Esmeralda Santiago, the acclaimed Puerto Rican author, suffered a stroke in January 2008 while completing her epic novel "Conquistadora." The effect of her stroke was the development of a condition known as aphasia, which devastated her ability to read and hindered her capacity to produce written language.

The initial indicators (drooping face, weakness in limbs and disruption in speech) were absent. She woke that January morning "feeling kind of off" and very tired, but fairly normal. Nonetheless, the thought that she may have suffered a stroke came to her, and she decided to videoconference with a friend in Rome, expecting that the friend would be able to tell if there was something wrong with her.

Her friend determined that she appeared normal after prompting her to answer a variety of questions, including the name of the president, and requested that she say the alphabet backward, which Santiago couldn't do, but neither could her friend.

Santiago determined that the long hours of writing had stressed her mind and body, so she opted to take a day off. She went to the movie theater, relaxed, cooked a meal and watched television, feeling normal except for her pressing exhaustion.

The next morning, Santiago woke ready to write, but couldn't understand the words on the screen. Her manuscript, which she'd been working on just a day prior, "looked like gibberish." She quickly reconnected with her friend in Rome, who told Santiago that she was now speaking slower than usual. Santiago then called her doctor, who told her "get in here immediately."

When she arrived she was immediately sent for a CT scan, where it was confirmed that she had indeed experienced a small stroke. And while Santiago had been made aware of the physical event, she didn't understand the seriousness of the situation until she was admitted into the hospital and placed in the ICU.

Where strokes are concerned, time lost is brain function lost. The longer a decrease in blood flow persists, the likelier it is that brain tissue will die and there will be permanent damage. This is particularly true when treating ischemic strokes with the clot-bursting drug tPA, tissue plasminogen activator. The longer sufferers go without the corrective drug, the more likely they may not return to normal function.

Santiago had experienced a blockage in the blood vessel that supplies the Wernicke area, the part of the brain that's involved in the understanding and control of written and spoken language. Her aphasia progressively worsened, and she wasn't able to understand anything written in English or Spanish.

No, Santiago didn't experience the muscular issues normally related to strokes, but as a person who lives in words and the use of language, not being able to read was particularly devastating. Santiago, who lamented not having read "War and Peace," knew that not being able to read was no small incapacity, and she feared that the damage would affect her for the rest of her life.

She learned that as recovery occurs, damaged cells are restored, and the brain creates new cells as new things are learned and parts of the brain that didn't experience damage take on the functions of the damaged parts.

Eventually, Santiago headed to the library, as she once had when she was a newly arrived Spanish-speaking teenage immigrant from Puerto Rico. She picked up a variety of books to familiarize herself with the written word, "starting with the alphabet books, then the ones with whole phrases, then whole sentences and paragraphs, and finally to chapters and then books."

Her tenacity paid off. Just six months after her stroke, she opened Charles Dickens' "Bleak House" and burst into tears because she could understand most of it.

Today, she estimates that her reading ability is at 98 percent and her Spanish ability is at 80 percent. She continues to work toward her recovery, and feels no shame about turning to the dictionary and sounding things out. She's also read "War and Peace." That said, Santiago's writing process is more labor-intensive and proceeds more slowly. She produces about 300 words a day, 10 times fewer than her previous 3,000 a day.

Unlike typical stroke victims, Santiago wasn't overweight, was never a smoker, was physically active and only drank on holidays, but she became far more likely to experience a stroke after being treated for a heart condition. High blood pressure is the most common risk factor for all types of strokes. But diabetes, high cholesterol, poor diet, lack of exercise and being overweight are also prime factors.

According to statistics, approximately 800,000 Americans have a stroke each year, and 130,000 Americans die from a stroke. Strokes are the primary cause of long-term disability in the U.S. and it's the fourth leading cause of death. Approximately 87 percent of victims experience ischemic strokes; the rest are hemorrhagic.  

Please call 911 if you or someone you know might be experiencing the warning signs of a stroke. To learn more about strokes, visit the National Stroke Association, the American Stroke Association and Neurology Now.