{"id":24380,"date":"2019-05-24T11:48:58","date_gmt":"2019-05-24T17:48:58","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=24380"},"modified":"2024-12-24T09:26:11","modified_gmt":"2024-12-24T16:26:11","slug":"strokes-in-young-adults","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/strokes-in-young-adults\/","title":{"rendered":"How life can suddenly change at 26"},"content":{"rendered":"
<\/div>
\"the
Amy Buford suffered a massive stroke at 26. Now at almost 32, she continues with therapy and challenges herself to do new things and meet new goals. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Amy Buford will occasionally look at a picture of her dad helping her walk.<\/p>\n

It\u2019s not a baby picture, as you might think, though her dad, Bob, raised her by himself since she was a toddler. He has always been her rock, and that is reflected in the five-year-old picture, taken when Amy was 26.<\/p>\n

\u201cI like this picture of my dad holding me up because it reminds me how far I\u2019ve come,\u201d said Amy, now 31.<\/p>\n

At 26, Amy felt she had most of life\u2019s questions answered. She was five years into a career she loved, helping at-risk preschoolers as a special education teacher. She volunteered as a court-appointed advocate for children while completing her master\u2019s degree. Nights and weekends, she\u2019d play club volleyball \u2014 very competitively, too. And she was engaged to be married.<\/p>\n

\u201cShe had the whole world by the tail,\u201d Bob said.<\/p>\n

\"Image
Amy with her \u201crock,\u201d her father, Bob. Photo courtesy of Amy Buford.<\/figcaption><\/figure>\n

But all that changed when Amy had a massive stroke<\/a>, leaving her with a transformed reality. She had new questions to answer. Would she ever walk again? Would she be able to teach again? Could she ever be a mom?<\/p>\n

\u201cIt was terrifying,\u201d Amy said. \u201cI wondered what I was going to do and how I was going to continue with my life because at the time, a lot of people were telling me what I could or couldn\u2019t do. I didn\u2019t like that. I wanted to prove if I could do something or not, and it wasn\u2019t always easy.\u201d<\/p>\n

Strokes in young adults are rare, but on the rise. So, health experts are working to boost awareness of them<\/a>. Amy\u2019s doctors first had to save her life. Then, they would learn more about the likely cause of her stroke.<\/p>\n

Three days before Christmas<\/strong><\/h3>\n

On Dec. 22, 2013, a blood clot lodged in Amy\u2019s middle cerebral artery, one of the major arteries that supplies blood to the brain. A medic in the military, Amy\u2019s then-fianc\u00e9 immediately recognized she was having a stroke and called 911.<\/p>\n

\n

Know the signs, think F.A.S.T<\/strong>.<\/h4>\n

FACE<\/strong>
\nUneven or drooping smile.<\/p>\n

ARM<\/strong>
\nOne arm is weak.<\/p>\n

SPEECH<\/strong>
\nSlurred or jumbled speech.<\/p>\n

TIME TO A CALL<\/strong>
\nCall 911 if you suspect any symptoms.]<\/div>\n

Paramedics rushed Amy to UCHealth Poudre Valley Hospital<\/a> in Fort Collins, where a CT scan confirmed the clot. Doctors gave her and tPA, a clot-busting drug, and then sent her via helicopter \u00a0to UCHealth University of Colorado Hospital<\/a>.<\/p>\n

Bob was in Denver when he heard the news. He raced to northern Colorado, then turned around when he learned his daughter\u2019s stroke was so severe that she needed to go to Aurora.<\/p>\n

While Poudre Valley Hospital is a certified Primary Stroke Center able to provide stroke care<\/a>, such as tPA, University of Colorado Hospital is a Comprehensive Stroke Center<\/a>, where doctors can provide more complex services.<\/p>\n

Bob made it to the hospital just as the helicopter landed. Amy\u2019s best friend, Valerie, joined him.<\/p>\n

\u201cOne of the nurses came and grabbed us,\u201d Bob said. \u201cShe told me to run and follow her. I was there when they brought Amy down from the rooftop. It was pretty grim. We were terrified she wouldn\u2019t make it through the night.<\/p>\n

\u201cAnd that\u2019s what started the long process.\u201d<\/p>\n

Working against the odds<\/strong><\/h3>\n
\"MRI
This scan taken Dec. 22, 2013 is from the initial MRI done on Amy Buford\u2019s brain. The bright area on the left side (which is the right side of the brain) is acute stroke. Image provided by UCHealth.<\/figcaption><\/figure>\n

A brain scan showed that the stroke had affected two-thirds of Amy\u2019s right hemisphere, said Amy\u2019s neurologist, Dr. Sharon Poisson<\/a>, medical co-director of the certified Comprehensive Stroke Center and an associate professor of neurology<\/a>\u00a0at the University of Colorado School of Medicine<\/a>.<\/p>\n

Bob credits Poisson and her team with saving his daughter\u2019s life \u2014 twice.<\/p>\n

The extensive damage caused Amy\u2019s brain to swell significantly, so doctors performed a hemicraniectomy. With a section of her skull removed, her brain swelling didn\u2019t put fatal pressure on other areas of her brain. (Doctors later reattach the skull once swelling recedes, which in Amy\u2019s case was several months later.)<\/p>\n

But Amy\u2019s brain began hemorrhaging again.<\/p>\n

\u201cThey recognized what was going on and saved her life again,\u201d Bob said. \u201cI have nothing but praise and admiration for those people.\u201d<\/p>\n

Battling the brain<\/strong><\/h3>\n

With the right side of Amy\u2019s brain so severely damaged, the left side of her body was completely paralyzed.<\/p>\n

\u201cI remember them asking me to move my left arm,\u201d Amy said.\u00a0 \u201cI reached over with my right arm and picked it up. They wanted to know if I could actually move my arm. I thought they just wanted it out of the way.\u201d<\/p>\n

\"Image
For a large milestone \u2014 the first time Amy was able to support herself on all fours \u2014 Amy put this piece together to remind her how far she\u2019d come. Photo courtesy of Amy Buford.<\/figcaption><\/figure>\n

Amy\u2019s stroke left her with what\u2019s called left-sided neglect, which is more than just not being able to use one side of the body. Amy\u2019s brain literally didn\u2019t acknowledge she had a left side. People with one-side neglect may leave food on half their plate or put on only one glove or shoe. Amy\u2019s doctors, friends and family had to cue her to look over to the left in an effort to improve her impairment.<\/p>\n

\u201cMy dad could be sitting next to me and I wouldn\u2019t know it unless he was getting my attention in a more direct manner,\u201d she explained.<\/p>\n

The stroke also affected her memory. She can recall some of the period of time she spent at the hospital, but mostly, her memories since the stroke are distinguished by seasons or big events, not actual dates.<\/p>\n

She remembers New Year\u2019s Eve, as her friends decorated her room for her favorite holiday. And she remembers Valerie by her side many of those days, bringing a small sense of normalcy to her life.<\/p>\n

\u201cShe\u2019d take me on wheelchair excursions, and we\u2019d just laugh and laugh about all the random things we\u2019d discover in the hallways,\u201d Amy said. \u201cShe often stayed the night. She was there through it all.\u201d<\/p>\n

After about a month, Amy was able to leave the hospital and begin rehabilitation. It was agonizing.<\/p>\n

\"image
After her stroke, Amy Buford was told she may never walk again. She wasn\u2019t OK with that. Here her dad, Bob, helps her in rehab. Photo courtesy of Amy Buford.<\/figcaption><\/figure>\n

Don\u2019t tell me what I can or cannot do<\/strong><\/h3>\n

\u201cI had this new normal, but there is nothing normal about being 26 and in a wheelchair when I was used to being active,\u201d Amy said.<\/p>\n

Still, she refused to give up. At one point, caregivers told her she might never walk again. It infuriated her, and she made that clear to her therapists.<\/p>\n

\u201cThen don\u2019t work with me if you\u2019re not going to get me where I was,\u201d she told them. \u201cI\u2019m a special education teacher. Don\u2019t tell me I can\u2019t.\u201d<\/p>\n

Poisson said Amy\u2019s drive was inspiring. Amy said it was Poisson who gave her strength.<\/p>\n

\u201cYoung adults with strokes are a different population than most,\u201d Poisson said. \u201cThey are not only dealing with the deficits of stroke, but yesterday they were healthy 26-year-olds. It\u2019s a sudden realization that they\u2019re a different person now. It changes the way people define themselves.\u201d<\/p>\n

Who I am now<\/strong><\/h3>\n
\"Imaging
Amy Buford was an athlete before she suffered a massive stroke five years ago at only 26. But she wasn\u2019t going to be told she couldn\u2019t walk again, and finds new ways to stay active, like cycling. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Being able to use her left side was Amy\u2019s biggest challenge, but she was determined to walk out of rehab \u2014 and by spring, she succeeded.<\/p>\n

\u201cShe had a cane and my arm, but she walked through all the nurses, PTs and OTs \u2014 all the people who helped her through rehab lined the corridor to the car. They were all crying and clapping, and we went home,\u201d Amy\u2019s dad said.<\/p>\n

\u201cThat\u2019s where we\u2019ve been since,\u201d he said. \u201cI live with Amy now, and she\u2019s probably my best friend.\u201d<\/p>\n

Amy struggles with daily tasks, and having her father nearby helps her manage. She wears an ankle-foot orthosis (AFO), a brace that helps her pick up her left foot to walk, as she can\u2019t wiggle those toes. Her left arm also has limited range of motion, and she\u2019s able to grasp things, but struggles to let go.<\/p>\n

\"Image
Amy Buford gets help from her Raintree Athletic Club cycling instructor, Courtney Petros, to get her foot and brace into the bike prior to class. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

\u201cHere I was, 26 and asking my dad to fasten my bra,\u201d she said, chuckling. \u201cIt was my best girlfriends who told me about front (bra) closures \u2014 now that was a game-changer.\u201d<\/p>\n

Amy said she spent a lot of time Googling self-care tips. She is unable to do what is basic for most young females \u2014 curling her hair or putting it in a ponytail.<\/p>\n

\u201cI just had to stop worrying about that stuff,\u201d Amy said. \u201cThis is who I am now.\u201d<\/p>\n

She focused more on functionality than glamour.<\/p>\n

\u201cI\u2019ll never wear stilettos \u2026 and shoe shopping is a pain,\u201d she explained. \u201cI need to bring my dad because of the management of fitting the shoe and the brace.\u201d<\/p>\n

She does grieve about her limitations. Even small things, like seeing another young women wearing flip-flops, can make her angry. She gets frustrated when she needs to multitask and can\u2019t. She also holds small celebrations like she did recently when she found sandals that she could walk in.<\/p>\n

\u201cIt\u2019s not only physical barriers I have to break down, but the mental barriers too,\u201d she said. \u201cThere are moments when I\u2019m walking into the store and the curb looks funny to me. I freeze and can\u2019t get up the curb.\u201d<\/p>\n

She finds inspiration in a poster that shows a horse tied to a small plastic chair. It says: \u201cSometimes the thing that is holding you back is all in your head.\u2019\u2019<\/p>\n

\"Image
Amy Buford on a hike, something she didn\u2019t realize she liked so much until she wasn\u2019t able to do it after suffering a massive stroke in December 2013 and told she might not ever walk again. Photo courtesy of Amy Buford.<\/figcaption><\/figure>\n

Her dad, though, is in awe of her strength. Amy returned to teaching high-risk preschool children the fall after her stroke.<\/p>\n

Lessons from her stroke give her empathy for her students.<\/p>\n

\u201cI can only focus on one thing at a time now. Sometimes, I have to make myself take a deep breath and slow down. I know that I\u2019ll get there, but if I want that quality of work, I need to take the time to do it,\u201d Amy explained. \u201cI see my students get frustrated in that same way. Maybe they\u2019re challenged by a puzzle. I have them take a deep breath \u2014 tell them to walk away from it for a minute and come back. I\u2019ve been in that position where a puzzle has actually been hard for me.\u201d<\/p>\n

Strokes in young adults<\/strong><\/h3>\n

At the University of Colorado School of Medicine, Poisson is studying strokes in young adults. Although she\u2019s seen a decrease in overall strokes over the past two decades, there has been an increase in strokes for those in their 20s to 40s.<\/p>\n

One possible explanation is that risk factors such as high blood pressure, obesity and diabetes are becoming more prevalent among young adults and, perhaps, not being addressed early enough.<\/p>\n

However, that was not the case with Amy. She didn\u2019t have those risk factors but she had Patent foramen ovale, or PFO, commonly known as a persistent \u201chole\u201d in her heart.<\/p>\n

Patent foramen ovale, or PFO<\/strong><\/h3>\n

When in the womb, every fetus has a foramen ovale, which is an open flap in the wall between the left and right atria of the heart. This opening allows most blood to flow from the right to the left atrium rather than to the lungs. When a baby is born and takes a first big breath, more blood immediately flows to the lung, and the \u201cflap valve\u201d of the foramen ovale closes. Within a few years it seals completely and permanently in most people.<\/p>\n

\"MRI
This MRI image of Amy Buford\u2019s brain in 2018 shows the chronic stroke area \u2014 the dark area on the left side of the photo (right side of the brain). Image provided by UCHealth.<\/figcaption><\/figure>\n

But in 25 percent of the population<\/a>, the flap doesn\u2019t fuse shut and this opening between the right and left atrium may intermittently come and go, called a patent foramen ovale (PFO). \u00a0For the vast majority of those people, there are health concerns related to their PFO.<\/p>\n

Researchers like Dr. John Carroll<\/a>, an interventional cardiologist with UCH and professor at CU School of Medicine, have wondered if there is a connection between PFO and strokes<\/a>, as about 50-60% of young-to-middle-age people without an obvious cause for their stroke were found to have a PFO, he said.<\/p>\n

Potentially, a PFO could allow for a small blood clot, originating in a vein, to pass into the arteries that lead to the brain. In most people, such a clot would go through the huge network of branching arteries in the lungs where it would be filtered out with no damage. But even a small clot of two to three millimeters could cross over a PFO and decrease blood flow to the brain, causing a stroke, Carroll said.<\/p>\n

A study to determine if indeed this was the case is challenging to design, he added. But one major clinical research study<\/a> led by Carroll yielded a clear determination that closing the PFO with an inserted medical device was more effective than medications to prevent a second stroke.<\/p>\n

Once Amy was healthy enough, Carroll performed a transcatheter PFO closure procedure on Amy.<\/p>\n

Five years later<\/strong><\/h3>\n
\"Image
Amy Buford gets help from her Raintree Athletic Club cycling instructor, Courtney Petros, to get her foot and brace into the bike prior to class. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Amy continues to attend physical and occupational therapy one to two times a week. And she\u2019s trying new things, instead of focusing on limitations. She said she uses her stroke as an excuse to \u201cbe a bit selfish.\u201d<\/p>\n

\u201cI feel like I owe it to myself to reach my goals and follow the dreams I had before my stroke,\u201d she said. \u201cI\u2019m focusing on me.\u201d<\/p>\n

She has joined a spin class and hopes to try a new exercise class every so often. Pilates is next. She has started hiking again and hasn\u2019t given up on teaching. She works hard every day to gain more independence.<\/p>\n

\u201cI have to look at things for my own personal growth \u2014 to prove to myself that I can still be an adult and capable of doing big things,\u201d she said.<\/p>\n

Her dad couldn\u2019t be more proud and his love is evident in his aspirations for her.<\/p>\n

\u201cShe fulfills her own destiny every day,\u201d Bob said. \u201cI\u2019d love to see her have a life that is independent of me. At 32 (which she\u2019ll turn on June 3), she absolutely deserves that. She\u2019s just an amazing person. She sets goals and accomplishes them. And if she fails, she sets a more achievable goal, accomplishes that and then sets a higher goal again. She\u2019s a pretty amazing kid.\u201d<\/p>\n

Amy said she couldn\u2019t have done it without her father.<\/p>\n

\u201cIf it weren\u2019t for him, I wouldn\u2019t be where I am now,\u201d she said. \u201cMy dad is my rock.\u201d<\/p>\n

She has a photograph to prove it.<\/p>\n","protected":false},"excerpt":{"rendered":"

Amy Buford will occasionally look at a picture of her dad helping her walk. It\u2019s not a baby picture, as you might think, though her dad, Bob, raised her by himself since she was a toddler. He has always been her rock, and that is reflected in the five-year-old picture, taken when Amy was 26. […]<\/p>\n","protected":false},"author":2164,"featured_media":24375,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[708,715,693,235,184,351,405,9171,869,2182,1497,209,212],"class_list":["post-24380","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-adults-65-plus","tag-comprehensive-stroke-center","tag-cu-school-of-medicine","tag-emergency-care","tag-neurology","tag-primary-care","tag-primary-stroke-center","tag-senior-care","tag-stroke-care","tag-uchealth-poudre-valley-hospital","tag-uchealth-university-of-colorado-hospital","tag-urgent-care","tag-womens-care"],"acf":[],"yoast_head":"\nStrokes in young adults: Learn the signs - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Strokes in young adults are rare, but it is on the raise. 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