This Christ-centered blog is designed to serve stroke survivors, families and friends, through sharing experience and faith. My own stroke came on May 8, 1998. God provided medical professionals, friends, fellow believers, and strength to get me through some struggling recovery times.
I ran across this article showing that while stroke rehabilitation services can provide a great deal of help, they can do harm as well. This is a great illustration that every stroke patient in a facility needs someone watching, and the facility personnel need to know that someone is watching.
The Department of Health and Human Services' Office of Inspector General found that nearly 29% of Medicare beneficiaries admitted to inpatient rehab facilities experience an adverse event during their stay including healthcare-acquired infections, medication errors and pressure ulcers.
Ever seen someone offering to guess your weight at a carnival? It's been a while for me.
Maybe we need to hire some of those folks for hospital work - when knowing someone's weight means administering the correct amount of a drug that could bring you back from a stroke, or put you in danger - at least partly depending on how the accuracy of your weight in its calculation.
"Relying on our ability to 'guess' the weight of a patient in the acute setting is no longer acceptable and potentially dangerous," Pankaj Sharma, MD, PhD, from the Institute for Cardiovascular Research at the University of London, told Reuters Health.
The recommended dose of alteplase (recombinant tissue-type plasminogen activator [r-tPA]) is 0.9 mg/kg, up to a maximum dose of 90 mg. In the interest of time, clinicians often estimate patients' weights to determine the r-tPA dose. ...
"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.
Another strong reason to make yourself aware of stroke signs and symptoms, plus what to do if it happens to yourself or someone you know. Even if you get to the right place in time, proper treatment is still not a guarantee, as this article illustrated.
While a growing number of hospitals boast that they are equipped to use the clot-dissolving drug, they don't always do so, a Journal Sentinel investigation found. And the organization that certifies those hospitals as stroke centers doesn't require that they actually offer the drug to eligible patients.
The clot-dissolving agent, known as tissue plasminogen activator, or t-PA, is the only approved drug for treating a stroke by stopping it and significantly reducing the risk of disability.
Yet the number of patients who get t-PA has remained dismally low, about 5% of all stroke patients, ever since the drug was approved 14 years ago. Much of that is because patients fail to recognize their symptoms and get to the hospital within the 4 ½ -hour window during which the drug can be administered.
It is not all the fault of patients.
This is a great and informative article about stroke centers and stroke treatment, or, too often, the lack thereof.
Is every stroke patient a candidate for this drug?. No. That's why we want training of health professionals so they'll do the best job they can do. It's also illustrates the importance of the need for advocates for patients. Often, the patient can't speak clearly or isn't completely lucid after a stroke. That's why it's so important for someone to be able to speak on the patient's behalf.
Take this story as a valuable lesson on those two points.
As a non-doctor, I'm convinced my care was excellent. But I might have had an advantage: I was relatively young (39) when it happened.
Older stroke patients, though, might receive inadequate care, according to this study:
Older people are less likely to receive high-quality stroke care compared with younger patients, researchers warn. And this is despite evidence suggesting that care is equally effective across age groups, they note. The new studies point to ageism in stroke care — the first is published online April 16 in BMJ and the second in the March issue of the Postgraduate Medical Journal.
"We found low rates of secondary drug prevention," report the BMJ study authors, led by Rosalind Raine, PhD, professor of health-services research from University College London, in the United Kingdom.
What can a non-doctor do? First, speak up for stroke prevention. But if it happens, be an educated advocate for a loved one who becomes a stroke patient.
