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

Wednesday, February 15, 2017

JFK Johnson Rehabilitation suggests that side sleeping may increase risk of stroke

The mention of a homeopathic author theory as reason for this idea already is a total non-starter. I slept on my stomach with my head turned to the left
http://www.mycentraljersey.com/story/life/wellness/2017/02/13/jfk-johnson-rehabilitation-side-sleeping/97349016/

A new study by researchers at Edison’s JFK Johnson Rehabilitation Institute suggests a possible link between side sleeping and a heightened risk of stroke

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According to the Centers for Disease Control, nearly 800,000 Americans suffer a stroke each year, a medical event that will prove fatal for some 130,000 and cause one out of every 20 deaths nationwide.
Killing one American every four minutes, stroke is also a leading cause of serious long-term disability that costs the nation some $34 billion annually in healthcare expenses, not to mention the havoc it wreaks on the lives of those who have a stroke and their loved ones/caregivers.
While the medical community has long known that strokes are typically caused by either a blocked artery (known as an ‘ischemic’ stroke) or the leaking or bursting of a blood vessel (known as a ‘hemorrhagic’ stroke), a new study being conducted by researchers at JFK Johnson’s Center for Brain Injuries in Edison suggests that there may be a correlation between sleeping on your side and the risk of having a stroke.
Based on data collected from dozens of stroke patients studied over the past two years, evidence is mounting to suggest that a potential risk factor for stroke “might be as simple as the side you sleep on,” said Joanne Azulay, Ph.D., clinical neuropsychologist and researcher within JFK Johnson’s Center for Brain Injuries.


Testing a theory

Azulay said that she’s been fascinated with the sleep-stroke connection ever since she reviewed a book called "Side Sleeper Syndrome" by author and homeopathic practitioner George Swearington in 2012.
“I found it so intriguing — I was astounded by the information he shared on the range of potentially devastating side effects that can result from sleeping on your side and it made so much sense to me,” said Azulay, who sees hundreds of stroke patients annually through her practice and found that Swearington’s theory made her see her patients in a different way.
“In 2014, I started asking patients who’d had a stroke what side they sleep on and found that their answers correlated very strongly to the opposite side of the brain that their stroke had occurred on and the same side their weakness was on, known as ‘hemiparesis,’” she said, noting the medical fact that the side of the stroke in the brain impacts the opposite side of the body. “I also asked them to notice any swelling in their body and found a similar relationship between unnoticed progressive swelling and habitual ways of positioning their bodies for extended periods of time.”
After collecting data from 50 to 75 patients, Azulay and her colleagues decided to launch an official study to investigate a theory which she believes is “so simple and intrinsic that it’s almost insulting,” she said. “We spend one-third of our lives sleeping — why would we think that this process wouldn’t potentially impact our health and vascular system?
“The medical community believes that stroke initiates in the brain, but it might actually initiate in the body and result in the brain as a function of habitual activities that affect our vascular system and cause either a lack or sudden surge of blood flow,” Azulay explained.
Among the patients she’s studied so far (and with another 25 to 30 to go before she publishes her findings), Azulay said she’s documented “a 95 percent correlation between the side the stroke patient sleeps on and the side that experiences the weakness or paralysis” — the potential result of vascular changes that this repetitive behavior causes in the body over a long period of time which contribute to swelling, lack of sufficient blood circulation, or a surge of vascular flow with positional changes.
Azulay also has found that right-hand and left-hand-dominant side sleepers tend to prefer the passive (opposite) side of their body for sleeping and confirmed that she can often determine the side a patient sleeps on as soon as they walk into her exam room based on visible asymmetries in their musculature.
In addition to potentially causing or exacerbating one’s risk of stroke, the act of side sleeping, she said, can lead to a range of other common medical issues as well, including carpel tunnel syndrome, sciatica mimickers, neck and shoulder issues, and hip degeneration, all of which might be avoided or minimized by sleeping on one’s back or stomach instead.
“Dr. Azulay is a brilliant and out-of-the-box thinker with an interesting, back-to-basics theory and this is how many medical breakthroughs take place,” said colleague Brian Greenwald, M.D., medical director of the JFK Johnson Rehabilitation Center for Brain Injuries and a co-investigator on this research with Azulay. “Stroke is a devastating occurrence that leaves people debilitated, so anything we can do to help decrease the risk of stroke will benefit so many people while reducing national healthcare costs,” he said.
“There’s very little in the medical literature on this topic and much more analysis remains to be done, but this type of study poses no risk to patients and is something very interesting that’s absolutely worth investigating,” he added.

Modifying behavior

Based on the data she’s collected and its implications, Azulay shared her best tips to help optimize your sleep and reduce your risk of stroke and other health issues potentially caused by side sleeping:
  • Change Your Position: A left-side sleeper herself who understands how attached people can become to sleeping a certain way, “I noticed things like the numbing of my hand in the middle of the night or the swelling of my facial muscles when I woke up, so I trained myself to get off my side,” she said. “Unless you have a sleep disorder, I tell all of my patients to sleep on their back if at all possible or else on their stomach — both of which are positions which distribute weight more equally on all parts of the body. This is the way we were designed to sleep and can actually help us sleep better once we get used to it.”
  • Assess Your Mattress: “Mattresses have become so soft, fluffy, and comfortable today that they often make us sink into ourselves, which is dangerous,” Azulay said. “Ensure that you have a solid mattress and that you flip it every six months for even support.”
  • Be Observant: “Pay attention to long-term positions you hold, such as leaning on one side while commuting to work or resting in a chair or on a couch in a certain way for years and be aware of things that aren’t symmetric on your body,” Azulay said, noting that these can cause or reflect uneven pressure on the vascular system.
  • Take Control: “We have more power over our health than we realize,” Azulay said. “By being aware of and in greater control of our behavior, we can impact the length and quality of our lives more than we know.”

For more information

JFK Johnson’s Center for Brain Injuries is at 2048 Oak Tree Road in Edison and can be reached by calling 732-906-2640 or by visiting www.jfkmc.org. JFK’s Stroke Center was the first in the tri-state area to receive the Joint Commission Comprehensive Stroke Centers designation.

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