HOUSTON -

It is the number 4 cause of death in the United States, but many people do not know the warning signs and the impact of a stroke until its too late.

A stroke is essentially the lack of blood flow to a particular area to the brain.

The stroke can be caused by two main reasons. Either you may have a clot that may go up to the blood vessel and produce a blockage of blood flow, or you could have a rupture of the blood vessel that could create some hemorrhage and could cause bleeding.

Houston has some of the best hospitals in stroke acute care and rehabilitation. St. Luke's Episcopal Hospital is a primary stroke certified facility and rehabilitation center.

"Our doctors and nurses are trained to recognize and treat stroke patients," said Dr. Jose Suarez, who is the Director of Strokes and Critical Care at St. Luke's Hospital.

According to the American Stroke Association you can lose up to 2 million brain cells every minute during a stroke.

"It is very critical to get the patient into the emergency room as soon as possible," Suarez said. "The first hour is very very critical."

John Gilmore, a program director at Houston Community College, was in good physical health when he was hit with a massive stroke to the right side of his brain.

"Tuesday night I came home, got ready for bed, and woke up just like any other day of the week," said the 65 year old. "When I tried to get out of bed, that is when I realized something was wrong. My whole left side wasn't working, but my right side was still functioning. So I dialed for help, and that's when I realized I couldn't talk."

Gilmore was rushed to St. Luke's and soon found out he was having a stroke, which took away his ability to walk, move his lips, mouth, and tongue to speak, and his ability to swallow.

After his MRI, doctors realized that this wasn't the first time he suffered through a stroke. X-ray scans revealed an earlier smaller stroke to the left side his brain.

"There are times when people don't realize they are having a stroke, because the symptoms do not produce pain," said Suarez. "So people can contribute their symptoms to old age, when in fact they need to see a physician."

Warning signs of a stroke include a drooping face, slurred speech, numbness or tingling, and dizziness. Less common signs are nausea, severe headaches, and double vision.

According to the American Stroke Association, 80 percent of all strokes are preventable, and that is why it is also important to know the risk factors.

"Long standing high blood pressure, diabetes, patients that smoke, and even elevated blood cholesterol are some of the most common risk factors," said Suarez. "Even if patients control everything, the risk isn't going to go down to zero, but it could be significantly reduced to the point that if they were to have a stroke it may not be severe."

Gilmore went through three feeding tubes, a countless number of test and procedures at the hospital. Three weeks after he had his stroke, he was able to swallow and eat solid foods, but most importantly he was able to walk out of the hospital.

Gilmore's speech therapists worked heavily with him on learning how to swallow again, and learning how to use his verbal articulators to speak.

"It's not easy therapy to go through," said Kayla McCoy, who is a speech pathologist at St. Luke's. "His words are there, his muscles just couldn't move to get them out. But the more repetition we do the better. We have to retrain the brain. You've talked your entire life and all of the sudden in a moments time that ability is gone from you, it can be a hard hill to climb but he is persistent to get on top."

During his treatment at St. Luke's, Gilmore had several session with speech pathologist Kristi Vidaurri as well.

"If you're working with only 50 percent of your mouth, you need the other half to work overtime," said Vidaurri.

Ironically enough, Vidaurri created a method called the "Dominique Sachse Approach," which focuses patients on their articulation.

"I literally tell them to turn on the news and watch KPRC Local 2, and I tell them to listen to Dominique speak," said Vidaurri. "Her articulation is phenomenal. I've been here for almost 6 and a half years and she has helped so many of my patients."

After Gilmore was discharged from St. Luke's Hospital, he is continuing his recovery care at TIRR's out-patient rehabilitation facility. His speech is developing with repetition.

"This is different season for me, but I know it is all apart of my journey," said Gilmore. "Even though I was alone when I had my stroke, I know God was there with me. I know He will be with me during my recovery as well."

Gilmore now has a tight schedule with 6 sessions of therapy a week, and strength training at the gym.

"The stroke initially took so much from me, but I was given back so much more," said Gilmore.

To learn more about the risks and warning signs of strokes, or to hear from other survivors, visit this website.