Transcription:
Stroke Recovery

Melanie: Welcome to Back To Health, your source for the latest in health, wellness, and medical care, keeping you informed so you can make informed healthcare choices for yourself and your whole family. Back To Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine.

I'm Melanie Cole. And today, we have an inspiring patient story on stroke recovery, and how thanks to the quick response of neighbors, family, and of course, Weill Cornell Medicine physicians, this patient has not only recovered, but is thriving. Joining me is Dr. Matthew Fink, he's the Lewis and Gertrude Feil Professor and Chairman of the Department Of Neurology at Weill Cornell Medical College and Neurologist-in-Chief at New York Presbyterian Hospital, Weill Cornell Medical Center; and Andrew Kampel, he's the patient of Dr. Fink's and has recovered from a stroke.

Gentlemen, I'm so glad to have you. I love these kinds of podcasts because they really tell a story and give hope to others that either have suffered the same or are worried about this. So we're going to give a lot of great information today. So Andrew, why don't you start for us? Tell us your story why you were treated at Weill Cornell Medicine. Tell us about your experience.

Andrew Kampel: Thank you, Melanie. And thank you, Dr. Fink, for letting me share my story. So eight years ago was a very particular stressful time in my life as people have stressful times, and I wasn't really handling well in terms of food and alcohol and I was already not a healthy person. And then, one night I was out with my friends in Manhattan and they said I said goodnight to them and I don't recall that. And I started walking home, about six blocks. I got about a block thinking a friend of mine at his restaurant could help me. And then I remembered he didn't work that night. So the next thing I remembered, I was trying to get into a building and I don't have a doorman. And then at some point, I realized that I was leaning to the left and I couldn't open my door, which was probably a good thing. And I knocked on my next door neighbor's door and I just said, "Barbara, I need help." And she screaming called Weill Cornell, saying, "Come help. We need help."

And then the ambulance came very quickly and they took me to the emergency room where it was just kind of like triage you see on MASH. They just kept running around, a lot of people around me pushing me around and doing things to me. They gave me the clot-buster shot. And then for about the next five days, I was pretty much unconscious. I remember just snippets. But after on the day six, things started to coalesce. And I had a few more days in the hospital then a week in rehab. And at that point, they gave me two tests. One was counting backwards from a hundred by seven. I aced that, believe it or not. And the other was to do the alphabet and I couldn't get to F and I didn't remember J and the whole L-M-N-O-P thing confused me.

And then, I was released after two weeks. And I went home and I was home and I started doing OT, PT, and speech. And then one night I had a bad headache. And instead of waking up my mom -- yes, here I was 48 years old, attorney litigator that had to live with my mom -- and instead of waking up my mom, I went and got Tylenol. And when I woke up in the morning, I couldn't see. And this is when I also found out that unbeknownst to me, I had lost the vision in the right side of my eyes after my first stroke, which I never realized. And then my mom took me to -- we were on Staten Island -- to a different hospital where they treated me. And then I went back to my treatment with Dr. Fink and some eye neurologist at Weill Cornell. And then, I started on our PT, OT, and speech and the rest is history.

Dr Matthew Fink: So Andrew's story is unusual. He told you as he was relaying what happened to him he was 48 years old when he had that first stroke. Extremely unusual. The vast majority of people that have strokes are over the age of 60 and what was remarkable also is that he was out with friends, they were having a good time, they were eating and drinking. And when he started developing some problems with his walking and his balance, most people would have said, "Oh, you had a little too much to drink and wanted to just go home and sleep it off." But his friends were sharp enough to recognize that this was unusual, something else was happening here. And they got him to the hospital right away.

And it also turned out that the cause of his stroke was something that does happen in younger people. One of the most common causes he had what we call a dissection of a vertebral artery. And dissection is a tear in an artery, which then causes a blood clot to form and that blood clot then travels up to the brain. And that's what causes the stroke. It's rare, but in a young person, it's one of the most common causes of stroke in a young person. It's one of the most common causes of a stroke in a child. Yes, children can have strokes this as well.

Why he developed this dissection? We're not exactly sure. It's usually from some type of extreme physical action of the neck, twisting or bending or something where the neck is severely twisted or strained in some way. And we think that that's probably what happened to him. So what happened to Andrew was very unusual. But in addition, prior to the stroke, he was overweight, not eating well, probably drinking too much, under a tremendous amount of stress, not getting as much exercise as necessary, and those are all risk factors for having a stroke. So the prevention of a stroke is largely in the hands of each of us. We can do what's necessary to prevent a stroke.

Melanie: So Dr. Fink, I'd like you to tell the listeners those symptoms that Andrew had, that his neighbors spotted and recognized. Can you please go over those symptoms for us? We're going to do that a couple of times today because it's so important that people recognize it because it is what quite possibly saved his life. So can you please tell us those symptoms and that acronym BE FAST?

Dr Matthew Fink: Sure. So the major problem that Andrew had was his loss of balance. He had trouble walking and he was tipping over as he described. He was tipping over to the left side and had lost his balance. And that is one of the hallmark symptoms of a stroke when it comes on suddenly as it did with him. And there are six different areas where we should be aware that a stroke might be occurring. And it's the acronym BE FAST. And BE FAST stands for B is for balance, which is what happened to Andrew. E is for the eyes, many people have blurred vision. F is for face, meaning there's a drooping of the face on one side. A is for arm, there can be drooping of the arm. S is for speech, many people have loss of speech or slurred speech. And T stands for time, meaning please act as fast as possible. We use the expression that time is brain and the faster treatment can be administered when someone is having a stroke, and that treatment is either a clot-busting drug, which is what Andrew was treated with, what's called Alteplase or mechanical thrombectomy, which is removing the clot from the brain with a procedure. The faster those procedures are done, the higher the probability that the person is going to make a complete recovery.

And what we've been learning as we've been getting faster and faster to do this, that if we can treat someone within under 60 minutes of onset of symptoms, the majority of those people will make a 100% recovery. They will get back to normal. So speed is of the essence. This is one of those conditions where when you come to the emergency room and you think you're having a stroke, or someone says, "I think this person is having a stroke," people are literally going to be running you around, getting things done as quickly as possible, because that is really the key to having a full recovery and doing well.

Melanie: What an important message. So Andrew, tell us what your recovery is like and life after stroke. What have you changed? What have you done that's really changed your life and how do you feel now?

Andrew Kampel: Well, first I feel great. But I've changed everything, my diet, my exercise, my attitude, my attitude in a way that like little things don't bother me anymore. I don't linger on little things. Like someone used to bump into me in the subway, and it would really anger me for hours. I'm a New Yorker. But in terms of right away, my first appointment with Dr. Fink was "You have to change diet and you have to cut out white flour, alcohol, salt, sugar, and fat. And then he said, "You have to exercise." And one of the exercises you said I could do was walking, and I love to walk, I'm a New Yorker. And so at first, I built it up. At first, it was 20 minutes because that's all I can do strengthwise to eventually it was about six months later or five months later, I was recovering in Florida, and I was able to take two-hour walks by myself. And since then when I take my long walks in Manhattan, I take two and a half, sometimes three-hour walks, which I find not just physically, it helps me, but mentally it helps me. It helps me relieve any kind of little stress that's with me and I get into this really good place in my life that I feel that I can accomplish anything. And that's what Dr. Fink told me to do. And he dared me.

"That's what I really like about Dr. Fink. He read me as a person, and he dared me. He said, Andrew, You have To do this. If you don't do this, who knows what's going to happen to you?" And I understood what he meant and I took it. And I also even back then remembered the looks on the face of my family and friends, especially after my second stroke, that the worry, the concern. And I don't want to do that to them again. I don't want them to get emotional about me. Like I said, I was a very unhealthy person who lived an unhealthy lifestyle and I really enjoyed it, but what I put my family and friends through, I'll not do that again.

Melanie: Oh, Andrew. You know, we can all hear what you're saying. And the fact is that none of us wants our loved ones to see us go through what you went through, but you're teaching us so much today. And I'd like to ask you what the staff were like. What in particular stood out? Obviously, we think Dr. Fink is awesome. And I can tell just by talking to him that he is not only no-nonsense, but brilliant. So tell us about the care that you received at Weill Cornell Medicine and why you appreciate your care team so very much.

Andrew Kampel: It's beyond treating me as a patient. The first thing they did and I cannot stress this enough is they treated me not as patient, they treated me as Andrew David Kampel. And I was always treated as Andrew David Kampel, as the person, as the human being, as the person with a mother and siblings and nieces and nephews and friends. And I felt they cared about me and I feel they care about me now, which is probably the real reason I've been volunteering at the hospital for two and a half years now, because of what they did and my friends did for me. Going back to when I was recovering in the hospital and then in rehab, people had to bathe me, people had to dress me. I don't know if they fed me. I don't remember actually eating the first time it was in the hospital. So for someone to do that to me and always bringing my mother a cup of tea and helping my family and being there for me and my family, again, is another reason I volunteer because I can never repay this. I always say, I know maybe 10% of what people and, of course, and my family and my friends, the hospitals, the people at rehab and the hospital did for me and my family, and I cannot believe that they did 10%. I'm saying I don't even know what the other 90% is.

Melanie: What an incredible story. And thank you, Andrew. Really thank you for sharing it with us today. And Dr. Fink, tell us a little bit briefly before we wrap up what you would like the listeners to know about stroke, lifestyle behaviors, that acronym that you mentioned, mentioned the importance of keeping track, because if we are not our own best health advocates, as Andrew learned, then we can't even help the ones that we love. And certainly women also are suffering stroke. And as the caregivers to the world, we have to learn to really put our own masks on as it were before we can help the ones that we love. So can you give us a little of your best advice here about what we can do to prevent a stroke?

Dr Matthew Fink: Absolutely. And we all can prevent a stroke. And it comes back to the basics of how we live our lives that we all learned as we were children. Our mothers and fathers told us about this. We have to eat a healthy diet. And a healthy diet is one that has lots of fruits and vegetables in it and has low amounts of carbohydrates and fats. It's not as complicated as you might think. And it's a healthy and very appetizing diet.

If you have high blood pressure, you must treat it and do whatever you have to do to get your blood pressure down to normal. You want to try to keep your weight in an ideal range. You don't have to be thin, but you don't want to be fat either. And then exercise is extremely important. And when we talk about exercise, it doesn't have to be anything exotic. The best exercise you can do for your general health is walking just what Andrew has been doing. Walk as much as possible. Walking has a special effect on the brain that is different than just about any other exercise. It has a positive effect on your brain. It protects your brain. It helps your brain recover. So you want to do as much walking as possible.

And then there are other medical problems that will be identified by your doctor. So you need to go for regular checkups. So you want to make sure that your heart is healthy. You want to make sure that you're not developing diabetes, which can be a very, very serious problem. You want to check on what your blood cholesterol is and if your blood cholesterol is high and does not respond to a diet, then you should take medications to lower your cholesterol. There's a class of medications we refer to as statins, which are actually miracle drugs. They have a profound effect in reducing your risk of having a heart attack or a stroke.

So there are so many things that we can do to keep ourselves healthy, but they are largely in our own hands. Your doctor can't make you lose weight. Andrew lost 50 pounds. He won the record of all of my patients in terms of the most amazing response in terms of his dieting. He lost a tremendous amount of weight. He started exercising in a way that is going to help him stay healthy for a long, long time. So we can do a lot to keep ourselves healthy and prevent a stroke. And then if you do have a stroke, the same things will help you to prevent a second stroke.

And by the way, there's a side benefit. All of the things we talked about will also reduce your risk of having a heart attack and will also reduce your risk of developing dementia later in life. So these simple interventions that you can all take, we can all take for ourselves, can prevent a whole range of serious illnesses as we get older. And hopefully, we'll all be living well past the hundred and have active lives, and be able to enjoy our families and our friends and have productive lives as we get older.

Andrew Kampel: And I just want to say this, and I say this to the patients at the hospital when they ask me why I volunteer and I tell them, and I share my story with them. If I can recover and change my lifestyle, that anyone can recover and change their lifestyle and live a healthy lifestyle. And I thank the hospital, especially Dr. Fink, his nurses, Kathy who's retired and Barbara and everyone and, of course, Gretta. And everyone who's helped me. Me and my family and my friends cannot thank them enough.

Dr Matthew Fink: And Andrew, I thank you for giving back by being a volunteer. Wonderful thing for you to do, so thank you for that.

Melanie: Very well said, both of you. Thank you so much. Really thank you for joining us, Andrew, for sharing your story for the listeners so that they can hear what's involved and really how great the staff at Weill Cornell Medicine was for you. And Dr. Fink, thank you for sharing your expertise and to learn more about Weill Cornell Medicine's general neurology practices, you can always visit Weill cornell.org/services/neurology.

And Weill Cornell Medicine continues to see our patients in person, as well as through video visits and you can be confident of the safety of your appointment at Weill Cornell Medicine. That wraps up today's episode of Back To Health. We'd like to invite our audience to download, subscribe, rate, and review Back To Health on Apple podcasts, Spotify and Google Podcast. For more health tips, please visit weillcornell.org and search podcasts. And parents, don't forget to check out our Kids Health Cast. I'm Melanie Cole. Thanks so much for listening