Strokes in older patients are often caused by a blood clot which blocks an artery in the brain which has been narrowed by arteriosclerosis, a condition which is usually associated with high cholesterol and poor eating habits. Strokes can also be caused by an aneurysm, which is a weak part of a blood vessel which expands, putting pressure on the surrounding brain tissue. If the aneurysm bursts, the hemorrhaging inside the brain can quickly become life-threatening.
Yossie Federman is a young man from a religious Boro Park family who suffered a stroke on January 18, 2005. That day his life changed. He has no memory of the stroke itself. It left him in a coma for the next three weeks. He finally awoke blind and unable to speak.
Doctors believe that Yossie’s stroke was caused by an abnormal connection of the veins and arteries called an arteriovenous malformation, or AVM. About 300,000 Americans have AVM, but only about 10% of them ever suffer noticeable symptoms from it. The only advance warning that Yossie received from his AVM was a series of severe headaches over of six months. However, the AVM did not show up on a CAT scan of his brain, so Yossie’s doctor diagnosed his headaches as simple migraines.
The stroke damaged areas on the left side of Yossie’s bran that control the movements of his right arm and leg, which is a common effect of strokes. In these cases, one of the goals of therapy is to stimulate equivalent areas on the other, undamaged side of the brain to take over the lost functions.
Yossie says that the worst part of his stroke was the initial blindness and forced separation from his family. He was determined to return home and resume his normal life as quickly as possible. After checking himself out of rehab to go home for Purim against doctor’s recommendations, Yossie refused to go back, and eventually developed his own rehab program to supplement his regular therapy.
Yossie has shared his rehab experiences on his web page, www.strokerr.com. He says that he has tried just about every treatment and therapy available, but his recovery has been uneven. He has regained enough vision to be able to safely drive a car, and he can now communicate his thoughts clearly, although more slowly than before. However, he has still not regained the full use of his right arm and leg, and is still unable to walk very far unassisted. To enhance his mobility, Yossie came up with the idea of modifying an adult tricycle which he could push with his good left leg alone. The idea worked. The tricycle has increased Yossie’s independence and encouraged him to be more active and to get up and around.
Yossie has also resumed his Torah learning, on a limited schedule. He goes to a local Bais Medrash each day for 30-minute sessions studying Gemorah and Chumash to “give my brain a workout.” But he tires more easily now, and needs more sleep each night than he did before his stroke.
Yossie has not been able to resume to his previous vocation as a keyboard pianist, but he does have a marketable skill that he is using to help support his family. He runs a small business called AjMyer Engravers & Signs (www.ajmyer.com) which creates signs in English or Hebrew for commercial or institutional use. With the tireless support of his wife, Esther and their six children, and much help and encouragement from the Boro Park community, Yossie has been able to resume a normal life.
Assemblyman Cymbrowitz recalls that his first reaction to his stroke was shock and disbelief, but like Yossie, he refused to give in to despair. His fierce determination and intensive therapy helped him to recover his physical functionality quickly and to resume his normal activities as an elected official, but seven years after his stroke, he is still fighting the stroke’s lingering effects.
As someone in public life who is photographed often, Cymbrowitz admits that he is sensitive to the fact that the stroke has slightly changed the appearance of the left side of his face when he smiles. Because he is left-handed, the stroke initially made his handwriting illegible. After diligent practice each day with a pad and pencil, it is now legible once again, but his signature is different than it was before.