Promising Advances in Stroke Treatment

Stroke survivors, loved ones of those affected and others who vowed to improve their lifestyles responded to our March 8 coverage of new research offering hope to millions of stroke victims. Readers recounted their experiences, described the therapies that worked for them--running the gamut from children's aspirin to yoga--and, above all, stressed the need for perseverance. After six weeks of hospital treatment and 40 sessions of physical therapy, one survivor claimed to have come "very close to my normal self." She advised against despair: Push yourself. "Your recovery stops when you stop." In the interest of prevention, one woman asked for a poster-size blowup of our illustration of a fat-clogged artery to "display prominently above the TV so it will be right in my husband's face. I want him to have more birthdays and see exactly why he won't if he continues corrupting his arteries with poor eating habits."

Striking Out of the Blue

Thank you for the informative March 8 cover story, "The New Science of Strokes." Your article is helpful to the public at large and enormously useful for stroke victims. About a month ago, at the age of 29, I had a stroke. I have low cholesterol and low blood pressure, work out regularly, don't smoke and have no history of strokes in my family. While spending the better part of a week at the hospital in the stroke unit undergoing a series of tests to determine the cause, I didn't get nearly enough of this useful information to better assist me in understanding the causes, effects and treatment of strokes. That's all the more reason to stress that it is the responsibility of the individual to take an active role in his or her personal health and take advantage of the comprehensive coverage on prevention and care in publications like NEWSWEEK.
Faye Rogaski
New York, N.Y.

I am a stroke victim twice over. My first stroke gave me aphasia, the inability to either speak or write. The next one was less severe, and I recovered from its effects within a few days. I am pleased to hear that physicians now believe that continued recovery happens even many months after a stroke. Doctors, family and friends attest to my continued slow but gradual recovery since the first stroke several years ago. Proper medicine, sometimes surgery and other medical skills are invaluable, but the patient also has a major role to play. The often long and difficult road to recovery involves long hours of exercises of various kinds. My advice to fellow stroke victims is, don't lose hope. Your body and your doctors are working to achieve recovery. You must work as well. Keep at it!
Beverly J. Walker
Gresham, Ore.

Your cover story failed to mention that 90 percent of strokes are preventable. Since 1996 the medical data have shown that most of the 770,000 strokes annually and the resulting 160,000 deaths need not occur. The effect on the victims and families and the enormous cost to our health-care system could be largely avoided with simple, non-invasive, low-cost testing and early intervention. The recommendation that all patients be screened at the age of 50 and above has been largely ignored by the medical community, as it was in this article. By identifying the people at urgent risk for stroke, we could save 395 of the 440 people who will die every day from this disease. The new science of stroke treatment is commendable, but if we could bring the medical world and the public to focus on prevention, as we have with breast cancer or colon cancer, we will save many more lives at very little cost. I am a cardiovascular surgeon with a special interest in stroke prevention. Surprisingly few physicians, despite the data and the recommendations of the American Heart Association, avail their patients of this program, or send them for testing before the stroke has occurred.
Morris M. Eisen, D.O.
Cherry Hill, N.J.

Fortunately, the treatment of strokes has improved dramatically. However, you report that stroke-related expenses in the United States are expected to reach $54 billion this year. One big way to reduce costs would be by following Japan's lead in reducing high blood pressure. A couple of decades ago the government campaigned for a reduction of sodium (salt) in food products. This had a huge impact on the blood pressure of the Japanese. It was one of the key reasons that stroke rates plummeted and life expectancy increased over the last several years. In this country salt must be reduced not just in processed foods but also in food sold in restaurants and bakeries.
Renie Helfgott, R.N. (Ret.)
Bay Shore, N.Y.

Thanks to NEWSWEEK for devoting a cover story to problems and progress in stroke. One of the sentences in your story hit the problem squarely: "He asked his wife to help him finish dressing so he could go to work. She ran for the phone instead." Those of us in stroke care know that too many patients choose to wait it out, not recognizing the potentially catastrophic nature of their symptoms. This May, the entire state of Wisconsin is being mobilized on a single day--May 12--to learn to understand the symptoms of stroke and when to promptly call 911. With new drugs and techniques under development, we have never been in a better position to prevent thousands of people from lifelong disability. On May 12, people and organizations across Wisconsin will saturate the state with the message "Don't Stall--Make the Call" when confronting the symptoms of stroke. NEWSWEEK just made our job easier!
George Newman, M.D.; Howard Rowley, M.D.; Christine Wilson, R.N.
Comprehensive Stroke Program University of Wisconsin Hospital and Clinics
Madison, Wis.

Having seen hundreds of heart attacks in my career as a cardiovascular nurse, I was concerned by the way you differentiate between stroke and heart-attack victims in an otherwise excellent article. The author writes that "Unlike a heart attack, whose pain generally sends people to the hospital immediately, strokes can be subtle." Unfortunately, the vast majority of patients who experience heart attacks also delay long past the one hour that is optimal for treatment. Most heart attacks are not accompanied by the sudden onset of excruciating chest pain. For women, the only symptoms may be shortness of breath and fatigue, not pain. For men the pain may not be pain at all, but rather a dull heaviness across the chest that comes and goes. Since the success of treatment (and ultimately survival) depends on getting to the emergency room quickly, it is important that the public know the symptoms and call 911 immediately if a heart attack is suspected.
Kathleen Dracup, R.N., Dean
University of California, San Francisco
School of Nursing
San Francisco, Calif.

The Legacy of Agent Orange

John Kerry is right in wishing his biographer had written more concerning Agent Orange exposure as part of the American experience in Vietnam ("Kerry & Agent Orange," March 8). Thirty-plus years later, Agent Orange still continues to cause problems for veterans, their children and for the Vietnamese living in contaminated areas. It took years before the Pentagon and the Veterans Administration could admit that Agent Orange might have been the cause of health problems occurring in veterans and therefore could be considered service-related problems. The government still needs to take the next step and find out why the exposures were damaging to health. European research over the last 20 years has clearly identified immune-system effects due to Agent Orange's poisoning of transthyretin, the protein that moves thyroid and vitamin A hormones around the body and controls modulation of the immune system. Neither the Clinton administration nor those of Bush 1 and Bush 2 has seen fit to deal realistically with this problem. Maybe the election of a Vietnam vet could provide the impetus for resolving this sorry state of affairs.
F. W. Plapp Jr.
Colorado Springs, Colo.

I read with great personal interest the article concerning Agent Orange. It should be noted that the list of diseases presumed to have been caused by Agent Orange has recently been updated by the Department of Veterans Affairs to include chronic lymphocytic leukemia (CLL). This was decidedly good news for the hundreds of thousands of veterans, myself included, who have been affected by this disease. Unfortunately, we have been receiving less than equal benefits since the Agent Orange Act of 1991, which Senator Kerry sponsored, expired in September 2002. Whereas all the other listed diseases were awarded benefits retroactive to the date veterans entered their claims, victims of CLL, many of whom had entered claims years ago, were awarded benefits effective only from October 2003 regardless of their claim date. This is unfair, to say the least.
John W. Datz
Veterans Benefits Counselor
Northport, N.Y.

Your story about agent orange was informative and long overdue. However, you left off one of the most common effects of Agent Orange, diabetes, which is fully compensable by the Department of Veterans Affairs. Also available are various treatments, medical care, doctor's visits and diabetic supplies for little or no charge. Every Vietnam veteran who has diabetes should go to a Disabled American Veterans office or VA Hospital and file a claim for treatment and compensation.
Don Hamilton
Phoenix, Ariz.

Well Within Bounds

I played high-school basketball during its infancy in the early '70s. Girls' sports were just getting started in Michigan at that time ("Out of Bounds," March 8). Although grateful to play, we were generally underfunded, ill equipped and assigned unqualified coaches. Never did I dream that in my lifetime I would be reading about a woman refereeing in the NBA. Violet Palmer is my hero, and reading about her life's work has helped me get over the anger I still feel about being so discriminated against so long ago.
Kathleen L. Higgins
Yorkville, Ill.

It's refreshing to see Violet Palmer outlast the sexist, closed-minded world of male-oriented sports by establishing herself magnificently both on and off the court, and without having to use sex appeal as a tool to get there. Palmer is a great role model for all women, someone who fended off both her critics and her own self-doubts to flourish in a profession in which other women may have caved. She is living proof that women belong in the world of sports and can succeed in that world without exposing themselves in front of a camera (witness Anna Kournikova). Maybe someone should send this article to the University of Colorado for Gary Barnett to read.
Leo Rommel
Hillsborough, N.J.

Religion and Liberalism

Thanks to Anna Quindlen for expressing so well the position of many of us who believe firmly in both God (with a capital G) and in left-wing policies ("At the Left Hand of God," March 8). Like Quindlen, I believe in following Christ's teachings to feed the poor, clothe the naked, tend to the sick and not wait for relief to "trickle down" from the wealthy. Jesus knew a thing or two about greed and self-gratification when he warned that it was as hard for a camel to pass through a needle's eye as for a rich man to enter the kingdom of heaven. And I ask the religious conservatives who supported the war in Iraq, Whatever happened to "Thou shalt not kill"? Where was these leaders' religion when they decided we had to strike first and not turn the other cheek? As a liberal, a Democrat and a practicing Roman Catholic, I am grateful for the American system that allows us the freedom to worship as we see fit. I resent being accused of being nonreligious or unpatriotic because I believe religious freedom means keeping religion out of politics. Let's show our religion through our actions instead.
Barbara Dowling
Fredericksburg, Va.

I enjoyed cradle Catholic Anna Quindlen's recent column on faulty assumptions about religiosity until I reached the penultimate paragraph where she gashed Mel Gibson for "trading on God for personal gain. The modern version of 30 pieces of silver." Even as a heretical product of the Jesuits, I recall the scriptural caution to "Judge not, lest ye be judged." Critique the movie as you will, but, absent solid evidence, let's give Gibson the benefit of the doubt as to his motivation.
Steve McGreal
Chicago, Ill.

I believe the reason so many Americans think "only conservatives [know] God" is that whenever our news organizations need a minister to represent the Christian viewpoint, they give us people like Jerry Falwell, Pat Robertson or Billy Graham. I'm a Bible-reading Jesus-lover and a political liberal who is married to an ordained minister (also liberal), and I know for a fact that there are many ministers of mainstream Protestant denominations in this country who are political liberals. Why aren't those men and women included in the conversation? The media give the impression that right-wing televangelists represent all devout Christians, and the truth is, there are many of us for whom those men could never speak.
Darcie D. Watson
Falls Church, Va.

Sending the Wrong Message

As the father of a young girl, I am appalled to see the picture that appeared with the story on boy-band singer J. C. Chasez ("Sexy, Solo and Out of Sync," March 8). It's one thing to write about the raciness of Chasez's first solo CD. It's quite another to promote his album with a picture of him on a bed with a bottle of booze and two young women, one with her pants wide open. Such a pose may draw a few more readers to the story, but it sends an awful message to many others already concerned about the way girls and women are treated and portrayed in the media. That's a very poor trade-off.
Alan Breznick
Raleigh, N.C.


In "A 'Shocking' Stumble" (Periscope, March 15), we reported that the Bush-Cheney campaign had used paid actors to portray firefighters in its first election ads, which drew heavily on images from 9/11. We relied on information supplied by a member of the campaign's media team. After publication, the official told us that he had been mistaken. The Bush-Cheney campaign has provided NEWSWEEK with documents that indicate the people in the ads were authentic volunteer firefighters, not actors. NEWSWEEK regrets the error.

In "Kerry & Agent Orange" (March 8) a caption accompanying a photo incorrectly identified a boat patrolling the Mekong Delta. The vessel is an assault-support patrol boat, not a Swift Boat. Also, in "A Poison's Legacy," a sidebar within the same article, we stated that Agent Orange is a "variation of" dioxin. In fact, dioxin is an unintended byproduct of two chemicals used to make the herbicide.