When Mary Russman considers the series of events she experienced on Sept. 23, 2005, she is convinced her life must have a higher purpose. Russman is so grateful for the happy coincidences that helped save her life, she has participated in a stroke education community outreach program for Mercy Hospital in Pittsburgh, and will walk in a fundraising marathon this weekend. The North Huntingdon Township resident has trouble believing her own story. "When you think of stroke," she said, "you don't think of me. Not a 38-year-old mother of three." Seven months after making a remarkable recovery, Russman, now 39, hopes to educate others about stroke. And the point she most wants to make is that early treatment is vital. She credits quick medical intervention to her ability to walk in a marathon instead of being paralyzed. That morning, as was typical, Russman took her oldest son, Zachary, now 9, to his bus stop. She then had breakfast with her two younger children, Luke, now 5, and Rachel, now 1. She took Luke to preschool, and she and Rachel went grocery shopping. For some odd reason, she said, she had prepaid her bills for October. At the grocery store, she found herself loading her cart with baby formula and diapers. She felt good, she said, to have so much accomplished. Her house was clean, and she had made cupcakes for her sons when they came home from school. "I never do that," she said, laughing. That afternoon, when it was time to pick Luke up, Rachel was fast asleep. Normally, Russman said, she would wake the baby. But this time she called a neighbor, Kris Horvath, whose son attended the same preschool as Luke, and asked her to bring her son home. At a time when she would have been in the car with Rachel, she was instead home, just as another neighbor, Jenny Cuthbart, came running down the street with her hands cupped. "She had, I'm not kidding you, a monster grasshopper," Russman said, that she was bringing to feed Russman's sons' pet toad. "I held the door open for her so she could feed the grasshopper to the toad. I was standing right there," Russman said, pointing to a chair near the door. "All of a sudden, something happened. Then I noticed my right side was numb, and I couldn't move my right arm," she said. Russman heard Cuthbart talking to her, and she tried to smile. "I was still thinking clearly," she said. "I didn't realize I couldn't talk. I thought I could. I had this feeling, 'I don't want to talk. I could talk, I just don't want to.'" Cuthbart asked her to say her name. Russman couldn't. Cuthbart helped her to a sofa and ran to the kitchen. "I heard her call 911 and say, 'You need to come right away. My friend's had a stroke.' "I thought, 'You're nuts. I'm not 80 years old. I have three babies. Who's going to take care of my babies?' "God put that grasshopper in her driveway," Russman said. "If she hadn't been here, I'd have had the stroke and been by myself, with my baby sleeping." Arriving paramedics immediately recognized her symptoms and prepared her for transport to Mercy Hospital. One paramedic kept shouting at her to tell him her name. "I opened my mouth and out came (something unintelligible)," Russman said. "I heard that. I thought, 'Holy mackerel, I did have a stroke.' I didn't panic. I knew I would be OK." Upon arrival at the hospital, a swarm of doctors and nurses were waiting for her. "I saw my husband (Mike Russman)," she said. "He was a wreck. I saw my father-in-law. I thought, 'Uh-oh.'" While Horvath and Cuthbart stayed with her children, another neighbor accompanied Russman to the hospital. She was able to tell the doctors when and what had happened. "Mercy was like a fine-oiled machine," Russman said. "Dr. Baker saved my life," she said. Dr. John R. Baker is endovascular surgical neuroradiologist and director of the Mercy Neurovascular Center at Mercy Hospital. Mercy Hospital is in the process of acquiring designation as both a primary and a comprehensive stroke center through the Joint Commission on Accreditation of Healthcare Organization. "Receiving treatment in the first three to eight hours of any initial symptoms can greatly reduce -- and sometimes eliminate -- the long-term effects of stroke," Baker said. "Symptoms that come and go should be taken seriously and evaluated by a physician." Stacey Lang is a nurse and current executive director of service line development for Pittsburgh Mercy Health System. "All of our treatments are contingent upon the amount of time that has passed since blood flow was interrupted," Lang said. For the clot buster tPA to be most beneficial, the treatment window shrinks to three hours. "Early intervention is the single biggest determination of how well people do," Lang said. Unfortunately, people sometimes describe symptoms of stroke -- including weakness, tingling and confusion -- only to be told by friends or family that they should rest. "By the time you get up, you have had a major stroke and hours have gone by," Lang said. Lang said there are two types of stroke -- ischemic (artery blockage) and hemorrhagic (bleeding into the brain). About 88 percent of strokes are ischemic, 12 percent hemorrhagic. Russman had a blood clot, putting her stroke in the ischemic category. "She had no predisposing factors," Lang said. "I don't smoke, I never have, I don't have high blood pressure, my cholesterol is perfect," Russman said. Russman's blood clot was a fluke, Lang said, one that could not have been predicted. A CT scan showed she had no bleeding, so her medical team knew she had a blockage, and tPA was administered. A CT angiogram determined exactly where the blockage was. Baker took the further step of inserting a catheter into her groin and routing it to and retrieving the clot. Although people older than 60 are considered at increased risk for stroke, it's not a disease of the elderly, Lang said. A family history of heart disease, hypertension, diabetes, smoking, a poor diet and a sedentary lifestyle are all stroke risk factors, Lang said. One preventive measure people can take, Lang said, is to maintain a good relationship with one's primary physician, and know stroke symptoms. "Then you can say, 'I feel them,'" she said. Russman woke up in the ICU before midnight. She pantomimed that she wanted her ventilator to be removed. "The first thing I did was fix my hair with my right hand and say, 'I want to go home,'" she said. That didn't happen immediately. She had to be assessed, Baker told her. He added that she might be hospitalized for weeks. Undeterred, Russman began roaming the halls, and took a shower unassisted. She walked up and down staircases for her therapists. Five days after her stroke, Russman returned home. That quick a recovery, Lang said, is atypical. She is taking a blood thinner, along with a prescribed baby aspirin each day. She experienced a slight delay with walking but exercised each day and gradually improved. "I notice I forget little things," she said. "I don't know if that's from the stroke or my everyday life," she added. She's returned to her part-time job as a tour counselor with AAA in Monroeville. "I'm so blessed," she said. "God must have plans for me. I know my time on this earth isn't over. I'm meant to do something." She's already begun one of those "somethings," presenting a community education program on strokes with Lang at the Baldwin EMS in Allegheny County. "I hope to do more," she said, "if it's going to help someone." And she, her husband, and her sister, Nancy Nowalk, are training for Sunday's 26-mile Train to End Stroke walk in Cleveland, Ohio. May is National Stroke Awareness Month. So far, Russman has raised about $10,000 from friends and family to benefit the American Stroke Association. "It's really important to me," she said. "I think they all recognize that. If it can happen to me, it can happen to anyone." Additional Information:

Statistics and warning signs

Stroke is a type of cardiovascular disease that occurs when a blood vessel carrying oxygen and nutrients to the brain is either blocked by a clot or bursts. Some factors people can't change include: increasing age; sex (more men than women have strokes, however, women account for more stroke deaths); family history of stroke; prior stroke or heart attack. This year, 700,000 Americans will have a stroke; 100,000 of those will be women younger than 65. Every 45 seconds, someone in America has a stroke. Warning signs include:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body; Sudden confusion, trouble speaking or understanding; Sudden trouble seeing in one or both eyes; Sudden trouble walking, dizziness, loss of balance or coordination; Sudden severe headache with no known cause. If you or someone with you experiences one or more of these signs, immediately call 911 or the emergency medical services number so an ambulance -- ideally with advanced life support -- can be sent. Also, check the time so you'll know when the first symptoms appeared.

Source: American Heart Association; American Stroke Association

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