Omaha Mayor Jim Suttle now falls into a group of people who face an increased risk of having a second stroke within five years, a status that doctors say requires adherence to a strict regimen to decrease the chances of another stroke.
Such a plan, doctors say, includes monitoring blood pressure and managing cholesterol levels, diet, exercise and weight.
» Find out if you have atrial fibrillation (an irregular heartbeat that allows blood to pool in the heart and cause blood clots)
» Quit smoking
» Limit alcohol
» Monitor your cholesterol levels
» If you're diabetic, manage your condition
» Exercise often
» Eat foods low in sodium and fat
» Monitor circulation problems
Suttle said Wednesday that he already has started addressing the habits, including long workweeks, that may have led to his having what his doctor called a mild stroke.
Recent studies have found that 21 percent of white men age 65 and older who have had a stroke will have another within five years. Each individual's risk varies, of course, based on such factors as overall health, cholesterol levels, activity level and race.
Suttle, 68, returned to his office this week after having the stroke while he was in Ireland early this month. Suttle said he became light-headed, had some vertigo and slurred his words.
He was hospitalized in Ireland, then flew back to Omaha in a private air ambulance. Neurological and cardiovascular exams conducted last week at Omaha's Methodist Hospital confirmed that Suttle had suffered a stroke.
Dr. Pierre Fayad, medical director of the Nebraska Medical Center's stroke center, cautioned against trying to assign a specific percentage of stroke risk to an individual based on a general study. He said someone who has had a stroke is at higher risk for another, “even if you do everything right.”
But a second stroke, he said, can be prevented.
“From a treatment perspective,” Fayad said, “the biggest focus is preventing another stroke” and managing any adverse effects so that people can return to their daily lives.
The American Stroke Association says that every year, about 795,000 people in the United States have a stroke. Of those, about 610,000 are people having their first stroke. The rest, about 185,000 people, are those who have survived one stroke and go on to have another.
Suttle's longtime physician, Dr. Elizabeth Denman, said last week that the mayor had been given a “clean bill of health” and had made a full recovery. Suttle said Wednesday that Denman has told him his heart is clear of blood clots and the arteries in his neck are clear, with no blockages.
The health concerns, which Suttle has characterized as “a wake-up call,” have not affected his plans to seek re-election next year.
“Nothing has changed,” he said last week.
Suttle said he already had been taking medications to address high blood pressure and cholesterol. After the stroke, he said, he was prescribed one additional blood pressure medication. He said he also now is taking an aspirin and a blood thinner.
Suttle's doctor wants him to lose 15 pounds over the next year to 18 months, he said, and he's aiming for a 5-pound drop in the next three to six months. To that end, he said, he has started a two-day-a-week exercise program involving treadmill work and weight training. He plans to build up to three days a week.
Suttle said he ran “religiously” for 25 to 30 years, but stopped about a dozen years ago when he picked up a respiratory infection. Lately, he said, he knew he needed to exercise but never made time for it.
People can return to work soon after a minor stroke as long as they ease back into their schedule, said Dr. Jose Merino, an associate investigator in the Section on Stroke Diagnostics and Therapeutics at the National Institute of Neurological Disorders and Stroke.
“It's a gradual restart,” said Merino, who, like Fayad, has no first-hand knowledge of Suttle's condition. “Make sure there's no cognitive problems, problems concentrating, problems with depression, (that they are) able to make good decisions.”
Suttle said he no longer will work 70 to 90 hours a week, which for years has been the norm for him.
“We're going to reduce my work schedule to 50 to 60 hours a week,” he said. Suttle plans to take off Friday afternoons and Sundays.
“I confess I'm a workaholic,” he said. “I've always been a workaholic.”
He said that as mayor, he thought he had to “see and be seen.”
“I've taken that to a very high level with my activities,” Suttle said. “Now we're going to have to do more streamlining of that.”
Suttle also is going to meet with a nutritionist to learn “how to eat, what to eat and when to eat.”
Suttle said his mother had what he said was a “mini stroke” when she was 75 and then had another stroke about eight years later that left her right arm paralyzed. When he began to feel ill in Ireland, he said, “I could see what I saw in her happening to me.”
Suttle's mother died in February at age 87.
A family history of stroke, the Stroke Association notes, is one risk factor that can't be changed, along with one's age, race or gender. Many other factors, however, can be addressed, the group said.
Suttle said he has good support from his wife, Deb, and his medical team. “I would welcome being a poster child for those who are stroke-prone or who have been through it so we can all extend our lives in a healthy way.”
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