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Recovering from a stroke, Milwaukee Symphony's Mark Niehaus encourages people to do 'simple things' to reduce risk

Milwaukee Journal-Sentinel 3/29/2023 Jim Higgins, Milwaukee Journal Sentinel

On Nov. 18, Milwaukee Symphony president Mark Niehaus was eating dinner at home with his girlfriend, Stacey Schmidt. Suddenly, his right hand didn't work. 

"I couldn't pick up my drink," he said. 

Then his speech became slurred.

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He was having a stroke. 

Niehaus, who recently turned 53, is sharing his story to encourage other people, especially those his own age, to do simple things that can reduce the risk of stroke, including eating healthily, exercising regularly, having annual doctor visits and taking prescribed medications. 

More than 795,000 people in the United States have a stroke each year, according to the Centers for Disease Control and Prevention. 

RELATED: Take two minutes to learn stroke symptoms, Racine survivor and fantasy novelist urges people

Niehaus recognized the symptoms. His years as a Boy Scout leader meant "I have had an insane amount of first-aid training," he said, including wilderness first aid for back-country emergencies. He knew time was crucial, because some anticoagulants are only effective for a limited time after a stroke begins.

Fortunately, he lives near Ascension Columbia St. Mary's Hospital Milwaukee. Schmidt drove him there. "So I was in the emergency room hooked up within 10 minutes," he said. 

After a CT scan, MRI and other tests, Niehaus talked with a neurologist through a video screen (the specialist was elsewhere at the time) about a course of treatment. Niehaus said his emergency happened during a lull in COVID-19 admissions; a month earlier and a month later, the hospital was inundated with pandemic patients. 

He spent four nights in the hospital, basically "to get my blood pressure back down to something within the realm of normal," he said. 

Niehaus had an ischemic stroke, the most common kind of stroke. A clot disrupted blood flow on the left side of his brain, affecting his right hand and right side of his face and tongue, hampering his speech and swallowing. The big test for him, he said, was, "can I use chopsticks with my right hand?" When he first got to the hospital, he couldn't touch his fingers together.

"I sort of joke (that) every day in the hospital, I got a finger back," he said. 

As soon as he could, Niehaus began FaceTiming people in his life rather than calling them. He was concerned they would think he was "incapacitated beyond belief." Strokes are scary, so he wanted to reassure people, he said. (I received one of those FaceTime calls. His speech was a little slurred, but I could still understand him.) He admits, though, that he underreported the severity of this medical incident to his son. 

'It's my fault,' Niehaus says

"The important part of the story is it's my fault," Niehaus said.

High blood pressure and high cholesterol levels run in his family, he said. He was taking medication for his blood pressure, but it might not have been the right fit. But he didn't know that because he skipped an annual physical during the COVID-19 pandemic. 

His stress level was high, too. As CEO of the Milwaukee Symphony, he had shepherded the organization through a campaign that raised more than $90 million to convert a former movie palace into its new home, the Bradley Center Symphony — only to open the new concert hall in a pandemic when performances were impossible. Audiences have returned but not at the capacity the MSO forecast in its planning. 

MSO president Mark Niehaus draws laughter from violist Samantha Rodriguez during the Symphony Soiree in 2019. © Jonathan Kirn, Milwaukee Symphony MSO president Mark Niehaus draws laughter from violist Samantha Rodriguez during the Symphony Soiree in 2019.

Niehaus said leading the MSO is not simply a job to him. He joined the organization half a life ago, in 1998, as a principal trumpeter. "This is my family. So through COVID, I felt like I had to take care of my family," he said. "Like, it was my job to make sure my people were OK. Musicians, staff, everybody. So that was a huge — and continues to be a huge — load on my shoulders."

He felt pressure, but what he could not feel were effects of hypertension on his health. "It's not something that manifests itself in physical symptoms. So it's very easy to pretend like it doesn't exist," he said.

In the hospital after his stroke, Niehaus worked with occupational and speech therapists to recover his functionality. Speech therapy consisted of finding the words that tripped him up the most, and then saying them a lot. 

"That sounds super simple, but your brain needs to relearn how to do things," he said. One of his words was interstitial, which he still repeats over and over today. "It's one of my words that helps me get all of the syllables in." 

Being a musician helped him with occupational therapy. When he didn't write down her instructions for an exercise, his OT was skeptical. But he practiced the movements diligently and precisely for several days. Doing simple actions over and over again to make incremental progress was something he was used to doing as a musician, he said. 

Making changes, understanding limits 

After his stroke in November, Niehaus expected to be on leave about six months to recuperate. But in January, his longtime colleague Susan Loris, the MSO's No. 2 executive and interim leader during his absence, died of an apparent heart attack. She was 52, just like Niehaus when he had his stroke.

Niehaus was as shocked as everyone else. He'd texted her a joshing message not long before her death.

"It's not fair," he said. "I should have died, not her."

If his stroke hadn't forced him to make changes, maybe he would have died, he thinks today.

Her death staggered an organization still coping with pandemic complications.

"I think we didn't touch her office for at least two or three months," he said.

So Niehaus returned to work in January. His blood pressure numbers and test results indicated it was safe to do so. But his brain was still healing.

"One of the things that happens when you have a stroke is you're tired. … Your brain is relearning. It's like you're taking a trigonometry test all day long," he said. Niehaus would work five or six hours, then go home zonked. 

In the hospital, his neurologist was optimistic about his prognosis. "Take your pills, man," the doctor told Niehaus. Today, he takes several medications to lower his blood pressure and reduce the threat of another clot: a statin, to lower his cholesterol level; a diuretic; a beta blocker, a calcium channel blocker and an angiotensin II receptor blocker, all of which work to relax blood vessels so the heart does not have to pump so hard. He hopes to wean himself off the beta blocker.

Niehaus takes his blood pressure twice daily and records it. On the day we talked, he recorded 104/61. 

Living alone after his son went away to college, Niehaus "was eating too much sugar," he admitted. Now he gets low-fat meals delivered by a service. "They're actually pretty good," he said. He's largely cut out caffeine; before his stroke, he was pounding coffee, he confessed.

Milwaukee Symphony president Mark Niehaus checks in with Mia Kogler during pre-concert activities before the Milwaukee Symphony's April 3 sensory friendly concert for people on the autism spectrum or with a sensory sensitivity, © Jonathan Kirn, Milwaukee Symphony Milwaukee Symphony president Mark Niehaus checks in with Mia Kogler during pre-concert activities before the Milwaukee Symphony's April 3 sensory friendly concert for people on the autism spectrum or with a sensory sensitivity,

Never a big drinker, he has switched his adult beverage of choice from sugar-laden rum and coke (which Loris used to tease him about) to red wine. He also joined an athletic club, where he exercises regularly. 

He pondered the timing of his stroke, coming after his son had left for school and after the symphony's new home was complete — two major pieces of life business. While doing so, a friend recommended Ram Dass' book "Still Here: Embracing Aging, Changing, and Dying," written after the counterculture guru Dass had a major stroke. 

On a visit to his hometown of New Orleans, Niehaus listened to the Ram Dass audiobook while taking a cruise to Mexico, Honduras and Belize, an impulse decision inspired partly by his compulsive rewatching of "Love Boat" episodes during the pandemic. (Niehaus said he identifies with the fictional Capt. Stubing: "Moderately overwhelmed bald guy trying to keep a ship full of characters afloat.")

He noticed that many people on that cruise were using scooters or had mobility problems. "I don't want to be incapacitated that way," he said. 

Niehaus' midlife medical crisis hasn't led him to quit his job and run off to Tahiti. Instead, he's grasped the humbler truth that he can't control, take care or fix everything at the symphony. "I'm not that powerful," he said. Now he understands "I make the best decision I can with the smart people around me. And I hope for the best."

Also, he knows he must take care of his own health before he can help anyone else. 

If he were addressing a roomful of men his age, his message would begin this way: "Chances are half of you haven't been to the doctor in the last several years." 

Most of us have some medical concern that needs attention, Niehaus said of his age group. All day long, doctors see people "who could have prevented things but didn't, and now they're playing catch-up."

Contact Jim Higgins at Follow him on Twitter at @jhiggy.

Stroke signs and symptoms 

signs of stroke

The CDC urges people to remember F.A.S.T.:

Face: Ask the person to smile. Does one side of the face droop?

Arms: Ask the person to raise both arms. Does one arm drift downward?

Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

Time: If you see any of these signs, call 911 right away.

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This article originally appeared on Milwaukee Journal Sentinel: Recovering from a stroke, Milwaukee Symphony's Mark Niehaus encourages people to do 'simple things' to reduce risk

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