STROKES: SUFFERERS LEARN LIFE'S SKILLS AGAIN

Deborah Clark, a physical therapy student at the University of Missouri, helped Modena Drennan regain her ability to walk.

Finding the right words can be a struggle for Modena Drennan.

Drennan, 58, suffered a mild stroke March 12, and began rehabilitation a few days later.

"One of the changes that I've noticed is I can't always think of the word that I want to use," said Drennan, who lives in Cape Girardeau.

Her therapists "told me that sometimes it's better to just talk around it."

Drennan's balance and control of her right side also were affected by the stroke.

Now she is undergoing physical, occupational, speech and recreational therapy at St. Francis Medical Center.

Strokes occur when blood flow to the brain is interrupted, either because a blood vessel in the brain ruptures or breaks or because a blood clot or build up of fatty tissue blocks a blood vessel.

The loss of oxygen to the brain causes brain cells to die, and body function is impaired by the cells' deaths.

The amount of damage caused by the stroke depends on where the stroke occurred in the brain and how it lasted, said Cathy Schweain, a clinical resource nurse at St. Francis' neuroscience institute.

"Most patients have some kind of life-altering problem," Schweain said. "Either they have a weakness or dizziness or a gait problem. Sometimes they have swallowing problems which may or may not be temporary."

Stroke patients also commonly suffer loss of speech -- either the ability to speak itself or the ability to choose and organize the right words -- and some may have visual problems.

Rehabilitation can help patients regain some -- and sometimes all -- of the functions initially impaired by the stroke.

The key lies in rebuilding the connection between the brain and the rest of the body, Schweain said.

Drennan's stroke earlier this month was her first, and was fairly mild. Her prognosis is good.

"I'm very thankful that it wasn't any worse," said Drennan.

In physical therapy, she works to regain balance and to improve muscle coordination on her right side.

She used a wheelchair to get around the hospital between therapy sessions, but doesn't plan to use it after she is discharged.

"I don't want to have to learn to manage this," Drennan said.

Deborah Clark, a student physical therapist working with Drennan, said physical therapy concentrates on strengthening and retraining muscles and coordination.

In Drennan's case, she has to learn how to walk normally again. The stroke has shortened her stride, and her gait is uneven.

"We try to get them as soon as possible to get back into a normal step pattern, so they don't end up with a limp," Clark said.

Fran Sauer, a speech therapist, helps patients recover memory and language function as well as re-learning to use the muscles needed for speaking and swallowing.

"The way I describe it is it's like a bridge with a hole in the middle of it," Sauer said. "You've got the brain capacity. You've got the muscle capacity, but you've got to find an alternate route to get across that bridge."

Re-learning everyday functions isn't easy, Drennan said.

"You can't remember learning to walk," she said.

On March 4, William Klein, 66, suffered his third stroke. His second was in 1996.

"At that time, he could talk, but his word association and word selection were the problems then," said his wife, Dorothy.

This time, the stroke left William Klein unable to speak or swallow and unable to walk.

"He does communicate with yes or no," Dorothy Klein said. "He's very sharp. He watches everything and he knows what's going on."

She knows her husband will require long-term rehabilitative therapy.

"Right now what we're really working on is the physical aspect so that he is able to walk around the house and take care of himself," she said.

She said her husband's attitude this time around is better.

"He's wanting to go out of the room, and he's wanting company, which he didn't want before," Dorothy Klein said.

William Klein met most of the risk factors associated with stroke. He is diabetic, has high blood pressure and cholesterol, plaquing in the carotid arteries and a family history of stroke.

Drennan had to undergo heart bypass surgery a few years ago, and coronary problems are sometimes factors in stroke.