Larry Hodges, age 45 and in the best shape of his adult life, was sure he was having a stroke.
Story by Angelique Gammon, Photos by Marci Greenbaum, Specialties Photography
It was Martin Luther King Jr. Day. Not unusually, Larry was at his desk at Copy Corner early. Dressed in sweats, his plan was to finish at his office for the morning and head to the gym for a workout before showering and getting dressed for an evening engagement.
Gym time figured large in Larry’s routine. About five years before he’d had one of those age-related reappraisals and come to the conclusion that the years between 30 and 40 had been too fast: too fast food; too fast and furious entrepreneurial lifestyle; too fast on his way to being heavier than he’d ever been in his life.
So he changed gears, started working out and eating better and dropped the excess weight.
Thinking back on that morning Larry says he felt great, even better than when he was 15 years younger. Life was good.
“I was about ready to go work out. Then I felt lightheaded,” Larry recalls, “but I’d had that before.” He wasn’t really worried, thinking maybe it was leftover from a winter cold. “I didn’t feel bad really,” he explains, “just odd.”
Then his left foot went numb.
Thirteen months later as Larry recounts the moment when the numbness shot from his left foot all the way up his leg, the left side of his body and his face, it is with a touch of incredulity.
“But I knew,” he adds, answering the question as much to himself as anyone.
Life Lessons The story of Larry’s business startup is a bit of its own incredible tale. He launched Copy Corner his senior year at Texas A&M, too impatient on his way to success to finish his finance degree before renting the mothballed post office on the corner of Texas Avenue and Jersey Street (now George Bush Drive) and opening a copy shop. Copy Corner opened in November 1988; Larry graduated in August 1989, and he never looked back. The business moved into a huge custom space on Texas Avenue in 2004 expanding Copy Corner’s desktop publishing and on-demand printing capabilities.
Copy Corner defined Larry’s professional life; it would also save his life.
“Years ago I was at the front counter and a guy came in wanting copies of ‘Signs of Stroke,’” says Larry, who read the sheet as he made the 20 copies the customer planned to send to friends.
The sudden left-side numbness and feeling lightheaded that MLK Monday fit the stroke signs he recalled reading years ago. “But you wonder. I got up and looked in the mirror; my smile wasn’t crooked. I had decent muscle control. But it wasn’t right. It was too weird,” he says.
Instead of calling 911 as the “Signs of Stroke” sheet recommended, Larry called downstairs to Vicki, his office manager and trusted friend of the past 18 years.
“I asked her to bring her truck to the door. I didn’t want to sound the alarm at the shop,” says Larry by way of explanation. “I could walk. I took the elevator downstairs.”
Larry called his personal physician, internal medicine doctor Philip Alexander, as Vicki drove him to the emergency room at the College Station Medical Center. He also called his neighbor, Dr. Ricardo Guiterrez, a cardiologist with Central Texas Heart Center.
Dr. Alexander was waiting for Larry at the ER, and Larry remembers the ensuing events clearly: being taken back immediately; the nurses starting an IV; having a seizure. What eludes him is any concept of time over the next 48 hours. “Zero,” he says, holding up a circled thumb and forefinger.
A CT scan of his head would show nothing amiss, but an MRI later that evening confirmed that Larry had suffered an ischemic stroke, the type of stroke caused by a blockage in an artery to the brain. The MRI results also indicated that Larry had likely had another stroke sometime in the past.
From those and other test results, Dr. Guiterrez wanted to check Larry’s heart for the presence of a Patent Foramen Ovale or PFO, a tiny hole in the wall that separates the two upper chambers of the heart. In the womb, the foramen ovale allows oxygen-rich blood from the mother to circulate from the umbilical cord to the fetus. This hole naturally closes at birth. Except when it doesn’t, which happens in about 25 percent of the population and creates a PFO.
Larry fit the profile of a PFO patient: someone who has a cryptogenic stroke – a stroke of unknown cause – particularly if they are younger than age 55 when they have a stroke. Forty percent of patients who present with these symptoms have a PFO.
Larry was awake during the diagnostic procedure and recalls watching the screen as Dr. Guiterrez tried to confirm a PFO with a scope inserted into his heart. They didn’t see a hole, but they did see bubbles leak through the upper chambers after air was injected. Bubbles didn’t guarantee a PFO, but made it “statistically likely,” says Larry. Those same statistics pointed to Larry’s higher risk for future strokes.
A Second Option Treatment for PFO isn’t cut and dried. The medical literature says that if a PFO is diagnosed through some routine test and the patient doesn’t have any other symptoms or hasn’t had a stroke, they don’t need treatment.
When a patient like Larry has both a PFO and a confirmed stroke the treatment is usually blood-thinning medication such as aspirin, Plavix or Coumadin to prevent another stroke.
From the outside, being put on Coumadin and sent home to resume your “normal” life only 48 hours after a stroke sounds pretty good. To look at Larry, you wouldn’t know anything had ever happened.
Larry knew. He was easily fatigued. He had to plan out once normal activities or risk feeling exhausted and befuddled. Coumadin requires regular blood tests for monitoring levels. It gave him nosebleeds, but because of the stroke, Larry would be on it, or another blood thinner, for the rest of his life.
It was Dr. Guiterrez who told Larry about a second option: a tiny wire mesh disc that could be inserted into the hole to close it. While a “percutaneous closure device” is routinely used for some cardiac abnormalities, the devices aren’t yet FDA approved for PFO repair. Larry had to have two doctors recommend him as a candidate for the procedure. He studied the literature online and then decided to talk to the surgeons at St. Luke’s Methodist Hospital in Houston who were routinely repairing PFOs with this type of device.
“They told me I could die,” he says. But to Larry, the better odds were on fixing the PFO and being spared 30 years on blood thinners and possibly another stroke. He scheduled the procedure.
Lying in pre-op waiting to have what looks like a tiny mesh umbrella inserted into the hole in his heart, Larry says he was in a good place emotionally. The first dose of the reality of his situation had been the look on his parents’ faces when they walked into his hospital room on afternoon he suffered the stroke. “It was sobering,” says Larry. “For the first time in 45 years I couldn’t tell them, ‘I’ll be OK.’”
Awaiting the procedure to fix the hole, Larry says, “I was good. I was OK with whatever God’s plan was for me.” He admits it was harder on the trust factor to believe in God’s plan for his then 12-year-old son and 15-year-old daughter to be OK if Larry wasn’t around. Then the happy drugs kicked in.
Larry describes St. Luke’s “factory-like” approach to cardiac procedures as oddly comforting – it’s just all in a long, very busy day’s work. Also on the OR schedule that day was an 18-year-old high school football player Division I who had elected the PFO repair procedure in the hope of returning to the gridiron. Before hearing the teenager’s story, Larry admits to some “Why me?” moments. Ever after … happily Months after his procedure to close the PFO, Larry is … well … Larry. Easy to talk to, quick to laugh, ready to share his experience in the hope of teaching someone how to recognize when they’re having a stroke but also apprehensive about how his story will be received.
Physically, he’s still as numb on his left side as he was seconds after the stroke. He’s strong. When he closes his numb left hand around a weight during his workouts he’s as strong as he ever was. He’s less sanguine about his coordination. Gesturing to the full cup of coffee on the table, he remarks he wouldn’t pick it up left-handed for fear he might spill it. The fatigue is better than in the first months after the stroke, but he still plans his activities for a milder pace than he would have five years ago. Larry describes his expectation that everything would return to “normal” after the procedure as his “mental mistake.”
There are upsides. “It made me a better dad,” he says immediately, mostly by not taking for granted that there will always be time to spend one-on-one with his kids. These days he comes down in favor of more family time over than more business time. He’s into flax seed for Omega 3s and heart health and exercise for life.
If you ask Dr. Alexander what cautionary tale Larry Hodges’ stroke at age 45 offers, it isn’t that you ought to run to your doctor to check for a congenital heart defect like a PFO. Larry’s case is unique for both its rarity in the general population and in that he has made such a remarkable recovery.
Dr. Alexander enumerates the reasons behind that remarkable recover: 1. Larry was in excellent shape when he had the stroke; 2. Larry has worked very hard doing rehab to regain his physical strength and coordination; and 3. Larry was lucky: his stroke was in a “good location” in the back of the brain.
Two out of three of those factors – the environmental factors of diet and exercise – were in Larry’s control. For the rest of us, that’s where both the fear factor and comfort come into play for every health risk from stroke, heart attack and most cancers to osteoporosis, obesity and most dementias.
“You can’t super focus on one [disease], because they all go together,” says Dr. Alexander. Lifestyle – what you eat and how you exercise – affect every one of those disease categories, primarily through chronic cell inflammation and the buildup of plaques, both inside arteries in the heart and in the brain.
The solution, says Dr. Alexander, is to educate yourself about the role of Omega 3s and Omega 6s in the diet and to choose foods that will maintain a healthy balance. That, notes Dr. Alexander, is something the typical American diet – overloaded with processed grains, meat, dairy and vegetable oils – fails at spectacularly. So out of balance is both our diet and our food chain with inflammation-producing foods it explains the explosion of all the disease categories we fear. That, suggests Dr. Alexander, is what reasonable people ought to worry about since lifestyle choices can balance the risks for most disease.
For Larry, now 46, balance is the take-home message, too: work and play; diet and exercise; optimism without taking things for granted. One thing Larry will never take for granted is the love and support from his family, friends and Copy Corner Crew who saw him through. He might add: sharing with family and friends the “Signs of Stroke,” because the life they save could be yours.
