God's love: Open for all

For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.

-Romans 8:38-39

Responding to a Stroke of Faith posting on Christmas Eve, an intelligent blogger commented that a particular medication does not work with complete effectiveness for every person.

My response included the phrase that "the results are very much case by case." That's true for any medication you can buy, use or receive. People are unique, so results are case by case.

Later, during Christmas Eve church services, I thought about that phrase in a different context: Unlike medications, God's love is NOT a case-by-case basis. As Paul wrote, God's love is for all and cannot be undone. Cannot be removed from us.

In this world, so much of life is case-by-case. God's love is not one of these. His love is offered to us all.

The world receives the 'Lazarus effect'

[This was originally posted Dec. 24, 2009]

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 (2008), I heard a presentation by one of the doctors responsible for making tPA (tissue plasminogen activator) available to stroke patients.

In my own 1998 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. Once there was no hope. A man's  sisters, relatives and friends knew they lost him. Jesus entered. Hope returned.

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.

Research points to new walking therapy

For many, walking means freedom - the ability to move freely and safely. Walking is part of  some  recent  news on the stroke recovery front - robotic assist gets stroke patients walking:

For patients who are unable to walk following a stroke, robot-assisted gait training results in greater long-term gains in mobility than conventional therapy for those with the most severe deficits, researchers found.

In a small randomized trial, the robot-assisted therapy was better at improving walking capacity through two years, but only among those with high motor impairment, according to Giovanni Morone, MD, of the Santa Lucia Foundation in Rome, and colleagues.

It was also superior to conventional therapy for improving patients' mobility and ability to perform basic activities of daily living, the researchers reported online in Stroke: Journal of the American Heart Association.

Fascinating development in stroke therapy

As most survivors know, much of the time, one post-stroke struggle involves one side of the body hampered. In my case, my stroke happened on the left side of my brain, losing movement in the right arm and leg. While those movements came back thanks to some quick-thinking health professionals, this is not always the case.

Now, Reuters Health reported last week, researchers have found some interesting results about how brain stimulation may help some stroke patients:

Treating stroke patients who have lost control and awareness of one side of their body with magnetic stimulation to the brain may improve their symptoms, researchers said today.

In a new, small study published in the journal Neurology, patients who were given quick bursts of stimulation over a couple of weeks improved by about 20 percent on tests of vision and attention, while those who got a fake stimulation treatment didn't improve significantly.

But researchers said it's still unclear what types of patients might benefit from the treatment and by how much.

It might be worth our while to read the whole story. And while this is merely research and not all the answers are in, this has some positive possibilities for improving therapy for stroke patients.

Another set of stroke prevention stories

I've been running across more and more stroke prevention stories. Here are two recent ones:

Vitamin, diet link to stroke risk assessed

In a review, neither antioxidant vitamins nor B-vitamins were associated with stroke prevention, but a healthy diet, such as the Mediterranean diet, did appear to diminish risk, Graeme Hankey, MD, of Royal Perth Hospital in Australia, reported in The Lancet.

"The overall quality of an individual's diet and balance between energy intake and expenditure seem to be more important determinants of stroke risk than individual nutrients and foods," he wrote.

Hankey reviewed the literature on individual vitamins, nutrients, foods, and overall diets and their effects on stroke risk.

Stroke risk reduced with treatment of prehypertension

Patients with prehypertension who take blood-pressure-lowering therapy have a highly statistically significant 22% reduced risk of stroke, a new meta-analysis shows. The study is published online December 8, 2011, in Stroke.

The reduction in stroke risk observed in the study was "clear-cut," "clinically meaningful," and evident among all classes of antihypertensive drugs studied, said lead author Dr Ilke Sipahi (Case Western Reserve University, Cleveland, OH).

"We saw it with ACE inhibitors, we saw it with calcium-channel blockers [CCBs], and we saw it with angiotensin-receptor blockers [ARBs] to a certain extent," Sipahi said in an interview. "So this is a true finding; the risk is truly reduced."

But the study results should not change current recommendations regarding blood-pressure-lowering therapy, said Sipahi. "It's not realistic to go ahead and recommend antihypertensive therapy to every single patient with prehypertensive blood-pressure levels, but I think our findings have to be discussed extensively within the medical community."

Let Jesus light your world

When Jesus spoke again to the people, he said, “I am the light of the world. Whoever follows me will never walk in darkness, but will have the light of life.”

 -John 8:12

This time of year, it's getting darker and darker early in the day, when, three times at week, I'm out running.

So most of the time, I'm wearing a headlamp to somewhat dimly light my path. Otherwise, I'd likely stumble and fall. And most of the time, I'm on a fairly popular running, walking and bicycling venue, a trail close to my house, so I see headlamps all along my route - so people won't walk, run or bike in the darkness.

Now, things can still go wrong. Headlamps provide only so much light. Outside of its fairly small area, there's darkness. And they are run on batteries and human technology. Batteries eventually expire, and human technology can fail. I've gone through two headlamps and now working on No. 3 in my almost 25 years of running. And No. 3 will eventually be discarded.

Unlike my headlamp, Jesus is not a light exclusive to me and will never fail. He is my light, can be your light - the light of the world. Let him light your world.

Stroke prevention news

Two different recent stories about stroke prevention...

Diet rich in antioxidants may cut stroke riskheheart.org

Women who eat an antioxidant-rich diet may significantly cut their stroke risk, particularly for those without a history of CVD, new research suggests.

The prospective study found that women with no history of CVD who consumed the highest amount of antioxidants in foods such as fruit, vegetables, tea, whole grains, and chocolate had 17% fewer strokes than those who ate the least amount. Among women with a history of CVD, those who consumed the most antioxidants had 45% fewer hemorrhagic strokes.

"This study suggests that eating a diet rich in antioxidants, especially from fruits and vegetables, may be of importance for stroke prevention," the study's lead author, Susanne Rautiainen (Karolinska Institutet, Sweden), said in an interview.

 (Chart from U.S. Department of Agriculture)

Stroke's teachable moment - NBC-2.com

It was his one and only stroke. To lower his chances of a second one, Al was forced to change his life.

"I was smoking the first time and then once you have the stroke you quit smoking. It's a drastic change and there's a lot of things that cause damage in your life and I've been fortunate enough that I've only had one stroke and one is enough."

About 25% of stroke victims will have another stroke within five years. But studies show following a set of established guidelines, aimed at prevention, can change the odds.

'His love endures forever'

Give thanks to the LORD, for he is good.
His love endures forever. ...

Give thanks to the God of heaven.
His love endures forever.

-Psalm 136:1,26 

 Who doesn't need love?

It's the human condition. We want love. We desire it. We need it. There's a human tendency to take it for granted when things are good. But, say, when those of us have struggled with stroke recovery or other challenges, we recognize our hunger for love.

And we are loved. Take in the words in the Psalm - God's love endures forever. Past human struggles. Forever.

Aphasia: A struggle for words

U.S. Rep. Gabrielle Giffords made news not long ago by sitting through an interview about her lengthy struggle with brain injury after a shooting that nearly killed her. She clearly struggles with words - a problem called aphasia.

Many stroke survivors struggle with aphasia, too. While the cause of Giffords' aphasia is different than mine, I certainly feel for her as she faces this communication challenge. As a newspaper reporter at the time, I was concerned that my language problems would endanger my livelihood. I'm sure that as a public official who runs for office every two years, she has some of the same concerns. Words are powerful tools for political candidates.


Her first television interview occurred not long ago on ABC News.

Aphasia is a silent-like problem - people who have it have trouble talking about it. I know that at one time, I had trouble getting words out. But the word "aphasia" is a word that needs to become more known.

One more reason for dental cleanings: Potential stroke prevention

More and more, it's clear that oral health is important to overall health. A recent article discusses how professional dental cleanings may reduce risk of heart attack, stroke:

The study included more than 51,000 adults who had received at least one full or partial tooth scaling and a similar number of people matched with gender and health conditions who had no tooth scaling. None of the participants had a history of heart attack or stroke at the beginning of the study.

The study didn’t adjust for heart attack and stroke risk factors — such as weight, smoking and race — that weren’t included in the Taiwan National Health insurance data base, the source of the information used in the analysis.

“Protection from heart disease and stroke was more pronounced in participants who got tooth scaling at least once a year,” said Emily (Zu-Yin) Chen, M.D., cardiology fellow at the Veterans General Hospital in Taipei, Taiwan.

Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke, she said.

(Image from Centers for Disease Control and Prevention)

Important: Even mini-stroke prevention

A somber story from USA Today and reported elsewhere: 'Mini-strokes' can shorten life expectancy.

The study calculated life expectancy by comparing mortality rates among people who had TIAs with other people of the same age and sex. Life expectancy declined steadily each year. After nine years, almost half of the TIA patients had died — 20% more than in the general population, according to the study of 22,000 people published Thursday in Stroke: Journal of the American Heart Association.

While having a TIA didn't substantially increase the risk of death in people younger than age 50, the attacks did increase mortality for those older than age 65. About 5 million Americans have had a TIA, according to the heart association.

TIAs are "very bad harbingers," says Nehal Mehta of the University of Pennsylvania's School of Medicine, who wasn't involved in the new study. Up to 10% of TIA patients have a major stroke within 48 hours, the American Heart Association says.

This is not a scare tactic, but a reminder that stroke prevention is clearly important, especially those people older than 65.

Appropriate blood thinner use is on the rise

From the Good News Department, via Reuters Health,  more stroke patients get clot-busting drugs:

As many as 95 percent of stroke patients with atrial fibrillation, a common heart rhythm disturbance, got blood thinners in 2010, researchers found. That's up from 88 percent in 2003.

The findings are based on nearly 1,400 U.S. hospitals in the "Get With The Guidelines -- Stroke" program, created by the American Heart Association and the American Stroke Association to make sure doctors are following up-to-date practices.

"Hospitals participating in this program improved their ability to deliver appropriate stroke care," said lead researcher Dr. William Lewis, a heart specialist at Case Western Reserve University School of Medicine in Cleveland, Ohio.

About 800,000 Americans suffer a stroke each year, according to the American Heart Association.

Stroke and memory: Connected?

An interesting article about the possible connection of stroke risk and predicting memory problems. Some details about the research on how stroke risk profile may also predict odds of memory problems: 

"Overall, it appears that the total Stroke Risk Profile score, while initially created to predict stroke, is also useful in determining the risk of cognitive problems," study researcher Frederick Unverzagt, PhD, says in a news release. He is a professor of psychiatry at the Indiana University School of Medicine in Indianapolis.

 After taking into account complicating factors, getting older and having thickened heart muscle were both independently linked with future memory problems. High systolic blood pressure (the first number in a reading) also appeared to raise a person's odds of memory decline, even in the absence of heart muscle thickening.

“Our findings suggest that elevated blood pressure and thickening of the heart muscle may provide a simple way for doctors to identify people at risk for memory and thinking problems,” Unverzagt said.

 You can't change every potential stroke risk factor, but some - blood pressure, as cited above, for example - can be addressed through exercise, diet or medication. Now, it seems, you might be able to steer away from memory problems, too.

(Photo from the Centers for Disease Control and Prevention)

'Grant me a willing spirit'

Restore to me the joy of your salvation
and grant me a willing spirit, to sustain me.

-Psalm 51:12

David was in trouble and troubled when he made this plea to God.

While our own troubles and travails might be different than David's, we, too, can find joy of salvation in one who can sustain us. God can help us find that willing spirit, that willingness to seek out a restoration, the prayers to sustain us.

Does this mean all troubles will cease? No, David still had his challenges. So do we. But God can sustain us through our own challenges.

Watching out for the details may help

The right treatment might be the key to success. A recent story gave the results of Australian research showing that certain after-stroke treatments may boost outcome:

"Clinical leaders of stroke services can adopt this strategy with confidence that their outcomes will improve," Sandy Middleton, a professor at the Nursing Research Institute at St. Vincent's & Mater Health in Sydney, Australia, and colleagues wrote in the report in the Oct. 12 online edition of The Lancet.

The researchers noted that patients who recover in units devoted to stroke care often experience fever (20 to 50 percent of patients), high blood sugar (up to half of patients) and problems swallowing (37 to 78 percent of patients) within the first few days of a stroke. These conditions "are not yet universally well managed," the study authors indicated.

In the study, Middleton and colleagues randomly assigned patients at 19 stroke units in New South Wales, Australia, to different types of treatment. Some followed existing guidelines, while others adopted new protocols involving monitoring of fever and high blood sugar plus treatment for the conditions. Nurses also underwent special training to treat swallowing problems in the patients.

Within 90 days, 42 percent of the 558 patients in the group that received the special treatment were dead or considered to be dependent, compared with 58 percent of the 449 patients who received the existing treatment, the investigators reported.

Patients who received the special treatment also scored better on a test of their physical functioning, the results showed.

This also shows the value of an advocate for every stroke patient to help manage these conditions - fever, blood sugar and problems with swallowing. My wife was my advocate after my stroke, when I could not, literally, speak for myself. I'm convinced that her efforts greatly improved my outcome. Thank God for my advocate.

(Photo from the National Institutes of Health)

Chocolate and stroke research

 A "sweet" story about stroke research...

Chocolate lovers have fewer strokes, study finds:

The results add to a growing body of evidence linking cocoa consumption to heart health, but they aren't a free pass to gorge on chocolate.

"Given the observational design of the study, findings from this study cannot prove that it's chocolate that lowers the risk of stroke," Susanna Larsson from Karolinska Institutet in Stockholm told Reuters Health in an email.

While she believes chocolate has health benefits, she also warned that eating too much of it could be counterproductive.

"Chocolate should be consumed in moderation as it is high in calories, fat, and sugar," she said. "As dark chocolate contains more cocoa and less sugar than milk chocolate, consumption of dark chocolate would be more beneficial."

Now as the quoted research says: This does not prove that chocolate prevents strokes. And don't go overboard, of course - too many calories are not good for you. But intriguing news - and who can argue against more chocolate research?

(Image from the U.S. Department of Health and Human Services)

Every stroke must be taken seriously

Time to take so-called "mild" strokes seriously. That's what one expert says. Almost one out of four people in a study of mild stroke patients later reported symptoms of depression. "Mild" stroke victims still face daily challenges:

"Typically, people who suffer mild strokes are released from the hospital if they can dress and eat. They are rarely screened for other problems or referred for rehab," Rochette told MedPage Today.

"If these patients are screened at all, it won't be until they have a follow-up visit with their primary care physician, which could be several months away," she said, adding that they need more immediate attention to address pressing concerns.

The incidence of mild strokes is expected to increase as the population ages. In addition, victims of mild stroke are five times more likely to have a stroke over the next two years compared with the general population.

"Although this group accounts for the majority of strokes, we know little about their quality of life, daily challenges, and concerns apart from a few qualitative or cohort studies including also moderate strokes," researchers said.

One particular issue is that problems are often not so obvious, so people are discharged from a hospital and not referred for outpatient rehab work. Often, only someone who knows the person before the stroke can see changes and problems after. So speak up!

Smokers raise stroke risks

Sort of a "no kidding" moment from USA Today - a study shows smoking doubles risk for stroke:

"Stroke is preventable," said Dr. Mike Sharma, deputy director of the Canadian Stroke Network (CSN), in a CSN news release. "This study highlights the sizable role smoking has on stroke. Quitting smoking, controlling blood pressure, following a healthy diet and being physically active significantly reduce the risk of stroke."

In conducting the study, to be presented Monday at the Canadian Stroke Congress in Ottawa, researchers examined 982 stroke patients over roughly two years. The researchers found the average age of stroke victims who smoked was 58 -- nine years younger than the average age of the non-smokers.

Smoking causes atherosclerosis, a buildup of plaque inside the blood vessels, and increases the risk of blood clots. The study's authors said smokers have double the risk of a stroke caused by a dislodged blood clot (ischemic stroke) and four times the risk of a stroke caused by a ruptured blood vessel (hemorrhagic stroke) than people who don't smoke.

I might quibble with Dr. Sharma - most strokes are preventable, I'd say, not all - but this study lays out some facts about something most of us already know: Smoking kills. In this case, smokers had strokes at a younger age. And one of the most serious findings is that the risk especially increases for the hemorrhagic stroke - the most deadly type.

(Photo from the Centers for Disease Control and Prevention)

Word of the day: aphasia

The truth is you don't hear the word "aphasia" in the newspaper or in the news or in everyday conversation. This is unfortunate.

-Aphasia Support Group

Sadly, this Aphasia Support Group blog has it just right. People generally don't know what it means or how it can - in an instant - wreak havoc for a stroke survivor.

I became intimately familiar with aphasia in 1998, when a stroke nearly killed me. I could hardly read for a time. Writing coherently was very, very difficulty. I struggled mightily to find the right words and put them in the right order.

Now, aphasia is a more subtle part of my life, but remains, especially with speech, and especially when I'm tired, stressed or distracted.

My recovery was, in great part, to a speech therapy who patiently worked with me. These professionals can make a world of difference in many lives. If you or someone you know has struggled - or still struggles - with post-stroke aphasia, help make the rest of the world become more aware.

Pay attention to stroke signs - and act

Important, important, important -- Signs of a stroke often ignored:

"The hallmark of any stroke is a sudden loss of neurological function," said Dr. Anthony Furlan, co-director of University Hospitals Case Medical Center Neurological Institute. This could include trouble walking, speaking, understanding language, seeing, swallowing or moving a limb. ...

"Time is brain when it comes to strokes," Furlan said. "The longer you wait for treatment, the less successful it will be."

Doctors want everyone to remember: Get to an emergency room immediately, and not more than one hour from the first symptoms, even if they seem to go away.

More than 135,000 people die each year from "these brain attacks," which are the third leading killer of U.S. adults, behind heart disease and cancer, according to the Centers for Disease Control and Prevention. Nearly 800,000 Americans experience strokes annually, making it one of the major causes of long-term disabilities in adults.

Know the signs. Act. F.A.S.T.

(Image from National Institute of Neurological Disorders and Stroke)

Blood pressure: Not to scare, but to alert

Ran across an interesting story from USA Today about the connection between above normal blood pressure might a higher-than-normal stroke risk:

People whose blood pressure was above normal — known as pre-hypertension — were 55% more likely to have a stroke compared to people with normal blood pressure, according to an analysis of 518,520 adults involved in 12 studies on blood pressure and stroke occurrence. The report was published Wednesday online in Neurology. One in three people in the USA has pre-hypertension.

The authors suggest treatments more aggressive than altering lifestyle might be necessary if future studies support the findings. Current treatments for pre-hypertension, defined by a systolic blood pressure (when the heart is pumping) between 120-139 and diastolic blood pressure (when the heart is at rest) between 80-89, include lowering it by losing weight, exercising, reducing salt intake and stopping smoking. Physicians might recommend drug therapy for patients with with pre-hypertension plus other diseases, including prediabetes and diabetes.

This isn't designed to scare people needlessly, just a reminder to know your blood pressure, have it checked regularly, and talk to your doctor.

(Photo from the National Institutes of Health)

'God's love has been poured out into our hearts'

Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us.

-Romans 5:3-5

I monitor a few other blogs and saw a video, showing how one stroke survivor has seen all the characteristics that Paul described: suffering, perseverance, character, hope.

Watch and learn...

Preventing stroke and heart attack

Recent news shows that in a study, stroke patients benefit from cardiac rehabilitation:

"Overall, the risk status of patients improved, and we think that that would be associated with a decreased risk of future vascular risk, both stroke and cardiac."

The study was published online September 22 in Stroke. ...

Most of the study participants were sedentary, hypertensive, hyperlipidemic, or had a smoking history. The intervention included education on these risk factors, as well as on diet and medications, advice regarding psychological issues, and a stress test. Patients had the option of either an on-site exercise program consisting of 50 twice-weekly exercise sessions with supplementary home-based training at least twice weekly, or a home-based option with exercise at least 4 days weekly and monthly contact either by telephone or on-site.

Of the 100 patients who attended the comprehensive cardiac rehabilitation intake clinic, 80 completed the program.

The outcome? Significant metabolic improvements and for three out of 10, better aerobic capacity. So, in efforts of preventing stroke, think heart.

Apple a day? Something to watch

Now, from the Netherlands, here's something that you can sink your teeth into. It's a study showing that white-fleshed fruits and vegetables reduce stroke risk:

A new study shows an association between a high intake of fruits and vegetables with a white flesh—mainly apples and pears in this research—and reduced risk of stroke on the order of 50%

.

In this large, population-based study, each 25 g/day increase in consumption of white fruits and vegetables was associated with a 9% decrease in stroke risk.

However, lead author Linda M Oude Griep (Wageningen University, the Netherlands) cautioned that as this is the first study to look at color groups of fruits and vegetables in relation to stroke, no definite conclusions can be made.

"There are more studies needed to confirm these findings," Griep told heartwire. "It's also the case that maybe other color groups of fruits and vegetables may protect against other chronic diseases, so it remains of importance that patients eat a variety of fruits and vegetables."

Their findings were published online yesterday and will appear in the November issue of Stroke.

It is, as stated, too early to give definite conclusions. However, I must say that I'm glad I like apples!

New stroke prevention efforts

Stroke and heart attack prevention efforts made news this week, as government agencies and the American Heart Association launched an effort to stop one million heart attacks and strokes.

As NPR's Shots - Health Blog noted:

The campaign has two parts. One aims to change the behavior of doctors and patients. The other aims to change what all of us eat. Both are summed up by the acronym ABCS – which stands for aspirin, blood pressure control, cholesterol control and smoking.

In the realm of doctors and patients, Frieden and a phalanx of other federal officials want to expand by 10 million the number of Americans who have their high blood pressure under control and by 20 million those with controlled blood cholesterol levels.

To get there will require raising blood pressure control from less than half the people with hypertension now to 65 percent. Cholesterol control will have to triple.

The other medical-care strategy is to get people at high risk of heart attacks and strokes to take a baby aspirin every day. Fewer than half now do. The government wants to get that up to 65 percent.

Another goal is to get four million smokers to quit by 2016. That target is more modest – lowering smoking prevalence from 19 percent of adults today to 17 percent five years from now.

Forbes set out some important statistics:

Nearly half (49.7%) of US adults in 2007-2008 had at least one of the three main risk factors for CV disease – uncontrolled hypertension, uncontrolled high levels of LDL cholesterol, and current smoking. This represents a significant decline from the 57.8% prevalence reported in 1999-2000. The decrease, according to the CDC, “might, in part, reflect improved treatment and control of hypertension and high levels of LDL-C and implementation of effective smoking interventions.”

But we can do better. As said, fewer smokers, better control of high blood pressure and bad cholesterol. Those are key stroke risk factors. Heart attacks and strokes hit 2 million Americans every year. More than 800,000 don't survive. Related medical costs and productivity lost: $450 billion ever year. We can do better.

No longer just for the elderly...

You've seen anecdotes - including mine - on this blog before, but researchers have found that strokes rising among teens, young adults:

The number of people aged 15 to 44 hospitalized for stroke jumped by more than third between 1995 and 2008, say researchers from the U.S. Centers for Disease Control and Prevention. The increase may be due partly to the increasing numbers of young people who have diseases such as high blood pressure and type 2 diabetes -- diseases usually associated with older adults, they added.

High blood pressure, smoking, diabetes, obesity and high cholesterol are all risk factors for stroke, the researchers noted.

This isn't an attempt to needlessly scare people, but a note that it's important for everyone to know the signs of a stroke and know what to do.

Shuffling gait might be clue of mini-stroke history

We all see people shuffling rather than walking, often associated with older people. Now, a study showed how transient ischemic attacks - or TIAs, may cause the shuffling gait of old age:

The small strokes may impair their ability to walk, balance and function just the same.

Scientists examined the brains of 418 priests and nuns after they died. The researchers found that one-third of the brains that had seemed normal using conventional tests while the people were alive actually had damage to tiny blood vessels. The damage was so slight it was impossible to see without a microscope.

The people whose brains had these tiny signs of hardened arteries and stroke were most likely to have had shuffling gait and other movement problems while they were still alive.

What good is this info? Well, a mini-stroke is a warning that a bigger one is on the way. So an unexplained shuffling gait might mean the person should take precautions - watching blood pressure, for example, and seeing a doctor about this - to perhaps prevent a more devastating stroke.

'He heard my voice'

I love the LORD, for he heard my voice;
he heard my cry for mercy.
Because he turned his ear to me,
I will call on him as long as I live.

-Psalm 116:1-2

The last few entries touched on aphasia, a language problem that often occurs when someone has a stroke. To this day, I feel that my speaking ability is not quite as good as it was before.

These verses in Psalm, however, reminds us: No matter the condition of voice, our speech, or even if we lack the ability to speak, God hears us. He hears you - no matter what - and waits your call.

Regaining speech after a stroke

Know a stroke survivor with trouble speaking? Here's a link with some basic information about regaining speech after a stroke:

Some people with aphasia have trouble talking but can easily understand speech. Others talk easily but can't understand what people are saying. Aphasia is a common problem, especially when a stroke has damaged the left side of the brain, where language is processed. Some people with aphasia get better quickly, but even with speech therapy, others continue to have trouble speaking, finding words, reading, writing, or doing math (the same area of the brain that controls language also governs math skills).

Rehabilitation for someone with aphasia involves a variety of speech and language exercises to help the patient relearn the ability to understand, speak, read, and write to the extent that he or she is able.

'Please be patient'

The card, carried by a woman from Appleton, Wisc., speaks volumes:

O'Brien — as a card and key chain she carries in her purse both explain — has aphasia. "Please be patient," it reads. "I have trouble talking." 

Aphasia, which affects about 1 million people in the United States, is a word many never have heard.

According to the National Institute on Deafness and Other Communicative Disorders, aphasia is an acquired disorder that results from damage to portions of the brain responsible for language, usually located on the left hemisphere.

Stroke survivors quite often struggle for words, to complete sentences. The thoughts are there, but for some, it's difficult to relay those thoughts. Thoughts that are as valid as anyone's. So, as the woman's card says: "Please be patient."

Struggling with language

"Frustrating" is a charitable term describing how people going through aphasia can feel. A story, not long ago, about one man's struggle. ...

Local resident shares recovery story:

After the stroke, he was unable to speak. Hours after he was admitted to the hospital, Cariveau was diagnosed with aphasia, a language impairment affecting his ability to communicate. ...

Dr. Joanne Pierson, associate director of the University of Michigan Aphasia Program, said this language disorder can be very frustrating for patients.

“Language encompasses so much that we do,” she said. “Imagine not being able to express your needs.”

'God is our refuge and strength'

God is our refuge and strength,
an ever-present help in trouble.

-Psalm 46:1

The next few posts will include information about aphasia, a condition that occurs with many stroke patients. Aphasia is a language issue - it can affect speaking, understanding, reading, writing.

It's a subject I think about from time to time. I was struck with aphasia in my stroke. Through speech therapy, working with an unofficial "writing coach" at work, various teaching tools, including some designed for schoolchildren, I worked through this issue because God was my refuge and strength and never left my side.

Worked through, but not completely healed. Stress and fatigue can bring some of the issues back. Indeed, not  everyone recovers completely. But God will give you strength to see you through through troubling times. He certainly helps me.

Good news on the clot-busting front

I received tissue plasminogen activator (tPA) in 1998 - early for the drug's use - and convinced that it helped in my stroke recovery. Went from unable to move my right side and unable to speak to getting back both.

A month or so later, I ran an 8-kilometer road race. After speech therapy, I went back to writing for a living. I do believe that my speaking skills are not nearly as good as before, but in all honesty, I am grateful to God for my outcome.

Most strokes are caused by a blood clot lodged in the brain. The drug works to dissolve the clot and speed recovery. Given that it's a powerful drug to prevent blood from clotting, it takes special training and good judgment to use the drug for the right stroke patients.

Thus, one problem is the reluctance of using the clot-busting tPA, even for patients would benefit. Recently, though, researcher found that more neurology residents are using the clot-busting drug:

Researchers found that the proportion of neurology residents who say they're comfortable using tPA rose from 73 percent in 2000 to 94 percent in 2010.

"This is good news," senior author Dr. Brett Cucchiara, an assistant professor of neurology at the Hospital of the University of Pennsylvania, Philadelphia, said in a journal news release.

"It is imperative that neurology residents attain a level of comfort using tPA that will allow them to use the medication effectively in their clinical practice and guide other physicians in its use," Cucchiara noted.

With this news, I feel better already...

Optimism associated with lower risk of having stroke

“Our work suggests that people who expect the best things in life actively take steps to promote health,” said Eric Kim, study lead author and a clinical psychology doctoral student at the University of Michigan.

Optimism is the expectation that more good things, rather than bad, will happen.

Previous research has shown that an optimistic attitude is associated with better heart health outcomes and enhanced immune-system functioning, among other positive effects.

Story of recovery and perseverance...

After reading this article about a Boise athlete not letting stroke keep him from his dreams,all I can say is - amazing recovery and an admirable example of determination. Reminds me of:

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, ...

 -Hebrews 12:1

An excerpt from the article:

That person is 34-year-old Justin Shields. The Four Summit Challenge will be the longest bike ride he’s ever done. For some, it may not seem like much of an accomplishment, but for Shields, it’s the culmination of years of hard work. In February 2008, a stroke would test Shields' limits, both physically and mentally. ...

Shields' recovery was long. He spent a month in the hospital, one week in the intensive care unit as well as countless hours in rehabilitation. He had to learn to do everything over again, from walking to talking.

“I didn't want to live without the use of my body, so that was really a motivating factor for me to continue on and overcome the obstacles,” said Shields.

But, Shields said some days are easier than others.

“There have been some bad days, I must admit, but for the most part I just look past them as I'll have to go through those periods of frustration in order to achieve my goal,” he said.

Two years after his stroke, Shields is once again working on realizing his dream of being an Ironman Triathlete.

A story about faith and stroke recovery

My trusty Google alert sent me this story - mixing stroke awareness, young stroke survivors and faith. It's about how a former basketball star is growing church and changing lives in Indiana:

“I remember him telling my family that I had had a stroke and that I needed to have surgery, but there was a 50/50 chance I might not make it off the table,” he said.

But [Chad] Hunter didn’t simply rely on modern medicine to get him through his physical ordeal. He took something much greater with him into that hospital room in February 2008.

“You have to have faith and trust God to help get you through the hardships of life,” he said. “With prayers things change.”

 Now, Hunter leads a congregation, giving back gifts from God.

Story of a 33-year-old...

Time to devote a few blog postings to a topic that is near to my heart - or better yet, brain: Strokes don't just happen to elderly people.

My age when it happened: 39. There are plenty of stories about people who have had strokes even younger.

Is this intending to scare people? Certainly not. Instead, it's important for people of all ages to be aware of stroke symptoms and know that it is important to get help quickly.


A recent story talks about how strokes can strike the young:

By age 33, Wichitan Bill Ramsey had suffered his second stroke. He hadn't even realized he'd had one at age 28 until he went to a doctor days after suffering the second one. ...

Both times, Ramsey said, it never would have occurred to him that he had suffered a stroke.
When Ramsey's doctor told him he'd suffered a stroke not once but twice, he had a hard time taking it serious.

"I laughed and said, 'I'm only 33.' " he said. "I thought strokes happen in older people."

'So do not fear, for I am with you'

So do not fear, for I am with you;
do not be dismayed, for I am your God.
I will strengthen you and help you;
I will uphold you with my righteous right hand.

-Isaiah 41:10

People with aphasia - a common outcome for stroke survivors that affects speech - feel isolated and therefore isolate themselves from others, according to a survey conducted in 2004 by the National Aphasia Association.

But nothing - no matter what in this life - can truly isolate one from God. The author in Isaiah said it far better than I can: you don't have to fear, you need not be dismayed. God is with you.

I certainly understand - to a degree - the feeling of aphasia, which afflicted me during my own stroke in 1998. For a while, I could not speak, write or read. I had trouble understanding what others were saying. Talk about feeling isolated.

But God never left me. In those days when my I needed strength, God was present. And God can be present for you.

Research looks at racial disparity and time

Currently, this blog theme is time. I saw several versions of this story that illustrates the great importance of getting help quickly for those suffering a stroke.

This article from The Washington Post talks about ways of preventing strokes and how time is important.

Study in D.C. hospitals reveals disparity in stroke treatment for blacks:

Researchers found that blacks are significantly less likely to get the stroke treatment medication tissue plasminogen activator (tPA) because they don’t arrive at the hospital early enough, and even when they get there in time, they often have other risk factors, such as high blood pressure, that make them ineligible for the medication. The drug increases the risk of bleeding into the brain. To be effective, the medication also needs to be given within three hours of the onset of symptoms.

“Based on our data, it appears that much of the explanation is due to things that happen before the patient gets to the hospital,” said Amie Hsia, the lead author and medical director of Washington Hospital Center’s Stroke Center. The research was conducted by Georgetown University Medical Center.

That is good news for patients and their families, because they can increase the likelihood of getting treated with a few simple steps.

At the first hint of symptoms, call 911 and get to the hospital quickly. Control risk factors, such as high blood pressure, “so that it doesn’t become a factor in [preventing] safe treatment,” Hsia said.

Educate yourself about stroke prevention

A few days ago, I saw a notice about a series of screenings by a commercial venture at a local church building. You've probably seen ads for this in newspaper inserts or in your mailbox. This bothers me a great deal.

Why? Because this type of screening, without advice from your doctor, is not an effective way to prevent strokes. For a total of $240, you supposedly get carotid artery screening, heart rhythm screening, abdominal aortic aneurysm screening and peripheral arterial disease screening.

Now, that sounds all well and good, except....


If you have zero stroke risk factors, you don't need these screenings. If you do have stroke risk factors, then you should have already talked to your doctor about what to do about these risk factors and what tests are needed.


If you don't trust your own doctor to provide meaningful help in that decision-making process, you need another doctor.

Follow this link to get details about stroke risk factors. For your future and the ones you love.

Those factors include cholesterol and high blood pressure - and if you don't know those numbers, that's a sign you need a visit to a doctor, not fly-by-night screeners. Circulation problems - a simple exam can give a doctor the information needed to justify additional screenings - the right ones. Another risk factor is diabetes. Again, there are specific symptoms of diabetes that should lead you to a doctor visit.

Educate yourself. Don't give in to scare tactics.

By the way, I don't blame the church allowing this company to use its building. I'm sure this was pitched very cleverly. But after you review the risks you think you need to take some steps to avoid a stroke, talk to your doctor instead.

Ambulance ride can make a difference

I've seen this happen with a family member - once, coming in to an emergency department by regular car, second time, by ambulance. She was seen a lot quicker when arriving by ambulance. That's key in care for stroke patients.

I was taken by this recent story about faster stroke care when patients come by ambulance:

(Reuters Health) - Patients with stroke-like symptoms get brain scans faster when they arrive at the hospital by ambulance than when they use a taxi or private car, a new study suggests.

Such scans are necessary to make a diagnosis, and doing them quickly ensures early care and better outcomes. ...

"EMS (emergency medical services) impact doesn't just stop at pre-hospital care, it can have an impact in the hospital as well," said Mehul Patel, from the University of North Carolina in Chapel Hill, whose findings appear in the journal Stroke.

A valuable lesson you can take advantage of if you or a loved one is having stroke symptoms, when time suddenly becomes extremely important: Call 911 and get an ambulance.

Canada also has trouble with time

The current theme of this blog revolves around getting help and getting help fast if you see any stroke signs or symptoms.

And that means any sign.

This research helps show that need is not United States-specific. I bolded the last item on a longer list of findings, emphasizing the need to be sure to get help quickly. Research in Canada, too, shows that stroke victims wait too long for treatment:

Stroke victims arriving at Canadian hospitals aren't being treated quickly enough, creating "unacceptable" delays that are increasing the risk of irreversible and devastating brain damage, according to a major new study.

The finding is part of the wider problem, highlighted in the study, that strokes aren't being treated like the medical emergencies they are by the tens of thousands of Canadians who suffer them each year.

It's based on a national review of hospital records and data representing more than 38,000 patients admitted with stroke across the country in 2008-09.

The audit by the Canadian Stroke Network, the first of its kind in this country, found: ...

- 39 per cent of all patients arrived at the hospital more than 12 hours after their first symptom of a stroke; ...

'Time is brain'

The next few weeks, we'll focus on time. All too often, people wait to seek help when a stroke occurs. It's vitally important to get a stroke patient help as soon as possible. The quicker the person gets to a stroke center, the better choices of treatment.

Here's a note from Kansas City:

'Time is brain' remains stroke mantra:

...[Kathleen] Henderson [RN, MN, ACNF, LNC] wants everyone to know the warning signs and importance of getting immediate help.

“Stroke is one of those time-critical diagnoses,” she said. “It’s similar to a heart attack. The faster you get help the better your outcomes may be.”

Henderson said any of the following signs merits an immediate phone call to 911:

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

Getting treatment within 60 minutes of the onset of symptoms can prevent disability, Henderson said.

Now, one of my "mantras" is that the last item about the "sudden severe headache" does not mean that no headache means no stroke. I never had a headache with my stroke. Most people I have spoken to didn't have a headache.

So think about the symptoms like this: If you see one of these symptoms, get some help. Fast.

A 'taste' of stroke prevention

Taking care of  your mouth is more than pretty teeth. More and more, it's clear that oral health affects overall health:

Though the research is still in its early stages, there is mounting evidence of a link between gum disease (periodontitis) and overall health, including an increased risk for heart disease, stroke, and maybe even pre-term birth.

"The links are still not enormously strong," says Dr. Paul Reggiardo, a pediatric dentist in Huntington Beach, Calif. "What they are right now are tantalizing."

For instance, a 2008 consensus report in the Journal of Clinical Periodontology concluded that periodontitis — in which the tissues surrounding the teeth are inflamed and infected, leading to progressive bone loss and ultimately loss of teeth — "may contribute to cardiovascular events and stroke in susceptible subjects."

'Your right hand upholds me'

On my bed I remember you;
I think of you through the watches of the night.
Because you are my help,
I sing in the shadow of your wings.
I cling to you;
your right hand upholds me.

-Psalm 63:6-8

"Right hand."

I remember the day, as if were just yesterday, when my own right hand wouldn't move. Had no feeling. Was useless.

Yet today, my right hand is typing. Last night, my right hand helped with routine work installing an electrical outlet and light switch. My right hand turns a steering wheel, carries groceries and does thousands of other day-to-day tasks.

The Psalm passage above, referencing the right hand of God, made me think of my own right hand and what happened to it. I thought of it this way: When my own right hand was useless, God's right hand upheld me.

Stroke is the most common reason for permanent disability, including the disability of the human hand. That's one reason why it's so important to work on stroke prevention, recognizing symptoms and know what action to take when you see those signs. Will everyone regain complete use of a hand? No. Will everyone rely on God's right hand, as the Psalmist described God's power? Yes.

(Image using photo by woodley wonderworks, via Wikimedia Commons; text added)

Olive oil linked to stroke prevention?

Interesting research reported - maybe something to consider in your own diet...

Olive oil linked to reduced stroke risk:

In the new study, seniors who regularly used this healthy monounsaturated fat had a 41% lower risk of stroke compared to their counterparts who never used olive oil.

“This is the first study to suggest that greater consumption of olive oil may lower risk of stroke in older subjects, independently of other beneficial foods found in the Mediterranean diet,” study author Cecilia Samieri, PhD, with the University of Bordeaux and the National Institute of Health and Medical Research in Bordeaux, France, says in an email.

Encouraging news about preventing second strokes

If you've had a stroke, or know someone whose lived through one, you know that a second stroke can carry serious danger.

So using statins - drugs normally used to control cholesterol - might help, according to an article about research on statins preventing second strokes in high-risk groups:

Statins reduce recurrent stroke risk in patients with type 2 diabetes and metabolic syndrome despite the higher risk of cardiovascular events and recurrent stroke in these populations, researchers found.

As always, consult your doctor - be an advocate.
 

Exercise and stroke prevention

Prevent a stroke - and you can save your life.

For the next few weeks, I want to focus on news and ideas on stroke prevention. Here's one that we can all take advantage of - a WebMD story on how moderate exercise may cut risk of "silent" stroke

People who reported engaging in moderate to intense exercise were 40% less likely to have the lesions than people who did not exercise at all, even after the researchers took into account other stroke risk factors such as high blood pressure and high cholesterol.

Regular light exercise, such as golf, walking, bowling, or dancing did not appear to decrease the risk for silent stroke, but study researcher and stroke specialist Joshua Willey, MD, says these activities clearly benefit health.

Willey is an assistant professor of neurology at Columbia University.

"I would not want these findings to discourage people from walking or performing other light exercise," he tells WebMD. "But it may be that a certain level of exercise frequency and intensity is needed to lower silent stroke risk."

Canada and stroke awareness

While Stroke Awareness Month in the United States was in May, our northern neighbor marks Stroke Awareness Month in June, according to CTV News:

June is Stroke Awareness Month across Canada. Strokes are the leading cause of adult disability and the third leading cause of death in Saskatchewan. That's why the Heart and Stroke Foundation is spending this upcoming month urging Saskatchewan residents, especially women, to educate themselves about the prevention and warning signs of stroke.

Despite all the efforts of government agencies, nonprofits and others, many people are not aware of stroke signs and symptoms, and what to do if someone is having a stroke. Awareness has a long way to go.

Yoga and balance

Personally, I'm not into yoga. Then again, maybe I should be. My own stroke didn't leave me with balance issues, but that is a very common occurrence. Stroke is the leading cause of permanent disability, and often, balance is affected.
 

WebMD recently reported that yoga may improve balance of stroke patients:

The study shows stroke survivors who participated in a specialized post-stroke yoga class improved their balance by up to 34%.

Researchers say the participants also experienced a big boost in their own self-confidence after their yoga practice and became more physically active in their communities.

"It also was interesting to see how much the men liked it," says researcher Arlene A. Schmid, assistant professor of occupational therapy in the School of Health and Rehabilitation Sciences at Indiana University-Purdue University, Indianapolis, in a news release.

Treatment better - but improvement needed

As a tPA recipient in 1998 - I live the value of this treatment every day. It must be used properly, of course, but it is used far less than it should be used. The latest...

More stroke patients get clot-busting drug but barriers remain:

Acute ischemic stroke occurs when a blood clot cuts off blood supply to the brain. Tissue plasminogen activator (tPA) is the only thrombolytic (clot-dissolving) drug approved to treat this type of stroke in the United States, and it can stave off death and lasting disability, but only if it is administered within 3 to 4.5 hours of stroke onset.

"Overall, tPA treatment rates are improving, but the proportion of ischemic stroke patients receiving the therapy remains very small," said study author Dr. Opeolu Adeoye, an assistant professor of emergency medicine and neurosurgery at the University of Cincinnati in Ohio. "The delayed hospital arrival in the majority of stroke patients is probably the most important factor contributing to low treatment rates."

The findings are published June 2 in the journal Stroke.

Concerns about the stroke care gaps

The American Heart Association recently highlighted a disturbing and continuing trend about racial, ethnic gap in stroke care:

In a scientific statement, the AHA notes that stroke is more common among African-Americans, Hispanics, American Indians, and Alaskan Natives than among whites.

The AHA calls for raising awareness of stroke factors and the need for urgent treatment, increasing access to insurance coverage in minority populations, and doing more research on the roots of racial and ethnic disparities in stroke care. ...

Stroke is more likely if you have risk factors including high blood pressure, diabetes, high cholesterol, smoking, obesity, and a history of peripheral artery disease (PAD), carotid artery disease, or certain types of heart disease.

Several of those risk factors are more common in minority groups than among whites.

Challenges in the Southern states

Cognitive decline is higher in Southern Stroke Belt:

People who live in the Stroke Belt are more likely to develop cognitive decline, according to new data from a long-running University of Alabama at Birmingham study. It’s hoped that linking cognitive decline to stroke-risk factors could lead to stroke prevention.

People living in this eight-state region, defined by a risk of stroke death higher than in the rest of the nation, are at 18 percent higher risk of developing incident cognitive impairment, which includes failing memory and processing thoughts more slowly, says the study author in the May 27, 2011, online issue of the Annals of Neurology, the official journal of the American Neurological Association.

For this stroke survivor, recovery has been slow

A note to end Stroke Awareness Month - an uplifting story about a man in Massachusetts and his struggle in recovery - for the last 10 years. Watch and learn.

Stroke survivor's journey back:

Larry Woodberry talks about his experience recovering from a stroke he had 10 years ago. Woodberry had to re-learn everything from speaking to holding a cup.

Good news: Recurring stroke rate declines

Despite the topic here, a stroke-dedicated blog is NOT a downer - here's some encouraging recent news about how the recurrent stroke, vascular event rate on decline during past 50 years:

During a 50-year span, the annual event rate of strokes and major vascular events declined by roughly 1% per decade each, according to an analysis of nearly 60 secondary prevention trials.

'Endurance and encouragement'

May the God who gives endurance and encouragement give you the same attitude of mind toward each other that Christ Jesus had, so that with one mind and one voice you may glorify the God and Father of our Lord Jesus Christ.

-Romans 15:5-6

For the last seven months, I've had some serious back problems - pain, sometimes searing pain, has certainly challenged my endurance as a runner and encouragement in general.

I also must admit that much of the time, I do not like to ask for help. And this self-reliance attitude can serve well, in some ways. But when it comes down to it, we all need help for endurance and encouragement.

Paul's word is a great reminder that we're here to provide said help to each other.

It's really OK to call for help

During Stroke Awareness Month, a good reminder...

Many say they'd call 911 for stroke signs, but most don't:

In a survey of 253 predominantly African American community volunteers in Washington, DC, 89% said they would call 911 at the first sign of stroke symptoms. However, in structured interviews with 100 hospitalized stroke patients (or proxy respondents) in the same city, only 12% reported actually calling 911 immediately at symptom onset.

The disconnect was "striking" when comparing what healthy participants said they would do hypothetically and what most actually did when faced with stroke symptoms, first study author Amie W. Hsia, MD, director of the Washington Hospital Center Stroke Center in Washington, DC, noted in a statement.

"The failure to act promptly contributes to delayed presentation, reduced opportunity for acute therapy, and greater stroke morbidity," Dr. Hsia and colleagues note in their report. They say further research is needed to "determine and conquer the barriers between behavioral intent and actual behavior to call 911."

(Image from State of Montana 9-1-1 Home Page)

More stories from stroke survivors

I'm running across more stories, from around the world, about stroke survivors. For Stroke Awareness Month, I'll highlight a few. Today, three stories:

May is National Stroke Awareness Month — know the signs:

I didn’t want to believe it. I always thought strokes were for people in their 70s or 80s, not 42-year-old men. ...

May is National Stroke Awaerness month and it is important to know the signs:

They are — numbness or weakness of face, arm or leg - especially on one side of the body, confusion, trouble speaking or understanding, trouble seeing in one or both eyes, trouble walking, dizziness, loss of balance or coordination, and severe headache with no known cause. More than anything else, don’t hesitate to call 911. It saved my life.

Nearly five years later, God has blessed me with a second chance at life.

I was having a stroke:

While I was in hospital, I did some research from my bed and came across the Irish Heart Foundation website, stroke.ie, which I found very helpful. I was very impressed with its FAST (Face, Arms, Speech, Time) campaign, which raises awareness of the signs of stroke and the need to act fast. Stroke can happen to people of all ages, which is why it’s so important for everybody to be aware of the signs and symptoms.

Woman talks about locked-in syndrome during stroke awareness month

Eight years ago, the then-15-year-old basketball star started feeling dizzy at practice.

"Someone was like, 'Oh my gosh, whats wrong with her?'" she said. Then she started to slur her speech and was rushed to the emergency room.

"It was panic, pure panic. I thought I was going to die," she said.

Spreading stroke awareness ...

These articles list some good info, from strike signs, what to do and stroke prevention.

From The Tennessean in Nashville, every 45 seconds, someone in America will fall victim of a stroke:

Getting help fast is the most important treatment for stroke, call 911.The longer you wait to get treatment, the more brain tissue can become damaged, often leaving permanent disability.

From Brooklyn Eagle, a daily paper in Brooklyn:

“Every second counts in the race to identify and treat stroke,” said Dr. Steven Rudolph, director of the Jaffe Stroke Center at Maimonides Medical Center. “The sooner we can make a diagnosis and start treatment, the more we improve our chances of minimizing damage to the brain. All of us should take a few minutes to learn the warning signs of stroke, so we can help someone we suspect may be experiencing this medical emergency by calling 911 right away.” ...

While some of the risk factors for stroke are hereditary, others are not. This means that each one of us can reduce vulnerability to stroke by being aware of our risk factors, including medical history and personal habits. Some risks can be reduced by living a healthier, more active lifestyle. Dr. Rudolph advises:

• Have your blood pressure checked regularly.
• Eat a varied and balanced diet that relies heavily on vegetables, whole grains, fish, lean meats and fruit.
• Keep your weight under control.
• Monitor your blood cholesterol: you should try to lower the “lousy” kind known as LDL, and increase the “happy” kind known as HDL.
• Get moderate exercise on a regular basis (at least two and a half hours per week).
• Avoid excessive alcohol consumption.
• Quit smoking.
• Consult your doctor if you have a family history of stroke or high blood pressure to determine if you need additional assistance in prevention efforts.

Needed stroke care delivered via robot

This is Stroke Awareness Month, and one issue is the need for stroke care offered to all who need it, no matter where. However, specially trained neurologists are, sadly, not everywhere. One way to combat that challenge is from Washington State.

Robot helper allows for real-time communication to save stroke victims:

Hospitals in outlying areas, such as Ocean Beach Hospital, do not  have a neurologist on staff who could make an assessment within this critical window, and that's where the telestroke robot comes in.

The robot allows neurologists to beam in live to the emergency  department to perform real-time examinations and evaluations of stroke victims. With the remote-controlled robot, equipped with cameras and microphones, consulting doctors can review charts, patient records, diagnostic images such as CAT scans and talk directly to ED physicians, the patient and the patient's family.

"Basically, it's just like having the neurologist right in the  room," said Valerie Mays, Providence's telestroke program coordinator.

Mine happened under 40...

Young adults’ beliefs about their health clash with risky behaviors:

Nine out of 10 Americans between ages 18-24 believe they’re living healthy lifestyles — yet most eat too much fast food, drink too many alcoholic and sugar-sweetened beverages and engage in other behaviors that could put them at risk of stroke, according to an American Stroke Association survey released today.

The results are part of a survey of 1,248 Americans ages 18-44 on their attitudes about health, including influences of and beliefs about health behaviors and their risks for stroke.

Stroke is a leading cause of death and disability in America.