Sunday, February 18, 2018

Simple Test

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Retreat & Refresh Stroke Camp

a division of United Stroke Alliance

www.unitedstrokealliance.org

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If you missed last week's post by Monica please be sure to see it. She posted about a unique and very, very rare experience at one of our weekend camps. I thank her for filling in for me. 

Due to personal constraints (nothing bad) I will be posting a new article every two weeks instead of weekly. The plan is to go back to a weekly schedule about the middle of March. Therefore, the next article after this will be posted March 5th. 

However, I suggest you check here every week anyway because you never know when Monica might delight us with another wonderful camp experience or personal observation.
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By AMERICAN HEART ASSOCIATION NEWS
https://news.heart.org

Simple test could help paramedics recognize dangerous back-of-the-brain strokes

A finger-to-nose test could help emergency medical workers better recognize a kind of stroke that affects the back of the brain, according to preliminary research released Thursday.

Training paramedics in this simple assessment during a small pilot project in southwestern Michigan nearly doubled the number of posterior strokes they were able to recognize. The coordination test asks patients to touch their own nose and then extend their finger to touch the examiner’s finger, going back and forth without difficulty or missing.

“It is potentially a fairly elegant solution to one aspect of the stroke recognition problem,” said Dr. John Adam Oostema, who led the project. He is associate professor of emergency medicine and director of neurological emergency medicine research at Michigan State University’s College of Human Medicine. “The findings are preliminary and with a pretty small sample size. But we were impressed with the degree of improvement we saw.”

The research, funded by the American Heart Association, was presented at the American Stroke Association’s International Stroke Conference. The meeting dedicated to the science of brain health gathers researchers and doctors from around the world.

Stroke is the No. 2 cause of death in the world and a leading cause of serious disability. Typically, most clot-caused ischemic strokes occur in the front, or anterior, part of the brain where most of the blood flow is provided by a pair of carotid arteries.

About one in five strokes, closer to about 15 percent in Oostema’s research, occur in the back, or posterior, an area that gets most of its blood from two vertebral arteries in the back of the neck.

Many of the symptoms for strokes in both regions are similar, such as face drooping, arm weakness and speech difficulty. The popular acronym F.A.S.T. encompasses each of those symptoms, with the “t” representing “time to call 911.”

But those symptoms can be milder in back-of-the-brain strokes – and accompanied by vertigo; nausea and vomiting; balance and coordination difficulty; and partial loss of vision or double vision.

These less-recognized symptoms can sometimes cloud the picture for paramedics and doctors. Oostema said research shows patients with posterior strokes are less often given the clot-busting drug called alteplase, or wait longer to receive it. Doctors give it intravenously, and if delivered quickly enough after a stroke, it can reduce death and disability.

“Posterior strokes have been shown in a few studies to get care slower,” he said. More training “could reduce the disparity in treatment times.”

Oostema and fellow researchers compared the recognition of posterior strokes between paramedics who received a 30-minute online standard training in stroke screening with those who received standard training plus in-person training in the “finger-to-nose test.”

The results:

–Paramedics trained in the test recognized 12 out of 16 posterior strokes, 75 percent. In the 12 months before training, they identified 9 out of 26, or 36 percent.

–Paramedics without the finger-to-nose training recognized 13 of 28 posterior strokes, or 46 percent. In the 12 months before, they identified 10 of 36, or 28 percent.

Oostema is working on the scope and funding for a larger-scale study. If the results stand, he hopes to eventually have the test be part of standard training for paramedics across the country.

Emergency medical service workers are a critical part of the front lines of identifying this under-recognized kind of stroke, he said. “They are a valuable part of the stroke system.”

If you have questions or comments about this story, please email editor@heart.org.
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American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to the American Heart Association News. See full terms of use.

Monday, February 12, 2018

Campers Shower Each Other with Patience and Laughter



Monica Vest Wheeler
Staff Volunteer   
Retreat & Refresh Stroke Camp

(This article appeared in the most recent Stroke Camp newsletter.)

You can run, but you cannot hide or avoid personal transformation when you’re caught up in an unlikely vortex of humidity ... humility ... humanity ... and heroes.

My classroom of life was filled with extremes this summer at Stroke Camp as I discovered new levels of my own physical and emotional limitations AND strengths ... and sent some fears careening into distant memories. And that doesn't even begin to describe how I was affected by everyone around me.

As I shared three days with stroke survivors, caregivers, and volunteers at the first of our two
annual Rockford, IL area Stroke Camps, it’s safe to say we were deeply humbled by the loss of
something we all take for granted: running water. Yes, there was bottled water to drink, but all
the toilets and faucets could not muster a trickle. We human beings were no match for Friday night’s relentless rainfall, swift and vicious lightning, and electrical disruptions that apparently fried the camp printer among other things...and more important, the generator that powered the entire campsite, particularly its water pump system. We witnessed one of the those events known as an act of Nature...or where Mother Nature reminded us how tiny and defenseless we can be against her mighty forces.

The backup generators kept the lights and air conditioning on during what was a very humid spell. The campsite crew tried to flush toilets as often as possible in the camper rooms by pouring in gallons of water, but they couldn’t be maintained in the main buildings, so we simply shut the doors. We made sure everyone stayed hydrated on the inside even if we were showerless.

However, we were never  “powerless." It wasn’t flippable power that was electrifying. It was the spark of human compassion, cooperation and steady streams of laughter. Our camp director that weekend was our founder, Marylee Nunley. She will be quite humble and said she didn’t do anything extraordinary, but her leadership to remain calm and “just camp” kept all of us going emotionally and physically while we awaited water updates. We still did all the crafts, zipline, pampering, meals, games, the Saturday Night show and even the camp photo...less than perfect hair and all. And the deodorant jokes flew like crazy…

We held out hope for running water revival by Saturday evening, until word came in that water wouldn’t be restored until later Sunday. It was suggested we break camp after Sunday morning breakfast.. Marylee put it to a vote, and everyone reluctantly agreed. We may have been exhausted , but those good-bye hugs were extra sweet and sentimental.

Even after a hot shower at home, I didn’t not sleep much that night because I was so overcome with emotion at what I had witnessed that weekend...and maybe even more by what I did NOT hear or see. I did not hear the complaints you often hear when someone is inconvenienced by poor service or being stuck in traffic or when someone rains on their parade. And these were stroke survivors and caregivers who have had more than their share of washed out parades.

Yes, it was a royal pain and inconvenient and uncomfortable at moments, but everyone at this camp was a real trooper, a team player, a comedian, a cheerleader, a comfort, a friend ... and more important, a human being in a shared experience. That weekend floods my memory every time I need a reminder of the real core of humanity and humility ... and reaffirms the heart and soul of Stroke Camp, the opportunity to connect at the most basic human level ... friendship and love.







Sunday, February 4, 2018

Finding a voice after massive stroke

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Retreat & Refresh Stroke Camp

a division of United Stroke Alliance

www.unitedstrokealliance.org

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Due to personal constraints (nothing bad) I will be posting a new article every two weeks for the next six weeks instead of weekly. The plan is to go back to weekly postings about the middle of March. Therefore, the next article after this will be posted February 19th.
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By AMERICAN HEART ASSOCIATION NEWS
https://news.heart.org

Finding a voice after massive stroke at 29

Meredith Gorham was finally relaxing after a busy, hot day of running around on July 17, 2009. But when she tried to stand up from the couch, she suddenly collapsed.

Her shocked husband, Chris, tried to help her up. But after realizing she was unable to stand, he quickly called 911 and Meredith’s parents, who live nearby in Greensboro, North Carolina.

Meredith couldn’t see what was happening. But she remembers feeling “eerily calm” as she listened to the commotion that followed moments later.

“I could hear all the walkie talkies and all I could think was, ‘Do not wake up my kids,’” she said. Asleep in their rooms were her three young boys who were 4 months, 2 and 4 at the time.

Meredith soon lost consciousness and was rushed to the hospital. She had a massive stroke that required a four-hour surgery to remove the clot. The severity of the stroke, which doctors said affected a third of Meredith’s brain, meant that she might wake up unable to move or communicate.

The next few days were devastating for the family.

“I remember coming home and putting all the kids in bed with me and just hunkering down,” Chris said. “I just couldn’t believe what was happening.”

When doctors began bringing Meredith out of a medically induced coma a few days later, she had a surprising amount of sensation in her limbs, and even tried to get out of bed that night.

“The doctors kept looking at her chart and being surprised at what she could do,” Chris said. “They still call her their ‘little miracle.’”


Meredith’s stroke was caused when a blood clot traveled through an undiagnosed hole in her heart called a patent foramen ovale, or PFO. All babies are born with a hole between the two upper chambers of the heart, but the hole normally closes shortly after birth.

But it remains open in about one in four people. While PFOs don’t pose a problem for the vast majority of people who have them, they can create an escape route for tiny blood clots that would ordinarily get filtered out by tiny capillaries in the lungs.

For Meredith, a clot traveled through the hole and up to the brain, causing a stroke. Doctors used a mesh material to help close the PFO a few months later.

Meredith’s recovery was difficult, requiring her to sleep for as many as 20 hours a day as her brain healed.

Coordination on her right side was limited, and Meredith had to learn how to do everything with her left side to manage daily tasks. For nearly nine months, though, she was limited to a few words.

She also struggled with aphasia, a condition affecting at least 15 percent of stroke survivors in which the brain has difficulty processing language.

“It was about a year and a half before we could have a regular conversation,” Chris said. “It was just frustrating because she couldn’t get out what she wanted to say.”

Normally outgoing, Meredith became uncomfortable in groups, unable to participate in fast-paced conversations, something she continues to struggle with at times.

“I would just freeze up because I couldn’t think of what to say,” she said. “I’m slowly getting back to being an extrovert, but in a new way because of what I’ve been through.”

The stroke also took an emotional toll. A year and a half after the stroke, Meredith became depressed. She and Chris eventually sought therapy, taking two years for her to accept what had happened.

“I tried to ball it up inside, because what happened was so scary,” she said. “I can’t help that I had a stroke, but I just decided I wanted to move on with my life.”

The rest of the family had to adjust as well, with the couple’s young kids taking more responsibility for household tasks, Chris said.

“We all had to work together more, and get frustrated together and lean on each other,” he said. “There are parts of Meredith we’ll never get back, but we feel blessed for what we have.”




Meredith also found support from other stroke survivors she met while volunteering with the local American Heart Association.

“It was such a relief to know other people who knew what I’ve been through,” she said.

Now 37, Meredith still experiences pain and involuntary movements in her right hand and foot, and still requires extra rest to avoid getting overly fatigued. Even so, she plays on a co-ed soccer team and runs regularly.

“My motto is never give up,” she said. “Get out there, even if it’s hard.”


If you have questions or comments about this story, please email editor@heart.org.
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American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to the American Heart Association News. See full terms of use.