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)