The list of opportunities for women has been growing steadily for decades and the amount of chronicling and analysis the change has had on culture has managed to keep pace with them. It is more recent that the problems associated with and resulting from some of the opportunities are being recognized. As a way of example, once considered a manís disease, strokes now occur with about 40,000 more women than men each year and more than 60 percent of deaths from strokes occur in women.

The frequency of strokes may seem to be an unusual topic for a Fatherís Day column, but for me it really is not that odd. If I were to participate in one of the word association exercises common among psychologists, and the word stroke was presented, I am almost certain my response would be ó father. Thirty percent of my fatherís life he spent as a stroke victim. It also coincided with the entire time we shared together. Stroke is the No. 3 cause of death in the U.S., behind heart disease and cancer, according to a New York Times report. Approximately 150,000 people a year die and many more are left permanently disabled. That is what happened with my dad. For 22 years he struggled with trying to do everything with his left hand that he used to do with his right, and with walking with a decided limp.

Carolyn Poirot, a Fort Worth Star-Telegram reporter, defines stroke in laymenís terms as a brain attack, very much like a heart attack, except the blockage is in the brainís blood supply. It is caused by either a blood clot or a rupture in a blood vessel feeding the brain. Recognizing the symptoms and determining if a person is having a stroke is critical because with strokes a quick response is crucial, according to Dr. Roger Blair, medical director of the stroke program at Harris Methodist Fort Worth Hospital. He said the best results come from starting appropriate treatment in three hours or less. In Poirotís report, she identified three quick tests for determining if a person is having a stroke; facial weakness, can the person smile, or is the mouth or eye drooped? Can the person raise both arms? Can the person speak clearly, and understand what you say? If a person fails any one of these test she advises calling for medical help.

Much has changed in the way of diagnosis, treatment, rehabilitation and prevention of strokes since 1946 when my dad had his. There is a treatment that has been shown to save lives and prevent brain damage in strokes caused by a blood clot, but according to Dr. Mark Alberts, a neurology professor at Northwestern University, it is under-prescribed. The drug is tPA (a clot-buster drug) given by IV infusion or by a catheter. The New York Times report said many patients with stroke symptoms are examined by emergency room doctors who are uncomfortable deciding whether the patient is really having a stroke or another ailment. Many hospitals say they cannot afford to have neurologists on call to diagnose strokes and cannot afford MRI scanners, the most accurate way for the emergency room to diagnose strokes. Consequently, the one drug therapy that can most help stroke patients is prescribed only about 3 or 4 percent of the time.

Most of us who have had children matriculate through a public school system in the last several decades are aware of the significant strides that have been made in physical training, conditioning and rehabilitation. In the area of equipment alone, what is available on the market today was not even on the drawing board 50 years ago. The same applies with speech therapy. The largest frustration for my father, and as I look back, regret for me as a son, was my dadís difficulty with speech. So much of family history is learned through the verbal story telling of family members. I would love to have heard of his experiences from the first two thirds of his life and been able to conjure up a picture of the man before the stroke.

The most important advancement regarding strokes, however, has been our collective education on the role lifestyle plays in personal health. Most strokes would never happen if people took simple measures to control their blood pressure. It would have worked for my dad; it can work for yours and your mother as well.

Robert Brincefield is publisher of the Brownwood Bulletin. His column appears on Sunday. He may be reached by e-mail at