SIOUX CITY | Jamie Alesch, of rural Remsen, Iowa, nervously giggles, before staring off into the distance as she comprehends how serving as a caregiver for her husband has impacted her.
After Kory Alesch, 46, suffered a stroke on March 9, 2015, suddenly Jamie Alesch was solely responsible for the couple's home, finances and three young children, while caring for Kory and helping him with physical therapy.
At first, Jamie Alesch, who teaches fifth grade at Maple Valley-Anthon Oto Community School, found her expanded role wearing. She turned to her faith and Mercy Medical Center's Stroke Support Group for comfort and encouragement.
"You kind of just have life flipped upside down in an instant," she says as she sits at a wrought-iron table in a courtyard enclosed by brick walls behind Mercy's Rehabilitation Center. "You go from being an equal partner to being in charge and responsible for everything."
The Alesches will retreat with other stroke survivors and their caregivers to a camp Sept. 15-17 at Inspiration Hills Camp near Inwood, Iowa. The stroke camp, which provides opportunities for education, socialization, relaxation and support, is sponsored by the Sioux City hospital.
"After meeting stroke survivors in our area and seeing Jamie and the other spouses looking exhausted in the waiting room during therapy times, we said, 'What can we do to help them?'" says Mercy stroke program manager Nicole Shea. "Stroke camp is really like a weekend away for them. It's so vitally important for these people who are overburdened and it's important for the stroke survivors to get to forget for a weekend that they've had a stroke."
The camp is something Jamie Alesch says she and her husband have been looking forward to since the end of Mercy's inaugural stroke camp last summer.
"For Kory, I think he's needed to find a purpose in life again. If I was doing something that used to be his job, he would just sit back and shake his head like, 'I can't believe you have to do this,'" she says. "I think spending time with others helps him to not feel alone -- like he's the only one going through this."
Kati Bak, 51, of rural Le Mars, Iowa, is one of the stroke survivors Kory Alesch will get a chance to socialize with at the stroke camp. She also had her stroke at age 43.
Bak, a mother of four and a former member of the 185th Air Refueling Wing of the Iowa Air National Guard, was set to be promoted to senior master sergeant at weekend guard drill, but she ended up receiving that promotion in the hospital.
After cleaning her classroom at Sergeant Bluff-Luton Elementary School, where she works as a reading specialist, Bak went to help her husband, Dave, at Bak BMW the morning of June 3, 2010.
At the motorcycle dealership, Bak was seated at a desk doing paperwork when she began experiencing vertigo. Then her muscles stopped working.
"It was almost like a concussion. I actually tried to stand to let (Dave) know something was off, but I couldn't," she recalls. "I knew there was something seriously wrong just because of how I was feeling."
Bak was rushed by ambulance to Mercy Medical Center, where testing revealed she had suffered a stroke. Bak, who could no longer speak or swallow, went from the intensive care unit to the stroke unit and then to the rehabilitation unit where she spent a month.
When she began intense outpatient rehabilitation, Bak's goals were to learn how to speak, write and type again, which would allow her to return to teaching. She also wanted to one day get back on a motorcycle.
"When I was doing physical therapy for writing, I was having a tough time even trying to write with my left hand. That was frustrating," she says. "I was thinking, 'I'm really up against the wall if I'm not going to be able to write with my left hand.'"
When Bak became discouraged, she says her friends and family members understood her frustrations, but encouraged her to keep pressing forward with rehabilitation. By 2012, she was back riding on the roads, but this time on a bicycle.
"My husband was working out with me and he said, 'Honey, I can't stand looking at these four walls anymore. I think I'm going to get a bike,'" she says. "I'm like, 'If you're going to get one bike, you're going to get two.' I don't think we've looked back."
Bak, now president of the bicycle club Siouxland Cyclists, says cycling has greatly improved her balance and made her fitter than ever.
"I love riding around the riverfront at dusk looking at the bridge when it's lit up. I love riding where there's lots of trees," she says. "We just completed all of RAGBRAI again and we actually dipped our tires in at Sioux City and rode up to Orange City."
Although Bak suffered a severe stroke, you can't tell by looking at her. She says that made her feel a little apprehensive about attending last year's stroke camp.
She ended up having a great time at the camp singing songs, playing games, painting rocks, getting her nails done and roasting s'mores around the campfire.
"It's a unique experience that you're able to network with those people who are experiencing the same thing; and it gives the caregivers a chance to understand they're not alone as well," she says.
Younger people impacted
Ischemic stroke, a stroke caused by a blood clot that blocks a blood vessel in the brain, accounts for nearly 80 percent of all strokes.
While hospitalizations for this leading type of stroke have dropped nearly 20 percent between 2000 and 2010, a study published in the Journal of the American Heart Association last year found a 44 percent increase in ischemic stroke among people between the ages of 25 and 44.
Shea says researchers don't know why the prevalence of stroke is increasing among younger people. She says unhealthy lifestyle could play a role, but that wasn't the case for Kory Alesch.
A hole in Alesch's heart allowed a blood clot to travel to and block his left carotid artery, which supplies the head and neck with blood. The massive stroke affected most of the left hemisphere of his brain.
Jamie Alesch says she was told her husband would remain in a vegetative state, never being able to walk or talk again. But after five months of intensive inpatient rehabilitation at Madonna Rehabilitation Hospital in Lincoln, Nebraska, and continuing outpatient physical, occupational and speech therapy at Mercy Rehabilitation Center, Kory Alesch has beaten those odds.
More than two years after the stroke, Kory Alesch walks down a ramp at Mercy Rehabilitation Center unassisted and sits next to his wife. The right side of his body was impacted by the stroke, so he has weakness in his arm and hand and wears an ankle-foot orthosis on his leg to help him lift his toes off the ground. Understanding and expressing speech is also difficult for him.
Shea says she doesn't know why some stroke patients, whose brain imaging looks identical, don't reach similar levels of recovery. She believes attitude and personality has some impact on the recovery process.
Through it all, Jamie Alesch says her husband has remained hopeful and engaged in his continuing recovery. Dancing was an activity he didn't think he would be able to do at last year's stroke camp, but he surprised himself.
"Do you like to dance with me?" Jamie Alesch asks.
Kory, whose amazing recovery continues to puzzle doctors, grins widely and nods his head.
"Kory still proves the medical world wrong when we go back for followups in Omaha," Jamie Alesch says. "They bring in a different doctor or resident every single time and our neurologist says, 'This is the guy I was telling you about.' They did not believe he would make this kind of recovery."