Jenn Bootsma had a lot going on in the summer of 2005. The Abbotsford native had just started her own aesthetics company, was going to school part-time, and had been spending time with a sick relative. With a booking that involved doing makeup for an entire wedding party, Bootsma woke up one morning that August already feeling somewhat stressed. But she knew something was seriously wrong when she literally fell out of bed.

“My leg was completely numb,” the 28-year-old Bootsma tells the Georgia Straight in a phone interview. “I crawled to my phone and called my mom and said, ”˜Something isn’t right.’ ”

Her mother, who lived nearby, came to pick her up and took her straight to the hospital, where Bootsma spent hours in the waiting room, then days as an in-patient, without any answers. After she was finally transferred to St. Paul’s Hospital and saw a neurologist, she learned that she had had a “mini” stroke.

Also called transient ischemic attacks (TIAs), mini strokes occur when a clot briefly prevents blood from flowing to the brain. According to the Heart and Stroke Foundation of B.C. & Yukon, symptoms only last for a few minutes or hours but are the same as those for a stroke and include sudden weakness in the face, arms, or legs; difficulty talking; confusion; vision problems; severe and unusual headache; and dizziness. Having a TIA puts a person at greater risk of having a major stroke and needs to be treated as a medical emergency.

Bootsma had another one in December 2007. This time, her speech was affected.

“I tried talking, and things just didn’t come out properly,” she explains. “I started panicking and rushed to the hospital.”

That Bootsma experienced mini strokes at such a young age isn’t so unusual given her health background: she was born with aortic stenosis, a congenital heart defect. At 13, she had open-heart surgery—only to be repeated six months later to repair one of the valves that was malfunctioning in the first place. Despite her history, she was still shocked to discover she’d had a stroke. And even though most strokes happen in people over age 65, she’s living proof that they’re not a health concern limited to the elderly.

Dr. Andrew Penn, the director of the stroke rapid-assessment unit for the Vancouver Island Health Authority, says that the causes of stroke in people under 40 are usually different than those in older people. Some of his younger patients have been weight lifters who tore blood vessels, while others have been men and women who overexerted themselves in the heat and became dehydrated—say, they ran a marathon—and a blood clot became dislodged and travelled to the brain.

“When young people have a stroke, they can sometimes almost be indignant and say, ”˜How can I have a stroke? I’m really fit.’ But it’s not the same mechanism that’s associated with the elderly,” Penn says in a phone interview. “Hardening of the arteries is a player, but it’s not the only player.”

Penn notes that in acute cases where someone is paralyzed and unable to speak—often it will look like he’s drunk—the damage can be reversed if a treatment called tissue plasminogen activator is given within four-and-a-half hours. He emphasizes that even though symptoms of a TIA are temporary, having one increases the chances of another stroke.

“It’s like a volcano: if it starts to rumble, it’s a serious sign it might blow up.”

What Bootsma took from her experiences is a lesson people of all ages can learn from: prevention is crucial and can’t be started early enough.

There are some risk factors that people can’t control, like family history and ethnicity; First Nations people and those of African or South Asian descent are at higher risk of stroke than others. However, there are several others that men and women can keep in check.

As Bootsma knows all too well, stress is one of them. Chronic or high levels of stress can cause people to be prone to developing atherosclerosis (narrowing of the arteries) or have higher blood cholesterol and blood pressure than others, three conditions that are in themselves risk factors for strokes. Signs of extreme stress include anxiety, headaches, and stomach problems.

The Heart and Stroke Foundation encourages several “stress-busting” techniques, including the first step of identifying the source of stress in order to manage it. Being physically active, talking to people about how you’re feeling, taking time for yourself, and taking holidays are other ways.

Not smoking is crucial to avoiding a stroke. Smoking—which nearly doubles the risk of stroke caused by a blood clot—contributes to the buildup of plaque in the arteries, increases the risk of blood clots, reduces the amount of oxygen in the blood, and increases blood pressure.

High blood pressure can damage blood-vessel walls, and very high blood pressure can cause blood vessels in the brain to burst, resulting in a stroke.

Achieving and maintaining a healthy weight can also make a difference. According to the Heart and Stroke Foundation, almost 60 percent of Canadians are overweight or obese. Even a slight reduction in weight—as little as 10 percent—can decrease the risk of stroke.

Eating well and exercising also reduce the risk of diabetes, which itself increases the risk of stroke.

Women have particular concerns when it comes to avoiding stroke. Oral contraceptives increase the risk of high blood pressure and blood clots, especially among female smokers. Pregnancy and childbirth can increase the risk of stroke by as much as 13 times. In these rare instances, strokes are usually the result of an underlying problem such as a pre-existing blood-vessel malformation, or eclampsia. Finally, the transition to menopause increases the risk of stroke, since the body’s production of estrogen—which protects the heart—slowly stops.

Bootsma is doing everything she can to avoid going through another TIA, including going to yoga, eating well, and taking time out for herself.

“It’s so important to take care of yourself,” she says.