Tuesday, July 31, 2012

Yoga and you...

I've never had the patience for getting interested in yoga. But perhaps I should look at this again. Who couldn't use improving balance? And while my stroke didn't leave marked physical changes, many stroke survivors struggle in regaining balance.

WebMD, among others, reported recently that yoga improves balance after stroke:

"It's an exciting thing," says study researcher Arlene Schmid, PhD. "People can improve their balance years after a stroke. They can change their brain and change their body. They are not stuck with what they have."
The study is published in the journal Stroke.
Schmid is a rehabilitation research scientist at Roudebush Veterans Administration-Medical Center and Indiana University in Indianapolis. For the study, her team recruited 47 stroke survivors who'd had strokes more than six months ago. Seventy-five percent of them were male veterans, including veterans of World War II.

Thursday, July 26, 2012

Efforts to save lives and minds

Stroke prevention - in the main - calls for basic actions to reduce risk factors. And those efforts can pay off in the long run, including reducing dementia that often sets in years after a stroke occurs.

While these actions to reduce stroke and dementia risk can't reduce the risks by 100 percent, they are logical and smart, as reported by MedlinePlus:
Over the course of five years, patients treated by doctors focused on reducing risk factors saw their need for long-term care drop by about 10 percent compared to the communities that didn't have this intervention. The study also showed that the cost of inpatient treatment for these patients was reduced.

The researchers believe a focus on curbing stroke and dementia risk factors decreased the number of deaths in the intervention group from the expected 2,112 people to just 1,939.

In order to prevent stroke and dementia, doctors encouraged patients to:
  • Get more exercise
  • Eat a healthier diet
  • Stop smoking
  • Reduce high blood pressure and high cholesterol levels
Read the entire article from the above link.

(Image from the National Library of Medicine) 

Tuesday, July 24, 2012

'No one who believes in me shall stay in darkness'

I have come into the world as a light, so that no one who believes in me should stay in darkness.
It was dark in the room, a place where memories are vague at best. I recall the light – a screen where, I suppose, a doctor was looking at an image of my brain via catheterization imaging.

I have no recollection of what happened next. But I remember the light.

Now, did the light save my life that day? Certainly not.

But there is a light you can rely on, one who brings you out of darkness. And no matter what happens in this world, you will never be alone, never in the darkness. A light for all.

Thursday, July 19, 2012

'What we've got here is failure to communicate'

Famous "Cool Hand Luke" quote: "What we've got here is failure to communicate."

That movie came out in 1967. But even now, we've still got failure to communicate - not in fiction, but in real life. Sometimes with deadly outcome. A recent article from MedlinePlus tells us that hospitals are often not alerted about incoming stroke patients
In the studies, researchers examined about 372,000 cases of acute ischemic stroke (caused by a blocked blood vessel to the brain) between 2003 and 2011. The patients were taken by ambulance to one of nearly 1,600 hospitals participating in a quality improvement program -- called "Get with The Guidelines-Stroke" -- launched by the heart/stroke associations.

One study, published in Circulation: Cardiovascular Quality & Outcomes, found that when EMS alerted hospitals about incoming stroke cases, the patients were diagnosed and treated more quickly. Fast diagnosis and treatment is critical because certain clot-busting drugs have to be given within 3 to 4.5 hours after the onset of stroke symptoms to be effective, according to the study."

But a second study found that EMS pre-notification of stroke patients happened in only 67 percent of stroke cases in 2011, a slight increase from 2003 when hospitals were notified in about 58 percent of cases. That study is published in the Journal of the American Heart Association.

"Despite national guidelines recommending pre-notification by EMS for acute stroke patients, it's disappointing that there's been little improvement," the senior author of both studies, Dr. Gregg C. Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles, said in an American Heart Association news release. "However, with these powerful new findings demonstrating substantial benefits with pre-notification, we have a tremendous opportunity to make positive changes in this component of stroke care."
So - when communication happens, we get better treatment. However, most of the time, that communication doesn't happen. That must change.

Tuesday, July 17, 2012

Note to hospitals: Strokes can happen on weekends, too

My stroke happened on a Friday. So what would have happened if it had occurred 24 or 48 hours later, on Saturday or Sunday?

Recent research found some evidence that in the United States and, more recently, the United Kingdom, you're likely to have a better outcome if your stroke happens on a weekday. One quoted researcher spoke about deals "potentially avoidable." From MedPage Today:
Stroke patients admitted to British hospitals on weekends were less likely to receive recommended treatment and had worse outcomes than those treated on weekdays, researchers said.

Replicating the "weekend effect" seen previously in the U.S., a retrospective study of stroke patients treated in National Health Service hospitals indicated that the 7-day risk of inpatient mortality was 26% greater among those admitted on Sundays than on Mondays ... , according to William L. Palmer, MA, MSc, of Imperial College London, and colleagues.

"The findings suggest that approximately 350 in-hospital deaths each year within 7 days are potentially avoidable, and an additional 650 people could be discharged to their usual place of residence within 56 days if the performance seen on weekdays was replicated on weekends," Palmer and colleagues wrote online in Archives of Neurology.
An article from U.S. News and World Report:
The researchers also found that the average seven-day, in-hospital death rate for patients admitted on Sundays was 11 percent, compared with just under 9 percent for patients admitted on weekdays. ...

Some previous studies in other countries also reported higher death rates among patients with a number of medical conditions who are admitted to hospitals on weekends.
I've never understood the "weekend effect" for any patient. But the medical community always tells us that time is important for stroke patients. And many providers in the medical community takes this seriously. But more work, clearly, is needed.

Thursday, July 12, 2012

Stroke info research tool

How does your county stack up in stroke statistics - how many and their outcomes, plus details of income, race, age and more, and how those factors might influence those numbers.

The U.S. Centers for Disease Control and Prevention just launched an interactive atlas of heart disease and stroke:
CDC's Division for Heart Disease and Stroke Prevention has created the Interactive Atlas of Heart Disease and Stroke, a new online mapping tool that documents geographic disparities in the burden of cardiovascular disease (CVD) at state and county levels. Users can create county-level maps of nine different CVD outcomes, by sex, race/ethnicity, and age group, and can overlay maps with congressional boundaries and locations of health-care facilities. Users also can view maps showing county-level social determinants of health and health services, including poverty, education, and food acquisition determinants.

The Interactive Atlas of Heart Disease and Stroke is available at http://apps.nccd.cdc.gov/dhdspatlas.

Tuesday, July 10, 2012

What's a cryptogenic stroke?

I've heard mine called this - cryptogenic stroke. That was 14+ years ago.

Fast forward to this recent doctor conversation about what is a cryptogenic stroke, and how they are searching for answers. Follow the link to the entire transcript and/or watch the video. Here are a few sentences:
"[C]ryptogenic stroke is an ischemic stroke in which we have not found a smoking gun. It is not due to carotid stenosis. It is not due to a clot in the heart. It is not due to atrial fibrillation. It looks like an embolism, but we cannot find where the embolism came from."

Thursday, July 05, 2012

Video hits the stroke basics

My Google alert brought me to this video, from the University of Minnesota's College of Pharmacy, covering stroke basics, symptoms and what do do.

My favorite part: If you see any of the stroke symptoms, call 911 immediately. Watch and enjoy these young people...