Time is the BRAIN

TimeisMoney,No,
TIME IS THE BRAIN
My Independent Story
Prepared for:
Rich Daniels, Department of Management
rdaniels@uga.edu
Submitted by:
ROGER L. BRATHWAITE, MBA

EMBA 2015 Independent Study Paper 1 | P a g e
Time is Money, No, TIME IS THE BRAIN.
Roger L. Brathwaite, MBA
Table of Contents
INTRODUCTION..................................................................................................................... 2
A FATHER’S DAY ACCOUNT.................................................................................................... 3
WHAT EXACTLY IS A STROKE? ................................................................................................ 6
HEMORRHAGIC STROKE (BLEED OR RUPTURE)....................................................................................... 7
ISCHEMIC STROKE (CLOTS OR BLOCKAGE)............................................................................................. 8
HOW TO RECOGNIZE A STROKE?............................................................................................ 9
IDENTIFY AND DETERMINE QUICKLY .................................................................................................... 10
THE SHEPHERD CENTER / SHEPHERD PATHWAYS ................................................................. 11
WHY DOES STROKE HAPPEN? .............................................................................................. 18
DIET ............................................................................................................................................ 19
PHYSICAL ACTIVITY ........................................................................................................................ 19
HIGH BLOOD PRESSURE .................................................................................................................. 20
SMOKING ..................................................................................................................................... 20
ALCOHOL ..................................................................................................................................... 20
TIME IS THE BRAIN .............................................................................................................. 21
SUMMARY .......................................................................................................................... 22

Introduction
Some people will sit down and read this with no prior knowledge of the Shepherd
Center, Stroke rehabilitation or even me, Roger Brathwaite. But I promise, if you invest the
time to read this study you will be enlightened. This paper centers around a personal tragedy,
but I thought it was also a public story that needed to be shared. Regardless of your exposure, it
is my hope that you walk away with a rejuvenated spirit and a feeling. “You Are Not Alone!”
This story originally started, right before the first day of the final class, “Mergers and
Acquisitions” at the University of Georgia for the Executive Masters of Business Administration
(MBA) degree. It was Christmas 2014, and I could remember how much effort I had put into our
“Entrepreneurship” and “Service Operation Management” classes and how much traveling I had
done for that past year. As I looked forward to 2015, I felt like certain things in my life were
finally coming together. I was in the final stages of purchasing a house, I started a new job
September 2014, my kids were all doing well, and my life was approaching a turning point of 45
years. It couldn’t be any better.
However, unbeknownst to me, on December 29, 2014 my life would change
tremendously. I suffered a stroke and subsequently fell into a coma. I was admitted to
Piedmont Hospital that night, where I stayed for 12 days and then another 42 days at Shepherd
Rehabilitation Center Hospital. I will present to you why so much care and what type of care
was necessary. The Shepherd Center is one the top rehabilitation hospitals in the nation,
specializing in medical treatment, research and rehabilitation for people with brain injury. But
before Piedmont and Shepherd, it all started with my children Chandler, Carrington, Cyon and
Chase, and I want them to give their account of how this all started.
I got a call a few weeks before Father’s Day in 2015 from Mia Taylor, interviewer from
the Shepherd Center. She said she wanted to interview my boys because she had heard that
they were involved in my traumatic story. I thought this was an awesome opportunity to
capture how my stroke story started. So Mia scheduled to conduct the interview and this is how
it began……

A Father’s Day Account
1
Roger Brathwaite refers to it as the day that
changed everything. It started out normal
enough. The 45-year-old Atlanta, Ga., resident
rose early, drove a relative to the airport and
returned home to participate in a conference
call for work. When the phone call was over,
Roger, who felt like he had a slight cold, went
back to bed. That’s the last memory he has of Dec. 29, 2014. “My boys heard me hit the ground.
I didn’t know I hit the ground. And they called the paramedics,” Roger recalls.
Roger’s four sons were staying with him that day. They typically stay with their mother,
Roger’s former wife, but the teen-aged boys had been visiting for the Christmas holidays. Their
presence likely saved his life. It was 16-year-old Cyon Brathwaite and 18-year-old Carrington
Brathwaite who first found Roger, lying face down, sweating and unconscious. “I had gone
downstairs to get him water, and I heard a big thud, so I ran back upstairs and he was on the
floor,” recalls Cyon, describing the frightening morning that forever changed his family’s life. “At
first, I thought he just fell. But he was actually going through the process of a stroke. So we
woke up my older brother Chandler. He came upstairs trying to talk to my dad to see what was
wrong. And then he told me to go in the other room and pray.”
Cyon went into his little brother Chase’s bedroom, trying to calm his young sibling while
also quietly praying, scared and wondering whether his father would survive. Roger was rushed
to Piedmont Hospital and lapsed into a coma. He had experienced
a hemorrhagic stroke that affected the left side of his brain,
leaving the right side of his body paralyzed. His sons, meanwhile,
worked to remain optimistic that their father, a man they knew to
be a hard worker and a fighter, would pull through. .
1
Shepherd Center article: by Mia Taylor
Figure 1. Brathwaite Boys
Figure 2. under comma
Comparison

After three weeks, Roger awoke and learned the details of his new reality. It is a day he
will not soon forget. “I was emotional to say the least,” he recalls. “It’s hard to explain the layers
of emotions. It’s mind-numbing because the whole right side of your body doesn’t work
anymore, and this is something you’ve been used to having for 44 years. I didn’t know how long
it would last. I didn’t have any answers. Doctors couldn’t tell me when I was going to come out
of it, or if I was going to come out of it. I cried for most
of the day. Being in a wheelchair and having people
bathe you, that reminds you: This is real.”
Once he was stabilized, Roger was admitted to
Shepherd Center, where he participated in inpatient
physical, occupational, speech and recreation therapy
followed by additional day program therapy at
Shepherd Pathways.
After three and a half months, Roger reached a milestone in his recovery. On that day,
Roger put away his wheelchair for good. “Roger is phenomenal,” says Payal Fadia, M.D., his
physician at Shepherd Pathways. “He was extremely hard-working and determined in therapy.
He continually strives to reach milestones in his recovery.”
Just this week, six months after his collapse, Roger reached another important marker in
his journey: He completed rehabilitation altogether. While Roger still considers himself a work in
progress, with his goals for the future including continuing to strengthen his right side and
improve his verbal skills, his focus has now happily shifted to improving the smaller, finer details.
“I’m fully operational,” he says. “I can walk, I can talk. I can write my name now, but I can’t
write it beautifully like I used to.” The precariousness of his existence during the past six months
has made this Father’s Day particularly meaningful for Roger and his family. He is here, alive
and well, able to celebrate the day with his sons – something more valuable than the high-
powered career and pursuit of the corner office at a Fortune 500 company that had been a
dominant focus of Roger’s life until his stroke.
Figure 3. Complete Paralysis

Roger and his sons will mark Father’s Day not by going out to eat or for a boat ride –
activities they have typically participated in together over the years. Instead, this year, they will
walk together at The Atlanta Beltline in a subdued, but particularly meaningful, celebration of
Roger’s long journey back. “My goal is not necessarily to walk the entire three-mile walk, but
just to have a good time with them, laughing and joking and just being together enjoying the
day,” Roger says. His sons are equally cognizant of the poignancy of this year’s celebration, well
aware they almost lost their dad. They are also proud of all the progress he has made, calling
him a diligent, but humble fighter.
“We could have not had a father this
year,” says 20-year-old Chandler Brathwaite.
“The fact that we still do, and that he
recovered from something that many people
don’t recover from, is a blessing. So, this
Father’s Day will be more special than all the
others.”
Cyon adds: “It’s a miracle. It’s kinda crazy that
on the day he had his stroke, we were there. I think
we all played a part in saving his life.”
Written & Published by Mia Taylor/Shepherd Center
This article is available for anyone to review on the web http://news.shepherd.org/this-
fathers-day-former-shepherd-center-stroke-patient-will-celebrate-life/
You might be thinking, “What exactly is a Stroke?” and what things could be done to
prevent it from happening again? Or you might be thinking, how are you going to recognize the
things that leads to a stroke? Although stroke is the fifth leading cause of death in America and
a leading cause of adult disability, many myths surround this disease. I hope the next chapter
serves as a way to educate…..
Figure 4. Walkway

What exactly is a STROKE?
2
A stroke is a "brain attack". It can happen to anyone, at any time. It occurs when blood
flow to an area of the brain is cut off. When this happens, brain cells are deprived of the blood’s
essentials oxygen and nutrients even for a few minutes, the brain cells begin to die. When brain
cells die during a stroke, abilities controlled by
that area of the brain such as memory and
muscle control are lost. Since dead brain cells
do not regenerate, damages from a stroke are
often permanent, but could also be temporary
depending on the type of stroke. Depending
on what portion of the brain is affected by the
stroke, the result may be some degree of brain
damage and loss of function affecting speech,
vision, or memory, for example. A stroke may also result in paralysis, coma or “death.”
How a person is affected by their stroke depends on where the stroke occurs in the
brain and how much the brain is damaged. For example, someone who had a minor stroke may
only have minor problems such as temporary weakness of an arm or leg. People who have
major strokes may be permanently paralyzed
on one side of their body or lose their ability to
speak, swallow and sometimes remain in a
coma or die. Some people recover completely
from strokes, but more than 2/3 of survivors
will have some type of disability. I was affected
on the left side of the brain, so that means that
the right side of my body was totally paralyzed.
2
National Stroke Association
Figure 5. Two types of strokes
Figure 6. Which side affected?

Hemorrhagic Stroke (bleed or rupture)
3
There are two types of stroke, hemorrhagic and ischemic. Hemorrhagic strokes are less
common, in fact only 15 percent of all strokes are hemorrhagic, but they are responsible for
about 40 percent of all stroke deaths. Unfortunately, this kind of stoke was the kind I
experienced.
A hemorrhagic stroke is either a brain aneurism burst or a weakened blood vessel leak.
Blood spills into or around the brain and creates swelling and pressure, damaging cells and
tissue in the brain. There are two types of hemorrhagic strokes called intracerebral and
subarachnoid. The stroke I suffered from was intracerebral.
Intracerebral hemorrhage. In an intracerebral hemorrhage, a blood vessel in the brain
bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the
leak are deprived of blood and also damaged.
High blood pressure, trauma, vascular malformations, use of blood-thinning medications
and other conditions may cause an intracerebral hemorrhage.
Subarachnoid hemorrhage. In a subarachnoid hemorrhage, an artery on or near the
surface of your brain bursts and spills into the space between the surface of your brain and
your skull. This bleeding is often signaled by a sudden, severe headache.
3
American Heart Association
Figure 7. Hemorrhagic Stroke
Figure 8. Roger’s brain damage

Ischemic Stroke (Clots or blockage)
4
Ischemic stroke occurs when a blood vessel carrying blood to the brain is blocked by a
blood clot. This causes blood not to reach the brain. High blood pressure is the most important
risk factor for this type of stroke. Ischemic strokes account for about 87% of all strokes. An
ischemic stroke can occur in two ways.
In a cerebral embolic stroke, a blood clot or plaque fragment forms somewhere in the
body (usually the heart) and travels to the brain. Once in the brain, the clot travels to a blood
vessel small enough to block its passage. The clot lodges there, blocking the blood vessel and
causing a stroke. About 15% of embolic strokes occur in people with atrial fibrillation. The
medical word for this type of blood clot is embolus.
A cerebral thrombotic stroke is caused by a blood clot that forms inside one of the
arteries supplying blood to the brain. This type of stroke is usually seen in people with high
cholesterol levels and atherosclerosis. The medical word for a clot that forms on a blood-vessel
deposit is thrombus.
While transient ischemic attack (TIA) is often labeled “mini-stroke,” it is more
accurately characterized as a “warning stroke,” a warning you should take very seriously. TIA is
caused by a clot; the only difference between a stroke and TIA is that with TIA the blockage is
transient (temporary). TIA symptoms occur rapidly and last
a relatively short time. Most TIAs last less than five
minutes; the average is about a minute. According to Dr.
Emil Matarese, director of a primary stroke center at St.
Mary’s Medical Center in Langhorne, Pa., the body has
naturally occurring clot-busting agents. “Eventually all clots
will dissolve, but whether there is damage depends on
how long the clot is in place,” Dr. Matarese said. However, because there is no way to predict
when a clot will dissolve on its own, time is of the essence. “Whenever you have stroke
symptoms, dial 9-1-1 immediately and get to the emergency room so you can be evaluated.
4
Excerpted from “Why Rush?”, Stroke Connection January/February 2009 (Science update October 2012)
Figure 9. Blood Clot

How to Recognize a STROKE?
5
Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of
awareness spells disaster. A stroke victim may suffer brain damage when persons nearby fail to
recognize the symptoms of a stroke. The acronym for FAST is a very easy and simple way to
recognize a stroke, and can help in identifying the onset of a stroke in someone - even a non-
medical person will be able to do this, by remembering the follow guidelines:
Here are some other common symptoms or ways it is happening in most.
 Trouble with speaking and understanding. You may experience confusion. You may slur
your words or have difficulty understanding speech.
 Paralysis or numbness of the face, arm or leg. You may develop sudden numbness,
weakness or paralysis in your face, arm or leg, especially on one side of your body.
 Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened
vision in one or both eyes, or you may see double.
 Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness
or altered consciousness, may indicate you're having a stroke.
 Trouble with walking. You may stumble or experience sudden dizziness, loss of balance.
5
http://www.myshepherdconnection.org/stroke/recognize-restroke-FAST
Figure 10. Shepherd Center Recognize Re-stroke - FAST

Identify and determine quickly
It is extremely important that the type, size and location of the stroke be diagnosed as
quickly as possible, so that the doctors can decide the best course of treatment to begin
immediately in order to lessen brain damage. As the saying goes, "TIME IS THE BRAIN",
because the more time that elapses between the onset of stroke symptoms and treatment, the
more brain cells are destroyed. Also, treatment for one kind of stroke may be harmful for
someone who has a different kind, since strokes are caused by different factors, thus they
require different forms of treatment. Additionally, patients diagnosed and treated within three
hours of stroke onset, can have a more positive effect, and a much greater chance of
recovery, and may experience just temporary, instead of permanent disabilities. So every
minute counts, as time is of the essence.
I must mention here that after my four boys, got no response from me, they
immediately called Emergency Medical Services (EMS), the best step anyone can take to get
quick medical care, since it is crucial to get to a hospital prepared to provide the diagnosis and
treatment as quickly as possible after the onset. I was then rushed to Piedmont Hospital (one
of the best, if not the best hospital in Georgia) on that day- December 29, 2014, a day that I will
never forget. Unfortunately, by this time I had lapsed into a coma, and after administering
different types of diagnostic tests, (blood tests, CT Scan, MRI, etc.) it was confirmed that I had
suffered a brain bleed, because of the bursting of a blood vessel which
spilled blood into the surrounding brain tissue, causing some damage
to my brain cells. It was discovered that the kind of stroke, I suffered
is known as an Intracerebral Hemorrhagic Stroke.
Then I believe the most significant and critical decision was
made by my brother, Leslie Brathwaite. He decided that after a few
days I was stabilized and should be discharged from Piedmont
Hospital on January 9, 2015, and had me admitted on that same day
to Shepherd Rehabilitation Center Hospital.
Figure 11. Transfer to Shepherd Center

The Shepherd Center / Shepherd Pathways
6
Well, what is this Shepherd Center that I have been referencing. The Shepherd Center,
located in Atlanta, Georgia, is a private, not-for-profit hospital specializing in medical
treatment, research and rehabilitation for people with spinal cord injury and brain injury.
Officially started in 1975, the Shepherd Center is ranked by U.S. News & World Report among
the top 9 rehabilitation hospitals in the nation. The Shepherd Center is a 152-bed facility. Last
year Shepherd had 965 admissions to its spine and brain inpatient programs and 571 to its day
patient programs. In addition, Shepherd sees more than 6,600 people annually on an
outpatient basis.
What I have been told,
the Shepherd Center has been
ranked among the nation’s
top rehabilitation hospitals for
spinal cord and brain injury.
Figure 12. Shepherd Center Main Facility
As a part of the center, there is a division called the Shepherd Pathway, dedicated to
outpatient therapy. The facility is located in Decatur, Georgia, just north of Atlanta. It includes
treatment rooms, two large therapy gym, a computer lab, state-of-the-art technology, outdoor
sports equipment and putting green for recreational and leisure activities. Patients at Shepherd
Pathway get more than just
medical care; they get an
experience that brings healing
and hope. Shepherd takes a
team approach to
rehabilitation.
Figure 13. Shepherd Center Main Gym
6
http://www.shepherd.org/about/about-shepherd

Although I do not remember everything that happened while at Shepherd, what I do
recall first of all is that my medical team was headed by Dr. Dennison, followed by the team of
Speech, Occupational, Physical and Recreational Therapists. Andrew Cullen Dennison, M.D.,
joined Shepherd Center’s medical staff in July 2011 as a staff physiatrist treating patients who
are recovering from traumatic or non-traumatic brain injuries, as well as
people who have had complications from a stroke or tumor. He was also in
charge of my leading medical team of doctors including a Neurologist,
Neuphrologist and Neuropsychologist.
Andrew Cullen Dennison, M.D.
Medical Director Brain Injury
Staff Physiatrist
Carly, Jenna, Erin and Anastasia were all therapists involved in their respective areas.
They spent countless hours using different areas of professional studies. They were in fact using
the right mixture of therapy, along with basic foundational needs that I couldn’t execute myself;
like using the bath room, walking and the use of my right hand. Their outstanding performance,
certainly contributed in a big way to my recovery.
Figure 15. First Days at Shepheard
Figure 14. First Team of Therapists

My treatment began with a number of different prescribed medications, that were all
prescribed for different reasons. Some of the reasons included: (a) reduction of pressure in the
brain, (b) consistency of overall blood pressure, (c) prevent seizures, (d) treat chronic nerve and
muscle pains (e) avoid blood clots and anemia (f) lower my blood glucose and cholesterol levels
and of course (h) depression. Here is my current list of medicine, that I take everyday.
1. Cymbalta 30MG 7. Buprenorphine 10MCG/MR Patch
2. Asprin Low 81MG 8. Lisinopril 10MG
3. MetFORMIN HCI ER 9. Simvastatin 20MG
4. Gabapentin 300MG 10. AmLODIPine Besylate 5MG
5. Ferrous Fumarate 324MG 11. Escitalopram 10 mg
6. Duloxetine HCL DR 30 mg 12. Clonidine HCL 0.1 mg
After being on these medications, I finally learned how to swallow, eat and drink again,
talk, and regained movement of my right hand and foot. Miraculously, by the middle of
February 2015, I was able to get up out of my wheelchair and started walking with the
assistance of my therapist.
Figure 15. Helping me to walk

By this time, coupled with improvement in my overall medical condition, on Friday,
February 20, 2015 I was discharged from Shepherd Rehabilitation Center inpatient services and
on February 23, 2015 I began my outpatient day program at Shepherd Pathways. I was assigned
to Dr. Papal Fadia, Medical Director of Shepherd Pathways, and her team of Therapists.
Payal Fadia, M.D.
Medical Director
She joined Shepherd Center as a physiatrist in Shepherd’s Acquired Brain Injury and
Neurospecialty units in 2008. Prior to joining Shepherd Center, Dr. Fadia managed the acute
rehabilitation inpatient service at Norwalk Hospital in Connecticut. Her therapist Auni, Reena,
Sarah and Briget covered the same areas as Dr. Dennison’s team speech, occupational, physical
and recreational therapist. But it seems we had more focus on the Brain. The picture of the
brain shows the areas that we focused on.
Frontal Lobe Parietal Lobe
Motivation Touch Sensation
Controls Attention Awareness of Spatial
Emotional Control Visual Attention
Social Behavior Left Hemisphere
Judgment Speech and Writing
Problem Solving Right Visual Field
Decision Making Temporal Lobe
Expressive Language Memory
Motor Integration Lang Comprehension
Voluntary Movement Musical Awareness
Occipital Lobe Brain Stem
Visual Perception Vital Signs (heart rate, temperature)
Visual Processing Level of Alertness
Cerebellum Right Hemisphere
Figure 17. Sketch of the brain w/Lobe & Stem callout
Figure 16. Second Team of Therapists

Certain rehabilitation activities needed to be carried out in order for me, a full stroke
victim, to fully recover. Speech therapy assisted with problems producing or understanding
speech. Practice relaxation changing communication style, using gestures or different tones, for
example, all help. Physical Therapy helps with relearning movement and coordination. It is
important to get out and about, even if it is difficult at first. Occupational therapy helps to
improve the carrying out of routine daily activities such as bathing, cooking, dressing, eating,
reading and writing. As a matter of fact, my therapies felt like job. Here is an example of my
weekly schedule from shepherd pathway:
Figure 18. Weekly Routine at Shepard Pathway
You will notice some assignments are not necessarily structured around the typical
therapy areas and/or subsets of the existing categories. The adjustment group is a counseling
group where group members discuss feelings about having a brain injury. The
cognitive/communication group is speech therapy designed to address a range of thinking and
communication skills. The group focuses on areas of cognition such as attention, memory,
thinking, planning, organization and problem solving. Some other areas are gait/balance group,
pet therapy and 7
medshare.
7
https://www.shepherd.org/files/file/SHEP_SC_Fall2014-Rnd3.Final.PDF (page11)

Those groups were responsible for non-traditional training like, music development,
swimming and even rock-climbing. Just imagine that I was not only new to walking unaided,
but also way up off the ground. That activity was a stimulating activity on several levels. In my
opinion this was one of the greatest accomplishment, but it was also a most memorable event
in my recovery. I reached the top on my second attempt. Just the thought of that after being
confined in a wheelchair for about one and a half months, I was able to successfully participate
in a Rock Climbing Activity, while still involved in my recovery process.
Figure 19. Rock Climbing
Joining a support group can help with common mental health problems such as
depression that can occur after a stroke. Many find it useful to share common experiences and
exchange information. Support from family and friends it is also useful and can provide
comfort. Letting family and friends know what can be done to help is very important. It can be
simply holding a hand or just listening to me ramble on about why this happened. The
Shepheard Center and Shepherd Pathways were my refuge.
Figure 20. Close Friends

To my surprise March 2015, I was invited to dinner by Argy Russell, the admissions
director of my MBA program. This dinner was at Del Frisco's Grille and it was my first time
seeing my classmates since having the stroke. This was typically the last dinner, after
completing all the requirements for graduation. The students were not aware that I was
attending. But their faces all lit up, knowing what I had experienced, about 3 months ago. The
professors, were truly surprised to witness how far I had come. It was even decided by my
director to allow me to graduate (walk) in May 2015, even with the unfinished assignment,
pending.
I don’t even think that they realized how much that meant to me. Yes I gained a lot of
new friends at the Shepheard Center, most of them I can’t even name. But I knew there were a
lot more pulling, for me, especially at the University of Georgia. So why did this all happen?
Figure 21. University of Georgia, Graduating Class of 2015
Figure 22. Celebrating with Graduating Class of 2015

Why does STROKE happen?
Stroke occurs in all ages groups, in both sexes, and in all races. Everyone has some
stroke risk, but some people have more risk than others. Not all of the reasons are clear why
African-Americans have an increased risk of stroke. Not even studies can tell us concrete
information to point to specific causes. But the amount of risk can be determined. Your risk of
stroke grows as the number and severity of risk factors increase. Some risk factors can be
reduced or eliminated. Others, however, are beyond control. Things we cannot change are:
(1) AGE - Older people have a much greater risk for stroke than younger people.
(2) SEX - The incidence of stroke is about 30% higher for men than women.
(3) HEREDITY - The risk for stroke is greater in people with a family history of stroke.
(4) RACE - In African American men and women, four times more common than in whites.
Lifestyle risk factors can have some impact on and can directly affect some medical
conditions by improving them. Lifestyle risk factors are habits or behaviors people choose to
engage in. If changed, these can make a significant impact
(5) DIET - Eating healthy can improve overall health.
(6) PHYSICAL ACTIVITY - A study showed people that exercise have a reduce risk of Stroke
(7) HIGH BLOOD PRESSURE - African-Americans suffer from a high blood pressure.
(8) SMOKING - The risk of stroke doubles when you smoke.
(9) ALCOHOL - Has been linked to stroke in many studies
These are some of the surprising factors for suffering a stroke. Check with your doctor.
(10) DIABETES - You have diabetes, you probably have other health problems.
(11) SICKLE CELL ANEMIA - The most common genetic discover amongst African-Americans.
(12) OBESITY - Adopting a lower-sodium (SALT) and lower-fat diet.

Diet
8
A healthy diet can help you reduce the risk of chronic diseases, improve your overall
health, and help you reach or maintain a healthy weight. Eating healthy includes making
informed decisions about food choices and balancing your calories. The latest guidelines from
Dietary Recommendations for Americans 2010 include the following:
 Eat more foods from plants, such as vegetables and
beans, whole grains, and nuts.
 Eat more seafood in place of red meat and poultry.
 Limit the intake of sodium, solid fats, added sugars.
 Reduce calories you eat and drink .
Excess weight puts a strain on the entire circulatory system. It can also make people more likely
to have high cholesterol, high blood pressure and diabetes, all of which can increase stroke risk.
Physical Activity
Physical activity includes anything that gets your body moving. A recent study showed that
people who exercise five or more times per week have a reduced stroke risk. The latest
recommendations from the CDC on Physical Activity Guidelines for adults include the following:
 Moderate Activity. 150 minutes of moderate-intensity activity per week (brisk walking,
water aerobics, bicycling) and 2 or more days a week of
weight training exercises.
 Vigorous Activity. Or 75 minutes of vigorous-intensity
activity per week (jogging, running, swimming laps) and 2 or
more days a week of weight training exercises.
 Break it up. If you can’t fit a 30-minute activity in one time,
break it up into 10-minute segments.
 Make physical activity fun. Walk or bike with a friend.
Regular physical activity will improve your overall health, and
reduce your risk for chronic disease.
8
http://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf
Figure 24. Getting in shape on bike
Figure 23. Learning to eat right

High Blood Pressure
9
High blood pressure means that the force of the blood pushing against the sides of your
arteries is consistently in the high range. This can lead to stroke, heart attack, heart failure or
kidney failure. Two numbers represent blood pressure. The higher (systolic) number shows the
pressure while the heart is beating. The lower (diastolic) number shows the pressure when the
heart is resting between beats. The systolic number is always listed first. A blood pressure
reading of less than 120 over 80 is considered normal for adults. A blood pressure reading equal
to or higher than 140 over 90 is high. Blood pressure between 120–139/80–89 is considered
“prehypertension” and requires lifestyle changes to reduce the risk of stroke.
Smoking
Smoking doubles the risk of stroke when compared to a nonsmoker. Smoking increases
clot formation, thickens blood, and increases the amount of plaque buildup in the arteries. If
you smoke, try as hard as possible to stop. Ask your doctor about quit-smoking aids like
nicotine patches, counseling, and programs that are available to you. Quitting smoking can be
difficult, so don’t give up if you are not successful the first time you try. I never struggled with it.
Alcohol
Alcohol use has been linked to stroke in many studies. Drinking too much alcohol can
increase blood pressure and the risk of stroke. Aim to drink in moderation – no more than two
drinks a day for men and one drink a day for women. I don’t drink at all.
The statistics are staggering—in fact, African-Americans are more impacted by stroke
than any other racial groups within the American population. African-Americans are twice as
likely to die from stroke as Caucasians and their rate of first strokes is almost double that of
Caucasians. Strokes in this population tend to occur earlier in life. And as survivors, African-
Americans are more likely to become disabled and experience difficulties with daily living.
9
http://www.cdc.gov/physicalactivity/everyone/guidelines/

TIME IS THE BRAIN
At some point all of us will face this disease, whether it’s directly or as care provider of
someone you know and love. I have to deal with this disease for the rest of my life, whether it’s
taking my meds, following my diet or following my workout plan and whatever it takes to avoid
an episode again. So I have the information that I learned over past year and I still have great
deal to learn.
My biggest goal in my life is not just to be healthy, but it is to return to work in a way
where I am a provider, servant and directly helping people. So it is going to take a lot work and
an incredible amount of belief. As a consultant in Service Management in the IT field, I felt that
my beliefs couldn’t be met. I couldn’t go back to the same job, the same industry or field. That
is why I have chosen the Healthcare IT industry. I don’t know yet, specifically in what area,
that’s why I am now taking a Big Data/Analytics and Healthcare for IT courses at Emory
University. After completing those courses the answer would be clear.
But that’s only part of it. I plan to use my personal time to speak to my friends about
what exactly is a stroke, how to recognize it and what to do to prevent stroke. With a message
tailored for each community, I plan to reach these affinity groups:
Workplace. Host a lunch and learn.
School. Make a presentation to a class.
Places of Worship. Have a table before or after the service.
Senior Center. Ask about having a table during events.
Home owners associations. Ask about newsletter or bulletin
Service Club. Contact groups like Lions, Rotary Club …
I have already started and had my final presentation, for the shepherd staff in august. It was my
last day for outpatient services. Each instructor gave a review and things we have to work on. I
was pleased with all of my reviews.
Figure 25. My First Presentation

Summary
Even though I am currently still experiencing brain loss and fighting through pain and
taking my medications, I must admit that I have a lot to be thankful for. First I have to thank
Almighty God, my Heavenly Father, who has been so good to me throughout my illness and
recovery. Also the support I received is so important during illness and the recovery process,
that it is fitting for me to say a "hearty thank you" to all family members, pastors, friends and
well-wishers, and to those who not only prayed for me, but also personally visited or sent Get-
well Cards. Even though I cannot mention all the names because the list would be too long, but
each one of you has not been forgotten.
At this juncture, I must sincerely thank my four boys, who practically saved my life, and
for notifying close family members, especially Leslie, my younger brother, who was at my side
from day one, and also assisted with all my personal and financial business. Special thanks goes
out to my loving Mom, Myrna, who travelled from the Caribbean, and stayed with me for 6
months while I was in therapy and recovery. And my dad, Chris, who visited me quite often
despite the long hours he spent driving from Florida to Atlanta.
It is my hope that people who have had a stroke will be
encouraged by my successful recovery. Although I am in the 2% of
those who have a severe stroke and are able to return to a
somewhat normal life. I can walk, talk, back in school, and have found an area of society where
I belong. The truth is when this disease comes, it is here to steal, kill and destroy. I know
because I was lying, half paralyzed, thinking optimism is hard to come by.
Figure 26. My family: Chris (dad), Jenny , Myrna (mom), and Leslie

I am hopeful that one day in the not too far distant future, that Pharmaceutical
company researchers will be successful in discovering more and more about the complex
mechanisms at work before, during and following a stroke. This knowledge will lead to new
and better ways to limit cell death in the brain when a stroke occurs, to salvage damaged brain
cells and to aid in recovery. Currently, there are more than 88 new drugs being developed to
treat or cure conditions that can make strokes more likely to occur. In addition, pharmaceutical
researchers have developed more than 12 new drugs to help reduce the terrible damage to the
brain, when a stroke does occur.
In the years to come, exciting new therapies will change the ways stroke is treated.
Pharmaceutical researchers are testing and developing new drugs known collectively as
neuroprotective agents designed to interrupt this cascade and protect the brain from
secondary injury.
Overall, the future holds great hope. We are now on the brink of a new era in stroke
research that could significantly change the ways in which acute stroke is treated. This is good
news, but it doesn’t mean the work is over. 10
James Shepherd set out on a backpacking trip
around the world in 1973 after graduating from the University of Georgia. While bodysurfing off
a beach in Rio de Janeiro, he was slammed to the ocean floor by a wave. Mr. Shepheard, who
was 22 at the time, sustained a serious spinal cord injury that left him paralyzed from the neck
down. What if he felt, there was no hope, and no reason to work.
After spending five weeks in a Brazilian hospital struggling to survive, he returned to the
United States. After six months of intensive rehabilitation, James regained his ability to walk
while using a cane and a leg brace. After returning home to
Atlanta, James and his parents - Harold and Alana Shepherd
- were frustrated with the lack of rehabilitation care
options in the Southeast. And now we have the Shepherd
Center, 40 years later, we can say, Thank You. Now it is my
turn, time is money, no, TIME IS THE BRAIN.
10
http://www.shepherd.org/aboubrt/history-and-mission
Figure 26. James Shepherd

Join my Blog - “Time is the BRAIN” - May 2016
www.rogerbrathwaite.com
http://www.linkedin.com/in/rogercio

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Time is the BRAIN