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Salinas teacher on road to recovery from stroke, thanks to perseverance, Community Hospital’s IRU

Derek Yonekura has come a long way in the last few months. The 57-year-old Salinas science teacher suffered a massive stroke in December, but with the help of intensive therapy and a positive attitude, he’s hopeful that he’ll be back in his San Benancio Middle School classroom this fall.

Derek Yonekura

Derek Yonekura works out at Peninsula Wellness
Center in Salinas.

“I feel like I’m really lucky,” says Yonekura, who underwent intensive therapy at the Inpatient Rehabilitation Unit at Community Hospital of the Monterey Peninsula. “Attitude is a big part of the recovery process. You can’t ever give up — it’s hard, but I keep trying.”

In the days just after his stroke, Yonekura was, in his words, “basically paralyzed” — unable to move or care for himself — but a team of therapists and other healthcare professionals have made all the difference, he says. And although progress is slow and sometimes frustrating, he realizes that he continues to improve and get better.

“When it happened to me, I didn’t know I was having a stroke,” says Yonekura, who notes that it was most likely caused by his diabetes, which at the time wasn’t well controlled. “If I could give anyone advice, I would say to take care of yourself. I would not want this to happen to my worst enemy.”
Most people don’t realize that strokes can happen at any age, although they are more common as we get older — people 65 and up make up the vast majority of stroke victims, and the risk climbs every decade after age 55. High blood pressure, high cholesterol, and smoking are also important risk factors for stroke, in addition to diabetes. Stroke is the fifth most common cause of death in the United States, according to the Centers for Disease Control and prevention, and a leading cause of serious long-term disability. But reducing risk of death and disability is possible.

Derek Yonekura with IRU staff

Derek Yonekura with staff from Community Hospital’s
Inpatient Rehabilitation Unit.

The most important thing is to call 911 right away if you think you’re having a stroke. The longer a stroke victim waits, the more likely there will be brain cell death. Getting to an emergency department quickly after stroke symptoms begin is the key to a better recovery.

Most strokes are ischemic, or caused by a blood clot in the brain’s small blood vessels. The clot blocks normal blood flow to that part of the brain, and thus cells are deprived of oxygen. If it isn’t remedied quickly, the cells perish.

“Every minute after a stroke, two million brain cells die,” says Byron Merritt, stroke program coordinator at Community Hospital. Merritt emphasizes that many stroke patients who get to the hospital quickly can have a clot-busting drug administered to open up the vessel and restore normal blood flow. But patients must get there no more than four-and-a-half hours after the first symptoms arise.

When a stroke is suspected, the patient is rushed to have a CT scan, which determines the type of stroke it is. If it’s an ischemic stroke, clot-busting tPA (tissue plasminogen activator) can be given.


Derek Yonekura works on walking and balance at
Community Hospital’s Rehabilitation Services location
in Salinas.

Because quick action is of the essence, experts say that it’s vital for everyone to know the FAST signs of stroke — and if you see these, it’s time to act. FAST stands for Face, Arm, Speech and Time: the classic signs of stroke are facial droop, especially on just one side; an arm that drifts downward if the person is asked to raise both arms; and slurred or impaired speech. Any of those signs mean it’s time to call 911 — immediately.
Patients like Yonekura who have had significant challenges following stroke turn to the Inpatient Rehabilitation Unit (IRU). The typical stay is about two weeks, with a minimum of three hours of therapy a day.

Mario Ruiz, IRU director, says about 40 percent of the unit’s patients are dealing with the aftermath of stroke.

“Receiving intensive therapy right away helps rewire the brain from the ground up,” he says, and takes advantage of the brain’s neuroplasticity — the brain’s ability to change and adapt.

Yonekura says that as soon as he got to the IRU, he began receiving therapy, even though he couldn’t do much for himself.

“Somehow, they got me up in the walker and moved my legs for me,” he says. “They’re just an amazing group. They kept giving me encouragement.”
Yonekura had to relearn how to walk, and had to learn to eat left-handed.

“All the things we take for granted, I’ve had to learn all over again,” he says. After a few weeks in the IRU, he went home, and continued his physical therapy as well as taking adaptive physical education at Hartnell College. He also began walking on a treadmill at home with the help of a rock climbing harness he rigged to help hold himself upright.

Yonekura realizes he’s on the road to recovery, with miles to go. But his diabetes is now well controlled and he’s lost 30 pounds, reducing his risk for future strokes. He is grateful for the help he’s gotten and has even gone back to visit the staff at the IRU: “If not for them,” he says, “I’d still be in bed.”

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