all new stroke cases were found in the under-55 crowd, representing about a 50 percent increase over the first figure.

A spokesman for the Stroke Association, Dr. Clare Walton, said, "With the number of younger people having strokes increasing, greater strain will be placed on health services to support them with their recovery." She went on to say that stroke risk could be reduced by healthy lifestyle changes.

According to the National Health Service in Great Britain, this rise in strokes among younger people is partially due to "poor diet and excessive junk food consumption." Dr. Kissella remarked that risk factors such as obesity (calories) leading to high cholesterol (fat), high blood pressure (salt), and/or  diabetes (sugar) are also factors.

Thus, enter the fast food. Let's take a look at the list presented by a men's online health magazine.

McDonald’s Big Breakfast with Large Biscuit, Hotcakes, Margarine, and Syrup :

1,370 calories, 64.5 g fat (21.5 g saturated), 2,335 mg sodium, 49 g sugar

Wow! Two-thirds the calories you should eat in a day.

KFC Half Spicy Crispy Chicken Meal with Macaroni and Cheese, Potato Wedges, and Biscuit:

1,610 calories, 98 g fat (25.5 g saturated), 4,340 mg sodium

This meal has close to 85 percent of your day’s calories and more sodium and fat than you should eat in a day's worth.

Burger King Large Triple Whopper with Cheese Value Meal with Fries and Coke:

2,110 calories, 104 g fat (35.5 g saturated, 2 g trans), 2,270 mg sodium

Eat one a week for a year and you’ll be toting on more than 30 pounds.

Quiznos Tuna Melt (Large) with Cheetos:

1,620 calories, 111 g fat (25 g saturated, 1.5 g trans), 2,070 mg sodium

A mountain of mayonnaise doesn't help.

Wendy's Dave's Hot 'n Juicy 3/4 lb. Triple with Bacon with Small Fries and Small Coke :

1,540 calories, 83 g fat (33 g saturated, 4 g trans), 2,370 mg sodium

See the problem yet?

And this from the ever-popular Subway where you can lose weight, according to Subway's health-conscious spokesman, Jared:

The 6" Double Meatball Marinara with Cheese sandwich is a fat-laden choice better-known for its healthy choices and its weight-conscious spokesperson.

860 calories, 42 g fat, (18 g saturated fat), 2,480 mg sodium.

And the occasionally advertised foot long? Multiply all the numbers by 2. Yikes!

I had most of those items before the stroke, but only, at most, once a year. Now, since my stroke, I wouldn't eat them because, by my observation, a heavy person with a stroke tends to sit around more than a thin person with a stroke. Repeat: that's only my perspective.

So what do you do for meals if you had a stroke and want to avoid the fast food? The antioxidants found in many fruits, vegetables, and "superfoods;" like blueberries, quinoa, and red pepper, the omega-3 fatty acids found in fish, and the nutrients found in walnuts, almonds, and various other nuts, are all great options for keeping you as healthy as possible.

But if clotting is in your genes, as it was in mine, there's nothing much you can do to prevent it. The stroke just may happen sooner to a junk food addict. Or the stroke wouldn't happen at all if you're lucky. With low cholesterol, low blood pressure, and no diabetes, I shouldn't have been prone to a stroke. But like I said, it was already fated.

This post is dedicated to my old buddy because his mother had a stroke. He didn't even want a copy of my new book, "The Tales of a Stroke Patient." Strokes suck, he said. He loved his mother and, with no quality of life left in her, the family literally pulled the plug. And that should be, my dear friend, your impetus to eating healthier foods. Capish? (Of course, you capish).

Up Close and Personal, aka Babies and Strokes, Part 2

I didn't plan to write what came into my lap. Then I had to tell the story. Stay with me on this.

The subjects in this post are two same-sex individuals who wanted a baby. I’ll name them Paula and Melissa to protect their identity. The baby’s name, protecting her identity, too, is Ali. The birth mother? I’ll call Sue. They weren’t from Illinois, and I’ll use it to further protect their future. The hospital also wasn’t in Baltimore. But make no mistake about this story. It’s about an infant who had a stroke. The post “Babies and Strokes,” published December 9, 2012, inspired them to write me an email.

Paula and Melissa had talked about kids for a long time, but in the past 7 years, they never really did anything about it. Then at the end of January, 2012, they received a phone call from Paula’s cousin saying he had a baby for her. He went on and told them about a coworker who had a pregnant sister. The sister already had a 3-year-old who she was barely maintaining. So the baby was up for grabs. They Paula and Melissa called the birth mother and the story panned out. The child was up for adoption. Sue was relieved, but even more so, Paula and Melissa were thrilled.

They spoke on the phone at first, and Sue told them all about herself—a tumultuous relationship with her family and ex-boyfriend, using cocaine the previous summer, drinking excessively, having sex with loads of men. She also told Paula and Melissa that she drank a “handle” a day and used cocaine through the first trimester. Once she found out she was pregnant, she stopped drinking and drug use. She was 6 months pregnant and she had no prenatal care. But they couldn’t completely trust a drug addict. Would you?

An attorney advised them to abandon the adoption, given Sue’s background, but it was too late in their opinion. They made a commitment to each other, and to Sue. They drove to Baltimore Presidents’ Day weekend from Illinois and spent a weekend with Sue and her 3-year-old who was smart, and Sue admitted to using drugs during that pregnancy as well.

So during that weekend, they bought Sue some prenatal vitamins, clothes and shoes (she only had flip flops and it was February). It seemed Sue didn’t have the best upbringing, from Sue’s point of view, and she was starting to turn her life around.

They returned to Illinois, had a baby shower (it turns out a girl was to be born), and painted the nursery. Paula continued to talk with Sue every day, gleaning everything about her and how she was feeling, her family, her daughter, and the men who might be the biological father. Paula and Melissa got very familiar with Sue as did she with them. At times, Paula got nervous about the harm that was caused by drinking and drug use in the first trimester, but Sue always made her feel better by saying she used drugs only a few times. And Paula didn’t do research either because she figured what’s done has been done. Paula and Melissa wanted the baby that badly.

Sue had already gone to the doctor several times and their baby was right on track for a May 1, 2012, due date. On March 29, Paula spoke with Sue several times, and Sue told her she was feeling very physically uncomfortable. The fourth time Paula spoke to her that night, she heard Sue say crudely, “Holy shit. There is blood and all kinds of shit coming out of me.”

Paula advised her to call her doctor immediately or call the ambulance. Instead, Sue called her mother, and then her friend, then Paula again to say she was going to the hospital. Paula called Melissa and told her they needed to get to Baltimore ASAP. The fifth phone call Paula received was from Sue, telling Paula she was at the hospital and they were admitting her. The sixth was from Sue’s friend telling Paula that Sue lost a lot of blood and had a placental abruption, and that she has to have an emergency C-section.

Paula’s first thought was of her soon-to-be daughter. Twenty-eight minutes flew by and then she heard the news. The baby was born at 10:49 pm. Sue was fine and so was the baby, but Paula wasn’t convinced. Tears poured down Paula’s face as she packed a bag. She knew this was a premature birth due to a placental abruption, and the little research she did said that this was a possibility when cocaine was used during the first trimester. Paula and Melissa were on their way to Baltimore.

Once they got to the hospital, they ran in as fast as they could to the maternity ward, only to hear Sue was sleeping and the nurse said they could not see the baby without her. Paula and Melissa told the staff they were the adoptive moms and asked if they could get any information. They were told to wait in the waiting room. Paula’s stepmom who was in Atlantic City immediately came to Baltimore to give Paula and Melissa support.

The hours passed so slowly, like an eternity, and they still could not see their baby. They used the time to their advantage and drove around securing lawyers and getting paperwork so they could get information about their daughter. Paula and Melissa returned to the hospital, only to have the staff reject the paperwork. Sue was up by this time and finally, 20 hours after coming into this world, they met their daughter.

Their hearts raced as they—Sue, Paula, and Melissa—all walked into the NICU. Ali was in an incubator wearing nothing but a hat and diaper and she had tubes and wires coming out of her because she was a preemie. Her arm had been bandaged. The nurse refused to tell them anything more because of the HIPPA laws. They pleaded with the nurse and explained that they were her moms, but all the nurse would tell them is that they needed to provide different paperwork.

Ali was a beautiful baby. She weighed 5 pounds 8 ounces and was 19 inches long with a full head of black hair. Paula and Melissa were allowed a 10-minute visit, but because of Ali’s condition, they were not allowed to touch her. They left the NICU and took Sue back to her room. We found out from Sue’s friend that Ali wasn’t on a bottle, she couldn’t maintain her body temperature, and she had some breathing issues.

Paula and Melissa wanted more answers. They asked if this was a result of the drugs that had been taken early in the pregnancy. The staff didn’t know. Finally, they were able to hold her for the first time 2 days after she was born. She was so little and sweet. Once again, the tears poured down their faces as they kissed her cheeks. She seemed so fragile. They had no idea the fight this infant had just gone through and the odds she had overcome just to meet them, her two moms.

Over the next few days, they would go to the hospital multiple times and hold their baby. They were only allowed to have her out of the incubator for 20 to 30 minutes at a time.

One of the nurses actually called Paula and Melissa on her own time and said, “This call is completely off the record, but I feel so bad for you girls. I want to answer any questions you may have about your daughter. I can’t say anything about Sue but can answer any questions you have about Ali.”

The first question they asked was, “Is she in any pain?” and then they asked, “What in the hell happened?”

She explained that Sue had a placental abruption, which they knew from Sue’s friend. She wouldn’t say what caused it. Then she told them that she lost a lot of blood and that Ali was deprived of oxygen briefly and almost didn’t make it. She explained that she was underweight and that they did not bottle feed her at first because of the early drug use. Her stomach might not be properly formed, so it is a safety precaution that they do with all premature babies. 

She said Ali couldn’t maintain her own body temperature, but hopefully, she would grow out of it. She said that she passed all of her screenings and Ali looked good and she was definitely a fighter. They were so thankful for this angel nurse. They could finally breathe a little easier knowing that their daughter, for the most part, seemed healthy. They had hope that she would be just fine. And Sue was released from the hospital.

They finally had all of their paperwork in place, and the nurses were able to speak with them freely about Ali’s condition. Her breathing was still sporadic and she was eating every couple of hours. Paula and Melissa told the nurses that they knew of the drug use during the first trimester and they were shocked. The nurses were told that Paula and Melissa knew nothing about it, so it was confusion all around.

They visited the NICU many times a day. There were 8 babies in there and all of them had exposure to drugs in utero. They felt confident that their little infant girl would be just fine. By day 12, Ali was out of the incubator, maintaining her own body temperature, breathing regularly, and ready to be released. They still had one more hurdle: Sue had not signed all of the papers so they could start the process to get Ali out of Maryland and home to Illinois. They couldn’t find Sue anywhere. Her friend said that she was drunk—again, but even though they felt sorry for Sue, they had to focus all their attention on their daughter.

After Sue was located, they were finally able to convince her to cooperate. She showed up at the hospital, high on 5 Vicoden and probably still drunk. She signed the papers and the hospital released Ali, Paula, and Melissa, but not before the last test. They did notice a small cyst on her brain. The doctor said it was nothing to worry about and to “just get a follow-up ultrasound in 6 months or so.”

They finally got Ali home to their friends and family, and her nursery awaited her. Paula and Melissa took her to her regular checkups and she had a clean bill of health. At 5 months, they remembered they needed to get that cyst looked at. The results came back and they were advised there was a small change in the matter in her brain and that it would be best to get a MRI, but still nothing to worry about. Their pediatrician assured them that Ali was developing just fine and that it was just a safety precaution.

On November 17, 2012, they had the MRI and on November 23, they had an appointment with the neurologist.

She entered the room and said, “So no matter what I tell you today, Ali is your daughter and you will always love her no matter what information I give you.”

She handed them a picture of the MRI and said, “Your daughter has had a stroke, probably in utero or shortly after birth.” Their collective chests tightened up. They asked the doctor how this was possible; she was a 6-month-old baby. Babies don’t have strokes. Old people have strokes and, on rare occasion, very unlucky younger adults. Babies and strokes don’t go together, they thought.

The neurologist examined Ali and said she had a significant stroke but yet hardly any symptoms. Paula and Melissa said she had severe drooling. At times, saliva just poured out of her mouth. They went through 8 to 10 bibs a day. Also, there was severe choking, multiple times a day, that kept Ali sleeping in their room for the first 9 months of her life. Both of these symptoms were initially misdiagnosed as acid reflux.

The neurologist went on to say that another symptom was the fact that she had trouble controlling her body temperature at birth. She also pointed out that at times, Ali had a crooked smile and her cheek slightly drooped. They stared at their daughter and they couldn’t see it. She also pointed out that Ali favored her left hand. Paula said that was nothing. She was a lefty, too. The neurologist disagreed. She said Ali was using her left hand because of the stroke. The reality began to take hold.

She passed them to another neurologist who she described as one of the best in the country. Fortunately, he was at Children’s Hospital nearby. She referred them to a county program so they could get help before Ali fell behind and her symptoms became more noticeable.

She also told them that Ali was at a higher risk for seizures and that they needed to pay close attention to her if she starts to stare, looking like she was in a trance. They were to call an ambulance immediately, at least for the first seizure. Paula and Melissa wondered if they missed noticing a seizure. They were distraught.

On January 22, 2013, they met their new neurologist. He told them that they were fortunate because Ali’s MRI did not match the data that was before him. He said maybe by the age of 7 or so, if she hasn’t had any seizures, she could show normal development. He said that sometimes, cognitive impairments wouldn’t show up until the age of 6.

Paula asked this doctor, even though it was partially answered, if Ali would grow up “normal.” He told them that all babies are different and all strokes are different. Babies have plasticity that adults don’t have so she may be able, optimistically speaking, to make her weak side strong, and she may be able to bypass the dead area of her brain by rerouting some of the learning.

Ali was assigned to a physical therapist who said she tested at a 10-month-old level. She was crawling when they were told she wouldn’t. Next came the speech therapist who told them Ali tested at a 6-month-old level. Her speech and understanding of speech were delayed. The occupational therapist who tested her said she had fine motor skills that verified Ali was right on track. They saw a hematologist who said all of the blood work came back normal.

In an email to me, Paula said, “We are going to register her for school on her first birthday so she can start in the fall. She will have one teacher, a teacher’s aide, and about 7 other kids in her class. We will have home therapists which come to the house regularly to help teach us various exercises and things to improve her speech, drooling, limb control, and anything else we need help with.

“We feel like for everything new we learn, there are a hundred things that we don’t know. We don’t know what the future holds for us--seizures, no seizures, full recovery, or partial. We do know that her biological mother was right when she said she was supposed to have this baby but not keep her. And no matter where Ali’s journey takes us, Melissa and I are better people because of her.”

Sue’s behavior was foolish and reckless—the drugs, the alcohol, the sex—just for moments of selfish indulgements. And Ali? Now, there’s the big question mark. I don’t know about how Ali would do physically or otherwise. Neither does anyone else.

But I’ll tell you one thing: Paula and Melissa are intent on doing the best for Ali. Paula’s stepmother, who is my friend, told me so.