When Symptoms of Stroke Occur, Timing Is Everything
One Brooklyn politician shares how he survived

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Assemblyman Cymbrowitz, and his wife Vilma, with the Maimonides Medical Center Stroke team that saved his life. Dr. Steven Rudolph is to Vilma's left and Dr. Jeffrey Farkas is to Assemblyman Cymbrowitz' right.
When someone walks into my district office, the first thing they are greeted with is an elbow-high counter with an assortment of helpful literature. In addition to the constituent services my dedicated staffers provide, residents can also help themselves to a wealth of useful resources on a wide range of topics - how to protect oneself from identity theft, the 2012 New York City parking calendar, as well as information about rent laws, Medicare, and so on.

We also have a pamphlet entitled "Important Stroke Information," with a list of warning signs as well as New York City's "Designated Stroke Centers." I never dreamed that one day that information would save my life.

I was planning on enjoying a relaxing day with my wife Vilma before my Sunday events and evening drive up to Albany. Snow was melting outside on a chilly Saturday morning, even though spring was only two weeks away. I had slept in a little later than usual, only getting up from bed at around eight in the morning to retrieve the newspapers by the front door.

This is when my life-changing saga began.

While it didn't even occur to me that something was wrong, Vilma, in the other room, heard me struggling to walk. She immediately suspected that something was wrong, so she ran over, saw that I couldn't keep my balance as I lumbered awkwardly toward the front door and, once there, I couldn't even grasp the doorknob. My left hand and entire left side were beginning to go numb although, incredibly, I didn't even realize it.

Adding to Vilma's worry, at some point during the early stages of this drama, I sneezed, so when I walked back to grab a tissue, I didn't even see her out of my left eye as I staggered past her. The vision in my left eye was severely compromised.

Vilma turned me around to face her and, alarmed, saw in my face that paralysis was beginning to set in on the left side. Calmly she told me, "I think you're having a stroke," and helped me over to the sofa to sit me down. She asked me to repeat something she said, but all that came out of my mouth was unintelligible gibberish and then she asked me if I could move my arms and legs. I couldn't. So, with orders for me to stay on the sofa, Vilma ran over to the phone to call 911.

Refusing to believe I was actually having a stroke, I thought: "I'll show her," and, with that, I attempted to get up from the sofa. It was an ill-conceived plan and, after Vilma got off the phone with 911, she was then faced with the arduous task of trying to get me back on the sofa - no small task for a woman of barely 100 pounds.

This is not how I planned to spend my weekend.

Once EMS arrived a few minutes later, I was reasonably positive that I communicated to the ambulance personnel that I wanted them to bring me to Maimonides Medical Center's Stroke Center, but it was actually Vilma who told them to bring me there - a decision that nevertheless saved my life, and gave me an excellent chance at recovery.

Coincidentally, only two weeks earlier, Vilma had seen an episode of the hospital show "ER" called "Alone in a Crowd," in which you were able to hear the thoughts of the character, portrayed by Cynthia Nixon, who was suffering from a stroke. She was fully able to see and hear all that was going on around her, as was I when it was happening to me, and, like her character, I was completely powerless to speak. I really did believe that I told EMS to take me to Maimonides, but it was all going on in my head - only one of many clear indicators of how powerful the effects of stroke can be.

Nixon's character in "ER" was treated with an innovative corkscrew-shaped device called a Merci Retriever™ - short for "Mechanical Embolus Retrieval in Cerebral Ischemia" - which was only just approved for use on stroke patients by the FDA in August 2004. Maimonides was the only hospital in Brooklyn using the device and, when employed, the Merci Retriever™ is able to either dissolve the blood clot with the discharge of a clot-dissolving drug called TPA (Tissue Plasminogen Activator), or physically grab and remove the clot from the brain of someone experiencing an ischemic stroke, which is the kind of stroke I was having (a loss of blood supply to part of the brain due to a clot obstructing the blood from flowing freely).

The team of doctors working on me - led by Dr. Steven Rudolph, director of Maimonides' Stroke Center, and Dr. Jeffrey Farkas, formerly Maimonides' director of Interventional Neuroradiology - wanted to use the same device to reverse my stroke. Vilma wasted no time in giving them the go-ahead on my behalf.

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Assemblyman Cymbrowitz enjoying a moment with campers during a visit to a local day camp, several years after fully recuperating from his massive stroke.

Now Dr. Rudolph and Dr. Farkas, both Orthodox Jews, feverishly worked to reverse the damaging effects of a stroke in a New York State Assemblyman. It was probably not how they had anticipated spending their Saturday either. Fortunately for me, the Torah principle of pikuach nefesh, which mandates that the preservation of human life overrides the application of any other Jewish commandment, overrode the two doctors' Shabbat observance.

I was very lucky. When I arrived via ambulance to the hospital, I was unable to feel the entire left side of my body, but because I was administered TPA, combined with use of the Merci Retriever™, as well as a biplane imaging system that provided real-time 3D imaging of my brain (also approved by the New York State Department of Health just days earlier) - all within the crucial three-hour window, known as the "golden hour" - the initially devastating effects of my stroke were able to be reversed.

After the procedure was completed, I was determined to go to Albany on Monday. While obstinacy is a pre-requisite for those in political life, that proposal was nevertheless solidly nixed by all involved. Eventually, however, because of the state-of-the-art emergency treatment I received during my stay at Maimonides, I was able to return to the Capitol two weeks after my stroke, albeit with someone else in the driver's seat. A week after that, I was given permission by the doctor to drive myself.

If Vilma was not with me the morning of March 5, 2005, there is a strong likelihood that I would not be an Assemblyman today, let alone even write these words. Thankfully, she knew to act "FAST" - a life-saving acronym that everyone should be aware of:

F - Face: Is one side of the face drooping down?
A - Arm: Can the person raise both arms?
S - Speech: Is speech slurred or confusing; is the person unable to speak?
T - Time: Time is critical. Call 911 immediately.

You probably wouldn't even be able to tell, just by looking at me, that I suffered a massive, life changing stroke seven years ago. And when I say "life changing," I don't mean physically life changing, although my hand-writing - I write with my left hand - certainly isn't as legible as it once was.

Knowing, however, that I could have been confined to a permanently vegetative state, or died, has altered my entire approach to my health. Suffering from a stroke, and being blessed to live and tell about it, and more importantly use my story as a warning to others, has fostered a renewed outlook toward life and my loved ones, particularly Vilma.

The biggest change to date is having to be on the blood thinning drug, Coumadin (also known as Warfarin), for the rest of my life. My blood levels need to be monitored every two to three weeks, so as to prevent another clot but, as Benjamin Franklin said, "An ounce of prevention is worth a pound of cure."

Since my stroke and subsequent full recovery, I have been, and will continue to be, an outspoken advocate of stroke prevention. I cannot stress strongly enough the life-saving importance, when the symptoms of stroke begin to occur, of getting to one of New York City's Designated Stroke Centers.

Strokes are the third leading cause of death in the United States and they account for one out of every 16 deaths in the country. Someone in the United States dies of a stroke every three to four minutes, and I am living proof that those statistics simply should not be. We need to constantly raise the public's awareness about strokes, because those frightening numbers can and must be reversed.

I am glad that the NYS Assembly passed my resolution in 2006, and every year thereafter, proclaiming May as Stroke Awareness Month, but we must do more. Just as people are inclined to call '911' in the event of an emergency, so should they know exactly what to do the moment they are faced head on with the potentially deadly symptoms of a stroke.

The bottom line is this: Time is very much of the essence. My quick and complete recovery from a massive stroke is attributable to the fact that I got to the Maimonides Medical Center's Stroke Center very quickly. Getting to a Designated Stroke Center - not waiting for your personal doctor to call you back, and not going to a hospital's emergency room - is the key.