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

Friday, June 16, 2017

A device designed for wake-up strokes: a sleeping cap with EEG monitoring could pinpoint the time a stroke happened

Full story here: I'm betting the mentors they used did not describe all the problems in stroke needing fixing.
https://www.washingtonian.com/2017/06/06/maker-movement-speeding-innovation-health-care-health-for-america/
I'm only copying the relevant sections below:

To get the fellows up to speed, Health for America’s current class kicked off with two-week crash courses on strokes. They listened to MedStar guest speakers, interviewed patients, spent a day in the emergency room, and went on rounds with clinicians.
“I basically turned these four bachelor-level fellows with no clinical experience into neurologists in 24 hours,” jokes Dr. Michael Yochelson, chief medical officer of MedStar National Rehabilitation Networks and one of three physician mentors MedStar has paired with the fellows.
The fellows also needed to develop empathy. In the maker movement, innovation often happens when someone is seeking a solution to a problem he or she is personally experiencing. So the fellows spent three days walking around with leg braces, canes, and slings to simulate the experience of stroke survivors, followed by two weeks on a stroke-survivor diet.
“Dr. Yochelson gave them a sample medication list so they could see that some of these patients are being discharged with up to 15 medicines,” says Health for America director Mandy Dorn. “Obviously, they weren’t having to take medications, but one nut represented one pill, one Skittle represented another, and they were literally thinking, ‘Okay, if I got discharged with 15 medications, how would I keep track of this?’ ”
Next came the “ideation” phase, during which the fellows generated a spreadsheet of more than 100 ideas tackling different stroke issues that had come up in their talks with physicians and patients. With the help of their mentors, the ideas were narrowed to two winners: Galva, the name they gave patient-education boxes that could be distributed to stroke-rehab patients and their caregivers, and KnightCap, a sleep mask with an EEG monitoring system meant to detect a stroke that happens while someone is sleeping, known as a wake-up stroke.
Wake-up strokes are an area ripe for innovation. They make up one in five acute strokes, and there’s a lack of treatment options.
“One of our physician mentors highlighted the problem of wake-up strokes,” says Health for America fellow Stephanie Guang. “The primary treatment for stroke is tissue plasminogen activator (tPA), and that has to be administered within a four-hour window. The alternative, mechanical thrombectomy, which is a surgical clot retrieval, has to happen within six hours. Every patient who is a wake-up-stroke patient—meaning they wake up and they’ve had a stroke in the night—is automatically disqualified for these treatments because they can’t determine whether they were in this window.”
Next came the prototypes. Rather than waiting for a large manufacturer to produce their models, the fellows constructed the models themselves. One fellow, Michael Mezher, has three 3-D printers at home—he uses them for side projects—so he was able to print the box that holds the EEG monitoring system on the top of the cap, along with a stand for KnightCap. Guang, who’d sewn before in a fashion-design competition, stitched together the elastic-and-fabric cap. Together they whipped up multiple prototypes that they first tested on willing patients for comfort and ease of use. Later, the caps were also hooked up to EEG monitoring.
“One of the first mottos we heard when we came into this fellowship was the ‘fail fast’ motto—the idea where you want to rapid-prototype and quickly get feedback from users very early on,” says Guang. “I admit [rapid prototyping] felt uncomfortable at first, coming from a traditional engineering background where you don’t want to give someone something that’s not perfect or only half functional.”
The goal is for KnightCap to be worn in bed by those at risk of a stroke—a risk that’s higher among those who have already had one. The EEG monitoring will detect signs of a stroke and, if it occurs, create a time stamp and have a built-in alarm wake the wearer so he or she can get the time-sensitive treatments.
KnightCap is by no means ready to be put into practice—it would require large clinical trials to prove its reliability before being doctor-recommended. But for an old problem, it’s a potential new solution that didn’t exist before a couple of college grads put their heads together last September.
“I was a skeptic at first, thinking these are people within three years of graduating college, no substantive experience in this space—what do they know? And I’ve come 180 degrees,” says Smith. “If you give them the right structure and the right mentors and the right experiences, they could perhaps invent the next thing in health care.”

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