Give me 5

By Nafis Ahmed
Medill Reports - Chicago

Retired police officer Gerald McLaughlin was vacationing in Mexico with his wife when he realized he couldn't feel his face.

The 63-year-old Portage Park native was standing at a hotel bar the evening of March 12 when his beverage began to spill out of his mouth.

"I took a sip, and it felt like my lips were totally full of Novocain," McLaughlin said. "The liquid went in and just came right back out."

Seconds later, McLaughlin began to lose his balance. He reached out with his left hand to grab the bar railing. But he had no feeling in his arm. He lurched forward towards his wife, but he had no movement in his left leg.

"Our immediate thought was that he had too much to drink," said his wife, Beverly, a trained Emergency Medicine nurse.

Had McLaughlin recognized his symptoms, he could have gone straight to the hospital. Instead, he went to bed, joining the thousands of Americans every year who do not recognize they are having a stroke.

"There is a very narrow time window that we have to initiate certain treatments for ischemic stroke, the kind of stroke where you have a clot that blocks an artery in your brain," said Dr. Shyam Prabhakaran, a neurologist at Rush University Medical Center in Chicago. "In that situation, you have three hours from the beginning of symptoms to get an IV clot buster, an agent that is given through your veins to break up the clot."

Prabhakaran stressed the importance of timeliness at a recent community information session on stroke in Rush's Armour Academic Center. "We try to tell people to come in right away by calling 911 so they can be taken to the hospital as soon as possible," he said.

Only 20 to 25 percent of stroke victims arrive at the emergency department within three hours of symptom onset, according to data from the Paul Coverdell National Acute Stroke Registry,

Almost nine hours had passed before McLaughlin woke up the next morning. He knew something was wrong when he couldn't button his shirt.

"I couldn't hold anything with my left hand," McLaughlin said. "I dropped my money three or four times within a two-minute period."

His wife became alarmed when she noticed he couldn't keep his left flip-flop on, because of weakness in his toes. She immediately called an ambulance.

Paramedics told McLaughlin he was exhibiting one of the classic signs of stroke: weakness or numbness on one side of the body. This is one of five common symptoms highlighted in the "Give Me 5" public awareness campaign, launched on March 26 by The Stroke Collaborative.

The other four symptoms are unsteadiness, slurred speech, loss of vision, and severe headache. The "Give Me 5" campaign uses five easy-to-recall words to represent each of these traditional symptoms: walk, talk, reach, see and feel. These five buzz words were chosen based on research conducted in 2007 by cardiologists, neurologists and emergency medicine physicians.

"The important message of the 'Give Me 5' campaign is early identification of stroke symptoms and early intervention by doctors in the emergency department," said Dr. Ralph Sacco in a press release from the American Academy of Neurology. "That can make the difference between life and death."

Twelve hours after his symptoms appeared, McLaughlin was rushed to a hospital. He learned he had elevated blood pressure, which contributed to his stroke. Also known as hypertension, high blood pressure is a critical risk factor in the development of strokes, according to Prabhakaran.

"It's one that everyone calls the silent killer," he said. "It goes undetected in most individuals if they don't see a doctor and causes damage to arteries throughout the body, including the brain for many years."

Jerry Sanders, 44, participated in the session's free blood pressure screening. "I've been advised by a doctor that I need to start exercising and cutting down on salt because my blood pressure is high. I think it's very important, me being the age that I am, to try to reduce my risk factors."

Blood pressure monitors available for public use in many pharmacies and home-use monitors allow most people to keep track of their blood pressure. One-third of Americans with high blood pressure are unaware of their condition, according to the Centers for Disease Control and Prevention.

Other risk factors for stroke include diabetes, high cholesterol, smoking, and heart disease, according to Prabhakaran. "If you did everything right: stopped smoking, you eat right, you get your medical conditions treated appropriately, 80 percent of all strokes are preventable," he said.

More than 24 hours after he experienced his first symptoms, McLaughlin found himself in a Mexican hospital bed, his left side completely paralyzed. Twenty seven days later, he remains in a hospital bed, this time in the Rehabilitation Institute of Chicago.

"When half of your body isn't functioning, it's almost like an alien part of you, it doesn't seem like it's never going to be you again," McLaughlin said. "But I'm just taking it step-by-step, training and rebuilding my ability to walk."

Although McLaughlin did not receive immediate treatment, he is showing steady improvement and is set for discharge in one week, according to physical therapists at the RIC. Nonetheless, Prabhakaran emphasized the importance of prevention.

"There is a chance for good recovery in patients who are having a massive stroke," he said. "But we still explain to patients that it's much better to prevent a stroke then it is to come in with a stroke and have to work on getting you better."

* Don't ignore these symptoms of stroke: http://www.giveme5forstroke.org/