Juli Turner has the same goal every day.
It's what propels her up 10 flights of stairs to her job in a downtown Tampa high-rise, Monday through Friday. It's why she eats egg whites and vegetables for lunch, peanut butter and an apple for a snack. It's why she's at the gym on Saturday mornings at 9 for spin class.
Turner's goal is to protect herself from having a stroke.
At age 37, she has already had several so-called mini-strokes, putting her at high risk for a full-scale stroke at any time. Concern about stroke "shapes my life . . . and has changed the way I look at things."
What's a mini-stroke?
The mini-strokes were found on an MRI, a scan of the brain, ordered when Turner was 23 and went to the hospital with a severe headache and blurred vision. A neurologist initially told her it wasn't a stroke. But the MRI turned up evidence that three mini-strokes had occurred at least a year or two earlier.
"I was like, 'What? You have to be kidding me,' " she says, "It was a complete surprise."
During a mini-stroke, or transient ischemic attack (TIA), a clot blocks or reduces blood flow to the brain for a short time. It may produce the same symptoms as a stroke, but the clot becomes dislodged quickly. Blood flow returns to normal and the symptoms go away, usually within 5 minutes or less.
Symptoms of a stroke or TIA come on suddenly. They can include dizziness or loss of balance or coordination; difficulty speaking or understanding speech; numbness or weakness, especially on one side of the body; drooping on one side of the face; vision problems; and what sufferers have called the worst headache of their lives.
'We need this'
According to the American Heart Association, about one-third of people who have a TIA will later have a stroke. Turner takes that risk very seriously. She follows her doctor's advice to take an aspirin every day to prevent dangerous clots from forming in her blood. The Riverview resident follows a low-fat diet from the American Diabetes Association. She logs everything she eats on www.fitday.com, a free Web site that helps users keep food logs and track nutrition and calories.
In addition to climbing stairs at work, Turner and her husband are members of Lifestyle Family Fitness, a gym with locations around the bay area. Wherever the family goes, they make it a point to drop in for a workout. The top-tier membership "is expensive," she says, "but we make it fit our lifestyle. I'm not giving it up. I need this. We need this."
Slash your risk
Stroke prevention can't start too early, according to Dr. Eric Lopez del Valle, an interventional neuroradiologist at Morton Plant Hospital in Clearwater. "We need to keep healthy early. Start this lifestyle once you've had an event, you're starting late," he says.
Lopez del Valle says the most important things you can do to prevent a stroke are quit smoking, control your blood pressure and lower your cholesterol. Each one of these steps independently reduces stroke risk by 20 to 30 percent.
Also, maintain a healthy weight, eat foods low in saturated fat and exercise. "These all work wonders for preventing stroke," he says. Diabetics need to have good glucose control, and some high-risk patients such as Turner will be advised to take an aspirin a day. Many high-risk patients will also be prescribed daily medication known as ACE inhibitors, to control blood pressure and prevent future strokes.
Turner believes she's doing everything in her power to prevent a stroke. She's within 10 pounds of her ideal body weight, she doesn't smoke, is physically active every day and exercises at the gym least 4 days a week. She closely watches her cholesterol and blood pressure.
"I don't worry about having a stroke,'' she says. "I'm just aware that it could happen and I don't want it to."
Irene Maher can be reached at firstname.lastname@example.org.