CHARLESTON, W.Va. -- Last fall, Steve Kersey went from running his first Tough Mudder -- a 12-mile military-style obstacle run that calls itself the "the toughest event on the planet" -- to learning to walk again.
"I thought it was in the best shape of my life, or pretty close anyway," he said.
Three weeks after the race, the 28-year-old Sissonville native was at Charleston Area Medical Center, unable to walk or feel the right side of his body.
"A stroke? I didn't even know what a stroke was," Kersey said. "A stroke was for out-of-shape older people. But then they tell me that's what it was."
Nov. 4, 2012, started out like any other Sunday for Kersey and Keara Stewart, his girlfriend of nearly four years.
Stewart went to take a shower and heard what sounded like Kersey snoring. Impossible, she thought, because she had spoken to him seconds before.
"I thought he was gone ... 'cause I couldn't wake him up," Stewart said. "I was trying to shake him and he wasn't responding at all. Then I went and called 911."
Kersey had come to by the time medics arrived. He recalls feeling pressure on his chest and wondering what happened.
"My first thing that I thought was that I was shot or that I shot a home intruder and I was shot," he said. "That's what it felt like. It was dead weight on me."
He had trouble putting words together and couldn't feel the right side of his body.
Stroke is a leading cause of death in the United States, according to the Centers for Disease Control and Prevention.
Nearly 130,000 Americans die from a stroke every year. And while the risk increases with age, strokes can happen to anyone.
Each year, CAMC treats around 650 stroke patients from all over Southern West Virginia, stroke program coordinator Deborah Rectenwald said.
The usual patient is 60 years old or older, but about 10 percent are younger than 45, she said.
Exercising and eating right can help prevent strokes, she said. The three biggest risk factors for stroke are high blood pressure, smoking and high LDL or "bad" cholesterol.
Obesity, diabetes, physical inactivity and excessive alcohol use can be other factors, she said.
Rather than his lifestyle, Kersey's stroke was partially caused by a small hole, called a patent foraman ovale, in his heart. The hole, a flap between the heart's two upper chambers that typically closes at birth, can allow a blood clot from one side of the body to travel to the other side and onto the brain, causing a stroke, according to the National Stroke Association.
Doctors at Cleveland Clinic, where Kersey had heart surgery to repair the PFO, told him 20 percent to 25 percent of people have them and fewer than 1 percent of those who have a PFO have problems.
While strokes are rare in young people, if a person under 45 has a stroke, half the time it's related to the PFO, Kersey's doctors told him.
"I wish I could have hit the lottery with those odds instead of this," Kersey said.
Kersey stayed in the hospital for nine days after the stroke.