Thursday, February 24, 2011

Opinion on Stroke Protocol part 1

I have been trying to come up with a comprehensive therapy protocol even though I am not medically trained because no one else seems to have done it or seems to care.
I leave the initial clot-busting or bleed stopage to the medical staff where it belongs. I was getting close to acute rehabilitation ideas for hospital stay use. This is absolutely necessary since I would compare the current acute stroke rehab to the civil war when the process was if you were injured in an extremity it was amputated and you were left to fend for yourself. Similar to today where if you are lucky you get tPA to remove the blockage or surgery to stop the bleeding and then are pretty much left to your own devices. But I did just find one doctor who has done a lot of thinking on acute stroke rehab and would like to publicize it more to see if it can be vetted. None of this would be helpful to me since I am now in the chronic phase and I'll talk about that rehab in another post.
Read up on Dr. Lewis Clarke
especially his Clarkes' Stroke Protocol and WHAT_IS_NEUROGENESIS
selected sections are below, but read them all on the link provided.
It's time to adopt a new emergent treatment plan for strokes that includes:
a. intervening in the chemical cascades that result in neuronal destruction occurring during the evolving ischemia; and
b. maximize local vasodilation to reperfuse this brain tissue; and
c. to bind receptors such as the NMDA receptors which will continue to propagate neuron death even after blood supply is restored; and
d. to reduce the free radicals released in enormous amounts during the stroke which continue to destroy more neurons and glia; and
e. to utilize biochemical mechanisms which minimize the damage resulting from the Ischemia-Reperfusion sequence.
These ongoing processes are the reason that the patient comes in initially with a weak arm and within 24 hours, the entire hemibody is paralysed.
The emergent treatment plan should focus on the following:

Stop the Cascade

v Increase Beneficial Tissue Perfusion

v Reduce Membrane Oxidative Potential

v Decrease Inflammation and Cytokine Production (IL-6, TNF-alpha)

v Block NMDA Receptors

v Block Platelet Activation Caused by Inflammation

I didn't see fish oil but you can read about that possibility in one of my posts. All you medical personnel start critiqueing and lets bring something like this to the attention of NINDS. There has to be a way to identify and create a standard stroke protocol. The comment usually used to debunk the standard part is 'all strokes are different, all stroke recoveries are different'. This is an incredibly convienent way to wash your hands of the survivor and leave them on their own.

1 comment:

  1. Good list. You might want to check out information here (http://search.yahoo.com/search;_ylt=AvNQObqOdkp_DhO0tKXUQgG2z34V?p=Gross%2C+stroke%2C+University+of+Colorado&fr=chr-frontier&toggle=1&cop=&ei=UTF-8&type=startpage_search). There used to be a doctor with the last name of Gross who was working on what to do when a stroke patient first comes in to the hospital.

    ReplyDelete