Strokes can be prevented as we age

 WOW! What a pollyannish view. A more concrete and exacting solution is 100% recovery protocols! Can't anyone in stroke actually think? You're leaving stroke survivors disabled because of your tyranny of low expectations!

Strokes can be prevented as we age

Editor’s Note: The following column was original published May 9, 2020.

Thanks to breakthroughs in medicine and nutrition in recent years, we are living longer than ever before. But this increase in life expectancy also brings an increase in the number of diseases, injuries and impairments that affect older adults. With this in mind, we at the Salem Visiting Angels office have created this series of articles to keep our older population and their families informed and to offer some practical advice for meeting the challenges faced by seniors and those who care for them. May is National Stroke Awareness Month. According to the American Stroke Association, strokes are the fifth leading cause of death in the United States and a leading cause of disability, and while the risk of having a stroke increases as we age, 80 percent of all strokes can be prevented(NOT GOOD ENOUGH!) by making healthy lifestyle choices. A stroke happens when blood flow in the brain is disrupted. To understand how our behavior affects our chances of having a stroke, it is first important to know that there are three main types of strokes: ischemic strokes, hemorrhagic strokes and transient ischemic attacks (TIA), which are commonly referred to as “mini-strokes.” The Centers for Disease Control and Prevention (CDC) reports that 87 percent of all strokes are ischemic strokes. These occur when blood flow through the brain is suddenly interrupted, usually by a clot or blockage in one of the arteries within the brain. This prevents the blood from getting to those parts of the brain beyond the blockage. A hemorrhagic stroke occurs when, rather than being blocked, a brain artery leaks blood or completely ruptures, damaging surrounding brain cells by putting them under excess pressure. Conditions within the body that can lead to a hemorrhagic stroke include high blood pressure and aneurysms, bulges in a weakened artery wall which can burst.Hemorrhagic strokes fall into two categories, intracerebral hemorrhage and subarachnoid hemorrhage. The most common type of hemorrhagic stroke is intracerebral hemorrhagic, which happens when an artery within the brain ruptures and releases blood into the surrounding brain cells. In a subarachnoid hemorrhagic stroke, the location of the burst artery sends blood into the area between the brain and the tissue around it, rather than into the brain itself. The third main type of stroke is the transient ischemic attack. Similar to an ischemic stroke, blood flow to the brain is blocked during a TIA. However, the blockage only last for a short time – usually no longer than five minutes, according to the American Stroke Association – and blood begins flowing again. The TIA is also known as a warning stroke because, while it may not result in major damage, it is sign that a more serious stroke could happen soon. As we age, our chances of having a stroke increase. The CDC reports those chances almost double every 10 years after we reach 55. According to the CDC women are more likely than men to suffer a stroke and are more likely to die after having one. Strokes are also more common among blacks, Hispanics and American Indians than among non-Hispanic whites or Asians. Blacks are also at higher risk of dying from a stroke. A family history of strokes could also mean a greater risk of stroke in one’s own future. Many of the health risks that can contribute to a stroke — such as high blood pressure, heart disease and high cholesterol – can be passed from one generation to the next through are genes. Certain genetic disorders, like sickle cell disease, can also increase a person’s risk for having a stroke. Although risk factors like age and family history cannot be avoided, making the right choices when it comes to diet and exercise can help moderate those risks. For example, a diet high in fats and cholesterol can contribute to heart disease, leading to plaque or cholesterol build up in the arteries and blocking the flow of blood to the brain. Too much salt can lead to high blood pressure, which can cause a stroke when the pressure of the blood flowing through veins and arteries is too great. Diabetes is another risk factor that can be controlled by eating right and keeping physically active, as is obesity, which can also contribute to both heart disease and diabetes. Research suggests that more younger people are having strokes now than in the past due to an increase in obesity at younger ages. The CDC reports that one in seven strokes now occurs in people between the ages of 15 and 49. Excess alcohol consumption can also lead to high blood pressure and increased stroke risk. Drinking too much can raise triglyceride levels in the blood. Triglycerides are a type of fat that can cause arteries to harden. The heart and circulatory system can also be damaged by cigarette smoke, as nicotine raises blood pressure and carbon monoxide replaces oxygen in the blood stream. The increased risk of a stroke is just as great for those breathing secondhand smoke as it is for the smoker themselves.—— Information provided by Visiting Angels, America’s choice in homecare. Visiting Angels non-medical homecare services allow people to continue enjoying the independence of their daily routines and familiar surroundings. To set up an appointment for a free in-home consultation, call 330-332-1203.

Beating stroke starts with awareness, timely medical intervention, says doctor

 But you're missing all the problems in stroke, this pollyannish view doesn't get stroke solved to 100% recovery.

Beating stroke starts with awareness, timely medical intervention, says doctor

Timely recognition and rapid treatment of stroke can make a major difference between a full recovery and lifelong disability, says Dr Sebastian, Associate Professor, Department of Neurology, Christian Medical College and Hospital.

Recognising stroke: Every minute counts

One of the biggest barriers to successful stroke care remains public awareness. Far too often, warning signs like sudden weakness of one side, speech disturbance or facial droop are missed or dismissed. Early detection is everything: each minute of delay results in lost brain cells and lost opportunity for recovery. The sooner the symptoms are identified, the better we can act.

Advanced treatments at stroke-ready centres

When a patient with suspected stroke arrives, our team is prepared to deliver advanced care(NOT RECOVERY!). At CMC Ludhiana, we are equipped to administer clot-busting medications (thrombolysis) that can rapidly dissolve blockages when given timely(But it's a failure at full recovery 88% of the time). In select cases, newer endovascular techniques (EVT) allow us to remove the clot directly from the artery and restore blood flow. Both treatments are highly time-sensitive; delays can permanently limit their effectiveness.

Rehabilitation: The forgotten phase

Recovery doesn’t end with acute care. Stroke rehabilitation, including neurophysiotherapy, speech therapy and occupational therapy, are crucial for helping patients regain independence.(NOT RECOVERY!) Unfortunately, this part of stroke care is often underemphasised. The right rehabilitation plan, led by a multidisciplinary team approach can maximise recovery and bring out the best outcomes in our patients.(But you have NO CLUE ABOUT GETTING TO 100% RECOVERY! I call that a complete failure!)

Health Take-Away: Therapy can maximize stroke recovery

Notice they don't bother to tell you that only 10% get to almost full recovery. And they ignore these 8 problems in stroke.  Once again listing that a multidisciplinary team is helpful when they have no protocols and no efficacy ratings to give stroke survivors.

1. Only 10% of patients get to full recovery.
2. tPA only fully works to reverse the stroke 12% of the time. Known since 1996.
3. No protocols to prevent your 33% dementia chance post-stroke from an Australian study.
4. Nothing to alleviate your fatigue.
5. Nothing that will cure your spasticity.
6. Nothing on cognitive training unless you find this yourself.
7. No published stroke protocols.
8. No way to compare your stroke hospital results vs. other stroke hospitals.

The pollyannish story here:

Health Take-Away: Therapy can maximize stroke recovery

By Jessica Dellaghelfa and Natacha Dockery-Livak

May is Stroke Awareness Month. This is the second of a two-part series on stroke. Part one, which focused on how to prevent a stroke, appeared in The Berkshire Eagle on May 7

Stroke can be a very complicated diagnosis. Some patients walk out of the hospital a few days after suffering a stroke without any obvious signs of disability. Others may be hospitalized for weeks or more and leave with very visible signs of a serious blow to their brain. But in every case, people who have had a stroke are never quite the same.

This doesn't mean that they can't get back to their lives, their families and friends. A stroke occurs when a blood vessel is blocked or ruptured, depriving a part of the brain with the blood and oxygen it needs and causing brain cells to die. Strokes come in all varieties, from minor to very severe. In almost every case, stroke patients need a period of rehabilitation to help them relearn skills that were lost when stroke affected part of their brain.

Their journey will begin as soon as they are able to participate in rehabilitation while still hospitalized in an acute care hospital bed. From there, they may be transferred to the rehabilitation unit of the hospital, where therapy will increase to several hours a day. Patients can next be transferred to a skilled nursing facility for more therapy, or to home — often with therapists visiting them daily. And many continue with therapy on an out-patient basis until they have regained as much function as possible.

In fact, therapy will become an integral part of the lives of stroke patients and their loved ones for weeks, months and maybe even years. People can and do continue recovering for a long time. In the best-case scenario, patients should be under the care of a multidisciplinary team that includes their primary care physician, a physician who specializes in rehabilitation, plus physical, occupational and speech therapists who each bring their own area of expertise to the patient, and who work creatively together so that the individual needs of each patient are met. (Really! You are meeting their 100% recovery needs? I want to see proof of that.)

Rehabilitation that begins as soon as possible can make a world of difference in the outcome. Therapists meet each patient where they are in terms of their ability and create a rehab plan that will gradually bring the stroke survivor to the next step. Once there, they work toward new goals. The focus is on maximizing essential functions that will improve their quality of life and help patients be as independent as possible.

Physical therapists focus on improving movement and balance with exercises to strengthen muscles needed for standing, walking and other activities. Occupational therapists help stroke survivors better manage daily activities such as dressing, preparing meals and living safely at home. Speech and language pathologists work with stroke patients to re-learn language skills like talking, reading and writing. They also help with swallowing problems that can affect some stroke patients.

In the process, the rehab team works together to enhance the progress of each patient, creating unique strategies that can help them compensate for lost function, adapt to a new way of life, and maximize every possibility for improvement. Their collaboration means that they look at each patient from three potential angles, often embedding a physical, occupational and speech-related component into many of the patient's therapy sessions.

Stroke rehab therapists are highly skilled caregivers who have deep understanding of the complex function of the brain, and how to guide patients back to the best life possible after stroke. They also understand that this disease can impact an entire family. They help their patients' loved ones maintain realistic expectations and suggest ways to continue useful practices at home. And they encourage participation in stroke support groups where patients and families can voice their hopes and fears, while also finding strength and even great ideas from each other.

Jessica Dellaghelfa, DPT, is a physical therapist and Natacha Dockery-Livak, M.A.,M.S., CCC-SLP, is a speech and language pathologist at the BMC Center for Rehabilitation.

If YOU don't say it, 'Everything in stroke is a failure', NOTHING will get fixed.

How the hell are we going to get to 100% recovery for all if we don't acknowledge the failures in stroke? Everyone is so fucking pollyannish. 

1. Only 10% of patients get to full recovery.
2. tPA only fully works to reverse the stroke 12% of the time. Known since 1996.
3. No protocols to prevent your 33% dementia chance post-stroke from an Australian study.
4. Nothing to alleviate your fatigue.
5. Nothing that will cure your spasticity.
6. Nothing on cognitive training unless you find this yourself.
7. No published stroke protocols.
8. No way to compare your stroke hospital results vs. other stroke hospitals.

From Seth's Blog;

Easier said than done

But at least you said it.
It's a mistake to hesitate on the saying part. Because if you don't say it, it's unlikely to get done.
Dreams, goals and projects don't require a likelihood of success merely to be discussed.

 

Strokes and your recovery Story 1 of 4 in a series

My god, everything is rosy in the stroke world if you work hard, your doctor doing absolutely nothing to help your recover.
Ignore this other stuff;

1. Only 10% of patients get to full recovery.
2. tPA only fully works to reverse the stroke 12% of the time. Known since 1996.
3. No protocols to prevent your 33% dementia chance post-stroke from an Australian study.
4. Nothing to alleviate your fatigue.
5. Nothing that will cure your spasticity.
6. Nothing on cognitive training unless you find this yourself.
7. No published stroke protocols.
8. No way to compare your stroke hospital results vs. other stroke hospitals.

A pollyannish story here:

Strokes and your recovery Story 1 of 4 in a series