More about post-stroke aphasia treatment

A few principles on aphasia treatment after a stroke, from a recent article from About.com, noting these principles "have been shown in small studies to improve the outcome of therapy."

* Regardless of the type of therapy used, the outcome is better if the intensity of therapy is increased. In other words, a given number of hours of therapy will yield a much better outcome if they are given in a few sessions over a few days rather than in many sessions over many days.
* The effectiveness of aphasia therapy increases when therapists use multiple forms of sensory stimuli. For instance, auditory stimuli in the form of music, and visual stimuli in the form of pictures, drawings, are routinely used during aphasia therapy sessions.
* Gradual increases in the difficulty of language exercises practiced during a given therapy session improves the outcome."

Read more about the study, and learn more about aphasia.

A story of good deeds

From a Canadian newspaper story about a stroke survivor using his own experience to help others:

Helping people reclaim their lives is "beautiful," he said, and makes each day special. He said he loves volunteering. He is never late, always cheerful.

His experience, as a stroke survivor is invaluable, he said. He knows about the struggles and the feeling of simply wanting to give up.

"I've been there. I know what it's like."

Sad news: Tennessee expects more, younger stroke victims

A study - reported on by The Tennessean in Nashville - predicts an increasing number of strokes and younger victims.

From the article:

Tennessee is in a swath of states referred to as the stroke belt. Factors such as the state's high rate of obesity, diabetes and hypertension, along with the aging baby boomer population, are to blame for the increasing risk of stroke, health experts say. And now, the flagging economy may also play a role, doctors say.

..."As a therapist I have seen more people in the last five years 30 years old and older with stroke," said Trent Nessler, managing director of Saint Thomas Health Services Outpatient Rehabilitation Services. "Typically, it was 50 and above, and seeing a 40-year-old patient with a stroke was unusual. And now you're seeing individuals in their 30s on a regular basis."

As an under-40 stroke survivor, it is not something people expect. While mine was caused by a common heart defect, Tennessee researchers suggest that many of the 1,700 additional strokes predicted are potentially preventable - through better eating, exercise, taking care of high blood pressure and getting a handle on diabetes.

And Tennessee is not the only state or region following this pattern. We must stop this madness - people are eating themselves to death.

'Testing of your faith develops perseverance'

Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance.

-James 1:2-3

"Faith." "Perseverance." "Joy."

Often, those are not words that are easy for those recovering from a stroke or those witnessing a loved one struggling. Such trials can indeed cause suffering and cannot be made light of. Of those without faith, words like "joy" are often taken lightly, but in the context of James, "joy" isn't used flippantly. Not transient, fleeting, human-generated joy - but joy that surpasses every pleasure in this life.

Keep your fellow stroke survivors or loved ones in your prayers - for faith leading to perseverance leading to joy.

To plug or not to plug...

Interesting article in The New York Times about lack of solid evidence of whether a patent foramen ovale is a stroke-causing condition.

The patent foramen ovale was one of two heart defects corrected in a procedure I underwent in June 2007. A PFO is a hole in the heart, between the two upper chambers. Everyone is born with the hole and most of the time, it seals up shortly after birth.

Another complication, described from a previous posting:

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.

To combat the problem, in June 2007, a doctor snaked a tube into my heart through a catheterization procedure, and deployed a device to plug the hole. My mother went through a similar procedure - not a PFO, but another type of hole - late 2008.

Now, as stated in the article, this connection between a PFO and a stroke isn't absolutely proven and that the Federal Drug Administration hasn't approved the specific use for the device. Won't prevent the use - just doesn't officially approve that specific use, according to The New York Times article.

Will plugging a PFO guarantee no more strokes, ever? No. The world doesn't work that way. That being said, no other explanation was ever found for my stroke. I had none of the classic indicators - cholesterol good, blood pressure good, nonsmoker, longtime distance runner, not overweight. I feel good about my decision.

More research needed? Yes, yes, yes. Even those convinced that the PFO and connection exist agree. How will the research be conducted? Who's willing to take the risks of fatal consequences? Questions seeking answers.

A special no-more-hole-in-the-heart story

Like mother, like son?

More than a year ago, this blog featured a posting about how a certain type of hole in the heart could raise the risk of stroke among elderly people. The study hit home the other day.

My mother, who is 81, has had a series of mini-strokes in recent years, including slurred speech and other symptoms. It turned out that, like her son, she had a couple of holes between her upper heart chambers. "Had" is an important term.

Like mine, this condition can cause unfiltered blood shunt from the right side of the heart to the left, then pumped out, perhaps with a clot, to cause a stroke or transient ischemic attack. The holes were not exactly the same variety of mine, but the danger was similar.

So on Dec. 29, 2008,my mother went throught the same catheterization procedure I went through, by the same doctor at the same hospital!

She's just over two weeks out and recovering well. An implanted device called an Amplatzer sealed the holes, which should mean reduced chances of stroke.

As I've said before, this blog is not really about me. Today, it's about my mother. As you read this, say a little prayer for her.