Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, November 29, 2016

What is life like after a stroke? Rehabilitation and recovery following a stroke

I hate these 'happy talk' articles. Obviously with everything working perfectly in stroke there is no need for any further research to help stroke survivors.
https://lasvegassun.com/native/sunrise/2016/nov/28/what-is-life-like-after-a-stroke-rehabilitation-an/
According to the Centers for Disease Control and Prevention, every year more than 795,000 people in the United States suffer strokes, and nearly 130,000 of them die. Strokes also are a leading cause of serious, long-term disability with an array of short-term and long-term effects. These include speech problems, difficulty swallowing and mobility issues.
However, it’s important to remember that prevention efforts and rehabilitation can help lessen the impact of strokes.
“An important aspect to remember about strokes is that there often is improvement. In general, 50 percent of whatever deficits are present at the time of the initial stroke are resolved within one year,” said Phaniraj Iyengar, MD, Vascular Neurologist and Stroke Medical Director at Sunrise Hospital and Medical Center’s Nevada Neurosciences Institute.
While the aftereffects of a stroke can present many challenges for both patients and their families, recovery is possible for hundreds of thousands of stroke victims.
Common aftereffects of a stroke
“In general, the deficits from a stroke could be described similarly as a real estate transaction. Location and square footage determine the price of the property. For a stroke, it is the location in the brain and the size of the brain damage that determine the aftereffects,” Iyengar said. The American Stoke Association breaks down the possible aftereffects based on the location of the stroke.
For some people, the physical damage suffered after a stroke can be reversed over time. For others, the damage may be permanent.
“Strokes can be devastating. The patient may not be able to function independently and may need to live in an assisted-living residence for the rest of his or her life,” Iyengar said.
He also noted that the patient, regardless of the severity of his or her stroke, may experience an ongoing sense of emotional discomfort even after physical symptoms have ceased.
“There are two ways to look at the effects of a stroke: One is what is obvious to others, such as paralysis, and the other is felt only by the patient suffering from it. Sometimes, outwardly a person may seem completely normal, but they can have a sense that something is different or missing,” Iyengar said.
Because our brains control our behavior and emotion, the patient may feel unexpectedly different afterward. The emotional and behavioral effects of a stroke can include forgetfulness, carelessness, irritability, confusion, anger, anxiety and depression.
A stroke on the brain’s right side can cause...
• Paralysis on the left side of the body
• Vision problems
• Quick, inquisitive behavioral changes
• Memory loss
A stroke on the brain’s left side can cause...
• Paralysis on the right side of the body
• Speech/language problems
• Slow, cautious behavior changes
• Memory loss
The brain stem
Depending on the severity of the injury caused by a stroke located in the brain stem, it can affect both sides of the body and leave the patient in a “locked-in” state, which is when a patient is unable to speak or move anywhere below the neck.
Recovering from a stroke
Because the effects of a stroke vary greatly between individuals, there are multiple avenues of recovery.
“All patients need to be monitored in a specialized stroke center that can evaluate and treat complications. This is especially important because the patient may continue to deteriorate in the first three days before he or she stabilizes,” Iyengar said.
Once the patient stabilizes, an aftercare treatment plan can be made. “Aftercare treatment comes under the broad umbrella of rehabilitation services, including speech, physical and occupational therapies,” Iyengar said.
The goal of any rehabilitation service is to get the patient back to leading a normal and independent life, which can mean getting the patient comfortable with a new normal.
Rehab therapies can help reteach patients how to perform tasks and/or teach them different ways of doing things considering their new limitations. Ongoing medication, counseling and support groups also may be necessary to help the patient cope emotionally.
Prevention and recognition
Strokes can often be prevented by leading a healthy lifestyle. “A significant number of strokes are caused by modifiable risk factors, so addressing those risk factors can go a long way toward preventing a stroke,” Iyengar said.
Modifiable risk factors include management of treatable diseases such as hypertension, diabetes, high cholesterol, heart disease, smoking and substance abuse.
Furthermore, recognizing a stroke and acting quickly to receive medical treatment can help save the life of the patient and lessen the extent of the brain damage.
Because the majority of strokes that occur are first-time strokes, it’s especially important to be able to identify the symptoms for yourself or loved ones, even if you don’t think there’s a risk.
Learn to identify stroke symptoms
BE FAST is an acronym to help identify a stroke as it occurs.
B: Balance — Does the person have a sudden loss of balance or dizziness?
E: Eyes — Has the person suddenly lost vision in one or both eyes?
F: Face — Does one side of the face suddenly droop?
A: Arms — Does one arm suddenly drift downward when both arms are raised?
S: Speech — Is the person suddenly slurring his or her words, or seem confused? Can he or she repeat a sentence correctly?

My reply:
 This is all just 'happy talk'. No discussion on all the problems/failures in stroke.
1. 12% full tPA efficacy is a failure.
2.  10% full recovery is a failure.
3. No publicly available stroke protocols with efficacy is a failure.
4. Nothing to cure spasticity is a failure.
5. Nothing to cure fatigue is a failure.
6. Nothing to stop the neuronal cascade of death in the first week is a failure.
7. Not able to objectively and accurately identify stroke in the ER is a failure.
8. Nothing to prevent dementia is a failure.

2 comments:

  1. "In general, 50 percent of whatever deficits are present at the time of the initial stroke are resolved within one year."

    So what's 50% of left-side hemiparesis? Does the answer to that start, "Every stroke is different..."?

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    Replies
    1. I'd have to say he is pulling statistics out of his ass. I hated the real estate connection because doctors don't know exactly where your stroke was.

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