Lisa Marie Westbrook admits that she shrugged off the warnings about high blood pressure. But seven years ago at age 40, she suffered an ischemic stroke that robbed her of the ability to walk and talk.
After a long rehabilitation, she regained those skills. Today, Westbrook said one arm still is weak, but she’s made changes in her diet, uses prescribed medications, and walks regularly and monitors her blood pressure at home.
“Before I had my stroke, I knew I had high blood pressure, but I didn’t realize it was so uncontrolled,” said Westbrook, a Spokane mother of three. Doctors in 2015 told her that her high blood pressure likely caused the stroke.
“When I had my stroke, it was 237 over 156,” she said.
Nearly 50% of adult women have high blood pressure, and most of them don’t have it under control, according to the American Heart Association. High blood pressure, or hypertension, occurs when the force of blood flowing through blood vessels is consistently too high.
“High blood pressure is a leading cause of stroke,” said Dr. Ken Isaacs, medical director for the Providence Spokane Neuroscience Institute, in a news release. He said blood pressure is controllable. People can monitor at home with a blood pressure cuff and follow a healthy diet, reduce salt, improve mental health and get regular physical activity.
Blood pressure is reported as two numbers – systolic pressure over diastolic pressure. Systolic pressure is the force of blood in the arteries when the heart beats, while diastolic pressure is the force when the heart is at rest. Healthy numbers are considered as below 120 systolic pressure and less than 80 diastolic pressure.
“I’d had high blood pressure for years and years, but like a lot of people, I didn’t have access to health care; I do now,” Westbrook said. “Before, I kept getting told, ‘You’re going to have a stroke because your blood pressure is so high,’ and I finally did. I thought, ‘It’s fine; I won’t have a stroke.’ ”
When she did, one daughter who had just graduated from high school was home.
“I felt a tingle in my brain and immediately lost all use of my arm and my leg,” she said. “If my daughter wouldn’t have been home, I probably would have died.”
Medical responders gave her the drug tPA, tissue plasminogen activator, which is given within a few hours of a stroke to restore blood flow if there’s a blood clot.
“I had to learn to walk again and use my arm, but because the tPA was on board so quickly, I was able to do that. Still, today, I’ll try to think of words, and I won’t be able to, so it takes a few minutes.”
High blood pressure wasn’t an early concern for Andrea Engfer, 36, who had a stroke five days after giving birth to her daughter Emma, now 2. The Tacoma resident was diagnosed near the end of pregnancy with preeclampsia, suspected as contributing to the stroke. Preeclampsia is defined as high blood pressure during pregnancy.
“Both my husband and I were so confused about how the stroke happened,” Engfer said. “I never really knew a whole lot about preeclampsia.”
Although pregnancy-related stroke is rare, the rate is rising, the AHA says. A stroke occurs when blood flow to part of the brain is blocked or when a blood vessel in the brain bursts.
The couple found information and statistics at goredforwomen.org, including that women with preeclampsia are more likely to develop hypertension and diabetes later in life. Having the condition also increases the odds of heart failure, research shows.
“I was just blown away by it,” Engfer said. “I had no idea this is a possibility.”
Her OB GYN noticed she had higher blood pressure in the last appointments before an April 13 due date. The doctor suggested inducing labor early, and Emma was born April 3
Five days later, she felt an extreme migraine unlike any other and shortness of breath. Although she’s had headaches since age 12, this was different.
“It felt like my head was going to explode,” she said.
“Other stroke survivors have described this, as well, but it felt like the worst migraine of your life. That’s the only way I can explain it to people.
“I don’t know what my blood pressure was the days leading up to my stroke. I’m assuming it was still elevated because the day of my stroke when my husband took me to urgent care, that’s when my blood pressure went up to 200 over 130. I became unresponsive.”
She was transferred to a hospital. Imaging showed a brain bleed that turned into a stroke. Doctors performed surgery to stop the bleeding.
“They had to put me in a medically induced coma,” she said. “Each day, my husband worried if I was going to wake up. It took 12 days for me to wake up.”
At home, her husband could bring her their daughter to hold if she sat stationary. She said doctors have since told her that a severe headache and listening to your body are important maternal warning signs to seek medical help.
“I wish I had listened to my body because if I had, then maybe I wouldn’t have had my stroke, or maybe I could have gone to the hospital sooner,” she said.
Engfer still has a vision deficit in her right eye. She had to relearn how to read, write, talk and walk.
“I have a memory loss and significant cognitive issues, so it’s been a long road,” she said.
She credits her husband, Martin, and her family’s help.
Engfer said she focuses on both her physical and mental health because she wants more years with her family. Heart disease runs in her family.
“As a family, we are making sure to watch our health, whether it be eating right, exercising,” she said.
“Since January, I’ve lost 40 pounds. Last year, I started seeing a therapist. That has tremendously helped me, because I hadn’t really focused on my mental health because I was so busy with doctors’ appointments and my daughter. … But then last year, it was the day after I celebrated my one-year stroke anniversary that I had a seizure. It was my first seizure; it was terrifying. I thought I was having another stroke.”
Seeing a therapist weekly has helped ease her anxiety. Women often get busy and ignore themselves as they care for others, she said. Engfer used to be among them.
“It’s so important that all women – including women who are pregnant – be aware of their blood pressure numbers and work to maintain them within a healthy range,” she said.
“I had to tell myself, ‘I need to take care of me.’ I had to realize I’m not being selfish, it’s just that I want to live a long time. I want to be there for the people I love the most, so I have to work on myself mentally, physically, emotionally.
“With everything that’s gone on in the past two years with the pandemic, it’s been hard on everybody. I want to make sure that we are taking care of ourselves.”
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