The world gets the 'Lazarus effect'

Jesus, once more deeply moved, came to the tomb. It was a cave with a stone laid across the entrance. "Take away the stone," he said.

"But, Lord," said Martha, the sister of the dead man, "by this time there is a bad odor, for he has been there four days."

Then Jesus said, "Did I not tell you that if you believed, you would see the glory of God?"

So they took away the stone. Then Jesus looked up and said, "Father, I thank you that you have heard me. I knew that you always hear me, but I said this for the benefit of the people standing here, that they may believe that you sent me."

When he had said this, Jesus called in a loud voice, "Lazarus, come out!" The dead man came out, his hands and feet wrapped with strips of linen, and a cloth around his face.

Jesus said to them, "Take off the grave clothes and let him go."

-John 11:38-44

Not long ago, I heard a presentation by one of the doctors responsible for making tPA (tissue plasminogen activator) available to stroke patients.

In my own experience, I could not speak, I could not move my right arm or leg - but after the clot-busting tPA, I regained those abilities. It was a dramatic experience. The doctor called it "the Lazarus effect."

It made me think of the story of Lazarus - see above - in John's gospel. There, a dead man regained his life. Once there was no hope. His sisters, relatives and friends knew they lost him. Jesus entered. Hope returned. Lazarus lived.

How about this world? On a cold night so long ago, a world needed this Lazarus effect. Today, this world needs it as well. On that first Christmas, God gave the world the Lazarus effect: a new beginning, a new covenant, a new life. Today, you can receive your own Lazarus effect.

New stroke-related videos

From United Kingdom and elsewhere...

Perhaps soon - a safer blood thinner

From a U.S. News and World Report article not long ago:

New blood thinner could replace warfarin

The new study, published early online Dec. 6 by the New England Journal of Medicine, follows on the heels of two other promising reports presented at the American Heart Association meeting in Orlando, Fla., last month. Those studies found that dabigatran appeared safe and effective in preventing blood clots when patients were treated for acute coronary syndrome, a cluster of symptoms that might indicate a heart attack; it was also found superior to warfarin in preventing strokes in patients with the irregular heartbeat known as atrial fibrillation.

In the new trial, warfarin and dabigatran seemed to perform equally well in helping patients with potentially dangerous clots in their veins avoid a subsequent clot or death over the next six months.

But it is in its ease of use that the newer drug appears to outshine warfarin, the authors of this latest study say.

A story near to my heart - or brain...

Heard this on NPR Monday morning, during my typical 40-minute run in my neighborhood. It includes a story about one woman's stroke, how time was critical and what we can all learn from it.

Back in 1998, I was blessed to receive tPA, a clot-busting drug. Most, as this report notes, are not quite so fortunate. Read, listen and learn:

Drug can stop strokes, but most patients don't get it

Strokes are the third-ranking cause of death and the leading cause of disability. But most stroke specialists think it doesn't have to be so bad.

The vast majority of strokes are caused by a clot that blocks blood flow to part of the brain. Depending on where, victims suffer dizziness, weakness, numbness, loss of speech or other symptoms. Most of the time, the damage is permanent.

Since 1996 there's been an approved drug called t-PA (for tissue plasminogen activator) that, according to some big studies, can often break up the clot, restore blood flow and prevent much permanent damage —- if the drug is given within a few hours of symptom onset.

Remember: Take that medicine!

Are stroke survivors taking their medicine?

People who have had an ischemic stroke are at higher lifetime risk for another stroke, but several types of medication can reduce that risk. One of the simplest regimens involves antithrombotic medications, otherwise known as blood thinners, of which the most common is aspirin.

But a new UCLA study to determine whether the use of antithrombotic medications among stroke survivors increased over a seven-year period found that in each of the years, approximately 20 percent of survivors were not taking these medications — a figure that did not decrease during the time period. The study also found that individuals who were younger, female or Hispanic were less likely to be taking antithrombotic agents.

The findings appear in the January 2010 issue of the American Journal of Preventive Medicine.

(Image from National Library of Medicine)

'I am the bread of life'

Then Jesus declared, "I am the bread of life. He who comes to me will never go hungry, and he who believes in me will never be thirsty."

-John 6:35

And of course, "hungry" and "thirsty" aren't limited to the literal - who isn't hungry for answers after a stroke, or thirsty for relief of the stress that can stroke to a stroke survivor or a caregiver.

Last Sunday, we had communion at Community United Methodist Church in Columbia, Mo. The bread and drink were in no way able to relieve any literal, physical hunger or thirst. But it brought to our attention the more important matters of feeding the soul.

If you don't have a church home, find a place that helps feed your own soul.



(Image from rthmhlds on Photobucket)

Pays to take preventive measures

Medical news: Southern 'Stroke Belt' maintains its grip

Although stroke mortality in the handful of Southern states with the morbid nickname decreased from 1980 to 2000, people born in the region and living there as adults still had a one-third greater risk than the general population, researchers reported in the December issue of Neurology.

Learn from these just-found videos

Words from Texas Health Harris Methodist Hospital in Fort Worth (a great city!). The speaker is Roger Blair, M.D., a neurologist on medical staff:

And from a two-month initiative, administered through the Virginia Department of Health and made possible with a grant from the Centers for Disease Control and Prevention:

'My salvation comes from him'

My soul finds rest in God alone; my salvation comes from him.

-Psalm 62:1

What is "rest" for a stroke survivor or caregiver?

I think of it as finding peace, as finding a place without constant turmoil, as finding how life's priorities.

As we begin to celebrate Advent this year, may God help you find your rest.

Good news on the prevention front

The levels of "bad" cholesterol is a known cause of strokes, and controlling those levels is a known way to help stroke prevention.

So good news from a recent study:

The number of adults who had high levels of low-density lipoprotein, or LDL, cholesterol dropped to 21 percent in 2005 to 2006 from 32 percent in 1999 to 2000, according to a study published today in the Journal of the American Medical Association. About 13 percent of those in the study were taking cholesterol-lowering medicines such as Pfizer Inc.’s Lipitor, the top-selling drug in 2008, and Merck & Co.’s Zocor, compared with 8 percent in the earlier period.

The drop in the rates of high levels of LDL cholesterol may be a result of more people taking cholesterol-lowering medicine, eating a better diet and getting more exercise, said the study’s lead author, Elena Kuklina, in a telephone interview today. Even with that improvement, too many people have elevated levels, said Kuklina and other researchers at the Atlanta-based U.S. Centers for Disease Control and Prevention.

Rewiring the post-stroke brain

A summary of a study done in the town where I live. Sometimes, you read about a report that mirrors your own experience. Like those studied in research on pushing the brain to find new pathways, I felt my brain rewiring itself for far longer than six months:

Until recently, scientists believed that, following a stroke, a patient had about six months to regain any lost function. After that, patients would be forced to compensate for the lost function by focusing on their remaining abilities. Although this belief has been refuted, a University of Missouri occupational therapy professor believes that the current health system is still not giving patients enough time to recover and underestimating what the human brain can do given the right conditions.

In a recent article for OT Practice Magazine, Guy McCormack, clinical professor and chair of the occupational therapy and occupational science department at the MU School of Health Professions, argues that health practitioners believe their clients need more time and motivation to reclaim lost functions, such as the use of an arm, hand or leg. With today's therapies, it is possible for patients to regain more function than ever thought possible, McCormack said.

"Patients are able to regain function due to the principle of neuroplasticity, or the brain's ability to change, especially when patients continue therapy long after their injuries," McCormack said. "Therapists once believed the brain doesn't develop new neurons; but, now they know neurons change their shape and create new branches to connect with other neurons, rewiring the brain following an injury or trauma."

Sometimes, it's hard for stroke survivors to learn patience - myself included. I felt so much frustration on reading and writing, finding the wrong words when speaking. In particular, volume or tone was wrong, or I would mixup pronouns - calling a guy a "her" or a woman a "him." Weird.

On some days, I could even feel that I my brain had moved up one more notch. One in particular was very close to home. I was in much (St. James United Methodist, in Little Rock) and was during a hymn. I had felt like I could no longer carry a tune. But on that day, suddenly I gained some ground; I could have sworn that I felt it.

So in a house of worship, I lifted up my own little prayer.

Patience is hard sometimes. But this study gives some hope that even months and months post-stroke, rewiring is possible.

More on high blood pressure and strokes

One more Kiwi-related item; it's clear that no matter where you are, know your blood pressure and if needed, act.

High blood pressure rate causes alarm:

The findings did not surprise South Canterbury Stroke Foundation field officer Christine Holling, who said at least five people in South Canterbury had a stroke every week, a third of them potentially avoidable.

"There are 22 a day in New Zealand.

"A third are caused by high blood pressure, which could be avoided if people had their blood pressure checked."

American Heart Association PSA -- Blood Pressure
Uploaded by weatherguru76. -

Depression can follow a stroke

Caregivers are important for stroke survivors, especially those who suffer depression post-stroke. According to this recent study, this effects women more than men:

Brittany Poynter, M.D., and colleagues from the University of Toronto looked at 56 studies on stroke and depression comprising more than 75,000 people, about 12,000 of them women. The time between the stroke and onset of depression ranged from less than two weeks to 15 years.

In women, rates of post-stroke depression ranged from about 6 percent to 78 percent, while in men depression rates ranged from 4.7 percent to about 65 percent.

These findings are important, Poynter said, because women who have had a stroke generally do more poorly than men. They tend to have higher rates of disability and longer hospitalization times. The authors say this might be due in part to higher rates of depression. In addition, “women may have less access to care,” Poynter said.

Time = brain

As one more report shows, call 911 at first sign of stroke:

In a report released Friday by the Centers for Disease Control and Prevention, a national registry of patients who suffered a stroke between 2005 and 2007 has found that nearly 40 percent used private transportation to get to a hospital emergency room rather than calling 911.

Bad decision, because as every neurologist will tell you: Time is brain.

ER crowds can keep you waiting

With H1N1 making news, with seasonal flu coming to an ER near you soon, this story about ER crowds and longer waits from ABC News makes sense - unfortunately:

Wait time for the very sickest patients, those would die without being treated promptly (for example, someone whose heart had stopped or who wasn't breathing) was not affected by crowding. But patients who were in the next tier down, for example someone with chest pain or signs of stroke, did have to wait longer in crowded conditions.

In my own experience and observation, people who arrive via ambulance get shorter wait time - even more evidence that if you're wise, you'll call 911 if you or someone near you is showing stroke symptoms. Life, or lifelong disability, could hang in the balance.

Perhaps some success in UK stroke awareness

A United Kingdom stroke awareness effort, launched in February, might have shown some success:

Statistics showed there was a 55% rise in the number of calls about possible stroke symptoms made to ambulance trusts in 2008/09.

Stroke is the cause of death for 9% of males and 13% of females in the UK. 150,000 people in the UK suffer from a stroke every year and a quarter occur in people aged under 65.

The FAST (Face, Arm, Speech, Time) campaign was created by doctors to help people recognise key stroke symptoms and allow emergency staff to identify problems quickly.

The quicker the help, quite often, the better the outcome! No matter where you are.

(Photo via flickr)

More from Kiwis about stroke awareness

A Kiwi suffers a stroke every hour

Director of the National Research Centre for Stroke, Applied Neurosciences and Neurorehabilitation at AUT University, Professor Valery Feigin says the summit will provide direction for the future development in management and prevention of stroke in New Zealand.

“Our stroke rates are four times worse than other developed countries with over 32,000 people suffering a stroke each year,” he says, “and every hour someone in New Zealand is struck by a new stroke.”

The numbers may change, depending on the country. But stroke rates, stroke signs and symptoms can't be ignored.

(Image from the Stroke Foundation of New Zealand)

High blood pressure - a killer

More news from New Zealand, a great and friendly country:

Stroke Foundation shocked at numbers with elevated blood pressure:

To mark Stroke Awareness Week, the Stroke Foundation, St John and Lions offered free blood pressure checks on Saturday 12 September at over 100 supermarkets throughout the country. About 12,000 people had their blood pressure checked.

Dr John Fink, Stroke Foundation Medical Advisor, says 46 percent of the blood pressures reported back to the Stroke Foundation were above normal.

"These were people with blood pressures of 140 systolic or higher and 90 diastolic or higher - in many cases, considerably higher. Blood pressure that is consistently above 140 over 90 is considered to be high. Normal blood pressure is around 120 over 80. In general, the lower the better."

(Photo from U.S. Department of Veterans Affairs)

Sounds like a downer until you think about it

For, "All men are like grass, and all their glory is like the flowers of the field; the grass withers and the flowers fall, but the word of the Lord stands forever." And this is the word that was preached to you.

-1 Peter 1:24-25

At first reading, Peter sounds like he's giving us a reminder of our own mortality. But think further.

Yes, grass and flowers wither - and they must be. Without withering, renewal cannot take place. The glory of renewal would never be known.

God's word is his promise - accept him, and you, too, will see the ultimate renewal in the proper time. And that's a great word.

(Photo from the Missouri Department of Natural Resources)

'A ransom for many'

Instead, whoever wants to become great among you must be your servant, and whoever wants to be first must be slave of all. For even the Son of Man did not come to be served, but to serve, and to give his life as a ransom for many.

-Mark 10:43-45

What better way to describe those people who care for those who lived through a stroke - as they survive, struggle and recover.

God bless the caregivers, the servants - like Christ, they do not come to be served, but serve. Today, pray for a caregiver you know.

World Stroke Day - a prayer

A late note about a day that should be more recognized: World Stroke Day. From the New Zealand Stroke Foundation:

Stroke is the second largest cause of death in the developed world, as it is in New Zealand. On World Stroke Day (29 October) the NZ Stroke Foundation is calling on New Zealanders to attend to their risk of stroke.

"The simple fact is that the majority of strokes are preventable," says Stroke Foundation CEO Mark Vivian. "Making simple lifestyle changes can help prevent stroke.

"Eating a healthy diet with reduced salt, having regular physical activity, not drinking too much alcohol and being smokefree will reduce your risk of stroke. And very importantly, make sure you keep your blood pressure down."

A prayer that people become more aware of stroke prevention efforts, and signs and symptoms.

(Image from Stroke, the journal of the American Stroke Association)

Walking post-stroke can help

As a long-time distance runner, I can attest that moving helps those who experience a stroke. And while I get the gist of the article, must point out that strokes don't always happen to "older" people.

Of course, moving can be limited due to the stroke, but this recent article that walking might be helpful after a stroke:

People who suffer a stroke can substantially improve their ability to get around independently if they take walks a few times a week, according to an updated review of the medical literature.

Strokes often occur in older people who have already lost some fitness and muscle strength. Suffering a stroke may further weaken an older person by causing partial paralysis and other neurological problems.

(Image from General Services Administration)

Good news, bad news for stroke patients

As non-disabled stroke survivor - thanks to quick treatment with the clot-busting drug tissue plasminogen activator - it's good to hear that more stroke victims are receiving that treatment. But there's a lot more work to accomplish because the numbers are still not good enough:

Duke University researchers reviewed records of 428 people brought to U.S. stroke centers in 2001, and 481 patients treated at those centers in 2004. In both years, only 37 percent arrived within two hours of the start of stroke symptoms.

But 37.5 percent of those who arrived during that two-hour window received the clot-busting tPA therapy in 2004, compared to just 14 percent in 2001.

"It's a double-edged sword," said study author Dr. Larry B. Goldstein, director of the Duke Stroke Center, in Durham, N.C. His report is published in the Oct. 1 issue of Stroke.

"The organization of acute stroke care in hospitals has improved, so more patients are actually being treated, but the bad news part of it is that the proportion of patients who show up in time hasn't changed," he said.

Another take on stroke/TIA study

The other day, I posted a note how a transient ischemic attack should be considered a warning about a full-blown stroke.

But on the flip side, that same recent study showed that stroke strikes without warning in majority of patients. So while you should a TIA seriously, the study shows the incredibly importance of taking stroke signs seriously - they can come without warning.

So as always: be aware of stroke signs, and move quickly to get some help!

Quick action can make a big difference

From Cleveland.com (aka The Plain Dealer), a video explaning why quick action can make a big difference for stroke patients:

... Dr. Joseph Hanna of MetroHealth Medical Center discusses those symptoms. If the drug TPA can be administered within three hours of the onset of those symptoms, disability from a stroke can be reduced by as much as 40 percent.

Among the symptoms: a droopiness on one side of the face, slurring of words or some interruption of speaking ability or the weakening of one arm.

Placing your trust in the Lord

Trust in the LORD forever, for the LORD, the LORD, is the Rock eternal.

-Isaiah 26:4

We've all had days of frustration, anger. When words fail. When we are physically exhausted. When the system seems to be working against us.

Fact is, there is little to this world we can trust, in the ultimate sense. Human inventions and conventions fail; humans make mistakes; people can be thoughtless.

But read the words from Isaiah - despite human shortcomings, we do have an ultimate Rock to trust with our very souls. So when those days of frustration come, remember these words. You will still find trials in this finite world, but as Isaiah wrote, trust in God can carry you past it.

Take warnings signs seriously

It's too easy to ignore a mini-stroke or transient ischemic attack - TIA - instead of acting and taking the event seriously.

After all, you get over it, with no lingering effect, right?

Wrong. A recent story, based on recent research, reporting that one in eight strokes are preceded by a TIA:

Mini-strokes, or TIAs, have the same symptoms as a full blown stroke, including sudden weakness, slurred speech and difficulty walking. The symptoms last only minutes or hours and since people recover within a day, many don't take them seriously.

But doctors say patients who suffer mini-strokes should seek immediate medical treatment, because intensive treatment can prevent a larger stroke.

For the study, researchers looked at 16,400 patients who went to Ontario hospitals after having a stroke over four years. Among the patients, 2,032, or 12.4 per cent, reported having the symptoms of a TIA prior to a major stroke.

This is a case where common sense prevails. Take action on a TIA, and you could avoid a deadly or severely damaging stroke. So take that action if you think you or someone you care about is having a TIA. Make sure you know the signs.

Get to an emergency room - or better still, a local stroke center if available - as soon as possible. Best bet: Call 911.

Common sense, standards help guide health screenings

It seems like a good idea - screening for stroke risks.

However, Jeff Baillon of KMSP-TV in Minneapolis-St. Paul reports that screening isn't as simple as it seems. There are actual government guidelines for tests cited in this piece aired not long ago.

Watch and learn:

'No longer an affliction of old age'

Something I've preached from time to time on this blog, here's yet another piece of information that confirms it: Even if you're not elderly, be aware of stroke signs and symptoms, and try to reduce your stroke risks. It can happen at any age, so read it and act:

Stroke may be striking at a younger age:

"Stroke is no longer an affliction of old age," said lead researcher Timothy J. Wolf, an instructor of occupational therapy and neurology and investigator for the Cognitive Rehabilitation Research Group at Washington University School of Medicine, in St. Louis. "People in the working ages of life are having strokes with greater regularity than ever before."

Facing survival post-stroke

A story about a Texas stroke survivor:

His advice for stroke survivors is simple - think positively and remember; you have to have a sense of humor about the situation.

"When I tell other stroke patients my story, I tell them, don't give up," he said. "You don't have to sit in your chair and waste away. Get up and do what you have to do in order to get over these things and you will get over it. It might take a long time, it's not easy, but you will do it."

Keep in mind that the "it" will be different for every stroke survivor. And as the survivor says - we're not talking about making recovery simple or easy.

Still, the sentiment is there. If you are a stroke survivor, you can make a difference, small or large.

Leaves football but not stroke awareness

Tedy Bruschi has an amazing and inspiring story - veteran linebacker for the new England Patriots, a stroke survivor who came back and played the game again, announced his retirement not long ago.

His retirement, that is, from professional football, but not the even more important task - promoting the cause of stroke awareness. From the Boston Herald:

“To see someone go through it the way he did was really inspirational,” said Katie Jerdee, 22, a stroke survivor and soccer player at Northeastern University. “People could see it happens to young people and they can overcome it and they can return to what they were doing before,” added Jerdee, who raised $10,000 for stroke awareness running two Boston Marathons on Tedy’s Team.

The 36-year-old linebacker announced his retirement yesterday, after 13 seasons with the Patriots [team stats]. Bruschi suffered a stroke in February 2005 and went on to play four more seasons and to champion the cause of stroke awareness through legislative lobbying, public service campaigns and a book, “Never Give Up.”

(Image from Flickr)

Despite some progress, disparities remain

This article by Reuters Health illustrates how strokes can impact. Despite age or race, this problem impacts us all, and we're all better off if we all work to reduce stroke risks:

Strokes in young blacks drain South Carolina's pocket:

In South Carolina, African Americans suffer strokes at younger ages and have worse outcomes than Caucasians, Dr. Wayne Feng and colleagues report in the latest issue of the medical journal Stroke.

They point out that in their state, lifetime costs for strokes that occurred in 2006 alone, including lost earnings, are likely to total $1.92 billion.

The persistent racial disparities in stroke "result in significant economic consequences to the state, particularly among younger patients," the researchers conclude.

Stroke survivors - watch out for falls

A recent study warns of the risk of falls - Stroke doubles risk of hip, thigh fractures:

The study compared 6,763 people in the Netherlands who had fractures of the hip and/or femur with a group of 26,341 people matched for age, gender and location who had no such fractures. The overall risk of fractures was 1.96 times higher for all stroke survivors and 2.12 times higher among women who had strokes.

The youngest stroke survivors, those 70 or younger, had the highest risk: 5.12 times normal, the researchers found.

The study was not designed to give information about the reasons for the age difference, but "we believe that in elderly patients, the relative contribution of risk factors other than stroke is higher," [lead study author Frank de] Vries said.

There are some well-known, common-sense methods to help prevent a fall - the right shoes and a cane or other assistive device, for example. If you're an advocate for a stroke survivor, or a stroke survivor yourself, take steps to reduce the risk.

Strokes in rural America

Always had a soft spot for rural places, being a small-town boy from Arkansas...

Providence wants to help treat stroke victims via high-speed Internet:

Providence neurologist, Nicholas Okon says many rural clinics don’t have a team of stroke experts, and flying a patient by helicopter or driving by ambulance takes time.

Nicholas Okon: “There’s only one FDA approved treatment for a stroke, and it’s an IV medicine that has to be given within three hours of the stroke symptoms beginning. So if they present to a facility that doesn’t have a neurologist or expertise in providing this medicine, they may not have that opportunity.

Wanted: Recognition of stroke symptoms

Not good news: A large number of older people don't know the signs of a stroke.

As reported not long ago, only 54 percent of older people said slurred speech indicated a stroke. And that was the most commonly recognized sign. Furthermore:

Researchers from Dublin, Ireland, questioned 2,033 older men and women.

They found that fewer than half knew that dizziness, numbness, weakness, and headache were common warning signs of stroke.

Dr. Anne Hickey of the Royal College of Surgeons in Ireland and colleagues also found that only 54% of participants listed slurred speech as an indicator of stroke.

What are the signs? Here they are, from the National Institute of Neurological Disorders and Stroke:

• Sudden numbness or weakness 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

And just one sign is enough. I never had a headache. Another stroke survivor never had a speech problem. Vision might or might not be affected. Again: One sign is enough. A stroke can hit the young or old.

What to do? If you have one of these symptoms, or if you are with someone who is showing a sign, get help immediately. Don't wait. Get that person to an emergency room (but don't, of course, drive yourself). Call 911.

'We are God's workmanship'

For we are God's workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.

-Ephesians 2:10

I am a very amateur woodworker. All of my workmanship is very, very imperfect.

That being said, even this amateur can make good use of his creations. We hang our coats on one of my creations. A shelf unit hangs in a bathroom. One supports a daughter's TV. Works in progress will hold some wind chimes, serve as a utility room shelf and eventually hold jewelry.

Now, imagine the workmanship of a craftsman who is far from amateur - even perfect. We are the creations of this craftsman. Perfect? Not yet. Like you - everyone - still a work in progress.

Simple test for those with risk

A transient ischemic attack can be a sign for worse to come, and strokes can reoccur. So an interesting story: Ankle test tells heart risk after TIA, stroke:

[A] simple test of blood pressure at the ankle can detect asymptomatic PAD [peripheral arterial disease], giving patients a chance to reduce their risk.

Heart disease risk goes way up in people who have suffered strokes or TIAs. That risk is even greater in people who also have PAD, a sign that plaque is clogging the arteries.

Should everyone rush out and get their blood pressure checked at their ankles? No. However, as the article notes, "But it is advised for people at high risk of PAD." When in doubt, ask your doctor.

(Image from the National Heart, Lung, and Blood Institute)

Stroke clot-buster works as well in women as men

Good news that makes sense - the stroke clot-buster works as well in women as men:

Results from some studies have suggested that male stroke victims treated with tPA fare better than women, while others have suggested just the opposite. Until now, no systematic review had been done comparing the results of clot-buster treatment in men and women, according to the report in the medical journal Stroke.

Since January 2002, Dr. Pierre Marino and colleagues from Bichat University Hospital, Paris, have collected data on all stroke patients who were given injections of tPA at their center. In addition to analyzing these data, the team performed a systematic review of other published studies on this topic.

In general, the team found, there was little evidence that gender had any effect.

I was fortunate enough to receive tPA (tissue plasminogen activator). My physical recovery came fairly quickly, followed more slowly by my language-skill recovery. Once you've gone through it, you can see the value of receiving the proper treatment. TPA isn't right for everyone, which is why stroke patients need qualified care.

One part of preventing second strokes

If it happens once, it can happen again.

Most importantly, there are ways to prevent second strokes. One is to reduce the "bad" cholesterol level. There are other elements of prevention. Among them: Watch your blood pressure and weight. Don't smoke. Control alcohol intake. Exercise (check with the doctor first).

High cholesterol-treating statins can help prevent second strokes in some cases:

The 10-year study of nearly 800 people who had strokes found a 35 percent lower incidence of second strokes and a 57 percent lower death rate among those who took statins compared to those who didn't, according to a report in the May 26 issue of Neurology.

Statins include blockbuster medications such as Crestor, Lipitor, Pravachol and Zocor.

Don't assume you suddenly need a statin, but this story is one more argument to keep working with your doctor to monitor your cholesterol and other stroke risks.

(Photo from the National Library of Medicine)

TIA care in the right places does matter

They aren't strokes, exactly, but take a TIA seriously.

A transient ischemic attack "a brief episode of a given neurological abnormality that resolves on its own, and by definition, TIA sufferers recover completely within a few minutes (or a few hours, at the most)," according to the recent article stroke hospitals offer better care for TIA patients.

And not surprisingly, stroke hospitals (those with stroke units) appear to be better than [other] hospitals at doing this. This is probably due to the presence of stroke experts in their facilities, which guarantees that patients with TIAs undergo rapid and thorough testing. This was shown in a recent article in the Medical Journal of Australia.

So be sure you know the TIA symptoms and take them seriously. Don't let anyone you care about - hey, that should be everyone, right? - just shrug it off. TIAs can be signs of a even more serious events to come. If you can, get to a stroke center, as they are called in the U.S. You can find them here if you pick your ZIP Code, with a range of at least 25 miles, choose Type of Service and choose a Certified Program called Stroke (Primary Stroke Center).

'Worth more than many sparrows...'

Are not five sparrows sold for two pennies? Yet not one of them is forgotten by God. Indeed, the very hairs of your head are all numbered. Don't be afraid; you are worth more than many sparrows.

-Luke 12:6-7

Ever have some trying times?

Trick question - of course you have. I remember the days shortly after my stroke in 1998 - struggling with speech, seeking unsuccessfully finding the right words, fighting to read. Trying times indeed.

On my better days during that time, I found these and similar words comforting and helped keep my recovery going. A mantra to remember when times get rough: You will not be forgotten.

(Photo from the National Park Service)

Again, battling stroke myths and misunderstandings

Here's another slant on taking down some misconceptions about strokes and survivors - in an article titled "Ex-scientist's stroke opens minds to recovery."

When Jill Bolte Taylor had a stroke in 1996, it didn't just change her life. ...

"I've actually had people write me, 'I'm apologizing to you for how I treated stroke patients,'" says Taylor, 50.

Her experience and book has changed how some health professionals have treated survivors.

'Do what it says'

Do not merely listen to the word, and so deceive yourselves. Do what it says.

-James 1:22

It's a busy world out there - so easy to get wrapped up on TV, telephones, computers, e-mail, text, etc. Much of the time, it seems, all we do is listen (or read, as in Facebook or Twitter).

I love to listen to the word. Often, in my running sessions, I plug in Bible recordings and just listen. It helps the miles disappear. I've gleaned so much understanding from just running along, with only Scripture with me.

So there's a time to listen and read, of course. But as James wrote, don't fool yourself - listening isn't all there is to it. You also must "do."

That's also the hard part. We can become so passive as we read or listen. The challenge to respond - at whatever level our abilities allow - is, to steal a Nike phrase, "just do it."



(Image by glorifing on Photobucket)

No guarantees in this world

In a project to keep dogging stroke myths: Here's a title of a recent article carries some needless baggage: Six ways to get on with stroke prevention and stay stroke-free.

It goes on to say:

[A]lthough stroke is the third leading cause of death in the United States, only a small percentage of Americans is able to name even a few of the diseases and unhealthy habits that can increase a person's risk of having a stroke. Here you will find six important tips that can help you improve your chances of never suffering a stroke.

While it is true that many people can, in fact, improve changes of never going through a stroke, the title or article might give you the impression that if you follow the rules, you might be "stroke-free."

The world doesn't work quite that easily. Ask me - was 39 years old, good physical condition, marathon finisher, low cholesterol, excellent blood pressure, normal weight, non-smoker, low alcohol intake, eating right, etc. Yet it happened anyway.

The problem an undetected heart defect - which you can't control with diet or other behavior.

So yes, follow this article's advice and follow the six important tips. But still, stay aware of stroke signs - it can still happen to you or a loved one, and you need to know what to do.

That is: Get some help immediately!

Another way to look at it

In a continuing effort to make sure people understand the importance of stroke signs and the need to get help, here are five symptoms you need to know to recognize a stroke:

The key is to immediately get to the emergency room for a brain scan to detect which type of stroke has hit. If it's ischemic—caused by a blood clot—the best treatment is a clot-dissolving drug called tissue plasminogen activator, or TPA, and the quicker the treatment, the less the disabling damage. Most hospitals will treat stroke patients with TPA only if the medicine can be injected within three hours of the appearance of symptoms, which is why getting to the hospital is such an urgent matter. A recent study found, however, that TPA can be safe and effective up to 4½ hours after a stroke. Treatment for hemorrhagic stroke, caused by a bleeding vessel in the brain, involves lowering blood pressure and reducing swelling in the brain.

Again, not every symptom will appear. But if just one shows, you know what to do.

Shedding stroke myths

Lately, I've done a lot of thinking about stroke myths and incorrect assumptions.

This blog touched on those last week, but the topic is too important - life and death important - to leave it alone.

One recent story - Survivors shed stroke myths and issue warnings - is worth reading. It starts with a 22-year-old survivor:

Luckily surviving her stroke, the next year became a battle few people in their 20s endure and next to none expect. Ms [Hana] Ascano began a long road to recovery from trauma to her cerebellum, causing temporary paralysis along the left side of her face and body.

Fighting to smile, sit up and walk again; she endured an arduous journey that she admits was lonely and seemed hopeless at times, but the university student says she is now close to 100 per cent recovered.

So even if someone is young and seemingly healthy, don't ignore stroke symptoms:

To quote the National Stroke Association, those include:

SUDDEN numbness or weakness of face, arm or leg - especially on one side of the body.

SUDDEN confusion, trouble speaking or understanding.

SUDDEN trouble seeing in one or both eyes.

SUDDEN trouble walking, dizziness, loss of balance or coordination.

SUDDEN severe headache with no known cause.

It's important, though, NOT assume you'll see ALL the symptoms. For example, mine didn't cause a headache. A friend's stroke didn't cause speech problems. Just one sign is enough to get someone to a hospital immediately.

Not later. Not tomorrow. Don't let them talk you out of it. Don't wait and see if they feel better.

The difference could be death or a lifelong disability.

(Image from CDC)

Are you at risk of stroke?

Can't happen to you, right?

Wrong.

Strokes can happen to anyone, any age. People in general are so under the wrong impression about strokes. For example, all the following are completely wrong:

• Strokes always cause headaches. That's completely bogus - strokes might or might not have accompanying headaches.
• Stroke patients are all elderly. Wrong! People in their 50s, 40s, 30s and younger can have strokes. Mine came at age 39.
• Strokes only happen to people who don't take care of themselves. Again, wrong! It can happen to a distance runner or, in one case, an NFL linebacker!

In article with some vital facts and stats about strokes include a set of numbers form a study performed six months after a stroke in people who were older than 65:

• 30% needed assistance to walk
• 26% needed help with activities such as cooking, feeding, and paying their bills
• 19% had trouble speaking, or understanding others when they speak
• 35% had feelings of depression
• 50% had some degree of paralysis on one side of the body
• 26% became nursing home residents

So please, share the facts. The life you save might be your own!

'Destroyed ... the dividing wall of hostility'

For he himself is our peace, who has made the two one and has destroyed the barrier, the dividing wall of hostility ... .

-Ephesians 2:14

I had an enjoyable time last week destroying something.

It was during a vacation during a little remodeling of my small workshop. In that basement shop, an old wardrobe, ugly and in poor condition, was present when we bought our house. We used it to store paint and various supplies, very inefficiently, but it was all we had.

But last week, we bought a utility shelf unit to replace the wardrobe. A pry bar took care of dismantling it quite easily, and I was able to retain pieces I plan to use for future projects.

What was junk, an obstacle, is gone.

Paul wrote about destroying something too - something in the way. He wrote about Christ destroying the barrier that kept people apart. Read the entire verses in Ephesians 2:11-22.

Are barriers still out there? Sadly, yes. Human-generated barriers are all over this world. Call them hatred, hostility, prejudice. Let's destroy them. Good news: No physical exertion required. Let's get the junk, the obstacles, out of the way.

(Photo from Shopping.com)

'Near through the blood of Christ'

[R]emember that at that time you were separate from Christ, excluded from citizenship in Israel and foreigners to the covenants of the promise, without hope and without God in the world. But now in Christ Jesus you who once were far away have been brought near through the blood of Christ.

-Ephesians 2:12-13

A friend had a stroke last week and reminds me of the concerns that so many stroke survivors and loves ones go through. One in particular: What will I get back?

For some, it's a question of physical recovery. In my own case, it was a matter of speaking, reading and writing. I made my living as a reporter and editor, so was naturally concerned - no, make that almost frantic - to get back the ability to use language.

So what's the Ephesians got to do with it? Consider Paul's words to a group who were one step away from a pagan culture. In verse 12, Paul tells them that not long before, they were without God and therefore without hope. But verse 13 - and a few verses before and beyond - Paul reminds the recipients the good news - they are now united in Christ, and they' re in the household of hope.

In a two-verse phrase, Paul reminds them that outside that household, they had no hope. As citizens of the household of God, they had hope eternally.

That’s pretty powerful but the word "hope" is so, so often misunderstood by a world. So many people have no idea even what hope means. I’ve even heard people badmouth hope. One commentator wrote that “hope is for losers.” If that’s true, then Lord, let me be a loser.

Did hope promise that everything will be perfect? No.

It means that no matter what happens, your place in the household of hope is secure.

'Listen and hear my voice'

Listen and hear my voice; pay attention and hear what I say.

-Isaiah 28:23

You can find several postings on this blog related to aphasia - a term that is rarely understood. That is, until it happens to you or to someone you love. It's common among stroke survivors.

I missed the fact that June was National Aphasia Awareness Month until one of my trusty Google alerts send me a posting, including the Scripture above, from a Lutheran church in Pennsylvania. It did some basic education about aphasia, quoting the National Aphasia Association:

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% of stroke survivors acquire aphasia). It can also result from head injury, brain tumor or other neurological causes. Aphasia affects about one million Americans or 1 in 250 people. While aphasia is most common among older people, it can occur in people of all ages.

(Image from WikiMedia Commons)

Barber shops and blood pressure

Now this is a good idea - how barber shops serve up blood pressure checks:

Nu-Image, Just the Way You Like It and Sly's each offered free blood pressure checks and educational materials to African Americans, who are twice as likely to have a stroke as white Americans.

Janelle Holder-Williams of the American Stroke Association said the idea of reaching out to black men in barber shops is simple: "We wanted to reach the men where they are. Historically, the barber shop was also a hospital for the black community, because there was little else. ..."

Holder-Williams said after the age of 35, black men are four times more likely to suffer a stroke than white men.

This was targeting a particular group, but what's the harm in doing this in any barber shop?

Fast thinking helps stroke victim survive

Always great to hear a story about stroke awareness and quick action, this one from the U.K.:

A grandfather is hoping to say a special thank you to two strangers whose prompt action may have saved his life when he suffered a massive stroke.

Dave Brint, 67, was walking along Cleveland Street when he collapsed against a wall unable to move down one side or speak.

Fortunately, two women passers-by went to his aid and asked an on-looker to call 999 (editor note: of course, in the U.S., that would be 911) immediately.

'Your love ... endures forever'

The LORD will fulfill his purpose for me;
your love, O LORD, endures forever—
do not abandon the works of your hands.

-Psalm 138:8

God's purpose for you doesn't require perfection. God's purpose for you doesn't require superhuman skills. God's purpose for you requires only acceptance - leave the rest to God.

You are works in God's hands, and you are held with that promise.

(Image from www.heartlight.com)

Not all, but many, are so preventable

Sad statistics from my old stomping grounds in Arkansas, from the Arkansas Democrat-Gazette:

In 2005, 58.6 of every 100,000 deaths among Arkansas adults were due to stroke, for a total of 1,847 stroke deaths. That's compared with a national average of 46.6 of every 100,000 adult deaths, or 143,579 total stroke deaths, according to the latest CDC statistics.

Alabama had the highest rate, with stroke deaths making up 60.9 of every 100,000 adult deaths that year, followed by Tennessee with 60.7 of every 100,000.

Arkansas' high rates of obesity, smoking, diabetes, high cholesterol and untreated high blood pressure all contribute to the state's high stroke death rate, said Dr. Margaret Tremwel, neurologist at Sparks Regional Medical Center and director of the hospital's Early Intervention and Treatment Program.

Sad because, among other things, states like Alabama, Tennessee and Arkansas could do so much better. And the people from those states should demand it and make it happen.

Yet another stroke survivor video

This truck driver found his way to safety and help, despite his stroke that occurred on the road.

Now, recovered and back on the highways, told his story to encourage others to act quickly if they see any stroke signs.

Story of faith and stroke recovery

Another stroke survivor story

This video tells the story of a Northland (near Kansas City, Mo.) man who had the help he needed.

Another story showing the value of knowing those stroke signs!

Awareness of stroke facts can save lives

Every group, every person should pay attention to and know basic stroke facts:

Every three minutes, someone dies of a stroke and one stroke occurs every 45 seconds. That is 750,000 strokes per year, according to Dr. Sayona John, a neurologic intensive care physician of Rush University Medical Center. She spoke at a program sponsored by Rush Generations, a free health program for older adults and their caregivers.

"Unfortunately public awareness of stroke is rather poor,” said John. “The knowledge is worse among the elderly, especially among women and minorities. They are also not aware of the treatment options that are available when you have a stroke,” she said.

'Joyful ... patient ... faithful'

Love must be sincere. Hate what is evil; cling to what is good. Be devoted to one another in brotherly love. Honor one another above yourselves. Never be lacking in zeal, but keep your spiritual fervor, serving the Lord. Be joyful in hope, patient in affliction, faithful in prayer.

-Romans 12:9-12

"Be joyful in hope ... ."

Paul went through some dreadful, awful, torturous experiences during his ministry. But again and again, he wrote about hope.

I can't imagine the life Paul had - he turned turned from society's "in" crowd and took the path of the often persecuted. Perfect? No. But that was not required for Paul and it's certainly not required for Christ followers.

So when human afflictions seem overwhelming, I hope you can find comfort in Paul's writings. He, too, was afflicted but found peace.

Every community should have this

Something that should happen everywhere: Stroke victim Web site is launched:

A new website on stroke awareness has been designed and developed thanks to St Camillus' Hospital and the Limerick Stroke Support Club.

Approximately 450 people present annually to the Mid-Western Regional Hospital in Dooradoyle following a stroke.

This website aims to provide information about stroke and ancillary services to stroke survivors, their families and friends.

Window widens - but still, don't wait

Treating stroke patients with the powerful clot-buster tPA has a wider window:

Last year, European clinical trials found that selected patients still benefit from tPA up to 4 1/2 hours after a stroke.

Now, an advisory from the American Heart Association formally spells out which patients might benefit from later tPA treatment. But the chairman of the committee that issued the advisory -- Gregory J. del Zoppo, MD, professor of medicine and adjunct professor of neurology at University of Washington, Seattle -- warns patients not to misinterpret the statement.

"The message is that stroke patients still need to come in for treatment as soon as possible. There is no benefit in waiting," del Zoppo tells WebMD. "Despite the fact that patients who come in even 3 to 4 1/2 hours after stroke can benefit, they should not wait."

Good words - "should not wait." As someone who was able to receive help right away, I can attest: Even if you think you or someone is showing stroke signs or symptoms, even for the mini-stroke variety, listen to what the doctor said, and don't wait.

Mini-stroke can be a major warning

A "mini-stroke" can be anything but, according to this mention from Forbes.com:

About half the people who have a major stroke soon after a less serious brain event, such as a transient ischemic attack or "mini-stroke," do so within 24 hours of the minor event, a new study finds.

The message here for people who have a TIA is to "seek medical attention immediately, particularly if you have either weakness or speech disturbance that lasts more than 10 minutes," said the study's senior author, Dr. Peter M. Rothwell, a professor of clinical neurology at the University of Oxford in England.

"Don't wait until the next day - it may be too late," he said.

Good advice. Remember that often, time = recovery.

(Drawing from the National Library of Medicine)

Older stroke patients might miss out on care

As a non-doctor, I'm convinced my care was excellent. But I might have had an advantage: I was relatively young (39) when it happened.

Older stroke patients, though, might receive inadequate care, according to this study:

Older people are less likely to receive high-quality stroke care compared with younger patients, researchers warn. And this is despite evidence suggesting that care is equally effective across age groups, they note. The new studies point to ageism in stroke care — the first is published online April 16 in BMJ and the second in the March issue of the Postgraduate Medical Journal.

"We found low rates of secondary drug prevention," report the BMJ study authors, led by Rosalind Raine, PhD, professor of health-services research from University College London, in the United Kingdom.

What can a non-doctor do? First, speak up for stroke prevention. But if it happens, be an educated advocate for a loved one who becomes a stroke patient.

Exercise to prevent stroke

Strokes happen around the world, and prevention measures can, too. A reminder that exercise can help prevent stroke:

...(S)trokes can be prevented. By doing 30 minutes of exercise five times a week the risk can be reduced - with walking an excellent and simple form of exercise.

Charity director Tony Richardson said: 'Walking 10,000 steps a day can help to reduce body fat, and to lower and prevent high blood pressure and cholesterol - two major factors for stroke."

As a longtime runner, I know exercise can make a difference.

(Photo from CDC)

Finally, God awareness

So Paul took his stand in the open space at the Areopagus and laid it out for them. "It is plain to see that you Athenians take your religion seriously. When I arrived here the other day, I was fascinated with all the shrines I came across. And then I found one inscribed, to the god nobody knows. I'm here to introduce you to this God so you can worship intelligently, know who you're dealing with."

-Acts 17:22 (The Message)

Paul's message to this group was about God awareness. His audience was learned, like Paul. He used the group's own intelligence to pique their interest, then instructed in God awareness.

This month, I've faithfully posted about Stroke Awareness Month - and will do the same thing next year, God willing. It's important to know about stroke prevention and stroke symptoms. But even more important was Paul's message of God awareness. So to all: Be aware.

Tai Chi: Not exactly my thing, but...

...For those who might have an interest in using it as a tool in stroke rehabilitation:

A recent study led by researchers at the University of Illinois shows that Tai Chi, a Chinese form of martial arts that consists of a series of coordinated movements of the head, trunk and limbs, and which does not need any equipment, is an effective form of stroke rehabilitation.

I'm more of a distance runner guy, but hey - this could be extremely helpful for some.

Hospitals might miss tPA benefits

Patients who need clotbusting tPA can fall through the cracks, as this recent Modern Medicine article illustrates:

Two-thirds of US hospitals do not administer tissue plasminogen activator (t-PA) to patients who have a stroke and are covered by Medicare, according to the results of a national study conducted between 2005 and 2007, which were presented at the International Stroke Conference 2009.

Furthermore, many of these patients reside in counties that do not have a hospital that delivers t-PA at a rate equalling or surpassing the national average in t-PA delivery. Hospitals that did not give t-PA to patients covered by Medicare tended to be small and rural, said the study’s lead investigator, Dawn Kleindorfer, MD, stroke neurologist and associate professor, University of Cincinnati.

Stroke survivor and hero

A story about the admirable efforts of a Tennessee woman who serves her fellow stroke survivors:

Her most important ministry is giving to people who are going through what she once suffered. She spends hours with the patients every week.

"I try to give them encouragement," Daugherty said. "It's a blow to them. If one day your arms and legs aren't working anymore it's a big shock. They wonder if they can get better ... I tell the patients to keep working at it and they may be surprised."

Seeking God, seeking answers

And without faith it is impossible to please God, because anyone who comes to him must believe that he exists and that he rewards those who earnestly seek him.

-Hebrews 11:6

This month, I've posted a lot of items about Stroke Awareness Month. Awareness is a key to prevent strokes, get stroke patients help as soon as possible, and assist people who are recovering.

But as the author of Hebrews noted, God awareness is a lifelong occupation. So keep the faith - no matter what.



(Image from www.heartlight.org)

Avoiding a second stroke - efforts needed

A recent article in U.S. News and World Report:

After suffering a stroke, the chances of having another are high, but a new report shows many patients aren't getting the interventions they need to reduce that risk.

Those interventions include lifestyle changes, such as smoking cessation and exercise, and medical treatments, such as aspirin, blood pressure medications and cholesterol-lowering drugs.

We need more and better strategies for these patients - rehab, counseling, medication, among other things. This Stroke Awareness Month is a good time to start.

Too much salt can increase stroke risk

Right amount of salt is good - we can't live without it. But too much can get you in trouble, according to a Centers for Disease Control and Prevention expert quoted in a recent WebMD article:

Seven out of 10 U.S. adults get 2.3 times the healthy amount of salt. It's putting us in a world of hurt, says Darwin Labarthe, MD, PhD, director of the CDC's division for heart disease and stroke prevention.

"This is a very important message," Labarthe tells WebMD. "There is no room for debate any longer that a high level of salt causes stroke and heart disease, and that lowering salt intake will diminish these very serious health consequences."

This Stroke Awareness Month is a good time to watch out for too much salt.

(Photo from CDC)

Another fellow stroke survivor, runner

A recent story about a fellow distance runner and stroke survivor Chris Bolio. I'd quibble with the term "luck" in the story's headline. In my experience, there's no such thing.

"I know how blessed I am," he said. "By the same token, internally, it’s still a struggle to accept the changes."

Exercise provides relief.

"I don’t have to worry about cognitive deficiencies," Bolio said. "I don’t have to field questions or resolve anything except the next stroke in the pool or the next step on the pavement. It really is kind of where my mind can relax now."

Yet another Stroke Awareness Month note that you a stroke can happen to anyone, any age, even those who seem healthy and fit.

Lack of stroke awareness is frightening

More evidence that too many people know too little about stroke symptoms, from a recent posting:

The results of the survey were a bit disappointing and some key points are summarized below:

* 93% of those asked knew a couple of the obvious symptoms especially the numbness.
* 59% of those surveyed didn’t recognize the less obvious symptoms such as a severe headache.
* Only 37% of those surveyed recognized all five warning signs of stroke as listed above.

So please, tell someone what to watch out for today.

Another study about clot-busting developments

Not long ago, researchers from Johns Hopkins University released a study about the use of an aggressive clot-busting treatment for stroke patients.

New results from a multicenter study led by Johns Hopkins show that patients who got an experimental clot-busting treatment for a particularly lethal form of stroke were not only dramatically more likely to survive but also continued to shed lingering disabilities six months later. The findings, announced Feb. 19 at the International Stroke Conference in San Diego, are likely to build support for the use of tissue plasminogen activator, or tPA, in patients with intracerebral hemorrhage, a treatment-resistant form of stroke marked by brain bleeding.

There's been some disagreement about tPA, so new studies are important to get some clear answers.

A note in passing...

Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.

-Philippians 4:6-7

It happened 11 years ago today. At least, that's when it happened to me.

On Friday, May 8, 1998, I found myself hit by a stroke working with a colleague who was smart enough to get me some help. The rest, as you might say, is history.

I was a devoted distance runner at the time and remain so. I will likely run 10 miles without stopping tomorrow (Saturday). Why do people run? Now, for me, it's an act of worship, thanking God that he gave me two strong legs - one of them twice.

This blog is my feeble attempt to provide help for fellow stroke survivors and those who care for them - in any capacity. I've prayed for those who have contacted me or I've heard about concerning their own circumstances or struggles. Anyone reading this can e-mail me anytime - jeff.porter@gmail.com - and you'll be in my prayers, too.

Do I completely understand what happened those 11 years ago? No. But as Paul wrote to the Philippians, God's peace surpasses understanding - leaving me under God's protection. It's there for you, too.