Thursday, March 28, 2013

Troubling age, race research results

I recently saw this troubling article from MedPage, from the annual meeting of the American Academy of Neurology. According to a study, age, race biases are seen in stroke transfers:
Blacks and the elderly were dramatically underrepresented among ischemic stroke patients in rural Alabama sent to a tertiary stroke center after initial thrombolysis, a researcher said here.
Compared with 212 patients presenting directly at the stroke center's emergency department, the 96 "drip-and-ship" patients were significantly younger (median age 63 versus 68, P=0.001) and less likely to be African American (21% versus 38%, P=0.012), said Amelia Boehme, MSPH, of the University of Alabama at Birmingham (UAB). ...
The drip-and-ship model is a method to deliver thrombolysis to acute stroke patients in facilities that lack onsite neurology coverage, the authors explained.
Again, these results are troubling. I realize that each case must be handled individually, but at the same time, every patient should expect quality care.

Tuesday, March 26, 2013

PFO closure still an open question

The question of plugging a hole in the heart - a patent foramen ovale, a possible stroke risk - made medical news a few days ago.

MedPage's article PFO closure still an open question came with the following bullet points:

  • Two new randomized studies found that there was no significant benefit associated with closure of a patent foramen ovale in adults who had had a cryptogenic ischemic stroke.
  • Point out that in one of the studies, there was a significant between-group difference in the rate of recurrent stroke that favored treatment among those in the pre-specified per-protocol and as-treated analyses, but that the low overall rate of events in both studies raises statistical questions about this result.
I have a vested interest in PFO closure because mine was closed in the summer of 2007. As a result, I no longer take the medication warfarin, which has its own risks.

Now, the research is indicating that PFO closure outcome is, statistically speaking, about the same in terms of preventing future strokes. There's a lot of language in the stories I read about making case-by-case decisions as to whether the procedure is a good idea.

From my vantage point, I am still glad I had this done. Fewer medications. Fewer side effects. Warfarin was giving me headaches and, especially for someone relatively young who tries to be active, can cause excessive bleeding.

Is that a good choice for everyone? Certainly not. Each individual's circumstances should be considered.

(Video of the implanting of my PFO occluder)

Thursday, March 21, 2013

'Who comforts us in all our troubles'

Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God.

Paul gave some wise words. God comforted my troubles after my stroke - not necessarily at the pace I'd prefer, not all at once in a flash, but comfort came to me. 

One goal for this blog is to share and spread comfort - given by God - to others who need it.

Troubles can be so real - slow recovery, daunting physical problems, language challenges, and more. Be ready to accept God's comfort, and be ready to pass along, as able, comfort to someone else who needs God's care.

Tuesday, March 12, 2013

Brisk walking helps stroke survivors

I'm a fan of moving - people who run or walk regularly benefit in countless ways. Now, a recent story mentions that research indicated that brisk walking helps stroke survivors:
Researchers at the University of the West Indies in Jamaica had one group of stroke survivors follow a supervised program of brisk outdoor walking for three months. A second group, which did not do supervised exercise, received therapeutic massages.
The walkers started out by following a designated route for 15 minutes, lengthening the duration of their walk by five minutes a week until they walked for 30 straight minutes. As people became more fit, they gradually increased their pace, reaching 60 to 85 percent of their target heart rate. People in the massage group received light massage on their affected side for 25 minutes three times a week.
At the study's end, the researchers found that the people in the walking group walked 17.6 percent farther in a six-minute endurance test than did people in the massage group and had a resting heart rate that was 1.5 percent lower. What's more, the walkers had nearly a 17 percent improvement in their quality of life, based on physical health, compared with the massage recipients.
I'm convinced that my longtime running habits helped me recover from my stroke almost 15 years ago. If you're not into running, walking can be vital, too!

Tuesday, March 05, 2013

Addressing some heart problems may help prevent strokes

Saw this story recently about the connection of a particular heart problem with stroke risk. The story notes that blocked heart arteries may be key risk factor for stroke:
People with arterial clogs caused by what's known as coronary artery calcification -- calcium deposits in the artery -- are at higher risk for stroke, even if they're otherwise considered to have a low risk, the German researchers found.
The findings are published Feb. 28 in the journal Stroke.
"Stroke risk is tightly aligned with coronary atherosclerosis [hardening of the arteries], showing the closely related nature of cardiovascular and cerebrovascular [brain blood flow] disease," lead investigator Dr. Dirk Hermann, a professor of vascular neurology and dementia at the University Hospital Essen, said in a journal news release.