For young stroke victims, aftereffects linger just below the surface

ROCKLIN, Calif. – The headaches were excruciating and wouldn't go away. Her doctor said they were migraines. Then, one morning a few weeks later, Jamie Hancock stood up from the couch and discovered she couldn't move the right side of her body. When she spoke, her speech was slurred.

At the hospital, doctors told her she was having a stroke. The 32-year-old, whose children were just 1 and 3, had a sobering epiphany: "My whole life is changed forever."

Now, six years later, no one would know she is a stroke survivor. A lifelong dancer, she is fit and muscular. She speaks clearly and walks quickly as she shuttles her kids around, runs errands and teaches dance classes.

But the effects — for her and other young stroke victims — linger just below the surface. They are there when she gets mad at her family, when she can't remember what she needs at the grocery store, when she tires after working for a few hours. The noise and light can be unbearable, forcing her to escape to a dark room.

Some days Hancock tries to be the energetic and sociable working mom she was before the stroke. Then she crashes.

"I sort of forget I have a disability and I think I can do everything anyone else my age can do," she said. "But I can't."

Hancock is among a growing number of younger adults who've had strokes, which occur when blood flow to the brain is blocked or a vessel in the brain bursts. Because strokes are most often associated with old age, symptoms in younger adults may be overlooked, according to patients, advocates and physicians. And their need for rehabilitation — to return to active lives as parents and employees, for instance — can be underestimated.

"The American public is still very locked on stroke being an [affliction] of the elderly," said Amy Edmunds, who started a nationwide advocacy and support organization called YoungStroke. "But we are an emerging population … and we really need to be recognized."

The rate of hospitalization for strokes dropped nationwide by 8 percent between 2000 and 2010 (from 250 to 204 per 100,000), but in those same 10 years it increased almost 44 percent for people ages 25 to 44, though from a much smaller base (from 16 to 23 per 100,000), according to research published in May in the Journal of the American Heart Association.

The reasons for the rising prevalence among young people are not clear, but physicians believe that growing risk factors such as hypertension, smoking and obesity contribute. And because younger patients aren't as aware that they can get strokes, they may not be proactive about controlling those risk factors.

Hancock's stroke was caused by a tear in the artery.

Years have passed since the stroke, and Hancock says she has trouble multi-tasking and gets angry about minor things — her daughter playing music too loud, her son bouncing the ball inside the house. "My family pays the price," she lamented.

In addition to the emotional roller coaster, Hancock said she has lost the cognitive ability to do some things.

Just a few months after the stroke, Hancock returned to her job, but she had trouble concentrating, couldn't manage her time or meet deadlines — and she eventually left. She later got fired from a subsequent job.

Hancock said she spiraled into depression, which therapists later told her was likely a symptom of the stroke. She also became addicted to a painkiller prescribed to treat her headaches.

With the assistance of Suboxone, a medication to treat opiate addiction, Hancock got sober. But that didn't stop her mood swings. There were times when she slammed cabinets so hard they fell off their hinges.

Her husband, Ken Hancock, said the stroke and its aftermath nearly tore their family apart.

Now, the family is in a better place, he said. Jamie Hancock sees a therapist and takes medication. The volatility has subsided.

Ken Hancock said his wife's brain injury isn't visible, but it's there. "She is still trying to recover, and we are sort of in the same boat with her," he said.