'I have overcome the world' - for you

I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.

-John 16:33

These are Jesus' words to his disciples about events that were about to unfold, events that will lead to the cross, and, thankfully, beyond.

And what comforting words for those needing comfort, those who have seen trouble in this world because people of faith aren't fashionable these days: "But take heart! I have overcome the world."

So keep the faith, in the struggles of stroke recovery, in the tribulations of this world. He's done the hard work - to your benefit.

Rehab unit for stroke patients

In Columbia, Mo., good news for stroke patients and caregivers, from the Columbia Missourian:

Boone Hospital opens rehabilitation unit for stroke patients.

Rehabilitation - physical, speech and other manifestations - is a must for those recovering. Should be a valuable resource for mid-Missouri.

Merry Christmas to all, and to all, the Word

Words of comfort in a world we only visit - strangers in a strange land.

And there were shepherds living out in the fields nearby, keeping watch over their flocks at night. An angel of the Lord appeared to them, and the glory of the Lord shone around them, and they were terrified. But the angel said to them, "Do not be afraid. I bring you good news of great joy that will be for all the people. Today in the town of David a Savior has been born to you; he is Christ the Lord. This will be a sign to you: You will find a baby wrapped in
cloths and lying in a manger. "

-Luke
2:8-12

* * *

In the beginning was the Word, and the Word was with God, and the Word was God. He was with God in the beginning. ...The Word became flesh and made his dwelling among us. We have seen his glory, the glory of the One and Only, who came from the Father, full of grace and truth.

-John
1:1-2,14

* * *

Come to me, all you who are weary and burdened, and I will give you rest.

-Matthew
11:28

Words to consider on this, the day we recognize and celebrate the great gift open to all. Have a glorious Christmas season.

Spot A Stroke campaign

A Web site devoted to a stroke awareness campaign in the United Kingdom designed to "spread the word" about stroke symptoms and what to do. From the Spot A Stroke Web site:

But while most people could recognise the onset of a heart attack, we know that many people are not aware of the symptoms of a stroke and are risking their long term health by not seeking medical help quickly.

You can even go to this page and with a single click prepare an e-mail you can send to anyone, anywhere, with valuable information on how to spot a stroke. The site also links to a video, shown below.

Be joyful always

Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus.

-1 Thessalonians 5:16-18

Be joyful always - a good sentiment for the Advent season that is upon us.

But how can this be? Nonbelievers scoff at the idea of being "joyful always." It's not easy, as we all know. But a worthy goal nonetheless.

So remember that phrase - "be joyful always" - as a reminder that in this season, the gift that allows us to conquer all gives us, at the end of it all, joy for the taking.

Cautionary note about mixing drugs, supplements

An article from MayoClinic.com recently gives a needed warning, starting with a question: Is it safe to take ginkgo with ibuprofen? Answer: Probably not.

The reason, wrote Mayo Clinic hypertension specialist Sheldon Sheps, M.D.:

Ibuprofen (Advil, Motrin, others) is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can impair blood clotting, typically by blocking the ability of platelets to form clots. Ginkgo — a dietary supplement used to treat memory problems, dementia and various other conditions — may also affect the clotting process. Bleeding may be a particular concern when ginkgo is taken with other medications that can affect bleeding, such as ibuprofen. In fact, at least one fatality has been linked to the use of ginkgo and ibuprofen.

Gingko, of course, is appealing to many stroke survivors at first blush because of it's supposed powers of helping with concentration. But many are on blood thinners far more aggressive than ibuprofen. In fact, we've got a link to a study reported not long ago. But please, talk to your doctor and pharmacist before taking any supplement. This kind of mistake can kill.

Another study confirms need for stroke awareness

Have you had a stroke? Know someone who has?

Then you probably already know the problem. People aren't aware of stroke signs and are not quick enough to react. Here's a snippet from a article about a recent study, showing how awareness of stroke symptoms can improve recovery:

A new study shows most stroke patients don't think they're having a stroke, and as a result don't get medical attention until their condition gets worse.

Researchers studied 400 patients who were diagnosed at Minnesota's Mayo Clinic emergency department with two different kinds of strokes. Only 42 percent thought they were having a stroke and most didn't even go to the emergency room when the symptoms appeared.

So remind those around you of the stroke symptoms - here they are from the American Stroke Association. And when you see the symptoms, act quickly. Here's another link from the National Stroke Association.

From the No Kidding Department...

A recent headline from U.S. News and World Report:

Specialized stroke care improves outcomes. From the article of Nov. 20, 2008:

Stroke patients treated at community hospitals with specialized stroke care and telemedicine support from major stroke centers are more likely to survive and live independently than patients treated at hospitals without stroke units, a German study finds.

It's vital to get stroke patients to the right place or in communication with the right people. Ideally both. This can be crucial in the outcome of a stroke.

As Thanksgiving Day gets closer, I give the Lord thanks that I was able to get into the hands of people who knew exactly what to do.

And the light will guide your way

Your word is a lamp to my feet and a light for my path.

-Psalm 119:105

I received a gift last Christmas - a light attached to an elastic band. The idea is to wear it around your head while working or moving.

What's the point of that? Well, during some times of the year, and on some days no matter what the time of the year, I run before dawn, and without light, it's easy to stumble. This small light has prevented countless falls.

Just like the little light, God's word lights the way for stroke survivors and caregivers. When it seems the darkness is impenetrable, when it seems you can't help but stumble, find the light. Listen to the word, study the word, pray with the word.

Running the daily race with perseverance

Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us. Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God. Consider him who endured such opposition from sinful men, so that you will not grow weary and lose heart.

-Hebrews 12:1-3

"[L]et us run with perseverance" is good advice in all pursuits, but especially in pursuits of faith. But the writer of Hebrews didn't stop there - we need to have some goals and aims, too, so the writer added "the race marked out for us."

Photo below shows my recent finish, along with one of my daughters, of the Bass Pro Shops Conservation Marathon in Springfield, Mo. That was the race marked out that day. But one day - an actual race or not - is just a part of the entire races marked out for us all.

The "cloud of witnesses" the writer refers are all the historical figures who had come before, listed in Hebrews 11 as examples of lives that Christians should attempt to emulate, all designated as lives lived "by faith."

Stroke survivors, caregivers and loved ones often have difficult races marked out. Faith and the support of fellow believers can make a real difference. No surprise for those with faith, and for outside evidence, there's an American Heart Association article.

So, "by faith," are we running our races with perseverance, following the marks? And supporting those who are running the race of stroke recovery?

Straining toward the goal - no matter what

Not that I have already obtained all this, or have already been made perfect, but I press on to take hold of that for which Christ Jesus took hold of me. Brothers, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus.

-Philippians 3:12-14

Many stroke survivors know what it's like to strain forward in recovery.

I had my own experience pressing toward a goal on Sunday, Nov. 2, finishing the Bass Pro Shops Conservation Marathon in Springfield, Mo. Didn't set a world record but did set a personal record of 4:40:38, which is better than 15 minutes faster than my last effort, pre-stroke in 1997.

Regardless of one's physical level, there's a goal we can strain for. The goal is winnable for all - as Paul's first sentence above talks about, it's not about being "perfect." But a perfect life with Christ is the ultimate prize.

Lean on me...

Carry each other's burdens, and in this way you will fulfill the law of Christ.

-Galatians 6:2

You can often find this Scripture passage in relation to Stephen Ministry efforts (for example, click on the illustration or this link).

Like the old song goes...

Lean on me when you're not strong,
and I'll be your friend,
I'll help you carry on;
For it won't be long 'til I'm gonna need
somebody to lean on.

Staying physically active can help in recovery

Be active, stay active.

That's the recent news as reported here. A quote from the article:

Strokes that occurred among the most physically active individuals were 2.54 times more likely to be mild and half as likely to leave victims impaired compared with those in the lowest exercise quartile, reported Lars-Henrik Krarup, M.D., of Copenhagen University Hospital, and colleagues in the Oct. 21 issue of Neurology.

In my own experience, I believe that God gave me an interest in running to keep me fit enough to survive and recover through my stroke.

Good news, but be cautious

Several blogs and other sources have played up news from a study written up in the journal Stroke:

Mice receiving a ginkgo biloba extract after a stroke - induced in a laboratory - suffered abouthalf the damage in mice who did not receive the extract. From one blog, here's a summary:

Extract from the leaves of the ginkgo tree offers promise to minimize brain damage caused by a stroke, scientists said on Thursday.

Mice given daily doses of ginkgo biloba extract before having a stroke induced in the laboratory suffered only about half the damage as animals not given it, researchers at Johns Hopkins University in Baltimore wrote in the journal Stroke.

Mice who did not get ginkgo before a stroke but were given it five minutes after a stroke sustained nearly 60 percent less damage in the day after the stroke than those not given ginkgo. And mice given ginkgo 4-1/2 hours after a stroke had about a third less damage than those not given ginkgo.

So this is promising news - something to follow.

One caveat, though - this isn't your over-the-counter gingko biloba. This supplement is widely marketed as a pill to help your memory and concentration. They also could interact - and not in a good way - with prescription medication for stroke prevention. Those would include warfarin, Plavix and Aggrenox.

So if you want try the supplement, talk to your doctor. For your health and safety.

Thirsty? Find your ultimate electrolyte

O God, you are my God, earnestly I seek you; my soul thirsts for you, my body longs for you, in a dry and weary land where there is no water.

-Psalm 63:1

I've been increasing my miles lately in my running schedule, and have been extremely thirsty from time to time. If you run long distances - say, 90 minutes or more - and drink only water, there's a chance you'll actually harm yourself, with something called hyponatremia.
That's why runners drink Gatorade or similar products. It's about electrolytes, the substances such as sodium and potassium that help your body retain fluids and may prevent muscle cramps. If you run, you sweat. Sweat contains electrolytes, and if you sweat too much without replacing electrolytes, you suffer. In severe cases, people have died.
Struggling with the aftermath of a stroke can lead to a thirsty soul. So consider this: Water is good. But your faith can lead you to your ultimate electrolyte.

With the wing, comes hope; with hope, comes strength

"[B]ut those who hope in the LORD will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint."

-Isaiah 40:31

I'm guessing you recognize this from a longer quotation, from Isaiah 40:28-31. I don't have any stats to back it up, but this has to be one of the most quoted verses in the Bible.

It's quoted because it's comforting. And who doesn't need that? It's about hope strengthening faith, and with a renewed strength in faith, so much is possible. Pray today for someone struggling with stroke outcome - pray for a renewal of hope and strength in faith.

Don't wait. Don't wait. Don't wait. And by the way, don't wait

Words to live by - in stroke care, at any rate - from a recent USA Today article about a recent stroke study:

"Don't wait," said Dr. Larry Goldstein, director of Duke University's stroke center and a spokesman for the American Stroke Association. "If you think you are having symptoms, call 911."

Symptoms to watch out for, from the National Stroke Association's F-A-S-T description:

F = Face
• Ask the person to smile. Does one side of the face droop?

A = Arms
• Ask the person to raise both arms. Does one arm drift downward?

S = Speech
• Ask the person to repeat a simple sentence. Are the words slurred? Can the person repeat the sentence correctly?

T = Time
• If the person shows any of these symptoms, time is important. Call 911 or get to the hospital fast. Brain cells are dying.

We're all in this together

Just as each of us has one body with many members, and these members do not all have the same function, so in Christ we who are many form one body, and each member belongs to all the others.

-Romans 12:4-5

Ever feel like you're useless?

No way. Read Paul's words in Romans 12 - you are part of the body of Christ, so how can you be useless? One small, kind word or gesture to someone who needs that little boost, for example. That's not useless. It's priceless.

A good word for hope and praise to God

Accept one another, then, just as Christ accepted you, in order to bring praise to God.

-Romans 15:7

I'm currently listening to Romans on my mp3 player during my running sessions these days. It's a great letter from Paul. This particular section - Chapter 15 - is full of hope and unity.

Do you need some hope? Read the chapter and Paul's other letters. Don't fall into the trap of not considering when the letters were written and the situations the particular groups faced. Find a good Bible with commentary, such as the Life Application Study Bible.

Rejoice in the Lord always

Rejoice in the Lord always. I will say it again: Rejoice!

-Philippians 4:4

So what's the key word in this one? How about:

Always.

For fellow stroke survivors and loved ones, "always" is difficult. I didn't exactly rejoice when I couldn't use one side of my body. I look forward to the day that the lesson is finally driven home: Rejoice. Always.

Why? Because in the final analysis, a stroke can't take away God. Can't remove you from him, can't remove him from you. No matter what happens, even death.

And for that, rejoice.

North Korean leader and prayer

The news (below video) is that North Korean leader Kim Jong Il survived a stroke. It's unclear at this writing how serious the stroke or the exact status of his condition.

I've been to South Korea a couple of times. It's a country rich with smart and kind people.

Ran across an interesting blog today: North Korean Prayer Blog. The prayer for Kim:

Let us pray that Kim Jong Il will be awakened to his own mortality and be brought to repentance and experience the Grace of God and turn to Jesus Christ as his Lord and Savior.

Kim has persecuted people of faith. Is it likely that will change? Who's to say? We can, however, hope.

Day of trouble? Help is at hand

In the day of my trouble I will call to you, for you will answer me.

-Psalm 86:7

Last several days have been busy and rough, with school starting, a very amateurish woodworking project in the works, a little travel, work, etc. So I'm a few postings behind.

But in a hectic time period - a day of trouble, if you will - this verse from Psalm 86 can give some relief.

If you are struggling with your own stroke experience or those of a loved one, consider what the author says.

Support for the younger stroke group

An article printed the other day talked about a group I can relate to:

Prime-of-life stroke victims find group solace. The stereotype for stroke victims: elderly. But many stroke victims are hit in the 30s or younger. Mine hit at age 39. Some of the people in the article were even younger.

So groups like this can help. As quoted in the article:

"Although stroke is the third leading cause of death and the number one cause of adult disability, people tend to be uninformed about strokes and life after stroke," said David Palestrant, M.D., director of the Stroke Program and director of Neuro-critical Care at Cedars-Sinai. "The support groups offer an opportunity for people to share their experiences and learn from one another about coping with the changes taking place in their lives," he said.

'John Doe,' stroke and aphasia

A few postings back, I recalled my bout with aphasia - which I believe still affects me, but only slightly.

Recent news broke about a man in Kansas City who was found suffering a stroke and coulddn't say his name. As reported by the Kansas City Kansan shortly thereafter:

The patient has suffered a stroke and suffers from Broca’s Aphasia, a disorder that affects speech. The man has told hospital officials that his first name is Greg or Gregory, but can’t provide any further information.

He was finally identified, according to The Kansas City Star. The Kansas City Fox TV station noted that the man was homeless - by choice, according to family - and faces rehabilitation at the Kansas University Hospital.

What is aphasia? You can find a definition by the National Aphasia Association. It can be a frightening and frustrating experience.

My own experience was, at the end, generally positive - with some speech therapy and some time, my speech skills in the main came back. A prayer goes out to this man in Kansas City for a positive outcome as well.

Setting the right priorities - placing God before

I have set the LORD always before me.
Because he is at my right hand,
I will not be shaken.

-Psalm 16:8

A comforting word to remember - for stroke survivors, caregivers, loved ones, friends and colleagues alike.

A key term here: "always before me." The author had the right idea - placing God always in front, always in high priority.

I know some stroke survivors are physically shaken. But spiritually, I've seen some of the same people solid and strong. And in the final analysis, we will all physically fail. But with the Psalm 16 author's attitude, we can stay strong in faith.

Paul's powerful words of death and gain

For to me, to live is Christ and to die is gain.

A passage from Philippians 1:21 that says it all - or at least volumes. Paul was profound in his thinking about what's important and what is to gain.

He's not begging to die in his statement in Philippians 1, but to make his priorities clear: despite his imprisonment, even the threat of death doesn't block him from Christ.

So any hurdle or obstacle in your way? Remember, you can still influence your fellow followers of Christ. Affecting one life can be a blessing.

Paul did it from prison. How can you?

Despite flaws, your body is a temple

Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore honor God with your body.

From 1 Corinthians 6:19-20, this should be a welcome message for anyone - after all, no one is without flaws - but especially for stroke survivors. Many of them have some physical difficulties. After all, strokes cause more serious long-term disabilities than any other disease.

A 90-year-old fellow churchgoer, mentioned in a previous posting, walks with a cane, sometimes unsteadily, in the aftermath of a stroke a few years ago. But despite what's happened, God still considers your body as a temple.

It's beyond flaw, beyond flesh. My friend knows this - and so should you.

As I consider entering a marathon scheduled in November, this is a message to consider. By the same token, this is a message for anyone and everyone while considering any physical challenge, despite the level. For as your body is a temple, undertaking a challenge can be an act of worship.

Here's a video of a 2008 Olympic marathoner Ryan Hall, who, according to Runner's World magazine, believes he was chosen by God to run for God.

'It is he who will save us'

Lately, this blog has posted a lot of stroke-related news, but now, an effort to do more faith-based postings. BibleGateway.com posts a daily verse, so I'm taking those as inspiration. A recent one, for example, came from Isaiah 33:22:

For the LORD is our judge,
the LORD is our lawgiver,
the LORD is our king;
it is he who will save us.

A Scripture reference to keep in mind when it seems the world is taking us over - our final authority is above all. So struggling with stroke recovery, struggling with caregiving, struggling with decisions, a note to remember: "...it is he who will save us." Consider all the ways he can save you, including the ultimate prize.

Another stroke-prevention medication in the works?

Blood-thinning medication can be tricky - bruising and other side effects. But they can also prevent strokes and death.

So some news from The New York Times the other day - European Drug Watchdog Supports New Pill by Bayer - indicates that another stroke prevention tool might become available for certain patients.

Outside Europe, regulatory filings for Xarelto have been submitted in more than 10 countries, including Canada and China. It is expected to be submitted for approval soon in the United States, where it will be marketed by Bayer’s partner Johnson & Johnson.
Although the initial use of Xarelto will be in preventing blood clots after hip- and knee-replacement surgery, the big commercial potential lies in using it to prevent strokes in people with atrial fibrillation, a common heart arrhythmia.
The medicine, which is also known by the generic name rivaroxaban, is taken as a single tablet, once daily.

Worth watching for future developments.

(Image from National Library of Medicine)

Not just a stroke of luck

Not that I believe in luck, but an article from Nurse.com - Not Just a Stroke of Luck - talks about an initiative that should happen - or already happening - everywhere:

Nurses from competing hospitals are joining together to improve the care that stroke patients receive at hospitals throughout New Jersey.

As in many circumstances, nurses wind up coordinating stroke centers, the article says, and special training helps to improve that coordination. Thus the effort in New Jersey. Efforts to upgrade stroke care coordination should either be ongoing or about to begin everywhere.

One stroke is enough

Sometimes, a picture says it all.

This is from the Stroke Update Web site, a United Kingdom-based Web site chocked with stroke-related links, articles, news, studies, books and events.

At this writing, its lead articles were about younger adults returning to work after strokes and the June 2008 Welsh Stroke Conference. Another article explores the connection of a stroke with the combination of patent foramen ovale and atrial septal aneurysm.

Often, one stroke, or even a transient ischemic attack - also known as a mini-stroke - increases the risk for another. That's one reason why research is so vital - finding ways to prevent that second event that can be deadly.

Translating language about stroke terms

Sometimes, you just need to know what the experts are talking about. So here are some definitions of common terms used by stroke doctors brought by the Stroke section of About.com.

The Web page talks about stroke signs, medication, stroke types, stroke location and more. More and more people - for good or ill - research their own or loved ones conditions on the Web, and here's a reliable resource.

Survivor brings joy to stroke victims

A few years ago, I had the opportunity to visit New Zealand. The visit was too short, with beautiful countryside and friendly people.

Here's some recent news from New Zealand about a stroke survivor who now heads a club that provides a support system for other survivors.

Survivors often get encouragement from other survivors, and this is one of the purposes of this blog. From The New Zealand Herald:

Barbara Mexted of Whakatane was visiting England with her husband Harold when he had a stroke in 1992.

Once home, they were invited to join the Whakatane Stroke Club. Mrs Mexted's answer was no. But two years later she was not only a member, but also the president.

Every month, Mrs Mexted greets 30 to 40 members at the Whakatane Disability Resource Centre before helping to push wheelchairs and show people to their seats.

"Someone had to take over when the old president left," she said. "I just feel that when you have a stroke you're often left feeling deserted. I do it because I enjoy seeing people enjoying themselves. We share a lot of laughs."

That's a lesson many of us can learn from.

Tracking a killer: stroke database

Tracking a killer is part of a plan to improve stroke treatment in Tennessee, the Chattanooga Times Free Press recently reported.

A state stroke database was recently created to help in the battle
of one of Tennessee's leading causes of death. From the article:

A newly created Tennessee stroke database will help improve treatment for one of the state’s leading killers, according to researchers and health advocates.

The stroke registry, created by legislation signed into law in June, will include stroke treatment and outcome data from as many Tennessee hospitals as possible, with an eye to identifying and improving weaknesses in stroke care, said Dr. Patti Vanhook, chairwoman of the stroke registry committee for the state’s stroke task force and assistant professor in the college of nursing at East Tennessee State University.

I'm convinced that technology and tracking trends can really increase recovery rates. Another positive step, if carried through correctly. Tennessee stroke care advocates, stay tuned.

Law sets up guidelines for stroke care

Good news for fellow Missourians. As reported in the Springfield News-Leader, a bill was signed into law setting up guidelines for stroke care. From the newspaper:

Stroke and heart attack patients across Missouri could soon get the right intervention faster, and in the right setting, boosting their chances of survival.

Gov. Matt Blunt on Friday (July 11) signed legislation creating a 'Time Critical Diagnosis System' for stroke and a fatal type of heart attack called ST-elevation myocardial infarction, or STEMI.

Missouri is the first state in the nation to enact legislation calling for guidelines for designating stroke and STEMI centers, a Blunt news release said.

"The sooner we treat people, the better they do," said CoxHealth Dr. Scott Duff. He was among CoxHealth and St. John's Hospital doctors and staff who helped develop the legislation.

The idea is to get stroke or heart attack victims into a setting that gives them the best chances of recovery.

Reduced reflexes: future stroke sign

A couple of clues to stroke risk recently discovered and reported by NPR recently: Reduced Reflexes May Indicate Future Stroke.

Research published this week in the Archives of Internal Medicine finds that it may be possible to identify otherwise healthy older adults at risk for stroke and death by screening for subtle, yet clinically detectable neurological abnormalities, such as reduced reflexes and an unstable posture.

Meanwhile, a report published this week in the journal Stroke found that about 10 percent of a group of over 2,000 apparently healthy study participants appear to have experienced a "silent stroke," or silent cerebral infarction. A "silent stroke" has no outward symptoms but can be seen via brain imaging techniques such as MRI. The study authors say the condition can be a risk factor for future strokes, or be an indication of progressive brain damage leading to long-term dementia.

I do question the last, to a degree. While I'm certain there are some truly "silent" strokes, I wonder how many are simply unrecognized when they occurred at some unknown time.

Makes the previous post highlighting an awareness video even more important.

Great stroke awareness video

Watch and share this video. A great resource to teach you how to be a Good Samaritan for someone suffering a stroke.

The life you save might even be your own.

Silent strokes take a toll

A slightly scary story from WebMD the other day: Silent Strokes Take a Toll.

From the story:

A new study found that nearly 11% of people who thought they were healthy actually had some brain damage from a 'silent' stroke. Silent strokes are true strokes but don't result in any noticeable symptoms. People who have had a silent stroke are at higher risk for subsequent strokes and for an accelerated loss of mental skills.

All the more reason to keep watch on your personal stroke risk factors, also listed in the article. Keeping watch includes regular checkups, proper medication, exercise, a good diet, no smoking.

Some factors you can't control - age, for example - so deal with the ones you can control.

While that behavior is not a guarantee against a stroke, it certainly reduces the risk and, if you do have a stroke, it improves the outlook of survival and recovery.

Air pollution may pose stroke risk

Food for thought, from a University of Michigan study, about stroke risk and the air you breathe.

A link about how air pollution may pose stroke risk, from the university's Web site. The item reports:

Short-term exposure to low levels of particulate air pollution may increase the risk of stroke or mini-stroke, according to findings that suggest current exposure standards could be insufficient to protect the public.

The vast majority of the public is exposed to ambient air pollution at the levels observed in this community or greater every day, suggesting a potentially large public health impact,' said Lynda Lisabeth, lead author and assistant professor in the University of Michigan School of Public Health.

Wii Fit: fun therapy

While I don't need a Wii Fit for physical therapy, I'd love to try one out just for the sheer fun of it. It sounds like a way to help some recovering stroke survivors. This one is from The Plain Dealer, in Cleveland, Ohio.

From the article in The Plain Dealer in Cleveland:

Physical therapy is best served with a little camaraderie and light conversation, but therapist Nancy Ditzel also dished out some fun to recovering stroke patient Marilyn Smigelski recently.

The LakeEast Hospital therapist put Smigelski to work on the latest Nintendo Wii video system game, called Fit. While the American Physical Therapy Association magazine recently reported widespread use among members of Wii games that simulate sports like tennis and bowling, the Lake hospital system is the first locally to use the Fit game in physical therapy.

Stroke sign and prevention tips

Another Web site with some stroke prevention tips: Signs and tips for prevention from familydoctor.org. A snippet:

Risk factors for a stroke

* Atherosclerosis (hardening of the arteries)
* Uncontrolled diabetes
* High blood pressure
* High cholesterol level
* Smoking
* Previous transient ischemic attack (TIA)
* Heart disease
* Carotid artery disease (the artery that carries blood to your brain)

Many of these risk factors are treatable - so if this list sounds like you or one of your loved ones, get to a doctor if you haven't already!

Anniversary of hole repaired

Close to the end of the day today, June 25, 2008, remembered that this is the first anniversary of the procedure that plugged a hole in my heart.

My 1998 stroke was likely caused by a small hole between the two atrial chambers, called a patent foramen ovale. Everyone is born with the hole and most of the time, it seals up shortly after birth. And add another defect: The wall between the two chambers, called the atrial septum, should be smooth and flat. If so, even a patent foramen ovale is unlikely to cause a problem. In some instances, though, the atrial septum is misshaped, called an atrial septal aneurysm. The hole and the aneurysm combination increases the chances of a problem.

Normally, the right atrium receives blood from the vein side of the circulatory system, then passes it along to the lungs. In addition to processing oxygen for the blood supply, the lungs also use a filtering mechanism to remove debris, such as clots. From the lungs, the blood is moved back to the other side of the heart and pumped out to the arterial system, supplying oxygen-rich filtered blood to the body. However, if the atrial septum has a divot, if you will, then debris can collect. When pressure builds up in the chest -- say, from coughing or sneezing -- then blood and debris can move through the patent foramen ovale from the right atrium to the left atrium, circumventing the lung's filtering system. Unfiltered blood is pumped out into the body, including the brain.

Because of this, 10 years ago I experienced a cryptogenic stroke -- that is, a stroke with no obvious cause. In April 2007, a much more minor episode occurred, which triggered a round of tests. As long as the conditions remained, my risk of stroke was several percentage points higher than the rest of the population, despite the fact that I don't smoke, have low cholesterol levels, excellent blood pressure readings and, being a distance runner going on 20 years, am generally quite fit.

Thus, a year ago, I went through a procedure, in which a doctor snaked a couple of tubes through some arteries and deployed a device that plugged the hole. Within six weeks, I was back to normal. After six months, I received a final OK that the hole was completely sealed. No more restrictions, no more prescription blood-thinner, no higher stroke risk than the rest of the population.

Found a video about the procedure, including the very same doctor who did the work at Barnes-Jewish Hospital in St. Louis. If nothing else, I hope this gives someone reassurance that even a hole in the heart can be defeated.

Stroke Doc - slightly off-beat but well-thought resource

A blog with the straightforward name - Stroke Doc - is a resource offering original postings and numerous links.

It categorizes resources aimed at everyone, then another set aimed toward experts.

Every now and again, it's good to remind ourselves a caveat the blog mentions: "The site contains general information only and is not intended to replace a physician's advice. Please consult a physician to address your specific health care questions."

Same is true for every Web site or blog. The Internet can't replace your own doctor(s). And for matters of faith, it can't replace a church home or pastor.

Stroke signs: Remember the first three letters, S. T. R.

One more way to remember stroke symptoms, recently from The HealthCentral Network - STROKE: Remember the First Three Letters, S. T. R.

The simple test, according to the article:

S: Ask the individual to SMILE.
T: Ask the person to TALK and SPEAK A SIMPLE SENTENCE (coherently) i.e., "It is sunny out today").
R: Ask him or her to RAISE BOTH ARMS.

So as you try to remind and teach people about stroke symptoms, another mnemonic device to help.

Beliefnet: Health and Healing

A Web resource worth checking out, especially the particular entry on stroke information on the Web site Beliefnet: Health and Healing.

Lots of other material that can be related to stroke survivors, family members and caregivers, including weight loss, fatigue, stress and depression, can be found on the main Health and Healing page.

All about stroke resources

An often-updated Web resource for stroke survivors, caregivers, loved ones and families: All About Stroke.

One good, educational article is about blood thinner medication - which clot-type stroke survivors often take - and the side effects. It covers aspirin, Aggrenox, warfarin, Plavix, heparin and enoxaparin, a particular form of heparin.

With the exception of enoxaparin (as far as I know), I've used them all and glad they're available to help with stroke prevention. The article does a good job of going quickly through the primary side effects to watch out for. Click on the drug names (or the photo of the pills) for additional links.

You can also sign up for an e-mail newsletter about stroke-related news from the site.

(Image from National Library of Medicine)

Growing African American awareness

A blog devoted to African American-oriented issues, including health, posted an important item recently, with a title at home even here: Would you know if you were having a STROKE?

The article brings out some key points to ponder, quoting National Stroke Association statistics:

• Half all black women will die from stroke or heart disease.
• Blacks are twice as likely to die from stroke than whites.
• In the 45-54 age group, black males have a three times greater risk than white males of having an ischemic stroke.
  

The blog links to a public service announcement video and gives some vital stroke facts. Plus, the National Stroke Association has lots of additional links and educational material focusing on the African American population and preventing strokes.

What's aphasia? Many stroke survivors know

This month (June) is Aphasia Awareness Month - and if you're like me, you weren't aware of aphasia until it hit close to home. Or maybe you're still unfamiliar.

So what is aphasia?

The National Aphasia Association defines it this way:

Aphasia is an acquired communication disorder that impairs a person's ability to process language, but does not affect intelligence. Aphasia impairs the ability to speak and understand others, and most people with aphasia experience difficulty reading and writing.
... The most common cause of aphasia is stroke (about 25-40 percent of stroke survivors acquire aphasia). It can also result from head injury, brain tumor or other neurological causes.
... Aphasia affects about 1 million Americans - or 1 in 250 people - and is more common than Parkinson's Disease, cerebral palsy or muscular dystrophy. More than 100,000 Americans acquire the disorder each year. However, most people have never heard of it.

I was hit by aphasia with my stroke, and through speech therapy, was able to regain my speaking, reading and writing ability. I suspect most people in similar circumstances wonder, from time to time, about a forgotten or misused word or a need to re-read a sentence: Would I have made that mistake if the stroke never happened? Another one of those unanswerable questions.

So if you know a stroke survivor, you might well know someone impaired - temporarily or permanently - with aphasia. Visit the National Aphasia Association Web site and review the resources. And share awareness of aphasia with others.

Awareness - Christ and his followers

Last Sunday, the revised common lectionary Gospel reading came from Matthew 9:9-13, 18-26, words you might have heard before.

Jesus called for Matthew, a man of poor reputation, to follow him. He responded to a woman's touch to his garment by healing her infliction. He knew what a funeral crowd needed to hear and witness:

"Go away. The girl is not dead but asleep." But they laughed at him. After the crowd had been put outside, he went in and took the girl by the hand, and she got up.

A constant theme through this reading: awareness. Jesus was aware of the struggle within Matthew, the faith of the woman, the need of the funeral crowd. And among stroke survivors, family members, loved one and caregivers, awareness is also a big deal.

Stroke is the third leading cause of death and the leading cause of permanent disability in the United States. Part of the reason is that people are generally not aware of stroke signs or symptoms, and we’re trying to change that, to make sure there’s stroke awareness. The more people who know, the better chance of survival and success and the better chance of fewer disabilities.

If someone’s face seems to droop on one side, that’s something to be aware of.

If someone has sudden weakness in an arm or leg, that’s something to be aware of.

If someone’s speech is suddenly slurred, that’s something to be aware of.

There’s no time to lose – the faster the person gets help, the more likelihood of better a outcome.

Awareness was a constant theme of Jesus’ ministry. Consider all those times that he was aware of a need for a word, for guidance, for calling to follow, for an action. Jesus didn’t do this in a random way, in a careless way. His word and action came through his perfect awareness.

In the Scripture reading above, we first have Matthew. As a tax collector, he’s got three strikes against him: an underling of the Roman government, constantly in contact with Gentiles and therefore unclean, and in a profession regarded, at the time, to be dishonest.

But Jesus was aware that Matthew was ready to follow. Just like those doctors who saved my life, Jesus used awareness to diagnose Matthew’s symptoms and acted to supply a cure. What an example for humankind: be aware of the signs and symptoms, and act.

Then there’s the woman, too afraid to approach Jesus face to face, reaching down to touch his garment in a crowd. But despite the crowd and confusion, Jesus was aware of that light touch, was aware of the woman’s faith. Jesus used awareness to diagnose the woman’s needs and acted to supply a cure.

And the story of the death of the daughter – when he arrives at the house, no one else has the faith that the synagogue’s leader showed when he asked Jesus to bring back his daughter. A funeral was taking place. Here, too, Jesus used awareness to know what the leader and the others needed and acted.

Let's take two ideas away from the story of Jesus’ awareness.

First, how can we use our own gift of awareness? Consider that question in even simple ways:

• Attention to those around us
• Using our faith and reasoning to gauge when it looks like someone has a need
• Willing to act or call out for help in that time of need

Second, let’s look at our relationship with Jesus Christ and his awareness:

• He has complete awareness of our needs; he is our ultimate physician
• His awareness gives us an open invitation to prayer and communion with Christ
• With that relationship of awareness and understanding, we can strengthen our bond with Christ every passing day

Because at the end of the day, we are all in need. Sometimes, I think back to the day of my stroke in 1998 and shudder and ponder the unanswerable questions: What if I was alone? What if I couldn’t get anyone’s awareness?

But the word today assures us with answers: In our relationship with Christ, we are never alone. And in Christ, we always have a friend with awareness.

Always.

A friend.

Who is aware.

And that is indeed good news.

Need for speed: Those three hours

An article in the magazine Innovate, published by Barnes-Jewish Hospital and Washington University Physicians, explains how tissue plasminogen activator (tPA) has dramatically changed the treatment of clot-type strokes.

And it emphasizes the need to get stroke victims - even suspected stroke victims - to a properly equipped hospital right away. The clot-busting medication tPA is know to be effective, in carefully managed cases, within three hours of the onset of an ischemic stroke.

It also goes to the need for preparation and the availability of the right health professionals. Not every stroke victim is a candidate for tPA, and there's a limited amount of time to make that determination.

“In the wrong hands, tPA can be deadly,” the article quotes Dr. Jin-Moo Lee, Washington University neurologist at Barnes-Jewish. “Studies have shown that hospitals without a lot of experience actually end up causing more harm than good.”

That's important to know - especially if you have to speak on behalf of a stroke victim. Call 9-1-1. Be insistent that the victim is transported to a hospital with the correct expertise.

Stroke survivor resources

If you've already lived through a stroke, you don't want another. A good Web resource on a project called Steps Against Recurrent Stroke (S.T.A.R.).

Just a few facts that demand your attention:

• Three-quarters of a million Americans experience a stroke each year, and at least 1 in four (25%-35%) will have another stroke within their lifetime.
• Within 5 years of your first stroke, your risk for another stroke can increase more than 40%.
• Recurrent strokes often have a higher rate of death and disability because parts of the brain already injured by the original stroke may not be as resilient.
• Within five years of a stroke, 24 percent of women and 42 percent of men will experience a recurrent stroke.

And some recommendations that make a great deal of sense:

• Stop smoking
• Keep blood pressure, cholesterol and diabetes under control
• If you have an irregular heartbeat work with your doctor to control it
• Eat a healthy diet
• Increase physical activity

This advice won't cover everyone in specific terms of stroke causes (see this link about cryptogenic strokes, which describes my own stroke history). Still, it's good general advice for one and all.

Detecting danger: Stroke survivor says free screening saved her live

A story worth reading was recently in The Daily News Tribune (Waltham, Mass) and tells the story of Massachusetts General Hospital employee and, on a whim, stopped in a corridor for a free ultrasound carotid artery screening, just happened to be offered at the hospital Feb. 13.

Turns out she had 90 percent blockage in her right carotid artery, putting her in high risk for a stroke. Doctor's at the hospital's vascular center did a procedure and cleared the blockage, drastically reducing the risk.

Now, some experts say you shouldn't just have a screening on a whim. A good article from About.com makes some good points about false readings. However, the About.com writer does suggest that some people - those with a family history or those with known vascular disease - might be good candidates.

With Stroke Awareness Month just behind us, a good suggestion: Consider your own history and act accordingly. Keep in mind that this is from a non-doctor. Why not ask your own doctor for advice?

More details on the snake venom research

Last posting linked to a news article about research in using snake venom to treat stroke patients. A more technical and detailed link can be found with the Internet Stroke Center's Stroke Trials Registry.

The page describes the efforts to learn about the results of an intravenous infusion of ancrod - pit viper venom - within six hours of a stroke. The study looks at patient status three months afterward.

The study is still recruiting facilities and patients to take part in the study.

In the future, stroke survivors might thank snakes

Stories about snake venom treating stroke victims have appeared from time to time, so it's high time to link to one for Stroke Awareness Month.

This one is from the Tallahassee Democrat. A particular study, in which the Tallahassee Memorial Hospital's Stroke Center is taking part, focuses on the use of Malayan pit viper venom. According to the article, the venom might work up to six hours after a stroke; a drug derived from the venom "is believed to have anti-coagulation and anti-clotting effects, which may improve blood flow to the brain."

The worldwide study started in 2005, and it bears watching.

Another hole-in-the-heart survivor

Another story about the closing of a patent foramen ovale - a hole between the two upper heart chambers - for a stroke survivor, increasing the chances that it won't happen again.

Green River Heart Institute of Owensboro, Ky., posted this story the other day. Interesting read for fellow survivors.

"I praise the Lord that He sent me to Dr. Mathew," the article quotes the survivor. Dr. Roshan Mathew was the cardiologist who sealed the hole via catheterization.

Strokes and the presidency

As the presidential campaign continues to heat up and Stroke Awareness Month is winding down, I ran across an interesting article, citing almost a quarter of U.S. presidents have suffered strokes, during of after their time in office.

A link to the article: Newswise Medical News Stroke Expert: 10 of the Nation's 43 Presidents Have Suffered Strokes.

"Woodrow Wilson was so incapacitated by a series of strokes that his wife, Edith, became the virtual acting president," says the article. "Franklin Roosevelt died of a massive stroke on April 12, 1945, leaving the presidency to an unprepared Harry Truman just as World War II was ending."

More recently, former President Ford, now deceased began slurring speech during a 2000 interview.

A stroke doesn't distinguish between a president or a pauper or anyone in between -- so keep aware of stroke symptoms.

Can a needle save the life of a stroke victim? Not this kind

A strange, weird and funny myth came up on my Google alert about stroke news.

From the urban legend department from about.com: Can a Needle Save the Life of a Stroke Victim?

Surprise answer (at least as the needle is described in the story): No.

A doctor used a needle to use tissue plasminogen activator (tPA) that helped save my life. Different needle, different location.

Stroke awareness: for the not-so-old

Another article, from the Norwich Bulletin in Norwich, Conn., brings attention to stroke awareness, even among the not-so-old. A good reminder for Stroke Awareness Month.

The article talks about a topic we've brought up here, that of New England Patriots linebacker Tedy Bruschi and his stroke in February 2005. Bruschi was all of 31 when it happened.

The article's author, Anthony G. Alessi, MD, a neurologist, discusses how while a stroke - which he defines as "a condition resulting from a lack of blood supply to an area of the brain" - is typically associated with elderly patients, it's not exclusively for the elderly.

Bruschi's stroke, like mine, was caused by a hole between the upper chambers of his heart known as a patent foramen ovale.

"This condition allowed free passage of a small clot from the right side of his heart to his brain, resulting in stroke," wrote Alessi. "Placing a patch over the hole through a catheter sealed the hole. Unfortunately, he was left with weakness on his left side and vision loss."

My own hole-in-the-heart was patched in June 2007. You can see a video of the patch here.

With dedication and therapy, Bruschi returned to the NFL on Oct. 15, 2005.

Recently, Alessi wrote, at this year’s American Academy of Neurology meeting, Bruschi received the Public Leadership Award for his work in the field of stroke awareness.

"Bruschi’s story shows us that the combination of modern medical care, a strong will and hard work can overcome the obstacle of a stroke — even to the point of returning to the highest level of sports," the neurologist wrote.

While most stroke survivors won't play for the NFL (before or after), fellow survivors can take heart, so to speak.

Q&A article on blood-thinning medication

A good article titled "Warfarin (Coumadin) diet: What can I eat?" from the Mayo Clinic's Web site goes through the basic information on how one's diet could influence the level of blood-thinning properties of warfarin.

"Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood vessels," according to the MedLinePlus, an online resource from the U.S. National Library of Medicine and the National Institutes of Health. It's commonly prescribed to prevent strokes.

I was on warfarin - also the main ingredient for some rat poisons - for a few years, and it's important to get your blood tested periodically as your doctor directs. Blood too thin, and you could bruise or bleed too easily. Not thin enough, and the medication isn't doing all it can do for preventing strokes.

Another Stroke Awareness Month resource

One more resource for Stroke Awareness Month, this one from the Centers for Disease Control and Prevention.

It's a Web page dedicated to the month with several resources and links of helpful material.

NINDS Know Stroke home page

Another great resource for Stroke Awareness Month (or any time) is the NINDS Know Stroke home page from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

According to the Web site, "in 1999, the NINDS began developing the Know Stroke campaign to help educate the public about the symptoms of stroke and the importance of getting to the hospital quickly. The campaign includes outreach to consumers and health care professionals using mass media, grassroots outreach, partnerships and community education."

Internet Stroke Center at Washington University

Yesterday's post mentioned the Internet Stroke Center at Washington University in St. Louis. It's also connected with Barnes-Jewish Hospital, which is next door to the university's medical school.

The Internet Stroke Center offers resources for patients and families, including basics on recognizing stroke symptoms, caring for stroke survivors and reducing stroke risk. There's a link to the latest stroke news. It's a good Web site to note during Stroke Awareness Month.

One of the more disappointed stories, from MedWire News, starts this way: "Only a fifth of people who suffer a stroke recognize the event as an emergency and go urgently to hospital, research reveals." That means, of course, four out of five people who suffer a stroke do not recognize the event as an emergency and go urgently to a hospital. We need to do better. Much better.

Here are the symptoms:

• Sudden numbness of the face, arm, or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

Even if you suspect that's going on - to you or someone else - get to some help fast. As stated before, a false alarm is better than a funeral.

Being several days out of my effort to post to this blog almost every day and keep it active, I've found it gets easier every day and discovered some fascinating people and additional resources. And on that note, thanks be to God.

Aspirin can help

For Stroke Awareness Month, you might want to consider this easy and cheap preventive measure: taking a baby aspirin.

The St. Louis Post-Dispatch quoted Dr. Abdul Nassief, an assistant professor at Washington University and director of the clinical stroke center at Barnes-Jewish Hospital, that an 81-mg aspirin, every other day, reduces stroke risk. He cautioned against taking it, though, if your blood pressure is more than 140/90.

"It's a winner," Nassief told the newspaper. "And for women over 40, a baby aspirin every other day reduces the risk of stroke by 25 percent." And it doesn't matter if it's coated or uncoated, although the coated aspirin might cause less upset.

Not being a doctor myself, I'd always check with my doctor to see if there's any other reason not to take the aspirin, especially if you're already taking a prescription medication.

Risk assessment tool

Washington University's Siteman Cancer Center offers a tool to assess your risk for a stroke, so for Stroke Awareness Month, this is a good time to take the test.

Go through a short questionnaire (no fibbing!), and you'll get easy to understand results about your own risk.

This is from the Spring 2008 edition of Innovate, a magazine from Barnes-Jewish Hospital and Washington University Physicians.

Another survivor's story

The inspiring story posted on the Nashville Tennessean's Web site is a good read for Stroke Awareness Month.

The writer suffered a massive stroke in 1994 - at age 36 - ending his ability to speak and left him "for all intents and purposes, a quadriplegic."

He could have called it quits, but instead founded The Stroke Network, designed to provide "support and information to stroke survivors, caregivers, family members and anyone whose life has been affected by stroke." There's also a link to the StrokeNet Blog and talks about, among other developments, how the founder "developed a close and loving relationship with God."

Anniversary and awareness

Stroke Awareness Month stories will come and go, with phrases to help you recognize stroke symptoms. We should all pay attention.

But any month, any day, any time, the bottom line: If things don’t seem right, don’t hesitate. If speech is slurred, get some help. If someone’s face becomes off kilter, call 9-1-1. If a limb gets weak or numb, stop what you’re doing and get to an Emergency Room. Vision blurred or sudden confusion? Don’t take a chance. Quick onset of a severe headache? Don’t take two aspirin and call the doctor in the morning. Get to the doctor now.

I was certainly blessed to receive help 10 years ago today, May 8, 1998, when my stroke occurred. Details are here.

My personal – and apparently final – resolution came last summer. In April, I had a mini-stroke, what doctors call a transient ischemic attack. A trip to the emergency room – hey, I learned my lesson - led me to some Columbia, Mo., specialists. A test involving a camera dropped down my throat to get an echo image of my heart confirmed what I was told 10 years ago, that the apparent cause was a misshapen wall and a hole between the two upper chambers of my heart.

With the combination of those heart defects, blood comes in on the vein side laden with clots and other debris - as normal - and instead of being pumped through the lungs and get filtered, sometimes debris collected along the wall, then shunted through the hole and pumped out, unfiltered, into the arterial system, a stroke waiting to happen.

Last June, a doctor in St. Louis snaked a tube through an artery and placed a quarter-size patch, made of nickel-titanium, over the hole. Six months later, my risk of a stroke became no more than the rest of the population in general. To celebrate my 10 years, I plan to run 10 miles, as usual, on Saturday morning.

Many stroke survivors do not have such an outcome, I know. But more awareness and faster treatment can save or improve a life. Perhaps even yours.