Sunday, July 29, 2018

Service Animals
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I have included articles about animals for stroke survivors before. I think they are a good idea. Here's another one from Stroke Connection about service animals, which are not the same as emotional support animals. They clarify this difference at the end of the article. You may also gasp, as I did, at the potential cost of a service animal. Their web site is at:

Service Animals

We interviewed Mary Burch, Ph.D., director of the Good Canine Program at the American Kennel Club, and Michelle Williams, public relations coordinator at Canine Companions for Independence. Canine Companions for Independence is a national, non-profit organization that provides expertly-trained assistance dogs to children, adults and veterans free of charge.
SC: In what ways might a service animal help a stroke survivor?
MB: People who have had strokes may have mobility issues, problems with memory and fine motor difficulties. Service dogs can be trained to help a person who has had a stroke by assisting with mobility — large dogs can steady the person who is wobbly; or the service dog can encourage the person to get up and walk — it’s hard to turn down a dog who wants to go outside. Service dogs can be trained to get things that have been dropped and bring them to the person, and they can be used as a part of a fine-motor physical rehab program. For example, the person with a stroke can squeeze an exercise ball, which is a boring task. They could also have a daily goal of brushing the dog, and this becomes functional rehab. Sometimes, after a stroke, the person tends to stay in the house. A service dog can provide companionship.
MW: Others may benefit from incorporating a trained service animal into therapeutic or rehabilitative exercises to help the individual meet their goals, whether they relate to motor control, speech, or ADLs. Individuals who use manual wheelchairs may also benefit from a service animal’s assistance in propelling the chair.
SC: How does someone go about getting a service animal?
MW: There are many organizations that provide service animals and interested parties can look at the Assistance Dogs International (ADI)website, where ADI-accredited organizations are listed. To apply for a service dog from Canine Companions for Independence, the first step is to learn more about our services and our assistance dogs on our website. Then, interested parties can submit a request for an application online to begin the application process.
SC: What are the potential barriers to getting a service animal?
MW: Sometimes, cost and wait times can be a barrier for people interested in receiving a service animal. Canine Companions candidates are placed on a waitlist ranging from a year to two years. Canine Companions provides its expertly-trained assistance dogs completely free of charge to people with disabilities. It is important for interested parties to carefully consider how they will meet the dog’s needs including feeding, toileting, exercise, grooming, training, covering the cost of veterinary care, and making the commitment to stay in regular contact with the organization for the duration of the placement.
MB: A common barrier is cost since the cost of a service dog can be from $10,000 to $30,000. Some agencies will advertise there is no charge for the dog. While this often means they don’t make the person with the disability pay for the dog, they may expect that there will be a fundraising campaign to raise the money that covers costs related to training and care. In cases where the dog is “free” to the service dog user, and costs are to be covered by community fundraisers or sponsorships, there is typically an agreement on the front end that specifies if the money must be paid before the dog is delivered.
Finding an available dog that is trained can be a problem. Also, if the person who has had a stroke is living alone or is spending a good part of the day alone, caring for a dog might be difficult.
Housing can also be an issue if the person lives in a no-pets apartment or a facility that cannot meet the needs of the dog, for example, no yard.
SC: Can emotional support animals be good for survivors, too?
MB: If the person who has had a stroke mainly needs company and a dog to spend time with, an emotional support animal might be fine. However, these dogs are not trained to perform specific tasks, so it should be understood that their primary job is to provide comfort and companionship.
MW: Some individuals may find that they would benefit from the relationship with an animal but do not need assistance in public spaces or through specific trained tasks. In this case, they may be interested in researching the options of getting a pet or emotional support animal. Canine Companions for Independence does not train or place emotional support animals; generally speaking, a good first step is to research local animal shelters or breed rescue programs.
This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Stroke Association.

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Sunday, July 22, 2018

Stroke/Heat Stroke? What's the Difference?

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I must admit this is the hottest summer that I remember. Now, maybe that's because my memory of a previous summer faded after my memory of last winter being the coldest I remember. I do remember thinking last winter that I wish summer would hurry up and get here, and I don't care how hot it gets just so it gets here. I was wrong, I found out I do care. I mowed and trimmed my yard over the weekend, and it felt like I could ring a quart of sweat out of my clothes. It was a prime time for a heat stroke. 

This weeks post taken from the American Heart Association will show you some things you can do to protect yourself from heat stroke. I'm sure we all know a heat stroke is not the same as an ischemic or hemorrhagic stroke and the AHA will explain that difference in about the middle of this article. They want people to know that heat strokes are dangerous, too, and they can sneak up on you.
Protect your heart and health during the ‘dog days’ of summer


Summer is a time for barbecues and other outdoor fun, but it’s also a time for sweltering heat. And experts say everyone, especially the elderly and very young, need to know how to limit the sometimes-deadly effects of high temperatures.

The ancient Greeks and Romans called the sultriest days of summer the “dog days.” The Old Farmer’s Almanac marks the time as 40 days from July 3 to Aug. 11, coinciding with the rising of the star Sirius, also called the Dog Star.

Already this year, the dog days have proved dangerous.

Heat warnings and advisories have been issued over a large swath of the country, with heat waves smothering the Northeast and shifting into the South and West. In Quebec, at least 70 people reportedly have died from a heat wave hitting eastern and central Canada.

More than 600 people die every year in the U.S. from heat-related illnesses that are preventable, according to the Centers for Disease Control and Prevention. The agency estimates more than 65,000 Americans visit an emergency room for acute heat illness each summer.

“I think people underestimate how quickly it happens. And when it starts to happen, if someone is progressing to heat exhaustion or heat stroke, you lose your self-awareness,” said Dr. Robert O’Connor, professor and chair of emergency medicine at the University of Virginia. “It’s important to keep an eye on those around you for heat-related problems. If someone is flushed, dizzy or uncoordinated, it can be an early sign.”

Dehydration can begin within just a few hours of extreme heat, so drinking extra fluids is important, especially when taking certain medications. Fatigue, headaches, muscle cramps, dizziness, sleepiness and dry mouth can all be signs of dehydration.

Dehydration causes the heart to work harder, putting it at risk. Hydration helps the heart more easily pump blood through the blood vessels to the muscles. And, it helps the muscles work efficiently.

A 2016 Environmental Protection Agency analysis of heat-related deaths said high temperatures could be a factor in many more deaths than officials realize – or count.

“By studying how daily death rates vary with temperature in selected cities, scientists have found that extreme heat contributes to far more deaths than the official death certificates might suggest,” the report said. “This is because the stress of a hot day can increase the chance of dying from a heart attack, other heart conditions, or respiratory diseases such as pneumonia.”

While infants and the elderly are more vulnerable to problems from heat, O’Connor said sometimes medicines can make someone more sensitive to heat and dehydration.

“They should talk to their doctor and look up their medications to see if it predisposes them,” he said.

Heat exhaustion and heat stroke are serious medical emergencies that require treatment. Both can cause headaches, nausea or vomiting. Heat stroke also can cause a high fever, warm skin with no sweating and confusion or unconsciousness.

Click here for a video of  Stroke/Heat Stroke? What's the Difference?

Heat stroke is not the same as a stroke. Stroke happens when a blood vessel to the brain either bursts or is blocked by a clot, causing a decrease in oxygen flow to the brain.

Beyond some of the obvious and sometimes extreme physical symptoms brought on by sweltering temperatures, a recent study showed it could affect how we think. And it doesn’t just affect the most vulnerable.

A group of researchers at Harvard University in Boston published an observational study last weekshowing students who lived in dormitories without air conditioning during a heat wave performed worse on a series of cognitive tests compared with students who lived in air-conditioned dorms.

The study was conducted over 12 consecutive days in the summer of 2016. Students living in buildings without AC experienced 13.4 percent longer reaction times on color-word tests, and 13.3 percent lower scores on addition/subtraction tests compared with students in air-conditioned rooms. The research showed students in rooms with AC were not just faster in their responses, but also more accurate.

Hot summers and heat waves won’t be going away any time soon, according to federal research. In fact, unusually high temperatures have become more common in recent decades, and heat waves are expected to become longer, more frequent and more intense in the future, according to the EPA and the CDC.

O’Connor said thinking ahead and being prepared in the heat will help prevent trouble.

“Drink plenty of fluids and limit the amount of time you are in the heat. Even if someone comes into a cooler environment for a few minutes every hour, that can prevent a heat-related illness,” he said.

“Limit outdoor activity to early morning or late evening, and stay in the shade,” O’Connor said. “It might be tough if you are working outside or on the golf course. Soak a towel in cold water and put it around your neck. Evaporative cooling, dousing in cold water and letting it evaporate, is the best way to eliminate heat.”

If you have questions or comments about this story, please email
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Sunday, July 15, 2018

Taking the Stage for Aphasia

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From the StrokeConnection Archives

John Daggan, now 62, was out running one day in 2009 near his home in Staten Island, New York, when he had a stroke. As he tells it now, somewhat haltingly due to his aphasia: “I was running, running here, and then falling down. And I said, ‘Hmm. That’s weird.’ . . . And doctor said, ‘It’s going to be fine. It’s okay. You’ll be down . . . five or six days, tops.’ And I said, ‘Oh. Okay.’ Drugs were really good. But then another one! And then it’s . . . bad. And I have a-a-aphasia.”

Life stopped. John could hardly speak; his right side was paralyzed. He could not return to work. He could no longer manage his role as an archivist in the Lutheran Church, nor talk with his kids and grandkids. His wife, Jeanie, her innate effervescence drained, continued to work at their gourmet wine shop, but life would never be the same. The following year, John and Jeanie enrolled in the Kean University Center for Communication Disorders in Union, New Jersey, where John would work to overcome his aphasia, and Jeanie would attend the caregivers support group. It was an uphill battle. As John described it, “Well at first, I was. . . I was out of luck. Just ‘Hi . . . hi, how are you?’ . . . Words were just terrible. But slowly and surely, it’s coming back.”

The center operates on a “life-participation” model. Clients with aphasia work individually with graduate student speech-language therapists and participate in group activities with other people with aphasia, as well as with their families, in special events and projects.

During one summer session, John and his student clinician, Shenee, worked on documenting and writing John’s life story. In the process, Shenee discovered something about John that did not appear in his medical records: He had earned an MFA from the University of North Carolina, and in his youth, he had been a successful actor in New York, a card-carrying member of Actors Equity, the prestigious union of professional actors. John had done three seasons of summer stock at the Indiana Repertory Theater, and he and Jeanie had both done summer stock in New Hampshire. John brought his professional actor’s “head shot” and resume to show Shenee, along with several photos and programs from productions in which he had performed. Everyone at the center was impressed.

Not long after that biography was completed, John got a motorized scooter. And while Jeanie was at work at the wine shop, John began embarking on long trips to Manhattan to get out of the house and visit old haunts. The trips were arduous. He first took a bus across Staten Island to the Staten Island ferry terminal, then rode the ferry to lower Manhattan, where he could catch the subway from Whitehall Street to Times Square. The trip took about two hours each way. Jeanie worried, but John felt alive. He often stopped for a beer on the way home.

As John tells it, one day while he was riding his scooter through Times Square, he noticed he was outside the headquarters of Actors Equity. On a whim, he decided to take the elevator up to their offices to see whether his name might still be on Equity’s membership roll. Although his aphasia made communication difficult, he found out that he was, indeed, still listed as an “inactive member” and that he was still eligible to audition for Equity productions, if he were so inclined.

On the two-hour trip home, an idea took shape in John’s head: He was planning to go to the next open audition for a Broadway play.
Thanking the woman at the desk, John stopped to get a bite in the Equity cafeteria and enjoy the sound of the show business chat before he headed back to Staten Island. At the time, he thought, ‘These people don’t have any idea what aphasia is. Two million people in this country have aphasia after their strokes. It could happen to any of these folks, and nobody even knows what it is.’

On the two-hour trip home, an idea took shape in his head. When he got back to his new speech therapist, Allison, the following week, John told her he wanted some help in writing and memorizing an audition script. After checking the listings of auditions on the Actors Equity website, he explained that he was planning to go to the next “open audition” for a Broadway play.
Open auditions in New York have been dubbed “cattle calls” because scores of Broadway hopefuls line up for blocks early in the morning, often in the freezing cold or pouring rain, just to sign up for an appointed audition time later in the day. Anyone with an Equity card is entitled to a five-minute audition. Did John think that five years after a severe stroke, still limping with a cane and struggling with aphasia, he was going to score a part in a Broadway show? Of course not, but maybe, just maybe, he could take the opportunity to educate people in the public eye about aphasia.

“Script therapy” is an evidence-based communication treatment frequently employed for persons with Broca’s (expressive) aphasia, so while Allison was not too sure about the purpose of John’s mission, she was happy to help him write and practice the script. 

The final product went like this:

Seven years ago, I had a stroke.

I was running and then I fell down.

I said, “This is odd.”

I collapsed in the park.

When I got to the hospital, the doctors said, “It’s okay.

Everything is fine. You’ll be home in five or six days.”

And I was thinking, ‘Okay.’

But then I had a big stroke. It was bad. Very bad.

Jeannie, my wife, cried. And I cried, too.

My first words were, “Damn, damn, damn, damn.”

The nurse said, “Oh, he’s going to be bad. He’s going to have a feeding tube.”

My second words were, “No, no, no, no, no!”

Then there was a long road ahead of me, a long process to recovery.

I now have limited movement on my right side.

My legs and arms on one side are now dead. Oh well.

I am getting better, but slowly.

And as a result of the stroke, I now have aphasia.

You’ve probably never seen it. Right?

Aphasia. It’s a language disorder. Your words are muddled up.

But then I found Kean University in New Jersey.

It has an excellent program in aphasia. Words are coming back — amazing.

And well, that’s it. Thank you very much for this. Thank you.

John’s first audition required a long wait in line outdoors early in the morning in order to sign in, and a return for the actual audition late in the afternoon. Given his four-hour round trip to Staten Island, it was an exhausting day, but John returned home triumphant. The next day, everyone here at the center was amazed at his determination. “How did it go?” everyone wanted to know. “Amazing!” was the gleeful answer. He was absolutely delighted with his personal effort to spread the word about aphasia.

As of this writing, John has performed his script at more than a dozen Equity auditions in New York and three more at the State theatres in New Brunswick, New Jersey, an 11-hour round trip by public transport from Staten Island. The reactions of directors, playwrights and casting directors have been varied. “Sometimes they just sit there totally shocked!” John said. “Sometimes they are silent and look dumbfounded, and sometimes they are very interested in what I’m saying. It’s great!” The satisfied smile on that handsome face says it all. This ambassador for persons with aphasia has succeeded in his mission. Take a bow, John Daggan.
This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Stroke Association.​

Sunday, July 8, 2018

The Juggling Caregiver
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Summer Juggling
By Claudia R Warner

Ah yes, summer has begun! I had forgotten how hectic the juggling can be during June.

However, that was quickly refreshed when the rains came. And the lawn grew. Then it was overwhelmed with dandelions. Plus it was too wet to mow! The lawn tractor spent a few days in the neighbor’s shop, getting refurbished. I was anxious to try out the new blades but waited patiently for the grass to dry. Finally it did and I was in my glory running the little tractor and getting the acreage mowed. Alas! It didn’t last. I noticed that the grass wasn’t getting cut. A close look at the underside of the tractor showed that a belt had come undone. I couldn’t get it back on, so back to the neighbors we went. Thank goodness for such helpful people!!! We were back in business the next day.

It rained and rained. Finally, after several days I was able to mow. It soon became evident that I needed a refresher course in mowing. Why isn’t there a Caregiver training session in lawn care? Many of us find ourselves suddenly responsible for mowing, etc.

Here’s what I needed a refresher session on:

1. It takes a while for the machine to stop once the brake is pressed. Yep, ran into the fence.

2. When backing away from above mentioned fence, be sure to back up a good distance before engaging the drive.

3. Going uphill while mowing wet grass tends to get a person stuck. No amount of rocking back and forth will solve this problem. Nope, one has to push the heavy machine (did I mention that Caregivers should be given strength training?). So push I did and it actually moved! By now Wes was on the deck, anxiously watching me---just adding a little more stress.

4. A couple of old rugs can come in handy, so don’t toss the thread worn ones. They are great to put under tires to give traction! It works!

5. It is easier to use a trimmer than it is to mow close to bushes and trees. Mowers tend to run over bushes, no matter how careful the driver is. (At this point, the Caregiver could use an encouraging hug.

How about a Caregiver’s Guide to Planting? When plants arrive, there is always a frantic feeling—they HAVE to be planted immediately. The tendency is for me to begin digging and planting and watering like crazy. The job does get done, but the back and shoulders complain about the activity for a couple of days. Obviously this is not the best method of planting. A Caregiver’s Guide could really help.

For example, the plants have been living in little pots for weeks and a little while longer won’t harm them. They need to be watered as their soil will dry out rapidly. Setting them outdoors helps condition them to their new environment. They’ll survive nicely for several days.

Bare root plants are another matter. They don’t need to be rushed to their new location. Just put them in a bucket of water and they’ll be fine for over a week. They, too, can be set outdoors to become conditioned.

Bare root plants are usually trees or bushes that need deep holes and lots of water when placed in the lawn. Having someone dig the holes for you would save lots of strain, giving you time to enjoy the planting process.

Once planted, the little things need water—lots of it. Standing over the plants holding a dripping hose is not a recommendation. Nor is hauling buckets of water to them. I found a neat dripper hose that has pin holes that gently spray the water on the plants. Once it is in place, it can be left for the season as it is flat enough to avoid mowing disasters! Just hook it up, turn on the water, and hands-free watering!

There is so much to learn about being a Caregiver! We aren’t just in charge of the well-being and needs of another person---we also have to maintain their environment!

Gardening is a matter of your enthusiasm holding up until your back gets used to it. ~Author Unknown
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Sunday, July 1, 2018

OSF Seeks Volunteers for Stroke Study

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                                   > Stroke Support Group Finder <

Journal Star

PEORIA — OSF HealthCare Illinois Neurological Institute is looking for healthy volunteers to participate in a study investigating a new kind of stroke treatment.

Participation could help start the process for approval of a new product by the U.S. Food and Drug Administration that may help improve stroke care. Participants must:

Be 18 to 55 years old

Be in healthy condition and on no medications

Have a normal Body Mass Index, which is a measure of body fat based on height and weight.

Be a nonsmoker for at least the last six months, including cigarettes, cigars, smokeless tobacco, nicotine patches and vaping

Refrain from consuming alcohol and caffeine two days before the study period begins and up to eight days after it ends

Be available for admission to the hospital for two full days and nights during investigational product dosing, lab testing, ECG testing and monitoring

All study-related visits, tests and procedures will be provided at no cost. Reimbursement for time and effort will be provided.

Register for the study at strokestudy. For more information contact Judi Beck, RN, CCRP, study coordinator at or call (309) 624-3240.

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