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WHO CARES: Chronic Illness in America
WHO CARES: Chronic Illness in America

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'A Lot of Hard Work'

A community leader slowly regains some of his former independence after a stroke transforms his home life

Vince Cacciapaglio was a successful restaurateur from LaCrosse, Wisconsin, serving his community as a city councilman. Just hours after having open-heart surgery in 1996, at age 72, Vince suffered a severe stroke on the right side of his brain. Although his surgery had gone smoothly and was over by 11 am, by 8 p.m. doctors noticed that Vince was suffering from tremors. He was unconscious for 15 days, and spent six weeks in the hospital.

Vince was transferred to a nursing home, his left side completely paralyzed. On his right side, Vince was able to achieve some leg movement, but his arm moved involuntarily and had to be restrained. He couldn't speak or swallow, and he had to be given his meals through a feeding tube. After another six weeks the tube was removed and Vince finally came home to his wife, Helen.

Their lives were dramatically transformed. Beginning a tough road of rehabilitation, Vince enrolled in a cardiac rehabilitation program at the hospital and in a university-based exercise program. He regained use of his left-side extremities after several months, but he still needed help with grooming and personal hygiene. At first, that fell to Helen. But, she works full-time and had to find volunteer assistance for him during the day for trips to doctors' appointments and to his exercise class.

For a working spouse, caregiving can be backbreaking work; volunteer assistance can be a godsend. Thanks to Helen's employer-sponsored health plan, most of Vince's medical needs have been covered by insurance. But when Helen retires, they will need to purchase supplemental insurance since Medicare's coverage is insufficient.

While holding down a full-time job, Helen devotes herself to Vince's needs. The day begins early at 5:30 a.m. so she can help him shower (she washes his hair), get dressed, and spend time with him before work. Vince also suffers from an intestinal disorder called Khron's disease, which can cause diarrhea and stomach pain. The disease requires him to use a colostomy bag, which Helen empties for him every day.

Vince continues to attend exercise classes three times a week, with the assistance of his volunteer caregivers. Today, he walks with the help of a cane. Though he has use of his left arm, his left hand remains paralyzed. However, he is now able to dress himself and brush his teeth, and he has become self-sufficient enough to stay home alone most days. Over time, Vince has regained his speech and his ability to swallow, and now he is able to eat regular food on his own.

Doctors and friends alike have been heartened by the extent Vince has coped with his chronic illness. But, Helen notes, "it was a lot of hard work."
Daybook
A day in the life of Vincent Cacciapaglio
Resources

National Stroke Association
A group dedicated to education, services and community-based activities in prevention, treatment, rehabilitation and recovery from strokes.

American Stroke Association
Sponsored by the American Heart Association, this group provides resources for doctors, patients and their caregivers.

National Institute of Neurological Disorders and Stroke
Sponsored by the National Institutes of Health, this site features news and resources, plus links to studies that are seeking patients.

STROKE FACTS

Approximately one-third of all stroke survivors will have another stroke within five years.

Four million Americans are living with the effects of stroke. About one-third has mild impairments, a third are moderately impaired, and another third are severely impaired.

The costs of treating stroke in the U.S. exceed $30 billion annually.

After age 55, a person's risk of stroke doubles every 10 years. Two-thirds of all strokes occur in people over age 65.

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