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:

Monday, May 29, 2017

Time is everything when it comes to strokes

More misrepresentations in reports on Stroke Awareness Month. A great stroke association president would make sure reporting on stroke was accurate.
My reply:
There really are no effective treatments in stroke. Even if you get tPA in time it only works to fully reverse the stroke 12% of the time. For stroke rehab, it is even worse, only 10% of patients fully recover. No hospital I have ever seen lists statistics on; tPA full recovery, 30-day deaths, stroke rehab protocols with efficacy ratings, full recovery rate. The awareness campaign should be that everything in stroke is a failure. The doctors are doing nothing in the first week when the neuronal cascade of death is occurring. I'm a stroke survivor and I worry that my children in 30 years will not have better stroke intervention results.
The difference between living with a severe disability and returning to independent activities after a stroke depends on time.
Health-care experts work to teach people how to recognize and react to someone showing signs of a stroke so effective treatment can take place in the window of time when the best possible outcome can be achieved.
Dr. Jorge Eller, Thomas Jefferson University cerebrovascular and endovascular neurosurgeon at AtlantiCare, emphasized during May’s Stroke Awareness Month how public education on strokes could save someone from long-term disability.
“We try to convey, every time, that strokes are potentially treatable,” he said. “With all the technology and understanding on strokes today, we can potentially completely reverse symptoms of stroke. However, time is everything. If they come to us too late, we may not be able to do that.”
Stroke, a lack of blood supply in the brain, is the fifth leading cause of death in the United States. It’s also a leading cause of long-term disability, according to the American Stroke Association.
The federal Centers for Disease Control and Prevention data show South Jersey counties lead the state in stroke hospitalizations, deaths and preventable deaths. Cumberland County had the highest rate, about 84 people per 100,000 dying from a stroke from 2013 through 2015.
Earlier this month, AtlantiCare Regional Medical Center’s City Campus became a Comprehensive Stroke Center — the highest designation given by the national joint commission to only a few hospitals in the state with extensive stroke care (not results)capabilities.
Eller tries to get patients, families and other health-care professionals to remember an acronym for signs of stroke: BE FAST. The acronym reminds people to look for loss of Balance, blurred or vision problems in the Eyes, droopiness in the Face, weakness or numbness in the Arms and slurred or garbled Speech.
The last letter, T, is for Time: People need to call 911 as quickly as possible when a symptom is present. Taking an ambulance to the hospital is key, he said, because paramedics can start immediate treatment and relay information to the hospital quickly.
“The symptoms could be from something else, but the bottom line is, until you know, you should think, ‘This could be a stroke,’ and get to the hospital to be evaluated,” he said. “Timing can be the difference between a small deficit one can live with versus a large deficit.”
Eller sees patients who come in immediately, and often can remove clots and restore blood flow to vessels in the brain for a good outcome, he said.
But some patients who wait too long.
When these people get to the hospital, Eller said, he may not be able to save brain vessels affected by a stroke, which can result in disabilities such as paralysis, chronic pain, speech disruption, memory weakness and emotional issues.
AtlantiCare experts often send local residents to the Bacharach Institute for Rehabilitation in Galloway Township for stroke rehabilitation.
Jessica Lewis, occupational therapist and co-coordinator of Bacharach’s stroke program, said she sees a range of people who come to the center to recover or improve physical and psychological functions and activities after a stroke.
“Within the first few weeks, we try to give them an intense rehab,” she said. “The goal is to try and recover from deficits they’ve experienced. It’s very time-sensitive.”
Some patients her stroke team treats — some as young as 18 — work on getting back to the physical and mental levels they were at before their stroke, she said.
Others work on walking, coordination, getting dressed, moving the upper extremities, swallowing, vision and other impairments to get the best improvement possible if a stroke caused a long-term disability, she said. Therapists have been using graded motor imagery therapy to “trick” the brain, using a mirror, into improving function in limbs affected by paralysis from a stroke.
Lewis said she and other rehabilitation experts emphasize the education component of identifying strokes, especially for patients at risk of future strokes.
“Once I worked with adult stroke patients, I fell in love with the progress they can make, and they work so hard because they want to get better,” she said.

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