Monday, October 19, 2020



 Retreat & Refresh Stroke Camp, Strike-Out-Stroke and Youth Education on Stroke, the three divisions of United Stroke Alliance, have been promoting the acronym BE-FASTER as a way to remember how to recognize if a person is having a stroke, and what to do if they are. Below is a detailed explanation of what each letter represents.  
United Stroke Alliance (USA) recognizes that each year 700,000 Americans suffer a new or recurrent stroke. Approximately 543,000 survive the stroke, many experiencing significant physical limitations as well as emotional and cognitive challenges. For almost everyone, the stroke was not a planned or wanted event. It struck without notice and changed the lives of the family forever.

BE-FASTER represents the majority of the signs of stroke. In short, most people in America do not know the signs and do not respond quick enough to receive early treatment to minimize post stroke challenges. In fact, 80% of Americans that experience a stroke do not respond quick enough because they did not know the signs of stroke.

Whether you know CPR or know the signs of stroke, you can save a life. Remember:


[B]Balance - Sudden loss of balance?
If there is a sudden problem with a person's balance or they fall and can't get up, it could indicate a stroke event, especially if it is accompanied by one or more of the other indicators mentioned in the 
BE-FASTER! list.

[E]Eyes - Sudden blurry or loss of vision?
If the person suddenly loses their sight or has other sudden and noticeable vision problems, this could indicate a stroke event, especially if it is accompanied by one or more of the other indicators mentioned in the BE-FASTER! list.

[F]Face - Sudden numbness, one side droops?
Ask the person to smile. Does one side of their face seem to droop more than the other? If so, this could indicate a stroke event, especially if it is accompanied  by one or more of the other indicators mentioned in the BE-FASTER list.

[A]Arms - Arms suddenly weak. Can both raise?
Ask the person to raise both arms. If the person has lost the ability to keep one of their arms up, it could be an indication of a stroke, especially if it is accompanied by one or more of the other indicators mentioned in the BE-FASTER! list.

[S]Speech - Slurred or mumbling speech?
Ask the person to repeat a simple phrase. (The sky is blue, The grass is green. Mary had a little lamb, etc.) If the person does not have the ability to speak or their speech is slurred or hard to understand, this could indicate a stroke event, especially if it is accompanied by one or more of the other indicators mentioned in the BE-FASTER! list.

[T]Time - Call 911 NOW !!!
If you recognize any of the symptoms indicating a stroke, it is critical to get the person to a stroke hospital immediately.

Go by ambulance, they know what to do FASTER.

1.9 million brain cells are dying each minute that blood is not able to reach the brain.

There is a drug that may prevent more brain cells from being damaged by the stroke, and that may lessen the effects of the stroke.
The drug must be administered within three (3) hours of a stroke's first symptoms.

[ER]Emergency Response
Get to the ER by ambulance.

They know what to do FASTER!

This is critical to remember. If you try to drive your own car to the hospital to deliver a person suspected of having a stroke, there are so many things that can go wrong along the way. 
You could have
mechanical problems, run out of gas, get in a traffic jam, or even an accident.

Remember, those 1.9 million brain cells are dying every minute.

Some may think waiting for an ambulance is a waste of valuable time but there are things the EMT can do along the way to the hospital.

They will be driving legally faster that you can.

They will be diagnosing the status of the patient on the way, performing any emergency medical assistance needed. They will know where a stroke hospital is.

They will be calling ahead to the hospital and requesting a stroke team that will be waiting at the door when you arrive. Remember, it is critical that you get transported to a stroke hospital, diagnosed, and receive treatment within three hours of the onset of the first symptoms of a stroke.

Knowing the signs of stroke can save a life. Once a stroke begins to present itself, BE-FASTER! and dial 911.

Monday, October 12, 2020

Depression and Stroke


The following is an article originally posted on the now discontinued website called StrokeNet. They published a monthly newsletter. Their articles are still very useful today. With the permission of their then editor, Lin Wisman, I am able to repost them on my site. 

David Wasielewski, the author of this article, was a member of the StrokeNet staff.
Depression and Stroke
By David Wasielewski


       Reactive vs Clinical

As stroke survivors we, and often our caregivers, are tasked with overcoming a variety of challenges. The physical challenges that can accompany a stroke are obvious to those around us. The mental and psychological challenges are less so. A common challenge that we often face following a stroke is depression.

To an outside observer depression is often perceived as a profound sadness or anger that overtakes an individual. To the individual experiencing depression the situation is rather one where they experience a lack of these and most any other emotion. It is described by some who have written about their condition as a profound emptiness, a sense that one simply does not care about themselves and their surroundings.

The circumstances that would normally cause us to be happy, sad, angry, interested and curious simply have no effect. The connections that drive us though our daily routines, that motivate us to perform certain tasks, are lost for the depressed. For the depressed, life becomes empty and meaningless without these connections and emotional responses.

Psychologists identify two distinct types of depression. Reactive depression is where the individual becomes depressed as a result of some emotional or physical shock to their life circumstances. The loss of a loved one or a disaster that takes one’s house can result in a profound emotional shock that leaves one unable to process life events as they normally do. This is seen as a normal response to a traumatic event in one’s life. For most individuals it is something from which they recover over time. As the shock of a traumatic event wears off the individual is able to return to normal.

The other type of depression is called clinical. With clinical depression an individual experiences a depression that may or may not be related to a specific event. The individual becomes depressed and remains in that state for an extended period of time. Understanding the difference between these two conditions is often important for stroke survivors and especially for caregivers. In the process of stroke recovery it is normal for the survivor to take time to process their post stroke condition.

They need to recognize and process the mental and physical losses associated with their stroke. These losses are often significant and, as with the loss of a loved one, represent a severe shock to the system. The reactive depression associated with these losses is normal. The recovery from these losses might be extended due to the stroke if the stroke also affects the survivor’s ability to recognize and process this information. It is important to understand that the reactive depression is a normal part of recovery.

If, however, the depression remains for an extended period of time the survivor may need to seek help. The challenge with stroke is to determine what ‘extended’ means in your particular situation. It is often up to the caregiver to understand and recognize the condition and alert the proper medical professionals of your concerns. The survivor may not be able to recognize or understand the condition themselves.

The survivor may not be willing to admit to being depressed. Treatment for depression is important as a long term depression can affect one’s health, recovery and in the most severe cases can result in suicide. A depressed survivor is not motivated to exercise, concentrate or put forth the significant effort required for recovery.

The caregiver needs to help the doctor determine if a survivor’s activity or attitude seems normal for them or if there is some significant problem in the survivor that needs to be addressed.

It is important to recognize, as well, that there are effective treatments available that help a survivor overcome depression. Depression is not just an undefined emotional response but, as research suggests, can be traced to identifiable chemical imbalances in the brain. A stroke can alter the chemistry of the brain as it deals with the loss of cells and cleans itself. A stroke might also affect the limbic system that resides within the brain.

The limbic system is a collection of cells or nuclei that excrete or distribute mood altering chemicals throughout the brain. Brain cells communicate with each other by releasing then reabsorbing a variety of chemical compounds into the microscopic spaces between the cells. For example, when a danger presents itself, it is the limbic system and its chemical messengers that alert the body, causing the fear and anxiety associated with that danger.

In normal circumstances it is the limbic system and its chemical messages that cause us to be happy, sad, anxious etc. If these cells are directly damaged by the stroke the ability to experience normal emotions can be severely impaired. If the limbic system is not directly affected the brain may be altered in more subtle ways. These changes can affect one’s ability to fully recover from the short term, reactive depression described earlier. One brain chemical, Serotonin, has been identified as important in maintaining one’s sense of well-being. A Serotonin deficiency is often associated with depression.

The good news here is that once depression is recognized it can often be successfully treated. Medications that alter brain chemistry are available. Most readers will recognize Prozac as a treatment for depression. This drug blocks the reabsorption of Serotonin in the patient’s brain cells, often increasing the patient’s sense of well-being, helping to overcome depression.

Other treatments, too numerous to detail here, are also available. It is known that each individual can react differently to these medications due to the complexity of the brain. With this in mind, it is up to the doctor to experiment with the types and doses of different ‘antidepressants in an effort to determine which medication and which dosage will be most effective for each survivor

The point here is to recognize that, in stroke survivors, some depression is normal but extended periods of depression are not. Since we all know each individual is different we need to pay attention to what depression is and how long it lasts. We need to determine if and when it is appropriate to alert your medical team of the possibility of a clinical depression and seek treatment when necessary. Depression is a mysterious condition, even in healthy individuals. It is even more of a challenge to stroke survivors but needs to be recognized and dealt with in order to promote the fullest mental and physical recovery.

Much of the information presented here is contained in an instructional CD set entitled “Understanding the Brain” available through Great Courses.
Copyright @November 2014
The Stroke Network, Inc.
P.O. Box 492 Abingdon, Maryland 21009
All rights reserved.

Sunday, October 4, 2020

Bounce Back


The following is an article originally posted on the now discontinued website called StrokeNet. They published a monthly newsletter. Their articles are still very useful today. With the permission of their then editor, Lin Wisman, I am able to repost them on my site. Moses Cherrington was a member of the StrokeNet staff. This article is Moses's response to a post submitted by "SassyBetty" on the StrokeNet site.
Bounce Back
By Moses Cherrington


We belong to a very exclusive club. We only enter by surviving a stroke.

We go From: being very independent -- running our own lives, having our own timetable, choosing our own options that meet the goals that we have set ourselves To: Thinking that we are helpless, others running our lives now.

We chose the best available options that meet our health needs as we now consider our diet, medication, therapy, marriages – yes many marriages suffer as the spouse cannot take the change in the stroke partner.

Our goals have changed, but we can Bounce Back!!!!

It’s not a bed of roses, but never feel hopeless. You have the privilege of going to therapy three times a week. Many cannot do that. Start keeping a journal about what frustrates you and don’t be shy to be a sour survivor: I sat in the corner of the lounge for three months looking out the window, the visiting of friends coming less and less. Even when they would come, I would go to my bedroom and lie down. Remember, we have survived one of the greatest traumatic experiences one can have!

Build upon your survival. You have changed. You have changed. You have changed. Did I mention that you have changed?

You get tired and irritable!

You cannot use certain parts of your body. I had a hard time adjusting!

Never apologise for not inspiring others. Never apologise!

Learn to know yourself now!!!, not who you were before the stroke. Did I mention that you have changed?

Watch your moods, attitudes, lack of inspiration, and diet. Move to exercise those parts of your body that have changed or are now limited in use. Know the location of most conveniences. People look at you differently, and sometimes that is enough to set off attitudes/moods. Feelings and emotions are now so close to the surface that any little issue will let them run rampant. They can be managed. I am still learning how to manage my emotions. Learn to KNOW your new self.

Did I mention that you have changed?

You say “bed of Roses” that you have “no outlet for my creativity or my intellect…” I disagree!

You managed to share your predicament and “touched” me and would have touched many others, hence you gave me the synergy to assist me to focus on my comments for this month’s column. Thank you for being you. Thank You!

Did I mention that you have changed?

Once you have learned about your new self (keep a diary) you will discover your new strengths I see that you now are building the attribute of perseverance – you go to therapy, PT,OT and speech three times a week Well done.

To “Sassybetty” thank you for sharing yourself, I admire that you are in a Doctoral program, may some of the above observations be profitable to you.

I am now studying (online) Introduction to Financial Accounting, How to Reason and Argue, the Law of Contracts, Evaluating Social Programmes, Introduction to Human Physiology (in which I am discovering how my body works), Forensic accounting and Yes I have put together a timetable to pace myself.

As a result of the above I am learning how to learn, especially after surviving a stroke. Fatigue is still very prominent in my life!

I am now sitting on two community boards, one as a board member, the other as treasurer, and the boards meet once a month for two hours. I can handle that – it took four years to get here! This is light at the end of the tunnel! I represent the community as my new self.

What is my biggest secret? I thank God every day that I can read, think, ponder, and admire a sunrise and that He has created me to “be the best.” I experience His grace on a daily basis! How else can I be where I am now?

Did I mention we have changed…For the Better!

If a ball can bounce back after hitting a hard wall, then we can Bounce Back by knowing ourselves and then building on our strengths for the purpose of building and nurturing others. The Stroke Network has encouraged me by offering me appropriate information given by a group of survivors who belong to a very, very exclusive club.
Copyright ©October 2014
The Stroke Network, Inc.
P.O. Box 492 Abingdon, Maryland 21009
All rights reserved.