Happy Halloween

Be strong and courageous. Do not be afraid or terrified because of them, for the Lord your God goes with you; he will never leave you nor forsake you.

-Deuteronomy 31:6

Life can be scary - I know.

Today, I take a little comfort in the "scary" Halloween events, people and decorations. You see, it's not scary at all. While we'll see the occasional Halloween Grinch who goes past the fun on this day and night, Halloween is mostly harmless.

But in real life - even when we're confronting the not-so-harmless - it's comforting to know that we don't need to fear. In the verses above, Moses is about to step down after leading God's people for decades. He reassures these people with these words. The words echo still. Be strong. Do not be afraid. God goes with you. He will never leave you.

So this day, with its fake scariness, know that God will never leave you when the real world closes in!

Medication/lifestyle vs. angioplasty for stroke prevention

Preventing a stroke can prevent disability. Preventing a stroke can save a life.

So I thought a recent story on how a recent study found that medication, lifestyle changes are safer than an angioplasty procedure for some stroke patients:

In this study, patients with narrowed brain arteries took medication to reduce blood clots, and to lower blood pressure and cholesterol ― all risk factors for stroke.

They were encouraged to exercise, improve their diets and stop smoking.

Half of the study participants also underwent a surgical procedure known as stenting, in which a metal mesh tube is used to prop open the damaged artery.

The result: Those who used medication and lifestyle change combo fared better than those who had the angioplasty/stenting procedure. That means fewer strokes, fewer changes of disability, fewer risks of premature death.

As anyone who's read this blog knows, despite the fact that I had my own medical procedure, I'm a believer that exercise and managing known stroke risks are some of the keys to stroke prevention.

Worldwide, strokes hit more people, many younger

One of the missions of this blog is to highlight stroke prevention. Every stroke prevented is a win. However, recent numbers show that stroke prevention has actually lost some ground - in the global perspective, at least.

A recent report shows that stroke numbers are up worldwide:

In 2010, there were 16.9 million people who had a first stroke, 33 million stroke survivors, and 5.9 million people who died from a stroke -- increases of 68%, 84%, and 26% respectively since 1990, according to Valery Feigin, MD, of the Auckland University of Technology in New Zealand, and colleagues. ...

What's more, there was a 25% ... increased incidence of stroke in those ages 20 to 64. At the end of the study period, 31% of first strokes occurred in people younger than 65, up from 25% in 1990. ...

Feigin and colleagues wrote that "these findings suggest that stroke should no longer be regarded as a disease of old age."

Read the entire article for more details. One comment especially touches on good common sense: reduce hypertension and unhealthy lifestyle.

'The Lord gives strength to his people'

The Lord gives strength to his people; the Lord blesses his people with peace.

-Psalm 29:11

Strength and peace.

In human history, those two terms have been at odds at times - you could easily cite examples of those in power with strength who have been anything but peaceful.

But we're not talking about human examples. Strength from God - that inner strength - is the perfect complement to God's inner peace.

So many times, I've needed strength and peace. It's difficult - and I'd say impossible in the final analysis - to find those things in the quality of God's strength and peace.

How does he provide this? Note the words - God "gives" strength; he "blesses" people with peace. We don't purchase or earn these things. God freely gives them. To you. To all.

Ambulance still best choice for stroke transport

This is not a big surprise - ambulance still best choice for stroke transport:

If "time is brain," then patients with ischemic stroke should get to the emergency department by ambulance rather than private vehicle, one study suggested.

Arrival times of 3 hours or less were more likely in an ambulance than in a private vehicle ..., according to Sheryl Martin-Schild, MD, PhD, of Tulane University in New Orleans, and colleagues.

If you read the entire article, you'll see that ambulance patients are more likely to show up within three hours of stroke onset, which means better chances with the only current treatment available for clot-type strokes.

The final outcomes at discharge, interestingly, of both ambulance-driven and private transportation patients are about the same. However, it's also the case that generally more severe stroke patients arrive by ambulance, while the generally less severe arrive by private transportation. So the ambulance-arriving patients generally start out worse but wind up about the same.

The takeaway on this - know stroke signs, and if you think someone is having a stroke, call an ambulance!

Exercise: Stroke prevention medicine

I'm convinced that being a longtime distance runner helped me survive and recover from my stroke in 1998. Fifteen years later, I'm still doing it.

Not to say that running is for everyone. Some people can't stand it or aren't ready for it. Even starting a walking program, though, could reap benefits, according to a recent article how exercise can be a powerful medicine:

Exercise may be as effective as medication in preventing early death in people who've had heart attacks or strokes, a new study suggests.

"Doctors should give their patients advice about the lifesaving benefits of exercise, and when possible they should refer patients to rehabilitation programs with exercise programs," says the study's lead author, Huseyin Naci, a fellow at Harvard Medical School and a graduate student at the London School of Economics.

Preventing a stroke is far better than trying to recover from one (or another one). Exercise, I'm convinced, can be a huge help.

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

Fascinating look at stroke results, recovery

A fascinating article - complete with videos - comes from a Canadian media outlet, how stroke survivors can experience 'bizarre' syndromes:

Every 10 minutes in Canada, someone suffers a stroke, and while the physical impacts are often obvious and familiar – a limp, or a paralyzed arm – equally devastating are the hidden, cognitive disabilities that can convince some people they’re losing their minds.

After decades of neglect, science is beginning to unravel the strange, but fascinating, neuropsychological syndromes that can occur when neurons die and the brain tries frantically to rewire lost connections – conditions that will increase as the population ages, because one of the single biggest drivers of stroke risk is age.

The articles runs through a half-dozen less common - but very real - stroke results that can change how people perceive our world and how they speak.

And it speaks to the real need for long-term therapy for stroke survivors. It quotes Dr. Dale Corbett, scientific director and chief executive officer of the Heart and Stroke Foundation’s Centre for Stroke Recovery in Ottawa.

“The brain is so fascinating, and so complicated,” said Corbett.

With the right therapy, people will often continue to recover “long past what we would have normally expected.”

Brain stimulation might be viable post-stroke

Stroke recovery can be a challenge - many, many know that better than I - but it's good to see research on possible ways to improve that recovery.

A recent study discussed how brain stimulation is viable in post-stroke rehab:

Repeated noninvasive transcranial magnetic stimulation (nTMS) helped treat spasticity, motor symptoms, and post-stroke pain in a small population of stroke patients, researchers reported here.

Check out the link for the whole story, and keep in mind the research included a small number of people. Still, this bears watching.

(Image from the National Institutes of Health)

Stroke recovery with an iPad

Back about 15 years ago, I used a educational toy called a Geo Safari to help me bring back some language skills after my stroke, in addition to speech therapy.

Now, moving 15 years to the present, current stroke survivors can use even cooler technology. I ran across one story how a support group uses iPads to help stroke survivors regain function:

"The applications are on my laptop," [Suzanne] Hill said. "I'm on it most of the time. There are 15 applications that I can use. I just enjoy it so much. There's no chore to any of this for me."

Indeed, some of the apps are games, such as Scrabble or connect-the-dots. Some resemble putting the user back in an elementary school classroom, such as viewing a picture of a dog, then selecting the letters from an alphabet jumble to spell d-o-g.

"I have limitations on my right side," Hill acknowledged. "My right hand is not so flexible, (but) my typing skills are coming back."

'Clot Picker' can improve outcome - sometimes

I've been reading about research results as reported in the World Congress of Neurology, and ran across an example of both good news and not-so-good news.

First, there's the item how a 'Clot Picker' rescues tPA stroke failures:

Treating ischemic stroke patients with endovascular therapy when initial tPA thrombolysis was unsuccessful led to good 3-month outcomes in most cases, a researcher said here.

Then, though, the not-so-good news - how endovascular therapy had poor outcomes in the elderly:

Only about one-quarter of stroke patients 80 and older who underwent endovascular treatment after thrombolysis had good functional recovery, according to a single-center study reported here.

A couple of notes - first, all this research involved a relatively small number of people. Something to keep in mind. Also, I think these results can show the need for qualified expertise in treating stroke patients.