TOLEDO - She could tell this was a different kind of headache.

Kim Carter was finishing her shift at Meskwaki Bingo Casino Hotel on April 21, 2004, when she felt the strong pain. She became dizzy, and her boss offered to call the paramedics.

It's a good thing he did: Carter was having a stroke.

She doesn't remember much else, until she woke up in the helicopter on her way to Iowa City.

"I remember thinking 'Oh sure, I've been waiting all this time to fly again," said Carter, who loves the view from airplanes.

Her next memory is of the emergency room doctors asking her if she had any children. She does. A daughter, Jenniffer, who was 15 at the time.

"Come on, we don't want to lose this one," one of the doctors responded.

They didn't. But she had a tracheotomy and was on oxygen for a month.

She couldn't talk, but she had other means of communication. She lived in a children's home at age 12, where a deaf girl taught her some sign language. She signed her needs to Jenniffer, who communicated them to hospital employees.

Carter's type of stroke is known as a pontine stroke, where the hemorrhage occurs in the brain stem. Though there are five million stroke survivors in the United States today, pontine strokes are rare - and surviving them is rare, too.

In May, she was moved to On With Life, a rehabilitation center in Ankeny that specializes in brain-injury patients.

After so much time with a tracheotomy tube, she had to relearn how to breathe and talk.

She also had to relearn how to walk. She began with a Johnny Jump Up-style machine that exercised her legs. Later she pulled around her wheelchair with her legs instead of her arms and finally began marching in place.

"They let me pick the music I would march to, and I chose Celtic music, because I'm Irish," she said, laughing.

In October, her insurance would no longer cover her treatment, and she returned home to Toledo.

But Carter's struggle to regain her former life had just begun.

The stroke strained relations with Jenniffer.

"I think my daughter felt robbed," Carter said. "We used to go shopping together a lot, and all of the sudden I couldn't do that. It's like when someone dies, and you're almost angry at them."

Carter said her daughter, who is now a mother herself, is doing better with the situation.

The left-handed Carter, who loved to draw before her stroke, also had to learn how to do everything - from dishes to sketches - right-handed. The left-side paralysis has faded, but she still has little function in her left hand. She relied on friends to pick up her medications, help take out her trash or get her to where she needed to be.

"I knew there was help out there, but I didn't know how to get it," Carter said.

She went to see Steve Goshon, a case manager with Tama County Case Management in March 2007. Goodwill was one of the first things he suggested.

That is when she met Donna Robinson, program coordinator, and Nicole Winther, the program manager at Goodwill Industries of Northeast Iowa.

The three woman have an easy rapport as they sit in Carter's living room. They tease each other like old friends as they talk about Robinson's efforts to help Carter to walk without stiffening her left leg. She tackled little hills and curves at first to help with her balance.

"Do you ever go out in the yard and close your eyes and turn in circles? It's like that, but only with one leg," Carter said.

Robinson said Carter has made progress.

"Now I'm the one going, 'Let's take a break,'" Robinson said.

Carter's program was approved by a physician. What Robinson does is not physical therapy; it's what Goodwill calls consumer-directed attended care. Workers do things their clients are physically unable to do. She began in the supported community living program that works on goals and skill development.

As far as goals go, Robinson is encouraging Carter to take care of herself first.

"She has the biggest heart for the community which should never stop, but we want to work on goals for Kim, too," she said.

Carter helps others with disabilities in her peer-to-peer group, teaching them how to make crafts and doing sketches for them. She also has a list of goals for herself: driving again, working again - not at her former job, the stress of which triggered the stroke, but with computers. And she'd love to continue drawing. She takes out one of the well-worn sketch pads on her end table. It is filled with sketches of family members and her dream house.

Four years after her stroke, Carter has wisdom to offer those in her situation:

"Do not deny to yourself or anyone the symptoms. It doesn't mean they're any less of a person because they have a stroke."

Carter herself is proof-positive of that.

"It was frustrating, but it was a challenge, too. I'm kind of one of those people," she pauses, laughs. "Don't tell me I can't do something."

Contact Laura Grevas

at (319) 291-1423

or laura.grevas@wcfcourier.com.