Joe Morse was an avid bicyclist in peak condition when he suffered a stroke days after the Ski to Sea race in May 2000. The Western Washington University professor of chemistry remembers collapsing in his office and being only vaguely aware that he was taken to the hospital.

His wife, Karen, who was Western's president at the time, was given three options for his treatment.

"The doctors told me that if they placed a catheter at the site of the stroke he'd be able to order a latte again," she recalls. "With the other two options, he'd be bedridden for the rest of his life."

The Morses' life together had changed in a matter of hours. When Joe left intensive care for a month of rehabilitation, he couldn't speak, count or walk. But his is a story of triumph and determination.

Fast forward 12 years and Joe can now speak and write. He works hard at his speech therapy and uses computer programs like WYNN to read the biographies and magazines he loves. He drives a car, helps around the house, makes dinner and does all of the grocery shopping.

His gentle, optimistic personality and sense of humor remain intact, and he and Karen are following their mutual passion for biking - with Joe in a recumbent bicycle - and for traveling. They're just back from China and are planning another journey, to Africa.

EMOTIONAL, PHYSICAL TOLL

There's an oft-used expression: different strokes for different folks, and it's absolutely accurate, says Robin Donaldson, manager of inpatient rehabilitation at St. Joseph Medical Center.

"Depending on where in the brain the stroke occurred, how big it was and what areas of function it affected, each person has their own unique issues," she explains. "There are some people who have a very rapid recovery period, and others who are on a slower track.

"How you fare depends on factors like how old you are, when the stroke occurs, what shape you were in, what other medical problems you have, and how well you manage the risk factors after the stroke."

A stroke occurs when a clot or ruptured vessel interrupts the flow of blood to the brain. When that happens, brain cells begin to die, leading to the loss of abilities, such as speech or movement, controlled by those cells.

In worst-case scenarios, stroke victims are left with severely impaired speech and cognition that leaves them unable to process information, make decisions or care for themselves. They tend to become very dependent and often end up in a nursing home "because the care they need is too intense to do at home," Donaldson says.

Aphasia - the partial or total loss of the ability to communicate - affects a third of stroke patients, and is devastating, says Kyra Becker, co-director of the University of Washington Stroke Center.

"Many people will say there are worse things than death, and this is one of them," she says. "There are people who are locked into their bodies, unable to move, but still awake and able to understand."

At St. Joseph Medical Center's rehabilitation services, Dr. April Sakahara and her team help stroke victims recover the ability to walk, get dressed, care for themselves, feed themselves, go to the toilet and improve their language skills. The emotional toll of a stroke is huge, she says.

"This is not a disease the just affects an arm or a leg," Sakahara says. "If people give up hope, give up on trying to get better, they don't do as well. So in addition to our physiatrist, occupational therapist, speech pathologist, dietician, physical therapist, social worker and nursing staff, we also have psychological services for the victim and their family."

The average age of people at the 12-bed inpatient rehab service is 70, but Sakahara frequently sees patients in their 40s, 50s and 60s. Many display typical stroke "risk factors," including smoking, diabetes, high cholesterol, hypertension, high blood pressure and obesity.

"The diseases we're fighting now are diseases of lifestyle," she says. "A lot of us live in denial, promising ourselves we'll lose 20 pounds next year or quit smoking. Or we'll say I won't live forever, so I'll do what I want today.

"But strokes don't necessarily kill," she adds. "More frequently, they will rob a person of their quality of life in some way. The stroke is like a dimmer switch that takes the brightness out of our lives."

DETERMINED TO RECOVER

That dimmer switch left Joe Morse without the knowledge of chemistry that had been his passion and his paycheck.

"He couldn't say my name and his right arm just hung," Karen recalls. "His physical therapist told me she thought he would never walk again."

One thing the stroke could not take away was Joe's willpower.

"He was so determined to walk out of therapy, rather than be pushed around in a wheelchair, that in the days after his stroke he got out of bed and into a chair by himself in the hospital, when no one was around," Karen says. "The doctor had to read him the riot act!"

With his right hand still weak, Joe has learned to tie his shoes and put on a tie single-handed. He reads up to four hours a day, works diligently on improving his speech, which is still difficult at times to understand, and writes in his logbook with his left hand.

"He's such an example of what you can do if you simply persevere," Karen says, with obvious pride.

She beams at her husband of 49 years, gently prodding and articulating on his behalf when his speech is unintelligible to others. It jogs her memory of how things were in the months after his stroke.

"When he was first learning to speak it was a guessing game trying to determine what he was saying," she says. "We'd laugh, but there were some tears, too. It was difficult, but it's been a journey, and it's become easier. I'm so grateful to have him in my life."

STROKE FACTS

Stroke is the fourth leading cause of death, and a leading cause of disability, in the United States.

There are two types of stroke. The most common is ischemic, when a clot obstructs blood flow to the brain. Less common is hemorrhagic, when a blood vessel ruptures.

About 795,000 people a year in the U.S. experience a stroke, 60 percent of them women. Nearly one out of six stroke victims die.

Source: American Stroke Association

WHO'S AT RISK?

The risk of having a stroke doubles each decade of life after age 55. Family history plays a role, with the risk of a stroke greater if a family member has had one.

Blacks are at higher risk of death from strokes than whites, because they have a higher risk of high blood pressure, diabetes and obesity.

If you've already had a stroke, a transient ischemic attack or "warning stroke," or a heart attack, then you are at greater risk of having a stroke.

Risk factors for stroke include high blood pressure; smoking; diabetes; carotid or other artery disease; atrial fibrillation; heart disease; sickle cell anemia; high blood cholesterol; diets high in saturated fat, trans fat and cholesterol; physical inactivity; and obesity.

Source: American Stroke Association

STROKE SYMPTOMS

Strokes can be gradual or fast, but recognizing their symptoms and getting immediate treatment can be key factors in potential recovery. Symptoms include:
-- Sudden numbness, tingling, weakness or loss of movement in the face, arm, or leg, especially on only one side of the body.
-- Sudden vision changes.
-- Sudden trouble speaking.
-- Sudden confusion or trouble understanding simple statements.
-- Sudden problems with walking or balance.
-- A sudden and severe headache different from past headaches.

Source: American Stroke Association

Lauren Kramer is a Bellingham freelance writer. Read her work online at laurenblogshere.com.