“I kept asking him, ‘What is the matter with you?’ I screamed at him and said, ‘Bradley, talk to me, it’s like you can’t hear me,’” says Kim, 63, who works at the University of the Cumberlands in Williamsburg, Kentucky. Bradley had just had his 61st birthday. He wasn’t overweight, did not have diabetes, and he didn’t smoke. He did have high blood pressure that was kept under control with medication. But for two weeks prior to this incident, he had complained of headaches. And unbeknownst to Kim, what she witnessed that day in the bathroom was her husband having a stroke. “I didn’t know the signs of symptoms of stroke then,” says Kim. Bradley was airlifted to a hospital in Louisville, Kentucky, where he was treated for an ischemic stroke. He remained in the intensive care unit (ICU) for three days before graduating to another hospital unit and eventually starting rehabilitation at a clinic in Lexington, Kentucky, which consisted of intensive occupational therapy, physical therapy, and speech therapy. Bradley had to relearn how to walk and talk. And what were once menial tasks were now significant challenges. “The thing that really bothered him was personal hygiene stuff. He wanted to cut his own toenails,” recalls Kim. Bradley and Kim both had to adjust to a new way of life. Fortunately, they didn’t have to do it alone. RELATED: Country Singer Randy Travis Opens Up on Life After Stroke
Building Solidarity in the Stroke Belt
The Deans live in the heart of the Appalachia’s Eastern Kentucky coalfields surrounded by the rolling mountains of Perry County. The community sits along the nation’s Stroke Belt — 11 states between Indiana and the Gulf of Mexico where stroke rates are more than one-third higher than the national average. Yet when it comes to prevention and support, other chronic conditions tend to take center stage. “We have a lot of cancer, heart disease, and diabetes, and a lot of the chronic diseases that we have in excess are risk factors for having a stroke,” says Keisha Hudson, an administrative research assistant senior at the University of Kentucky Center of Excellence in Rural Health. “Patients hear diabetes, but they may not hear that not managing their diabetes is one of the factors that can cause them to have a stroke.” Because of this dearth of information about strokes — the fifth leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC) — and a shortage of stroke specialists in the area, Hudson cofounded the Perry County Stroke Survivor and Caregiver Support Group in 2015. The project was born out of a pilot stroke navigation program in the area that she led. “It was easier to recruit people in the beginning because we already had a relationship with stroke survivors and they had told us that a stroke support group was something they wanted,” says Hudson. “Now it’s harder to reach people and to form that trusting relationship. People are sometimes very skeptical about joining a support group because they don’t know what to expect. It’s getting people to that first meeting that’s the challenge. But once they are here, the support they are shown makes them want to come back.” Hudson says that most new members hear about the group while at the hospital recovering from stroke, or during rehabilitation. She distributes flyers to hang in hospital gift shops and for nurses to give to stroke patients when they are discharged. Oftentimes, family members are the ones who push stroke survivors to attend their first meeting. The Deans found out about Hudson and the support group through Bradley’s inpatient rehabilitation center in Louisville. And as soon as they returned home, Hudson made sure the couple knew they had support. “Kesiha checked in on us the first day we got home. She’d call to ask if we needed anything. She was always there and available if we had any questions,” recalls Kim. A couple of weeks after Bradley and Kim came home, they attended their first group meeting, a dinner hosted by the Perry County Stroke Survivor and Caregiver Support Group in the dining room at Appalachian Regional Healthcare, the hospital in the town of Hazard that worked with the University of Kentucky to launch the program. The Deans kicked off the potluck meal by sharing their story for the first time. One by one, veteran members followed, sharing their own stories with the Deans. “It was a humbling moment when everyone shared their stories,” says Kim, who says that hearing others’ experiences made her feel grateful for their own situation. And although Bradley, an introvert, was nervous at the beginning of the meeting, he became comfortable enough to open up to his fellows because they had speech issues, too. As Bradley kept attending monthly meetings, he began to form friendships with others in the support group. Watching the progress of one fellow member, Mark Kincaid (who was honored this year with the Stroke Hero Awards from the American Stroke Association), inspired Bradley to relearn a skill he never thought he would have again: climbing up and down a ladder so he can do small painting jobs for his family. “I thought, if Mark could walk three miles a day, why couldn’t I?” says Bradley. The couple now regularly attend monthly support group meetings. For the Deans, the group is a place to vent, to find resources, including funds that help pay for accessibility equipment and home modifications, and a place to look for recommendations for doctors. It’s also a community that supports stroke survivors and their caregivers to push the limits of what they have been told is possible — “a lifeline,” as Kim puts it. “It’s been invaluable for us.”
Bridging the Gap About Stroke Awareness
Both Kim and Bradley also volunteer to help with stroke screenings, which the group conducts in partnership with healthcare organizations. They provide free screenings at businesses throughout the area, where healthcare systems are sparse. Kim has also helped Hudson teach stroke awareness in elementary and high schools. “We’re reaching kids, which is especially important in our rural areas where substance abuse has become a huge issue and because of this, we have a lot of grandparents raising kids,” says Hudson. “The kids go home and they educate their parents and grandparents.” Kentucky is among the states that have been most affected by the opioid crisis, according to U.S. National Institute on Drug Abuse figures. And rates of drug use in coal mining regions of rural Central Appalachia, including the Eastern Kentucky coalfields, is higher than in areas of Appalachia that are rural but not reliant on the coal mining industry, according to a study published in April 2018 in the Journal of Rural Mental Health. The group now supports members in seven counties in Eastern Kentucky, and, as a result of the coronavirus pandemic, has had to adjust to virtual meetings. Hudson says she consults a stroke expert who works at a local hospital to answer people’s questions about stroke via social media. In addition, she’s helping people access resources and equipment during this time. She is also in the process of creating mini-grants for stroke survivor families — $500 or so — to be put towards adaptive equipment, home modifications that need to be done to accommodate reduced mobility, transportation to and from doctor and therapy visits, and anything else they may need. “Basically, we’re just trying to adapt virtually to help people. Stroke survivors need help all the time, but even more right now with everything shut down,” says Hudson. So far, their efforts have paid off. Hudson says that even though internet access can be spotty in rural areas, the organization has recruited even more people who are eager to learn about stroke prevention. “I would never have thought about the risk of stroke before this happened,” says Kim. “Now, I want to make our community in Eastern Kentucky aware of stroke signs and symptoms because time is of the essence once a stroke happens.” In addition, when someone in her community does have a stroke, “It’s important to know that there’s a place to go,” says Kim.
