Whitefish woman battles back from strokes

BY DAVID REESE, Montana Health Journal


The headaches she was getting were bad, but Leslie Leroux had gotten used to them.

These headaches were different, though. “They were mega headaches," Leroux said.
Four years ago, Leroux, a native of Paris, was a successful business person operating a boutique in Whitefish for her fashion company, Ethos Paris.
After about a week of painful headaches and unable to get out of bed, she called 911 and was taken to the hospital. After being releaesed, her family came home to find Leslie largely unable to explain what was happening. Her husband took her back to the hospital. What they found inside Leslie was a bacterial heart condition that had been sending showers of bacteria into her brain — in effect, causing eight separate strokes.

Leroux had what is known as ongoing diffuse embolic shower, according to Kalispell vascular neurologist Kurt Lindsay, M.D. Lindsay is the medical director for the stroke program at Kalispell Regional Medical Center.
In embolic showers, the areas of stroke caused by restricted blood flow are usually small, Lindsay said. But recovery takes a long time and the degree of recovery can vary. “Leslie was young and healthy, had a great medical team, and worked very hard to get back to where she is now,” he said.
Leroux underwent open-heart surgery at Kalispell Regional. But her condition was in peril. She could not speak or walk. Before the strokes, Leroux had been a vibrant, healthy woman. So she persevered, and taught herself how to re-learn reading, walking and talking; she did every possible brain-training exercise she could find, and after a few months she was able to walk to the end of her driveway.
She regained her health on her own in a year, with a dogged perseverance and independence she is known for. But it was that independence that also may have caused her problems in the first place. If she had not waited so long to seek medical attention when she was having headaches, the bacterial heart infection might not have gotten so severe.

"I was having incredible pain in my brain, and I thought it would never cease," she said. "I had been having migraines, but these were mega headaches. It literally felt like I was dying."

While she was in the Kalispell hospital, she remembers feeling as if she was entering a calm, peaceful world, one without pain. “I felt I was being pulled into another reality, another world,” she said. “That was incredible, wonderful. It was an unreal place of bliss.”

Then she began to realize, deep inside, that her body wanted to heal. Her sister, who had arrived from France, whispered in her ear and Leslie awakened, opened her eyes and found herself surrounded by family. "I realized then I had another chance," she said. "From that point I was really driven to get well again."
“I always took pride in my intellect,” Leroux said. “I found it very hard to accept my condition—I not only could not speak properly, I couldn’t read, I could not make sense of words on the page.”

“I couldn’t really talk. I couldn’t express myself and I was very bothered and hurt by the way people were acting towards me."

 

When she had been in the emergency room, she wasn’t very responsive and was sleepy. She showed confusion, facial droop and was not able to walk or speak — all classic signs of stroke.
“I couldn’t really talk. I couldn’t express myself and I was very bothered and hurt by the way people were acting towards me,” Leroux said. “They didn’t know I was still in there, still with the power to think, even though I couldn't do much else."
Leslie explains that she holds a deep belief that a body, on a very basic cellular level, wants to survive and repair itself. She believed she could recover. After months of retraining her brain, finally she began to be able to talk more fluidly and express herself.

Leroux learned from her experience to appreciate the simple gifts of life — like just waking up to another day. “I really see the world differently now," she said. “I feel lighter, and thankful every morning I am alive.”
She said she didn't think stroke could happen to her. “I was almost obsessively healthy, with an all-organic, vegetarian diet,” Leroux said. “But nothing guarantees your health, and no extreme is good.”

She now says, “Pay attention to your body and when it feels wrong, do something about it.

Don’t be prideful; be willing to seek help. I should have called for help earlier instead of staying in pain for days.”

Leroux is, literally, a changed person after the stroke. She said one of the things she lost was all her baggage — all the regrets,  grudges or peeves that humans may accumulate in their lives. “Negativity is gone, and I feel lighter and freer without it,” she said. “I wake up every morning and know we all have such an amazing beautiful life. I'll never be 100 percent again, but I'll be something else.”

Stroke is a leading cause of long-term adult disability in the United States.
Stroke survivors often have lingering problems with speech, balance, mental functions or emotions — depending on what part of the brain is affected. Multiple areas of Leroux's brain were damaged by her strokes. Dr. Lindsay said cardiac disorders like the one Leroux had are one of the most common causes of stroke, and he recommends all stroke patients have a thorough cardiac evaluation to rule out any abnormal heart rhythm or structural abnormality.
 
LINDSAY and LEROUX spoke at a program last fall called “Faces of Stroke.” Jason Gleason, who lost his wife to a stroke, leads the Faces of Stroke program around Montana. The program helps to educate people about stroke awareness.
Gleason told the story of how he lost his wife unexpectedly one day in 2011. Gleason had said goodbye to his wife, Heather, one morning when he went to work at a Great Falls emergency room. Then he heard the police scanner report the address of their home. His wife was having a stroke. In half an hour she was being wheeled into the emergency room where Jason worked. Two days later she was declared brain dead. She lived only 29 more days.
Heather Gleason had suffered what is called a locked-in stroke — her brain was in perfect condition but she couldn't move anything, Jason said.
For the 29 days that Heather remained alive, Jason and his sons made sure every day was special for her, as a wife, mother and friend. The boys did lots of little things for their mom, like bringing flavored lip gloss to her so she could taste her favorite flavors.
 
The family was the other victim of the stroke. Hospice care was instrumental in the family's care, he said. “They were the Keebler elves of love and gooshiness,” he said.
Gleason said it's crucial that stroke victims receive tissue plasminogen activator, or TPA, during a stroke event. The drug, which is sold as alteplase, works to break down clots in blood vessels. The drug costs around $3,000 per dose, according to Nichole Perisho, the coordinator of the stroke program at Kalispell Regional Medical Center.

Heather Gleason's dose of TPA wasn't administered until 233 minutes after her son called 911, Jason Gleason said. He said TPA needs to be given to the victim in under 60 minutes. Nearly 2 million brain cells die every minute during a stroke, Gleason said. That means early activation of emergency medical services during a stroke is important, Gleason said. He commented that Benefis Healthcare in Great Falls is averaging under 30 minutes for TPA administration to stroke victims.
Self-diagnosis is crucial to understanding signs of stroke, Dr. Lyndsay said, especially among men, who may tend to “just sleep it off.” Lyndsay, Montana's only vascular neurologist, is the director of the telestroke program at Kalispell Regional Medical Center that helps bring professional expertise to rural areas of Montana that don't have stroke care. Using a robot in the Kalispell Regional Medical Center that is connected via Internet to eight Montana communities, Lyndsay is able to communicate live with healthcare professionals and their stroke victims. Telestroke serves emergency rooms in Whitefish, Libby, Ronan, Plains, Cut Bank, Conrad, Shelby and Chester. The technology is also used for neonatal care in those communities.

With the telestroke program, the stroke victim undergoes a CT scan of their head, and neurologist in Kalispell is able to assess the patient live via technology interface. Then, if the patient is transferred to Kalispell, the neurologist is already well-informed on the case, according to Perisho, at Kalispell Regional. The technology and expertise allow people in remote areas of Montana to receive professional care in time of a stroke, Perisho said. “If I lived on the Hi-Line, I'd feel confident in the level of care,” she said.

Perisho became committed to stroke healthcare after working at Craig Hospital in Denver. She witnessed how a professional photographer struggled to regain his speech and mobility after he suffered a stroke. Then, when she met Dr. Lindsay and saw his dedication to stroke patients, Perisho joined the Montana Stroke Working Group. “All Montanans should have access to this level of expertise and stroke care,” Perisho said.

Community awareness of stroke — and the professional expertise available — are keys to reducing stroke mortality and disability, Perisho said. The Montana Department of Health and Human Services began a stroke-awareness program in 2014, and with Kalispell Regional Medical Center's telestroke program, more communities are learning about stroke. “Stroke awareness is gaining a lot of ground,” she said. “Community awareness is key, and it has to be non-stop.”
With increased community awareness, Perisho said KRMC in the last year tripled the number of  emergency room visits with stroke victims.

FIRSTHAND KNOWLEGE

Carla Williams recognized the sign of a stroke when she was having one. She had a stroke scare while washing dishes. Her left hand remained clenched, and her lip went numb for just a few seconds. Her husband, who works for a volunteer fire department, was able to perform a few verbal tests with her, to see if she was having a stroke. While she passed the test, she still felt uncomfortable. She went to the emergency room in Kalispell, where she was administered TPA.
Jason Gleason now takes his message of stroke awareness around Montana. He gives a presentation of stroke education that is part stand-up comedy, part personal testimony with a slideshow of him and his family before, during and after his wife's stroke. The combination rivets the audiences, although for him to relive the death of his wife “is like ripping open scabs every time I tell it.”
He remembers his wife's final words as he left for work that morning in 2011: “I love you.”
On the Web: montanastroke.org; jasongleason.com