Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, March 2, 2024

How Long Should I Take to Walk a Mile?

 

Mile walk test. This I can pass, 25 minutes to the mile, goal was 26 minutes in other tests. and this is walking on trails in the woods.

How Long Should I Take to Walk a Mile?

IF YOU LIVE somewhere with sidewalks, you probably do your fair share of walking to get around. Even if you live in a more car-centric space, you likely have access to parks and other green space to take a stroll. Whether you think of walking as exercise or as a means to get from A to B, there are so many reasons to give your ambulatory habits some more focused attention.If you’re wondering how your current walking practice stacks up to how much—or how fast—others are moving, consider testing how long it takes you to walk a mile. That’s just one benchmark that walking coach Michele Stanten, founder of MyWalkingCoach.com and author of The Walking Solution, says could help to incentivize you to reach for your sneakers more often. Once you know how fast you’re walking and about how many steps you’re taking per mile, you can set walking goals that work for your lifestyle. Here's what to keep in mind.

The Benefits of Walking

You’ve likely heard many times over about all the reasons you should prioritize walking, but they deserve repeating.

Walking Can Help to Boost Your Mood

“As soon as you get out there and you start moving your body, it reduces stress, [and] reduces tension,” says Stanten.

Walking Can Help Reduce Risk of Disease

Walking is cardiovascular exercise, and this type of exercise helps to reduce your risk of heart disease, diabetes, and lowers blood pressure, among other health perks, according to Stanten.

Walking Is Accessible

“Walking is so flexible and readily available,” she says. “You can do it anywhere — from home, from work. You can do it by yourself. You can do it with people. You can do it in short bouts, long bouts—there's so many different ways to walk.”

Walking Is Joint-Friendly Exercise

Movement gets blood flowing to working muscles and lubricates joints, which can ease pain and stiffness, says Stanten. “Walking is low impact,” she says. “So, if you have any kind of joint problems, it's still an activity that most people can do.”

Walking Is Good for Cross-Training

Even if you enjoy doing other types of exercise, walking is a simple and accessible way to stay active otherwise, she says. “It's a great cross-training modality for runners or anybody doing higher impact exercise.”

How Much Should You Walk Every Day?

Before you think about how much you should be walking or consider setting a goal, assess how much you’re currently walking, says Stanten. Go about your normal routine and track how many steps you’ve taken at the end of each day. Do this for a few days, and make sure at least one day is a weekday and one a weekend. Capture those results so you can have a baseline to increase from there.

You might be confused about exactly how many steps you should be getting every day. Is it 7,500, or is 10,000 still the magic number? Instead of thinking about step count, consider starting with the current Physical Activity Guidelines for Americans, which recommends 150 minutes of moderate-intensity physical activity and two days of muscle strengthening activity per week. For cardio, that correlates to about 30 minutes, five days a week, “which breaks down to three 10-minute walks a day, which is generally pretty doable,” says Stanten.

If you still find that counting steps is more motivating, she suggests trying to add another 500 or even 1,000 steps a day, if that feels doable.

How Long Should It Take to Walk a Mile?

Another way to track your walking fitness is to gauge how long it takes you to walk a mile. “In general most people will cover a mile somewhere between 15 to 20 minutes,” says Stanten. “Fifteen is on the faster side, but [for] people who are working out, that 15-minute-per-mile pace is very reasonable.” If you find that you’re closer to 20 minutes, and your goal is to walk a mile every day—or an additional mile daily— try breaking up your work into a pair of 10-minute walks, she says.

Ultimately, it doesn’t matter how long it takes you to walk a mile, or whether you walk that mile consecutively or throughout the day. Simply increasing the amount of activity in your life and cutting down sedentary time will help you attain those mind and body benefits.

How to Increase Your Walking Pace

If you’re interested in boosting your walking pace—whether to challenge your cardio fitness or just beat the train doors before they close—there are a few tricks and tips that can make a difference immediately, says Stanten.

Bend Your Arms

Think about it: “You don't run with our arms down at your side,” she says. “You're going to walk faster with your arms bent.”

Take Shorter, Quicker Steps

The biggest tip to improve your speed is to take short, quick steps, says Stanten. “When people try to walk faster, they automatically start to take these big long steps, and that actually slows you down, and it puts a lot more stress on your joints,” she says. Stepping directly in front of you allows you to roll through the middle of your foot and push off your toes to keep your stride smoother, she says.

Swing Your Arms Straight

Avoid swinging arms side to side or having them cross your body as you move, says Stanten. “Your hand should go back to about your hip and swing forward, but not above chest height.”

Keep Good Posture

"Stand up nice and tall,” she says. “Open up your chest. It's easier to breathe. Keep your abs tight; that's going to help.”

Pick a Target to Walk Toward

“People walk faster if they pick a spot ahead of them, and focus on that instead of looking around,” says Stanten. Pick someone who is walking ahead of you and try to mentally catch up to them.

Mix Up Your Paces


MPETUS Stroke: Assessment of hospital infrastructure and workflow for implementation of uniform stroke care pathway in India

I guess India still has no fucking clue that survivors  want recovery NOT 'CARE'!

MPETUS Stroke: Assessment of hospital infrastructure and workflow for implementation of uniform stroke care pathway in India

Abstract

Background:

India accounts for 13.3% of global disability-adjusted life years (DALYs) lost due to stroke with a relatively younger age of onset compared to the Western population. In India’s public healthcare system, many stroke patients seek care at tertiary-level government-funded medical colleges where an optimal level of stroke care is expected. However, there are no studies from India that have assessed the quality of stroke care, including infrastructure, imaging facilities, or the availability of stroke care units in medical colleges.

Aim:

This study aimed to understand the existing protocols and management of acute stroke care across 22 medical colleges in India, as part of the baseline assessment of the ongoing IMPETUS stroke study.

Methods:

A semi-structured quantitative pre-tested questionnaire, developed based on review of literature and expert discussion, was mailed to 22 participating sites of the IMPETUS stroke study. The questionnaire assessed comprehensively all components of stroke care, including human resources, emergency system, in-hospital care, and secondary prevention. A descriptive analysis of their status was undertaken.

Results:

In the emergency services, limited stroke helpline numbers, 3/22 (14%); prenotification system, 5/22 (23%); and stroke-trained physicians were available, 6/22 (27%). One-third of hospitals did not have on-call neurologists. Although non-contrast computed tomography (NCCT) was always available, 39% of hospitals were not doing computed tomography (CT) angiography and 13/22 (59%) were not doing magnetic resonance imaging (MRI) after routine working hours. Intravenous thrombolysis was being done in 20/22 (91%) hospitals, but 36% of hospitals did not provide it free of cost. Endovascular therapy was available only in 6/22 (27%) hospitals. The study highlighted the scarcity of multidisciplinary stroke teams, 8/22 (36%), and stroke units, 7/22 (32%). Lifesaving surgeries like hematoma evacuation, 11/22 (50%), and decompressive craniectomy, 9/22 (41%), were performed in limited numbers. The availability of occupational therapists, speech therapists, and cognitive rehabilitation was minimal.

Conclusion:

This study highlighted the current status of acute stroke management in publicly funded tertiary care hospitals. Lack of prenotification, limited number of stroke-trained physicians and neurosurgeons, relatively lesser provision of free thrombolytic agents, limited stroke units, and lack of rehabilitation services are areas needing urgent attention by policymakers and creation of sustainable education models for uniform stroke care by medical professionals across the country.

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Friday, March 1, 2024

Cannabis Singled Out for Cardiovascular Risk

 Not enough information here to tell me if this cannabis use is smoked or an edible. So without that this click-bait title tells us nothing!

For my next stroke I will use cannabis for recovery.

Didn't your competent? doctor prescribe marijuana years ago to help your stroke recovery?  Oh, you don't have a functioning stroke doctor, do you? 

Cannabis Singled Out for Cardiovascular Risk

Findings independent of tobacco and e-cigarette use considered a "call to action"

A close up photo of a woman holding cannabis flowers

Cannabis use was independently linked to adverse cardiovascular outcomes in the general population even after accounting for tobacco cigarette and e-cigarette use, a large national study found.

Using data from the CDC's Behavioral Risk Factor Surveillance System (BRFSS), there was an increase in most incident cardiovascular disease events among adults using cannabis daily compared with non-users:

  • Coronary heart disease: adjusted OR 1.16, 95% CI 0.98-1.38
  • Myocardial infarction: adjusted OR 1.25, 95% CI 1.07-1.46
  • Stroke: adjusted OR 1.42, 95% CI 1.20-1.68
  • Composite of the three: adjusted OR 1.28, 95% CI 1.13-1.44

Evidence of an association between cannabis use and cardiovascular events persisted in non-tobacco smokers and younger people at risk of premature cardiovascular disease (men under 55 and women under 65), reported the study authors led by Abra Jeffers, PhD, a data analyst at Massachusetts General Hospital in Boston.

"We also accounted for number of days used per month as a continuous variable. This analysis is important, because it suggests that cannabis use alone may be a risk factor for adverse cardiovascular outcomes," Jeffers and team wrote in the Journal of the American Heart Associationopens in a new tab or window.

Of note, cannabis use has been rising while conventional tobacco use has decreased nationwide. According to the CDC, marijuana is the most commonly used federally illegal drug in the U.S., with 48.2 million people (or 18% of Americans) using it at least once in 2019.

"Despite common use, little is known about the risks of cannabis use and, in particular, the cardiovascular disease risks," said Jeffers in a press release from the American Heart Association (AHA). "Cannabis smoke is not all that different from tobacco smoke, except for the psychoactive drug: THC versus nicotine. Our study shows that smoking cannabis has significant cardiovascular risks, just like smoking tobacco."

The investigators noted that their study is consistent with older, smaller BRFSS studies supporting a relationship between cannabis and cardiovascular harms. Being three to 17 times larger, however, the present report had an adequate sample to show harms in the subgroup of tobacco and e-cigarette never-users.

"This is an important public health finding, particularly given our ongoing efforts to reduce the burden of heart disease in this country," said David Goff, MD, PhD, director of the National Heart, Lung, and Blood Institute's Division of Cardiovascular Sciences, in a statement.

Outside the CDC survey, other work has suggested that use of cannabis and other recreational substances is associated with early-onset atherosclerotic cardiovascular disease.

Yet cannabis is often undisclosed by patients. One French study showed that many recreational drug users with acute cardiovascular events landed in cardiac intensive care units without disclosing their drug use.

"As cannabis use continues to grow in legality and access across the U.S., practitioners and clinicians need to remember to assess cannabis use at each patient encounter in order to have a non-judgmental, shared decision conversation about potential cardiovascular risks and ways to reduce those risks," commented Robert Page II, PharmD, MSPH, of the University of Colorado School of Medicine in Aurora, in the AHA press release.

"The findings of this study have very important implications for population health and should be a call to action for all practitioners, as this study adds to the growing literature that cannabis use and cardiovascular disease may be a potentially hazardous combination," he added.

The population-based, cross-sectional study was based on data from the BRFSS covering 27 U.S. states and two territories. The analysis relied on data from the 2016 to 2020 telephone surveys, for which there were 434,104 respondents ages 18 to 74 years.

Overall, 55% of the respondents were ages 35-64, and 14.5% were ages 65-74; 51.1% were women, and 60.2% were white. The prevalence of daily and non-daily cannabis use was 4% and 7.1%, respectively.

Jeffers and colleagues acknowledged their reliance on self-reported cardiovascular conditions and cannabis use. Anonymous data also precluded linkage to mortality records for analysis.

Prospective cohort studies are needed to confirm their findings, they said.

  • author['full_name']

    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was funded by grants from the National Heart, Lung, and Blood Institute and the National Cancer Institute.

Jeffers had no disclosures.

Primary Source

Journal of the American Heart Association

Source Reference: opens in a new tab or windowJeffers AM, et al "Association of cannabis use with cardiovascular outcomes among US adults" J Am Heart Assoc 2024; DOI: 10.1161/JAHA.123.030178.

Real walking thru ice; Your doctor will never approve


 I never listened to my doctor, he knew absolutely nothing about stroke recovery! I challenge myself a lot, this is walking on my trails thru 6-8 inches of water with 1/8-3/8 ice thickness.  It required me to lift my left leg properly; up and completely above the ice. The walking stick was mandatory.  If I don't challenge myself now I'll never be able to get to age 90 in any sort of decent condition. And thus not able to do any  traveling. I just signed up for a Madeira Portugal trip with Road Scholar.

Hard to tell that  I've been thru this

 

The trail before I walk thru it. Only 6-8 inches deep. I cut thru those logs in the background with my chainsaw. A total of 5 logs in that stretch.