Retreat & Refresh Stroke Camp Blog

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Jim Sinclair, the author of this article, was a member of the StrokeNet staff.

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Eleven Year Journey to Acceptance
By Jim Sinclair

As I am approaching the eleventh anniversary of my strokes later this month, it seems like a good time to take stock of my present stroke circumstances. I have always felt that in my particular situation dealing with the physical effects was a lot less formidable task than dealing with the mental aspects of the strokes. My first awareness that I had experienced strokes came when I realized that my left arm and hand had changed into what I thought was lead.

Although I could not move that arm or hand, it was not long before the little finger on that hand started to twitch. Somehow that twitch came with a confidence that if something has even the smallest ability of movement, efforts can be undertaken to enhance that ability to a far more advanced level of functioning. First it was that twitch and then very, very gradually there was movement in each of the fingers of that hand, which was slowly followed by movement of my left arm.

Hundreds of hours of physiotherapy and occupational therapy resulted in strengthening that hand and arm into fully functioning appendages. I don’t recall having that same lead like feeling in my left leg which was also paralyzed, but I do recall my first post stroke physiotherapy session in a neurosciences unit. After packing my newly replaced right hip with sandbags to restrict movement the physiotherapist asked me to wiggle the big toe on my right foot. Following that achievement I was asked to try to wiggle the big toe on my left stroke affected foot.

To the surprise of both of us it moved. Following this seemingly miniscule victory about ten days post stroke, gradually expanding therapy activities over three months resulted in my gaining pretty much full use of my left side. The very last physical effect to be overcome was the paralysis in the left side of my face. At this point (11 ears post stroke) my physical deficits are minimal when things are going as they should. Whenever an opportunity arises I try to open jar lids with my left hand.

Usually it works, but at times I need to use my right hand with my left hand bracing the jar. It is of little consequence that I occasionally fumble slightly when picking up small items with my left hand. When I am tired or frustrated my left leg will drag a little. At almost 11 years post stroke the most major persistent physical issue remains to be fatigue. At times my cognitive functioning is not quite what I would like it to be.

When I learn that I have misinterpreted information or that my thinking is incorrect, these can lead to confusion and frustration; which can in turn influence my physical functioning much in the same way as fatigue and overtiredness. I believe that making a full recovery refers to attaining a quality of life which is meaningful and satisfying given our present circumstances. I consider myself to be fully recovered with any residual stroke effects being simple annoyances.

My strokes themselves were an event that occupied only a microsecond of my life but resulted in very dramatic changes in my life, including changes in my personality. Early on in my recovery much of my focus was on dealing with these changes. A decade later I don’t think I am even aware of what these changes entail. I only know that most of the time everyday life is as just as good as it was over more than a decade ago.

In fact, being a Canadian snowbird celebrating Thanksgiving in Canada in October and US Thanksgiving in November allows me to be doubly thankful for all the positives in my life. This appreciation of all that is positive is enhanced by my awareness that in the early afternoon of December 24, 2003, the medical professionals attending to me believed that I was not going to survive past that day.

I remembering that there was a period that I could not sit in a wheelchair without slumping over. I remember that there were periods of time when I felt very confused. I remember times when I struggled with being easily overwhelmed by the environment around me. These experiences accentuate the positive nature of my current quality of life. Like many stroke survivors, I had a very difficult time the first two years when it felt almost impossible to view my life and stroke issues in anything other than very negative terms. I believed that life was not the way that it was supposed to be.

After these many years, I have finally accepted the notion that stroke is not something we ever get over; it is something that we learn to live with and adapt to. During this eleven year journey life became much better once I came to truly believe that the way the things are at any given moment are the way they are meant to be at that particular moment.

The Stroke Network, Inc.

P.O. Box 492 Abingdon, Maryland 21009

Sunday, November 1, 2020

Finding a Place Where Handicap Does Not Matter

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David Wasielewski, the author of this article, was a member of the StrokeNet staff.

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Strategies for Surviving Stroke and Diability

By David Wasielewski

Finding a Place Where Handicap Does Not Matter

A stroke often leaves a survivor with extensive physical and mental deficits. The survivor must deal with a variety of new challenges or what is commonly referred to as handicaps. Interaction and discussions with others who face similar challenges has recently led me to a personal realization. One of the ways to address a handicap is to find a place where the survivor is not handicapped, where the physical or mental challenge becomes irrelevant. Moving on after a stroke may not always be about overcoming physical or mental challenges, but rather can be about finding a place where they don’t matter

As a survivor with hemiplegia I was initially frustrated that I could no longer participate in a variety of physical activities. I initially tried to participate in some modified way. Skiing with specialized equipment proved to be too much of a challenge, physically and mentally exhausting. Being in that environment only served to emphasize my stroke related losses. Frustration and anger were evident as I continued my struggle. This was obviously not a good direction for me. It wasn’t easy but I just finally stopped beating myself up. Testing myself in this way, although necessary to the process, was not productive.

My post-stroke adventures included returning to school. This was a step into the unknown as was unsure of my ability to concentrate study and learn. I quickly realized that I was able to function in the classroom environment and that, in that environment I was not handicapped. Sitting in a classroom desk, studying and discussing issues was a place where my handicaps did not matter. In that place I was just like everyone else!

I spoke to a woman who suffered a traumatic brain injury. Prior to her injury she was a successful finance professional. The injury left unable to deal with numbers read or write, a devastating loss which ended her career. She always enjoyed singing and still retained that talent. Instead of fighting to get her finance skills back she enrolled in music classes, performs locally, and is now a music major in the honors program. She found a place where her handicap did not matter.

Another member of my stroke group is challenged by severe aphasia. Prior to her stroke she was a child care professional and enjoyed painting. The aphasia prevented continuing with child care but did not interfere with the ability to paint. Rather than struggle with communicating with children she now spends her time painting, a place where her handicap doesn’t matter. She has managed, over time, to regain some speaking ability and now appears at seminars and classes to increase aphasia awareness in the community, again a place where the handicap doesn’t matter or rather, is seen as a positive thing.

Yet another member of the group with aphasia recently decided to take piano lessons. Playing the piano is an activity where her aphasia is irrelevant.

Of course, for these survivors, the challenges of the new handicaps still exist. The finance professional needs help managing her personal finances. She carries a recorder to help compensate for the reading and writing deficits. The aphasic woman has difficulty with communications, especially phones. I have trouble navigating around campus to and from classrooms with my cane. We all find that dealing with these struggles is worthwhile on our journeys.

The lesson here for the reader is that stroke survivors have number of different strategies they can use to move on with their lives. Some may choose to recreate their pre stroke lives and overcome challenges that stand in the way. Others can and do find places to be where their newly acquired handicaps do not matter. Is one strategy better than the other? Does the survivor need to choose one or the other strategy? That is always up to the individual as we all have different paths to our new places in this world.

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The Stroke Network, Inc.

P.O. Box 492 Abingdon, Maryland 21009

Monday, October 19, 2020

BE-FASTER

http://www.unitedstrokealliance.org/

www.strokecamp.org

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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.

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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:

BE-FASTER!

[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

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David Wasielewski, the author of this article, was a member of the StrokeNet staff.

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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.

http://www.thegreatcourses.com/courses/understanding-the-brain.html
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The Stroke Network, Inc.

P.O. Box 492 Abingdon, Maryland 21009

Sunday, October 4, 2020

Bounce Back

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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.

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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.
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The Stroke Network, Inc.

P.O. Box 492 Abingdon, Maryland 21009

Sunday, September 27, 2020

Can a Stroke Survivor Recover 100%

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Can a Stroke Survivor Recover 100%

Answers to Recovery Questions with Tracy Markley

Tracy posted a 45 minute Youtube video on the United Stroke Alliance Community Facebook page September 21, 2020 to answer the above question.

Tracy is a Fitness Trainer in Florence Oregon. She is a Fitness Specialist, Personal Trainer, Yoga and Pilates Instructor. She is also an educator and an author of 8 Fitness and Health books. Her books are on Stroke Recovery, Fall Prevention, the Brain and a book on Healing Loss coming soon. She is known in the fitness industry as the "Stroke Recovery Specialist Personal Trainer". If you are looking for a Personal trainer on Zoom or live or Books on Stroke recovery and exercise, you should visit her website. Tracy is also a 2020 IDEA Personal Trainer Finalist and Runner up for Medical Fitness Trainer of the Year with the Medfit Foundation. She is a Pro Trainer with FiTOUR and a radio show and podcast host. "The Health and Fitness Show with Tracy"

She was asked her thoughts on this question?
"Can a Stroke Survivor Achieve 100% Recovery or is this a false belief?"

I know it's long, but watch the whole video. Something may help you. It could be the best 45 minutes of your life with stroke.

Click Here To View Video

You may contact Tracy with questions using the following link:

www.tracymarkley.com

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Sunday, September 20, 2020

In Her Patients’ Shoes

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Article provided by Medtronic

Medtronic is a global leader in medical technology, services, and solutions. We collaborate with others to take on healthcare's greatest challenges.

https://www.medtronic.com

In Her Patients’ Shoes: Lisa’s Stroke Story

For more than 10 years, Lisa has been a stroke coordinator and cared for stroke patients in Wausau, Wisc., ensuring they get the best treatment and helping them in their recovery. She is a stroke expert.

One morning, in August 2017, Lisa learned even more about stroke: She learned what it was like to actually have one.

At the age of 51, Lisa was rushed to the hospital, her workplace, and the familiar faces of her coworkers were now treating her. Luckily Lisa received medical care quickly, but even then, she experienced several post-stroke conditions including facial droop and arm weakness. After several tests, her stroke care team couldn’t tell her what caused her stroke. Her stroke was a cryptogenic stroke, or a stroke of unknown cause.

In the months following her stroke, Lisa worked hard to recover — physically and mentally. She found her physical recovery to be progressing, but mentally, she was stressed. She didn’t know what caused her stroke and she didn’t know if, or when, it would happen again. Lisa, an independent and adventurous woman before her stroke, was scared and afraid to be alone.

Finding Peace of Mind — and Atrial Fibrillation

Lisa’s doctor suggested they use the Reveal LINQTM Insertable Cardiac Monitoring (ICM) System to monitor Lisa’s heart and determine if her stroke could have been caused by atrial fibrillation (AF). AF is a common condition in which the upper chambers of the heart beat very fast and irregularly. As a result, blood is not pumped effectively to the rest of the body and may pool and clot. If a clot dislodges, it can travel to the brain and result in a stroke. AF can happen infrequently and without symptoms and, when left untreated, AF patients have a five times higher chance of having a stroke.1

With the Reveal LINQ ICM continuously monitoring Lisa’s heart for irregular heart rhythms, Lisa found peace of mind and started gaining her independence back. She felt comfort knowing that if she was having irregular rhythms, her monitor would find them, and her doctor would be informed.

Almost one year later, the ICM detected AF and with the information from the monitor, Lisa’s doctor prescribed medication for Lisa to help prevent her AF from causing another stroke.

Lisa is now back to work and she immediately noticed her care for stroke patients has changed because of her experience — she can put herself in their shoes. She truly understands their fear, and she’s able to share her personal experiences of what helped her get through the challenges of stroke recovery.

To learn more about cardiac monitoring for unexplained, or cryptogenic, stroke, visit MonitorYourHeart.com.

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Treatment with a Reveal LINQ Insertable Cardiac Monitor is prescribed by your physician. This treatment is not for everyone. Please talk to your doctor to see if it is right for you. Your physician should discuss all potential benefits and risks with you. Although many patients benefit from the use of this treatment, results may vary. For further information, please call the Medtronic toll-free number at 1-800-551-5544 (7:00 a.m. to 7:00 p.m., Monday–Friday, Central Time) or see the Medtronic website at www.medtronic.com.

Reveal LINQ™ LNQ11 Insertable Cardiac Monitor and Patient Assistant

The Reveal LINQ insertable cardiac monitor is an implantable patient-activated and automatically-activated monitoring system that records subcutaneous ECG and is indicated in the following cases:

■ Patients with clinical syndromes or situations at increased risk of cardiac arrhythmias

■ Patients who experience transient symptoms such as dizziness, palpitation, syncope, and chest pain, that may suggest a cardiac arrhythmia

This device has not specifically been tested for pediatric use.

Patient Assistant
The Patient Assistant is intended for unsupervised patient use away from a hospital or clinic. The Patient Assistant activates the data management feature in the RevealTM insertable cardiac monitor to initiate recording of cardiac event data in the implanted device memory.

Contraindications
There are no known contraindications for the implant of the Reveal LINQ insertable cardiac monitor. However, the patient’s particular medical condition may dictate whether or not a subcutaneous, chronically implanted device can be tolerated.

Warnings and Precautions
Reveal LINQ LNQ11 Insertable Cardiac Monitor
Patients with the Reveal LINQ insertable cardiac monitor should avoid sources of diathermy, high sources of radiation, electrosurgical cautery, external defibrillation, lithotripsy, therapeutic ultrasound, and radiofrequency ablation to avoid electrical reset of the device, and/or inappropriate sensing as described in the Medical procedure and EMI precautions manual. MRI scans should be performed only in a specified MR environment under specified conditions as described in the Reveal LINQ MRI Technical Manual.

Patient Assistant
Operation of the Patient Assistant near sources of electromagnetic interference, such as cellular phones, computer monitors, etc., may adversely affect the performance of this device.

Potential Complications
Potential complications include, but are not limited to, device rejection phenomena (including local tissue reaction), device migration, infection, and erosion through the skin.

Medtronic MyCareLink™ Patient Monitor, Medtronic CareLink™ Network, and CareLink™ Mobile Application

Intended Use
The Medtronic MyCareLink patient monitor and CareLink network are indicated for use in the transfer of patient data from some Medtronic implantable cardiac devices based on physician instructions and as described in the product manual. The CareLink mobile application is intended to provide current CareLink network customers access to CareLink network data via a mobile device for their convenience. The CareLink mobile application is not replacing the full workstation, but can be used to review patient data when a physician does not have access to a workstation. These products are not a substitute for appropriate medical attention in the event of an emergency and should only be used as directed by a physician. CareLink network availability and mobile device accessibility may be unavailable at times due to maintenance or updates, or due to coverage being unavailable in your area. Mobile device access to the internet is required and subject to coverage availability. Standard text message rates apply.

Contraindications
There are no known contraindications.

Warnings and Precautions
The MyCareLink patient monitor must only be used for interrogating compatible Medtronic implantable devices.

See the device manual for detailed information regarding the implant procedure, indications, contraindications, warnings, precautions, and potential complications/adverse events. For further information, please call Medtronic at 1-800-328-2518 and/or consult the Medtronic website at medtronic.com.

Caution: Federal law (USA) restricts these devices to sale by or on the order of a physician.

1 Fuster, et al. Journal of the American College of Cardiology. 2006; 48:854-906.

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Sunday, September 13, 2020

Dancing with Stroke - Educating Medical Students

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The following is from the Stroke Network Newsletter. They don't do a newsletter anymore but so many of their past articles are so good I like to pass them on. They have a very good online Stroke Support and Information site you might find useful:

http://www.strokenetwork.org/

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Dancing with Stroke
By Jim Sinclair

Educating Medical Students

Recently I had the opportunity to do presentations to four groups of third year medical students about to begin working in the rehabilitation hospital in which I volunteer as a stroke survivor peer support counselor. I was to tell them the story of my strokes and journey of recovery in an attempt to provide them with some insight into stroke and the journey of recovery from a survivor’s perspective. I realized this could be a very rare opportunity to impact the thinking of doctors in such a way that at some future point their actions could be of greater benefit to stroke survivors.

With concern about my occasional memory issues, I decided that it would be best to keep my presentation as close as possible to what I normally present to groups of stroke survivors. I chose to start my presentation as I do with all my presentations by welcoming them into our worldwide family of folks living with the effects of stroke and other acquired brain injuries and those who participate in our support infrastructure.

During my preparation it took me quite some time to settle on what things to emphasize with this group. I decided that once I had completed the chronology of my strokes and my journey of recovery, it would be best to conclude by promoting six thoughts for them to incorporate into their framework of thinking about how to work with stroke survivors.

I asked them to take a moment to envision what they considered to be a stereotypical stroke survivor. I followed this by commenting that it would be my guess that many of them envisioned a person in a wheelchair or using a walker with a multitude of issues which needed to be addressed. I emphasized that while this is often the scenario, I thought that they would be of greater service to their patients if they viewed the term survivor as embodying strength, and ability rather than having the disabilities as their primary focus.

I emphasized that they would not be working with stroke victims as the only stroke victims were those who died from their strokes. I suggested that they encourage the survivors with whom they work to adopt the attitude that the fact that they survived an event that kills a great many people indicates a strength and ability that will assist them as they move forward in their journey of recovery.

I reminded these young people who were about to become doctors that I was certain that they were already aware that the story of my strokes and journey of recovery were mine alone and that every survivor has an experience that is unique to them and needs to be approached in a manner relevant to that uniqueness. During the second session someone cited the example of a young survivor who had indicated that he did not want to be considered to be disabled. He was differently abled. I repeated this concept in my third and forth presentations.

I recommended to these groups that they not approach their stroke patients with a narrow focus solely concentrated on the physiology of the stroke; but instead approach with a wider global view that is inclusive of the family. I pointed out that while the actual physical event occurred within my brain my wife/carepartner was every bit affected as I, if not more so, and requires every bit as much attention. Additionally many of us become dependent to some degree on our carepartner such that their involvement in the process is essential.

One of my primary goals was to encourage these young folks to help their stroke patients adopt an attitude that their rehabilitation and recovery is not about going back to what they were prior to their stroke; it is about continuing on with their life and attaining a quality of life that is meaningful and satisfying in terms as defined by each individual given their present circumstances.

I suggested that when discussing prognosis their emphasis should be more on positive possibilities rather than likely outcomes and that they should not hesitate in encouraging survivors to dream big as this leads to setting goals; which is necessary if the best possible recovery scenario is to be achieved. If our future is to include the worst possible scenario we will be forced to deal with that as we move along in our journey.

I noted that they needed to be very clear and concise in their communications of possible negative scenarios. At times when a doctor says “you should prepare yourself for the possibility that you will never walk again” all many of us hear is “you will never walk again.” At times when critical information such as this is presented it would be advisable to have the survivor repeat back exactly what was said to insure the information was correctly received.

My sixth suggestion was that it was essential to promote an attitude of taking small steps slowly and that a survivor’s journey of recovery is more akin to a marathon than a sprint. Having had the opportunity to repeat the presentation to four groups over two days I know I emphasized all these points, but with my memory issues I doubt that I covered all the issues with all the groups.

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Copyright ©October 2014
The Stroke Network, Inc.P.O. Box 492
Abingdon, Maryland 21009
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Sunday, September 6, 2020

Street & Steeple by Phil Bell

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