A holiday gift - resources about ending stroke

Mayo Clinic, on resource-rich website, offers some Holiday health hints and the faces of stroke prevention:

I learned earlier this year while working on a project that the biggest risk for a stroke is to have had one already. I also found that the incidence of stroke – and heart attacks – increases at the holiday season.

Read through the article to find stories, videos and links.

'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.

Stroke is a global issue

Stroke is not just a killer in the United States, of course - a recent article highlighted the global burden of heart- and stroke-related deaths:

Ischemic heart disease and stroke caused almost 13 million deaths in 2010 — one in four deaths — worldwide, compared with just one in five back in 1990. ...

In a second paper tracking the burden of disease related to 67 risk factors, Dr Stephen S Lim (Institute for Health Metrics and Evaluation, Seattle, WA) and colleagues report that the top two risk factors for disease in 2010 were high blood pressure and tobacco use ... .

Distress and age: a dangerous combination

The older I get, the more interested I become in senior health. A recent note about how fatal strokes strike distressed seniors:

"People should be aware that stress and negative emotions often increase with age," Everson-Rose noted in a statement. "Family members and caregivers need to recognize these emotions have a profound effect on health."

How exactly the link works isn't clear, whether due to neuroendocrine and inflammatory responses to stress and depression or via poorer lifestyle factors associated with them, her group acknowledged.

In the study, the most distressed seniors were less educated, less physically active, and had more chronic health conditions and antidepressant use -- all of which may add up to problems with medication adherence and maintaining a healthy lifestyle.

More research needed to address stroke risks for blacks

Ran across a story about research that shows that more research is clearly needed to find some answers and solutions.

Here's a link and excerpt of a recent story about how blood pressure-related stroke risk in blacks is not about race:

"When these racial differences are coupled with the previously documented higher prevalence of hypertension and poorer control of hypertension in blacks, they may account for much of the racial disparity in stroke risk," they wrote.

It has been well established that stroke risk is higher in blacks than in whites, but traditional risk factors explain only about half of the difference. One potential explanation for the rest of the variance is that certain risk factors affect blacks and whites differently, a possibility explored in the current study.

Frankie Muniz, 26, tweets about his 'mini-stroke'

Stroke awareness, even for the young, is important! Note the recent story about Frankie Muniz, 26, tweeting about his mini-stroke:

"I was in the hospital last Friday. I suffered a 'Mini Stroke,' which was not fun at all. Have to start taking care of my body! Getting old!," the young actor tweeted today.

He did not explain why, and according to TMZ, doctors are still stumped, awaiting test results. TMZ says Muniz was taken to an Arizona emergency room after his friends became alarmed when they noticed he was acting strange, and having trouble speaking and understanding.

Remember those signs, as explained by the National Stroke Association:

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

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

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

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

Stroke linked to drug abuse

We've seen news about the increase of stroke among younger people. Now, another study seems to show that strokes are tied to drug abuse:

An increase in stroke in the young parallels an increase in substance abuse, particularly cocaine and marijuana, according to a study of records from the Greater Cincinnati and Northern Kentucky area.

The number of strokes in those ages 18 to 54 increased from 297 in 1994 to 501 in 2005, mirroring a similar trend in the overall use of tobacco, alcohol, and illegal drugs (45% versus 62%), reported Brett Kissela, MD, of the University of Cincinnati in Ohio, and colleagues.

Blacks and men were disproportionately affected compared with whites and women (65% versus 51% and 61% versus 47%, respectively), according to the study published in the December issue of Stroke: Journal of the American Heart Association.

'I am the light of the 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 is the 500th posting on this blog - started in December 2005 and for many years, updated sporadically. Now, it's generally updated two or three times a week and has a companion Facebook page and Twitter feed.

I chose the verse above, from John's Gospel, because as a stroke survivor, I stumbled in the dark, in a blur of barely recalled images, while others were steadfastly working to keep me alive.

Now, Jesus is not talking about physical light, but spiritual light. So even if we are in the dark times in this world, you have the promise of the light of life that means so much more.

Now, on to the next 500 postings...

(Photo from NASA; text added by author)

Playing games in stroke recovery?

More potential tools for home recovery for stroke survivors. A Patient-Centered Outcomes Research Institute grant funds Ohio State researchers using Kinect for at-home stroke rehabilitation:

Lynne Gauthier, an assistant professor of physical medicine and rehabilitation, is leading the team creating a video game for the Microsoft Kinect that the team hopes could expand access to a specific kind of rehabilitation called constraint-induced movement therapy. The game would allow patients with mild-to-moderate upper-limb impairment to perform guided CI therapy in their homes.

The game uses Microsoft Kinect’s motion capture technology to guide patients through a series of therapeutic exercises set in a river adventure theme, Gauthier said. Patients would visit a clinic for initial consultation and the game would act as a consultant to guide them through exercises at home. Patients would also be given a restraint mitt to encourage them to use their affected side more often in daily activities.

“A lot of these kinds of rehab games are basically about just getting the person to move a lot,” she said. “But we’re trying to make it so that the game would stimulate what the therapist would do. Just as a therapist would make a task harder when the person improves, the game would do the same thing.”

Battling misconceptions about aphasia

I stumbled across this recent blog posting about 10 Things You Should Know About Aphasia. I especially thought this item might help avoid the typical (but wrong) assumption that people with aphasia are always confused or have a lack of intelligence:

4) Aphasic patients are not necessarily confused. Most aphasia occurs in the absence of confusion and it can be extraordinarily frustrating (and frightening) for the patient. Consider that every time the patient is unable to speak (or even write) there is something that they desperately want to say.

Read the entire list, though, using the link above.

Happy Thanksgiving!

Can any one of you by worrying add a single hour to your life?

-Matthew 6:27

Happy Thanksgiving to all. Today, I'm especially thankful that I can bring God my worries.

We all have plenty of things we could worry about - money, health, family, work, to name a few. But in his Sermon on the Mount, Jesus cautions us that worry is a time-wasting, useless task. Today, I pray that I continue to bring God my worries and that helps me find a center of my life in Him.

On this Thanksgiving Day, thank God - literally - that I don't have to carry a burden of worries.

.

'Safe and effective...so few patients get it'

This blog author wrote an entire book about a clot-busting drug for stroke patients - tPA for Stroke: The Story of a Controversial Drug - and still finds people are still having a hard to avoiding a fate worse than death (not so easy):

Although appropriate for almost 9 in 10 strokes — those that are ischemic, or due to blood clots — only a small fraction of potentially eligible patients, not more than about 4-8%, receive tPA. Consider this:

It’s safe and effective…so few patients get it. As a drug for a major and life-threatening disorder, tPA was shown to be effective with a 11-13% absolute benefit (cancer drugs that provide a 2% absolute benefit are routinely approved).

I've harped on this before - it's critical to get help for someone right away. Every minute counts. But even when someone is at a hospital on time, it's important to be an advocate for that person to get the right help.

Sugary drinks linked to higher stroke risk

Not a huge surprise here - those sugar-laden drinks are associated with higher stroke risk around the world. This one involved research in Japan on women health and found that sugary drinks linked to higher stroke risk:

Women who imbibe sugary soft drinks almost every day are 83 percent more likely to have a certain type of stroke than women who rarely drink sodas and other sweetened beverages, according to a new study from Japan.

Although the findings don't prove that sweet drinks are to blame for the higher stroke risk, other studies have shown links between high sugar intake and clogged arteries, said Dr. Adam Bernstein, a researcher at the Cleveland Clinic, who was not involved in the study.

And "as the authors here saw, most of the (increased) risk was with ischemic stroke, the kind of stroke with plaque buildup" in the arteries, Bernstein said.

(Photo from the U.S. Food and Drug Administration) 

'The door will be opened'

"So I say to you: Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives; the one who seeks finds; and to the one who knocks, the door will be opened."

-Luke 11:9-10

God wants the persistent prayer. People pray all the time, but persistent praying is not the norm.

Just before the verses above, Jesus tells how you might open your own door to a friend who persists knocking, even late at night.

So when you pray, don't stop at once or twice - pray with persistence.

Stroke survivors who smoke raise risk of more strokes

Back on the "stop smoking, or never start!" beat for this blog, recent news about researching showing that stroke survivors who smoke raise risk of more strokes, heart attack, death:

Compared to those who never smoked:

• Those who smoked when they had a stroke were 30 percent more likely to have a poor outcome.
• Among those who survived the first 28 days after stroke, current smokers had a 42 percent higher risk of poorer outcomes.
• Ex-smokers had an 18 percent higher risk of poorer outcomes.
• Compared to past smokers:
• Among those who survived the first 28 days after stroke, current smokers had a 23 percent higher risk of poorer outcomes during the 10 years."

Read the entire story. Stopping helps. Never starting helps even more.

(Image from the U.S. Centers for Disease Control and Prevention)

Debating PFO closure for stroke risk

An article a bit thick to get through, but very informative about the debate about patent foramen ovale closure for stroke risk. That being said, if you're interested in the topic, heart.org did a nice job in getting different expert opinions. Read the entire article, but here's a snippet:

Depending on one's point of view, the studies fail to support the continued treatment of patent foramen ovale (PFO) with the Amplatzer occluder (St Jude Medical, St Paul, MN) for the prevention of stroke recurrence or provide yet more evidence that closing PFOs is the right thing to do.

The conflict arises from the fact that both randomized, controlled clinical trials missed their primary end point. As reported by heartwire, the studies were negative, with RESPECT suggesting a benefit when evaluating the "as-treated" patients only, and this has left researchers, clinicians, and other experts trying to understand what went wrong and the potential reasons the trials don't line up with published observational reports.

Are stroke patients getting younger?

There's been a lot of news lately about how U.S. stroke patients are getting younger:

"... while stroke patients between the ages of 20 and 54 made up nearly 13 percent of all stroke patients in 1993 and 1994, that figure rose to just shy of 19 percent by 2005.

The result: In the interim, the average age at which strokes now occur has dropped significantly, down from roughly 71 years old in the mid-1990s to about 69 a decade later.

"This is pretty important, and a pretty big jump," said study lead author Dr. Brett Kissela, professor and vice chairman of neurology at the University of Cincinnati College of Medicine. "And what it means is that even though young people typically feel like they're healthy and that a stroke can't happen to them, the fact is that our study is evidence that that is not true."

Mine happened at age 39 - so it's vital that every know the stroke signs and know what to do.

Plugging holes in the heart good for you? Maybe. Maybe not.

So ... for stroke prevention, do plugging holes in the heart serve better than taking blood thinner medications? The resounding answer: Maybe not. But maybe so.

A recent paper outlined the results of research of the effects of plugging a patent foramen ovale (click here for details about that term) in terms of preventing strokes. My 1998 cryptogenic stroke - that is, a stroke with no clear reason - was finally attributed to a hole between two heart chambers. (Click here for my own story about what happened.)

For this post, let's go through two articles and one press release (which you should read in their entirety) with a few snippets included. First, here's one headlined that Plugging PFOs no help for stroke -- maybe:

He said physicians should consider the following:

• First, we're talking about a stroke risk reduction that, if it plays out over time in a 46-year-old, is important.

• Second, for patients who are in the midst of their lives regarding career or family, they are looking for the best strategy to reduce the risk of having another stroke with all those consequences. So, what may be a small difference [in absolute risk reduction to an observer], is a huge difference to these patients

• And third, when we review pharmacologic studies that look at the risk reduction of secondary stroke prevention, we are not dealing with the same magnitude. These magnitudes of risk reduction [in RESPECT] are really substantial. That's what you must keep in mind when dealing with this patient population.

So, the story is that decisions need to be made on a patient-by-patient basis. I agree with that idea. The next item is a little more positive on the closure side.

PFO closure may be superior to medical therapy in preventing stroke:

"In contrast to a previously reported randomized trial for the treatment of cryptogenic stroke, the RESPECT trial enrolled only patients with documented cryptogenic embolic strokes and excluded patients with other potential causes of stroke and/or TIA. The period of follow-up approached nine years and was not restricted to only events within the initial two years of follow-up," said Richard Smalling, M.D., Ph.D., James D. Wood Distinguished Chair in Cardiovascular Medicine at The University of Texas Health Science Center at Houston (UTHealth), who served on the steering committee and as a principal investigator of the trial.

"As a result, the trial enrolled patients at high-risk for recurrent events and followed them for a long period of time, enabling the detection of relatively infrequent recurrent stroke," said Smalling, who is director of interventional cardiovascular medicine at the Memorial Hermann Heart and Vascular Institute. "The totality of evidence in the RESPECT trial clearly demonstrates the superiority of device closure using the Amplatzer PFO Occluder in patients with the above entry criteria compared to standard medical therapy."

Finally a story with a decided negative bent is headlined how St. Jude device to close heart holes fails to stop stroke:

The results won’t change medical practice very much, with some high-risk patients still likely to get treated even without formal FDA approval, Ajay Kirtane, director of the interventional cardiology fellowship program at Columbia University Medical Center/New York-Presbyterian Hospital in New York, said at the meeting.

“I would like as a physician to have the option to discuss it with the patient and be able to use it if the patient elects to do so,” he said. “That would be the ideal scenario. To use it in everybody, I don’t think you can do that on the basis of this data.” ...

“These are healthy people, and the results are something a 46-year-old stroke patient wants to know,” said lead researcher John Carroll, director of interventional cardiology at the University of Colorado. “It works. What we are debating is how superior it is to medical therapy. Any benefit that could potentially cut the risks down the road has a big impact.”

So my own bottom line hasn't changed on this: It's very much a decision that needs to be informed and made carefully between doctor(s) and patient. A single answer won't fit everybody, in this case.

I am convinced mine has prevented further strokes or mini-strokes. That being said, I was an active relatively young man when mine happened. Everyone has his or her own circumstances, and those have to be taken into account in any serious medical decision.

‘Hercules’ urges stroke awareness

Today is World Stroke Day, a day to push for awareness of stroke signs and know what to do when you see these signs.

Even ‘Hercules’ star and stroke survivor Kevin Sorbo urges stroke awareness:

On World Stroke Day, Oct. 29, he’s joining forces with the American Stroke Association, a division of the American Heart Association, to spread the word about something else he’s learned about stroke: In many circumstances, it is beatable.

Kevin Sorbo, star of the television series “Hercules,” was only 38 when he suffered three strokes.  That was how he learned anyone can have a stroke.

"Like my character, Hercules, I thought I was invincible," said Sorbo, author of True Strength: My Journey from Hercules to Mere Mortal and How Nearly Dying Saved My Life. “There are many myths and misconceptions about stroke. As a survivor, I have learned that stroke is largely preventable, treatable and beatable."

New treatments for those going through aphasia

Catching up on news about aphasia, which I went through after my stroke some years ago. Check out the story on how new treatments may help restore speech lost to aphasia:

But technology, Riedel said, has introduced new language-improvement techniques into the mix over the last few years that are both exciting and fun. Several apps available for iPhone or iPad involve synthetic speech that helps engage those with aphasia in yet another realm of communication.

"Our patients have much more access to different kinds of programs that are computer-based," she said. "There's always something new around the corner."

What remains a constant concern, however, is the misunderstanding many people have of those with language difficulties and how to treat them, Ganzfried and Riedel agreed.

"Many people with aphasia will become socially isolated because of their communication difficulties, which can lead to depression," Ganzfried said. "There are also many misconceptions about aphasia, including that the person is mentally unstable or under the influence of drugs or alcohol. It's also extremely frustrating. Imagine knowing what you want to say in your head but you can't get the words out."

This problem can indeed by frustrating. It doesn't affect your level of intelligence - just getting those thoughts out in the form of language.

Video demonstrates role of exercise in stroke recovery

Through the new use of Twitter (click there to follow Stroke of Faith!) I found this video about the role of exercise in stroke recovery:

To recover from her TIA and head off a full-blown stroke, Helen enrolled in a year-long study of exercise and stroke recovery run by the Heart and Stroke Foundation Centre for Stroke Recovery. This video tells her story, and explains how exercise can help people recover from stroke.

A good video to share ...



And a second find from the same Centre for Stroke Recovery talks about the the importance of research into stroke recovery:

The best thing is to prevent stroke before it happens. The next best thing is to treat stroke quickly, before it can seriously damage the brain. This is easier said than done. Brain cells die quickly after stroke (which is why we often say “time is brain”). One effective treatment does exist – but most stroke patients don’t get to hospital soon enough to benefit from it. Even those who get the drug in time are often left with deficits.The vast majority of stroke patients rely on rehabilitation to provide them with an improved quality of life after stroke. This is why we urgently need to find better ways to help stroke survivors recover more quickly and more completely.

Tomatoes for stroke prevention?

I'm not a big fan of raw tomatoes, and turns out cooked tomatoes might be even better in terms of tomatoes for stroke prevention:

"This study supports the recommendation of eating [more] servings of fruits and vegetables a day," said Nancy Copperman, MS, RD, director of public health initiatives at the North Shore-Long Island Jewish Health System in Great Neck, N.Y.

"Foods such as tomatoes, guava, watermelon, and grapefruit are good sources of lycopene," she said in a statement. "When a tomato is cooked, the heat processing actually increases the levels of cis-lycopene, which is easily absorbed by the body."

(Photo from the Arkansas Secretary of State) 

Stroke recovery - someday an app for that?

From across the pond, comes news about university students launching a new app in hopes of helping stroke victims:

StrokeLink, a free app that uses a patient-focused interface, empowers stroke survivors by providing them with the necessary tools to regain their independence. The app’s toolkit of health reference material and its powerful tool for rehabilitation was created to guide and actively engage stroke patients as they recover, using accessible design and rich media content.

These self-care tools include rehabilitation programs with exercises ranging from fine motor skills to full body movements, and are presented as text, pictures, or videos, accompanied by audio cues.

We've seen other technologies - video games, for one - being adapted as tools for stroke recovery. Hope this one comes to fruition, too.

Resources about stroke effects

Simple resources for stroke survivors and loved ones are all over the Web. I stumbled across this one recently, a Web tool to explore the effects of a stroke, courtesy of the National Stroke Association:

Stroke affects physical, cognitive and emotional functioning, but there are things that can be done to reduce the impact of post-stroke effects. Each patient’s stroke experience is different and depends on the type of stroke and which areas of the brain are damaged.

Effects can be experienced at varying degrees at any phase of recovery. Understanding the nature of the effects of stroke and what can be done about them is the first step to recovery.

Just follow the link to explore.

Aphasia advocate's story

I'll never forget one stroke story I heard some years ago - long before my own stroke.

The newspaper editor was at a meeting and was leaving when he turned and spoke to someone. He - and everyone else within earshot - heard nothing but gibberish. Classic aphasia for a stroke patient.

My good old Google alert found a story of another stroke survivor recovering from aphasia:

The first month after my stroke I was told I would never walk again or be able to use my left arm. I sat in my wheelchair and cried. Today, I would say I am 99 percent of the woman I was before my stroke due to the therapy I was able to receive. Because of that, it’s important that I stand and fight to help others just like me.

Click on the link and read her entire story, but one phrase stands out for me - "due to the therapy I was able to receive."

In my own recovery, I'm convinced that speech therapy was an important part of bringing back my abilities to read, write and speak. So if you've recovered some abilities - even if it's below her 99 percent - look for ways to support others who are in their own struggle. You can make a serious difference in someone's life.

'Be our strength every morning'

Lord, be gracious to us;
    we long for you.
Be our strength every morning,
    our salvation in time of distress.

-Isaiah 33:2

Somewhere along the way, I became a morning person. Most days when I run, I wake up before dawn, quietly prepare, and run. Not fast, to be certain, but run.

Because of this, I've seen lot of sunrises. Yet I'm never tired of them. A new day, new strength, new hope - all because of God's grace and love.

We often equate night - darkness - with times of distress. Yet God is waiting for us with a sunrise. We long for God, as the verse in Isaiah says. But in his time, morning is coming, with salvation, despite all the distress we face.

(Photo from National Center for Atmospheric Research)

Minor isn't so minor...

What's a "minor" stroke?

Turns out, we might have to redefine that term. Recent research, as reported by heart.org, notes that minor stroke can cause major disability:

"We found that patients with blocked or narrowed blood vessels were at the highest risk of disability," she added. "These patients need to have brain and blood-vessel imaging quickly to decide what interventions are needed to prevent disability."

Their findings build on previous work that has shown that patients with stroke considered "too mild for thrombolysis don't do as well as we might think," Coutts said.

The study was published online September 13, 2012 in Stroke.

Reached for comment on the study, Dr Pooja Khatri (University of Cincinnati Academic Health Center, OH) said: "Dr Coutts and her colleagues have once again demonstrated that so-called mild strokes are not always so mild. Even in this particularly mild cohort, consisting of both TIAs and the mildest strokes, they saw a substantial amount of disability at 90 days.

All the more reason for this blog's constant refrain: Know stroke signs. Act quickly. Be an advocate for someone.

Diet part 3: Yogurt might help blood pressure

Last post talked about raising blood pressure via salt intake. Today, the news is a little more positive - about yogurt. I've been a fan of yogurt for years - and especially, lately, Greek yogurt, which generally contains more protein. So here's a link how yogurt is linked to lower blood pressure:

People who ate at least the equivalent of one serving every three days were 31% less likely to develop high blood pressure than those who ate no yogurt at all, Huifen Wang, PhD, of Tufts University in Boston, and colleagues found.

An even stronger effect was seen among individuals who were not taking antihypertensive drugs, according to their analysis of the Framingham Heart Study Offspring Cohort reported at the American Heart Association's High Blood Pressure Research meeting in Washington, D.C.

"Yogurt is a nutrient-dense, low-fat dairy product," the group noted. "Higher yogurt intake, as part of a healthy diet pattern, may be beneficial for blood pressure control and hypertension prevention.

High blood pressure, of course, is a leading stroke risk factor. So any reasonable way to maintain a normal blood pressure puts you ahead in the game!

Diet part 2: Children's high blood pressure?

We've all heard about salt - as in, people in the United States generally consume too much of it. That, in turn, can cause raise blood pressure. That, in turn, becomes the biggest stroke risk factor.

Typically, we're talking adults. But now, new research indicates, too much salt spells health trouble for kids too:

Most adults consume too much sodium and that can have serious health implications. Too much salt in a person's diet can raise your blood pressure; high blood pressure increases the risk for heart disease and stroke.

In this new study, published ... in the journal Pediatrics, researchers found that if a child is overweight and eats as much salt as an adult, the risk for high blood pressure goes up dramatically.

Health experts recommend that most people eat no more than 2,300 milligrams of salt a day, the equivalent of 1 teaspoon. But children and adults alike are consuming, on average, about 3,400 milligrams daily, according to the study.

Can't start too young in stroke prevention!

Diet part 1: Omega-3 questioned

Diet seems to be making news lately. So for the next few days, I'll link to some stories about diet and stroke prevention.

First one up - Omega-3 fatty acids don't reduce stroke:

"Our findings do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3," said Evangelos Rizos, chief author of the study.

After examining 20 studies comprising a total of 68,680 randomized patients, the researchers said there were 7,044 deaths, 3,993 cardiac deaths, 1,150 sudden deaths, 1,837 heart attacks, and 1,490 strokes.

An analysis of those figures indicated no "statistically significant" association with all-cause mortality, cardiac death, sudden death, heart attack, and stroke when all supplement studies were considered.

Click on the link above to read some of the past research related to omega-3 fatty acids. Time to stop taking the fish oil pills or similar? If a health professional told you to take it, check first.

(Image from National Institutes of Health)

More good news for moderation

If you've read this blog before, you know I'm a moderation fan.

Now, more authoritative words to give pause from recent news - Heavy drinkers at greater risk for stroke:

“The study does add to our knowledge that excessive drinking is bad for our health in a variety of ways, including increased risk of bleeding into the brain,” says Deepak L. Bhatt, MD, MPH. He is a heart doctor at Brigham and Women's Hospital in Boston and an associate professor at Harvard Medical School.

Still, the study is small, and larger ones will be needed before telling people not to drink past a certain level.

Heavy drinkers may be more likely to have high blood pressure, which is a major risk factor for stroke. “If someone enjoys drinking, I don’t discourage them, but I will caution them even more so after this study to make sure that the amount is considered moderate,” Bhatt says.

'My help comes from the Lord'

I lift up my eyes to the mountains —
    where does my help come from?
My help comes from the Lord,
    the Maker of heaven and earth.

-Psalm 121:1-2

Need help?

Or rather: Who doesn't need help? Sometime, somewhere, somehow.

Personally, I need all the help I can get, every day. The struggles might change - health, family, work, even just getting from one place to another.

Have you ever had a struggle, seeking help? When I had my stroke, God helped me. During my recovery, my help came from the Lord. Every day, that help continues.

When you get help from people, is it always the help you thought you needed? I'm guessing the answer is no. Same is true here - God is indeed where your help comes from. Often delivered by humans. And God gives you the help he knows you need - just lift up your eyes to the mountains. Trust and accept that help.

(Photo from the Arkansas Department of Parks & Tourism; text added by author)

Young people have strokes, too

Mine happened at the ripe old age of 39. Way too young? No. It does happen. And, sadly, for people who are as "young" as I were, strokes too often can be misdiagnosed and therefore not treated properly.

Check out this article titled Too young to have a stroke? Think again:

Although a vast majority of strokes occur in people over age 65 (the risk is 30 to 50 per 1,000 in this age group), 10 percent to 15 percent affect people age 45 and younger (a risk of 1 in 1,000). A study by doctors at the Wayne State University-Detroit Medical Center Stroke Program found that among 57 young stroke victims, one in seven were given a misdiagnosis of vertigo, migraine, alcohol intoxication, seizure, inner ear disorder or other problems — and sent home without proper treatment.

“Although young stroke victims benefit the most from early treatment, it must be administered within four and a half hours,” said Dr. Seemant Chaturvedi, a neurologist at Wayne State who directs the program and led the study. “After 48 to 72 hours, there are no major interventions available to improve stroke outcome.”

“Symptoms that appear suddenly, even if they seem trivial, warrant a meticulous work-up,” he added.

Stroke recognition needs improvement - even and especially among trained health professionals. It's important to remember: Young people can have strokes, too.

Smoking: Post-stroke death risk

If you've read this blog at all, chance are you know how I feel about smoking. It's deadly.

Now, it seems that after a stroke, stopping smoking can be an effective "medication." This article talks about  how smoking after a stroke triples the risk of death within a year:

After adjusting for a number of other factors, the researchers concluded that patients who resumed smoking were three times more likely to die than those who didn't begin smoking again.

The study was presented Tuesday at the European Society of Cardiology annual meeting in Munich.

"It is well established that smoking increases the risk of having a stroke," study author Furio Colivicchi, from San Filippo Neri Hospital in Rome, said in a society news release. "Quitting smoking after an acute ischemic stroke may be more effective than any medication in reducing the risk of further adverse events. However, on the other hand, our study shows that stroke patients resuming active smoking after leaving the hospital can raise their risk of dying by as much as threefold."

(Photo from the U.S. Department of Health and Human Services Office on Women's Health)

Blood pressure problems

High blood pressure is a leading cause of strokes. If you don't know your typical blood pressure, you should. Recent news from MedPage Today highlighted that problem, saying that's uncontrolled blood pressure BP is a major problem in the U.S., according to the Centers for Disease Control and Prevention:

On a conference call with reporters, CDC director Thomas Frieden, MD, MPH, said that hypertension -- which he called public health enemy number two behind tobacco use -- accounts for $131 billion in healthcare costs each year and contributes to about 1,000 deaths a day.

"We have to roll up our sleeves and make blood pressure control a priority every day with every patient at every doctor's visit," he said.

Blood pressure control is a priority of the federal government's Million Hearts initiative, which has the goal of preventing one million hearts attacks and strokes by 2017. Part of the effort calls for increasing the number of people whose hypertension is under control by 10 million.

That comes a few days after another story about recent research about black stroke patients have blood pressure troubles:

Blood pressure control is poor following an intracerebral hemorrhage (ICH), particularly among black patients longer term, researchers found.

Fewer than 20% of black and white patients who suffered an ICH achieved a normal blood pressure (less than 120 mm Hg/80 mm Hg) at 30 days and 1 year after the event, according to Darin Zahuranec, MD, of the University of Michigan in Ann Arbor, and colleagues.

Although at 30 days there was no racial difference in the percentage of patients considered hypertensive, at 1 year, black patients were more likely to meet ... criteria for Stage 1 or 2 hypertension ..., the researchers reported online in Stroke: Journal of the American Heart Association.

So please - know about your own blood pressure. And if called for, act.

(Photo from CDC)

Chocolate news?

Last week, we saw a spate of stories such as:

Stroke prevention: More sweet news for chocolate lovers:

Researchers followed more than 37,000 men for more than 10 years, and found that those who ate the most chocolate had a 17 percent lower risk of stroke than those who never ate chocolate.

Flavonoids in chocolate have previously been linked with a reduced risk of heart disease and better mental performance. It's thought they may protect against cardiovascular disease through antioxidant, anti-clotting and anti-inflammatory factors, or by reducing cholesterol.

But neurologists aren't sending patients to the candy store based on this new report.

"You have to be very careful with these types of observational studies," said Dr. Richard Libman, vice chair of neurology at the Cushing Neuroscience Institute in Manhasset, N.Y.

Yes, be careful. You see too many stories about the health "benefits" of chocolate or coffee because, like those two popular products, the stories are hard to resist. More headlines:

Chocolate each day may keep strokes away

Chocolate: A sweet method for stroke prevention in men?

Chocolate may help men dodge strokes, too

As cute as some of these headlines may be, the doctor quoted above is right: Be careful. Yes, chocolate tastes great. But don't treat it like a magic pill.

(Photo from U.S. Food and Drug Administration)

'An ever-present help in trouble'

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

-Psalm 46:1

Refuge. Strength. Help.

Trouble.

Who hasn't seen trouble? Some days, trouble seems to permeate a life, with struggles, setbacks and disappointment. Stroke survivors know too well how recovery can see progress one day, trouble the next.

But even in days of trouble,God is with us. Bring your needs for refuge and strength to God. You are never alone, never without help.

Will trouble magically vanish? Perhaps not. But with God's strength and help - and often, human help provided by God - you can find a refuge in your journey and strength to continue it.

Inexpensive drug goes through stroke prevention trial

Many more people write much  better about clinical trials than I do, so I don't do it very often.

However, I was a bit surprised by an article I ran across an upcoming trial about the drug methotrexate for stroke prevention. Why? In at least one of its form, it's cheap. I have a relative who took  it for rheumatoid arthritis, and the cost was nominal.

So, I hope there is some success in the use of this potentially inexpensive medication. Not a bad idea to check back on its progress from time to time, especially through your own doctor.

Here's a link to a MedPage Today article and a small excerpt:

"We believe that the concept of reducing inflammation has enormous potential as a new method to reduce the burden of heart attack and stroke for our patients," Ridker said in a press release.

Selection of the planned 350 to 400 sites for the trial is to begin in November, with patient recruitment in the U.S. and Canada to get under way in March 2013, according to an NHLBI statement.

Methotrexate, an antifolate drug, has powerful anti-inflammatory properties. It's the standard disease-modifying drug for rheumatoid arthritis and psoriasis. At higher doses, the drug suppresses cell proliferation and is used to treat various cancers.

'You are 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

Lately, I've been collecting some Bible verses that speak to me for this blog. The Luke passage above talks about your importance to God.

Many people who know me also know I'm a fan of the BBC program Doctor Who. I even own a sonic screwdriver.

Several months ago, I saw an episode that spoke to me, too. The Doctor is in a room with a cranky old man and a young women who is in a coma-like state. The Doctor studies and stares at the woman. The cranky man asks why - telling the Doctor that the woman is unimportant.

The Doctor ends his reply with "I've never seen anyone unimportant before" - or words to that effect.

If only we all had that attitude. God certainly offers that relationship with you - to God, we're all VIPs.

(Photo from U.S. Fish and Wildlife Service)

Saving stroke patients in Arkansas

Being born and raised in Arkansas, I have to mention an article about a federal grant for the state Department of Health to improve stroke prevention and outcomes.

The KARK-TV story about saving stroke patients in Arkansas also had some sobering information:

Arkansas has ranked first among the states in the stroke death rate for five of the last 10 years, and is now ranked second in the United States, based on data from 2009, the most recent available. Each year, it is estimated that more than 795,000 Americans suffer from a stroke, about 25 percent of those who are 40 years of age or older die at the time of the stroke or soon after. Among the survivors, some 15 - 30 percent remain permanently disabled.

By 2023, it is estimated that the total indirect and direct costs associated with strokes in Arkansas will be $1.19 billion if improvements are not made in the management of the diseases that cause strokes.

Strokes can disable, kill and cost billions. Preventing a stroke: Priceless.

Air pollution and strokes

This isn't the first blog posting about the potential link between air pollution and strokes, but  ran across yet another article about research on air pollution - including indoor smoking - and how air pollution, heart disease and stroke:

Pollution can come from traffic, factories, power generation, wildfires or even cooking with a wood stove. One of the most common indoor sources is smoking — a danger to the person lighting up and to those nearby.

 “There are a wide variety of things in the air. Some are natural, some are manmade,” said Russell Luepker, M.D., a cardiologist and the Mayo professor in the School of Health at the University of Minnesota. “We are all exposed, to a certain degree.”

Acute short-term effects of air pollution tend to strike people who are elderly or already struggling with heart disease, said Dr. Luepker, who is also an epidemiologist.

For instance, someone with atherosclerosis, or build up of fatty deposits on the inner lining of the arteries, experiences immediate trouble when pollutants play a role in causing plaque in a blood vessel to rupture, triggering a heart attack.

“This kind of pushes them over the cliff,” Dr. Luepker said.

Awesome treatment: Walking

Walking is one of the best "medicines" anyone can take. It can be habit-forming - for the good. Walking - and other exercise - can help prevent strokes and a myriad of other health problems.

Not long ago, the U.S. Centers for Disease Control and Prevention released some survey information about walking activities. More people are walking, but not yet enough, says a MedPage Today article:

Still, walking is a "wonder drug" that can prevent a variety of maladies from diabetes to cancer, CDC director Tom Frieden, MD, MPH, said during a phone call with reporters.

"I would say there's no single drug that can do anything like what regular physical activity does," Frieden said.

The data come from the CDC's 2005 and 2010 National Health Interview Surveys, and Frieden said the increase in walking prevalence was seen across almost all demographic groups.

Yet only 48% of Americans are meeting 2008 guidelines that recommend at least 150 minutes of moderate-intensity aerobic exercise, such as brisk walking, per week, and a third of Americans said they don't get any physical activity at all.

(Photo from CDC) 

Red meat - moderation, moderation

I'm a big believer in moderation: No huge food portions. Social drinking at most. No overtraining for running. Limit sweets. And, of course, moderate red meat intake.

So no surprise in this recent article from MedPage Today about research into the link of red meat and stroke risk:

Each one-serving-per-day increase in fresh, processed, and total red meat intake was associated with an 11% to 13% relative increase in the risk of all strokes, driven by an increase in the risk of ischemic stroke, according to Joanna Kaluza, PhD, of the Warsaw University of Life Sciences in Poland, and colleagues.

There was, however, no relationship between red meat consumption and hemorrhagic stroke risk, the researchers reported online in Stroke: Journal of the American Heart Association.

The findings are "of great public health importance because of the widespread consumption of red meat and the high morbidity and mortality associated with stroke," Kaluza and colleagues wrote.

Now, I have no plans to avoid red meat entirely. But clearly, it's important to control red meat intake.

'God turns my darkness into light'

You, Lord, keep my lamp burning; my God turns my darkness into light.

-Psalm 18:28

A not-long-ago posting referred to light, as in an image screen at the hospital where began my stroke recovery.

So I ran across this verse a few days ago and had to add this to my collection. "Turns my darkness into light" is pretty powerful. Darkness - fear, hopelessness, despair. Light - hope, strength, love.

Is the light going to erase all problems? Oh, I wish. But God's light can shine and help all of us find a way through our struggles - with hope, spiritual strength and God's love.

Yoga and you...

I've never had the patience for getting interested in yoga. But perhaps I should look at this again. Who couldn't use improving balance? And while my stroke didn't leave marked physical changes, many stroke survivors struggle in regaining balance.

WebMD, among others, reported recently that yoga improves balance after stroke:

"It's an exciting thing," says study researcher Arlene Schmid, PhD. "People can improve their balance years after a stroke. They can change their brain and change their body. They are not stuck with what they have."

The study is published in the journal Stroke.

Schmid is a rehabilitation research scientist at Roudebush Veterans Administration-Medical Center and Indiana University in Indianapolis. For the study, her team recruited 47 stroke survivors who'd had strokes more than six months ago. Seventy-five percent of them were male veterans, including veterans of World War II.

Efforts to save lives and minds

Stroke prevention - in the main - calls for basic actions to reduce risk factors. And those efforts can pay off in the long run, including reducing dementia that often sets in years after a stroke occurs.

While these actions to reduce stroke and dementia risk can't reduce the risks by 100 percent, they are logical and smart, as reported by MedlinePlus:

Over the course of five years, patients treated by doctors focused on reducing risk factors saw their need for long-term care drop by about 10 percent compared to the communities that didn't have this intervention. The study also showed that the cost of inpatient treatment for these patients was reduced.

The researchers believe a focus on curbing stroke and dementia risk factors decreased the number of deaths in the intervention group from the expected 2,112 people to just 1,939.

In order to prevent stroke and dementia, doctors encouraged patients to:

• Get more exercise
• Eat a healthier diet
• Stop smoking
• Reduce high blood pressure and high cholesterol levels

Read the entire article from the above link.

(Image from the National Library of Medicine) 

'No one who believes in me shall stay in darkness'

I have come into the world as a light, so that no one who believes in me should stay in darkness.

-John 12:46

It was dark in the room, a place where memories are vague at best. I recall the light – a screen where, I suppose, a doctor was looking at an image of my brain via catheterization imaging.

I have no recollection of what happened next. But I remember the light.

Now, did the light save my life that day? Certainly not.

But there is a light you can rely on, one who brings you out of darkness. And no matter what happens in this world, you will never be alone, never in the darkness. A light for all.

'What we've got here is failure to communicate'

Famous "Cool Hand Luke" quote: "What we've got here is failure to communicate."

That movie came out in 1967. But even now, we've still got failure to communicate - not in fiction, but in real life. Sometimes with deadly outcome. A recent article from MedlinePlus tells us that hospitals are often not alerted about incoming stroke patients

In the studies, researchers examined about 372,000 cases of acute ischemic stroke (caused by a blocked blood vessel to the brain) between 2003 and 2011. The patients were taken by ambulance to one of nearly 1,600 hospitals participating in a quality improvement program -- called "Get with The Guidelines-Stroke" -- launched by the heart/stroke associations.

One study, published in Circulation: Cardiovascular Quality & Outcomes, found that when EMS alerted hospitals about incoming stroke cases, the patients were diagnosed and treated more quickly. Fast diagnosis and treatment is critical because certain clot-busting drugs have to be given within 3 to 4.5 hours after the onset of stroke symptoms to be effective, according to the study."

But a second study found that EMS pre-notification of stroke patients happened in only 67 percent of stroke cases in 2011, a slight increase from 2003 when hospitals were notified in about 58 percent of cases. That study is published in the Journal of the American Heart Association.

"Despite national guidelines recommending pre-notification by EMS for acute stroke patients, it's disappointing that there's been little improvement," the senior author of both studies, Dr. Gregg C. Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles, said in an American Heart Association news release. "However, with these powerful new findings demonstrating substantial benefits with pre-notification, we have a tremendous opportunity to make positive changes in this component of stroke care."

So - when communication happens, we get better treatment. However, most of the time, that communication doesn't happen. That must change.

Note to hospitals: Strokes can happen on weekends, too

My stroke happened on a Friday. So what would have happened if it had occurred 24 or 48 hours later, on Saturday or Sunday?

Recent research found some evidence that in the United States and, more recently, the United Kingdom, you're likely to have a better outcome if your stroke happens on a weekday. One quoted researcher spoke about deals "potentially avoidable." From MedPage Today:

Stroke patients admitted to British hospitals on weekends were less likely to receive recommended treatment and had worse outcomes than those treated on weekdays, researchers said.

Replicating the "weekend effect" seen previously in the U.S., a retrospective study of stroke patients treated in National Health Service hospitals indicated that the 7-day risk of inpatient mortality was 26% greater among those admitted on Sundays than on Mondays ... , according to William L. Palmer, MA, MSc, of Imperial College London, and colleagues.

"The findings suggest that approximately 350 in-hospital deaths each year within 7 days are potentially avoidable, and an additional 650 people could be discharged to their usual place of residence within 56 days if the performance seen on weekdays was replicated on weekends," Palmer and colleagues wrote online in Archives of Neurology.

An article from U.S. News and World Report:

The researchers also found that the average seven-day, in-hospital death rate for patients admitted on Sundays was 11 percent, compared with just under 9 percent for patients admitted on weekdays. ...

Some previous studies in other countries also reported higher death rates among patients with a number of medical conditions who are admitted to hospitals on weekends.

I've never understood the "weekend effect" for any patient. But the medical community always tells us that time is important for stroke patients. And many providers in the medical community takes this seriously. But more work, clearly, is needed.

Stroke info research tool

How does your county stack up in stroke statistics - how many and their outcomes, plus details of income, race, age and more, and how those factors might influence those numbers.

The U.S. Centers for Disease Control and Prevention just launched an interactive atlas of heart disease and stroke:

CDC's Division for Heart Disease and Stroke Prevention has created the Interactive Atlas of Heart Disease and Stroke, a new online mapping tool that documents geographic disparities in the burden of cardiovascular disease (CVD) at state and county levels. Users can create county-level maps of nine different CVD outcomes, by sex, race/ethnicity, and age group, and can overlay maps with congressional boundaries and locations of health-care facilities. Users also can view maps showing county-level social determinants of health and health services, including poverty, education, and food acquisition determinants.

The Interactive Atlas of Heart Disease and Stroke is available at http://apps.nccd.cdc.gov/dhdspatlas.

What's a cryptogenic stroke?

I've heard mine called this - cryptogenic stroke. That was 14+ years ago.

Fast forward to this recent doctor conversation about what is a cryptogenic stroke, and how they are searching for answers. Follow the link to the entire transcript and/or watch the video. Here are a few sentences:

"[C]ryptogenic stroke is an ischemic stroke in which we have not found a smoking gun. It is not due to carotid stenosis. It is not due to a clot in the heart. It is not due to atrial fibrillation. It looks like an embolism, but we cannot find where the embolism came from."

Video hits the stroke basics

My Google alert brought me to this video, from the University of Minnesota's College of Pharmacy, covering stroke basics, symptoms and what do do.

My favorite part: If you see any of the stroke symptoms, call 911 immediately. Watch and enjoy these young people...

The 'eyes' might have it...

The story quoted below identifies this as something "may someday" happen, but makes you wonder what else the eyes might someday tell us.

Seems that early research shows that a simple eye test may help detect stroke risk:

A simple eye test may someday offer an effective way to identify patients who are at high risk for stroke, say researchers at the University of Zurich. They showed that a test called ocular pulse amplitude (OPA) can reliably detect carotid artery stenosis (CAS), a condition that clogs or blocks the arteries that feed the front part of the brain. It's a known risk factor for stroke. The OPA test could be performed by ophthalmologists – physicians who treat eye diseases – during routine exams. The study, which is published in the June issue of Ophthalmology, the journal of the American Academy of Ophthalmology, confirmed that patients who had the lowest OPA scores also had the most seriously blocked arteries.

So - someday, your eye doctor might indirectly save your brain.

Aphasia basics

Traditionally, in the United States, June is, among other things, Aphasia Awareness Month.

And those involved have a lot of work to do to generate awareness. I'd be willing to guess - maybe even a small wager - that most people have no idea what aphasia is.

As someone whose stroke floored me - temporarily - with aphasia, I offer this basic information for you to pass along to people you know:

Aphasia is a disorder caused by damage to the parts of the brain that control language. It can make it hard for you to read, write and say what you mean to say. It is most common in adults who have had a stroke. Brain tumors, infections, injuries and dementia can also cause it. The type of problem you have and how bad it is depends on which part of your brain is damaged and how much damage there is.

There are four main types:

• Expressive aphasia - you know what you want to say, but you have trouble saying or writing what you mean

• Receptive aphasia - you hear the voice or see the print, but you can't make sense of the words

• Anomic aphasia - you have trouble using the correct word for objects, places or events

• Global aphasia - you can't speak, understand speech, read or write

Some people recover from aphasia without treatment. Most, however, need language therapy as soon as possible.

Read the entire article linked above. Lots of other links for good resources about aphasia.

'He is my refuge and my fortress'

Whoever dwells in the shelter of the Most High
    will rest in the shadow of the Almighty.
I will say of the Lord, “He is my refuge and my fortress,
    my God, in whom I trust.”

-Psalm 91:1-2

Ever need shelter?

Life certainly throws a lot bad stuff in our direction. Struggles with health concerns. Hard decisions. Life-altering events.

Note a couple of words in the Psalm quoted:

1. "Dwells." Not passing through God's shelter, but dwelling there. We don't have to rush out and face our struggles alone, then rush back to shelter. No. We face these struggles in God's shelter.

2. "Rest." Dwelling in God's shelter doesn't mean we abandon our duties. We can rest near to God - in his shadow - to regain energy and strength to battle these struggles and storms in our lives.

So stay close. Dwell in his shelter. Rest with God. Let him be your refuge.

What the heck is aphasia?

If you've read this blog much, you'll know. But most people don't know much about aphasia, a language disorder that affects many stroke patients.

June is Aphasia Awareness Month, and my Google alerts found an article with a great point: People with aphasia can struggle to find the right words, use the wrong words, or speak haltingly, or speak very little.

All that being said - and I've been through all of those things myself - aphasia does not remove your intellect. People with aphasia are, by and large, just as intelligent as always. The problem is not intelligent. The problem is language.

I found this article on the National Aphasia Association website - sorry, but the PDF version is the only one I could find. A few sentences:

A National Aphasia Association survey found that because of their difficulty in communicating, over 70% of people with aphasia report that people avoided contact with them and 90 percent felt isolated, left out, ignored and lonely. This isolation, coupled with the fact that intellect remains intact, makes depression another serious result of aphasia.

Try to imagine what your life would be like if you suddenly were not able to communicate any longer. Every aspect of your life would be forever changed. Your role and responsibilities in your family would change. Your relationships with friends and colleagues would change. Completing everyday tasks like making a phone call, driving, shopping, dining out or getting cash at the bank, would become challenging or perhaps impossible without assistance, even though your intellect would remain intact.

Most of my signs of aphasia were effectively treated by speech therapy (an often unheralded but important line of work). It still can emerge during a time of stress or fatigue, which still can be frustrating.

But do know that someone you know with aphasia is still there - intellect and all.

Good news to modest-mile runners!

Without even realizing it, I'm ahead of the curve for runners!

Saw a recent story about how running helps you live longer. No big surprise there.

However, the article went on to say that when you run more than 20 miles a week, the benefit actually declines a bit. Unless I'm ramping up to a half or (maybe again one of these days) full marathon, I hit about 20 miles a week.

And don't get me wrong: High-mileage runners are still miles ahead, so to speak, than couch potatoes, no question. But the article discusses how even people who aren't elite athletes can reduce, among other things, stroke risk:

So read the article about running and mortality benefit:

What doesn't kill you is supposed to make you stronger, an adage that many a long-distance runner has clung to, but intriguing findings from a new study presented last week suggest the mortality benefits of running are best accumulated in shorter distances, specifically at less than 20 miles per week  In fact, at longer distances, the researchers observed a U-shape relationship between all-cause mortality and running, with longer weekly distances trending back in the wrong direction, toward less mortality benefit.

"We were thinking that at some dose of running, things would level off, that we'd see that runners would have a reduction in mortality at certain distances and then it would kind of level off," Dr Carl Lavie (Ochsner Health System, New Orleans, La.), one of the study investigators, told heartwire. "The fact that it reached its plateau at such a low level is surprising, as is the fact that it didn't level off but actually went the other way. We never had a point where runners did worse than nonrunners,"

So, no matter how slow, if you're a runner, get a few miles in this week!

'... Who takes hold of your right hand ...'

For I am the Lord your God who takes hold of your right hand and says to you, Do not fear; I will help you.

-Isaiah 41:13

Since my stroke and recovery, I've always had a soft spot for this verse in Isaiah. "...I am the Lord your God who takes hold of your right hand ... ."

What a message for someone who - even temporarily - loss the use of his right hand! But thinking further, no matter what my weaknesses might be, God is there to grasp me, with support and strength.

God does grasp the hands of stroke survivors - no matter the level of recovery in this world. Let him grasp you. Let him help you. He will lead you with love.

Southern states need stroke prevention priority

Being born a Southerner (now living in the Midwest), it's disheartening to hear about how strokes are more common in Southern states. To quote the article:

States with the highest rates of stroke include South Carolina, Alabama, Mississippi, Louisiana, Arkansas, Oklahoma, Tennessee, Kentucky, Missouri and Nevada.

Those with the lowest rates include New York, Michigan, Colorado, Minnesota, Wisconsin, Wyoming and the New England states.

Older people, American Indians/Alaska Natives, blacks and people with lower levels of education had more strokes than younger people, whites and those with higher levels of education, the researchers found.

The disparities in stroke, a leading cause of long-term disability, are largely due to lifestyle factors including obesity, high blood pressure and smoking, Fang said.

"Southern states have higher rates of obesity, smoking and hypertension, which are all risk factors for stroke," she said.

What is especially said is that many of the risk factors mentioned in the excerpt are preventable or at least (in the case of hypertension) addressable. Stroke prevention has a long way to go in Southern United States. It's past time to start!

Age-adjusted prevalence of stroke among noninstitutionalized adults (18 or older), by state.

(Image from Centers for Disease Control and Prevention)