Saturday, July 25, 2015

Shortened Achilles? Here's an option.

There are 3 reasons drop-foot happens:

1. Stroke is a brain injury. The brain injury no longer provides enough "brain power" to  activate the muscle that lift the foot (tibialis anterior).

2. Survivors often have spasticity of the calf muscles. The job of the calf is to cause a "toe down" posture at the ankle. A spastic calf muscle is one that contracts too much, forcing the "toe down" position.

3. Because of both #1 and 2, above, there is often a contracture (permanent shortening) of the calf muscle and the Achilles tendon.

There are a number of aids and shots and exercises and so on to help drop-foot, but I'd like to focus on one option. Its called Percutaneous Achilles Tendon Lengthening.

Quick hits:

  • It is a surgery, often done outpatient and under a local. 
  • Healing takes 6-8 weeks
  • GRAPHIC video here 
  • Its permanent
  • Its effect is (after healing) immediate

Wednesday, July 1, 2015

Do doctors know?

Medical doctors. MDs. They can be your best friend. If you’ve had a stroke they spent a lot 
Sherrington
A great MD/Scientist
that advanced stroke recovery
of their decade-plus of schooling training to save your life and save as much of your brain as they possibly could. When some MDs show up at the Pearly Gates, St. Peter is going to provide velveteen pathways to the VIP room.

BUT.

Let’s be clear about this, your doctor is probably not a scientist. Very few are. The ones that are usually work at major academic institutions. Think Johns Hopkins.

A few quick points here…
1. Without a doubt, a rare few MDs do great, great scientific work that promotes medicine. 

2. Almost all medical science is developed by neuroscientists, biologists, chemists, etc. Scientists develop treatments (from x-ray
Taub
A great
psychologist who
advanced stroke recovery.

to antibiotics) and MDs make it illegal for anyone beyond themselves to prescribe them. Sometimes they make great gatekeepers, but they often screw it up. 


Most MDs don’t do science, don’t do clinical trials and are not qualified as scientists. Many MDs are not qualified to interpret the science they need to do their jobs, especially if they are not specialized in the area in question. Asking a GP about leading-edge rheumatoid arthritis treatment is like asking a soccer player about basketball’s triangle offence; they may know, but they probs don’t. Even asking, say, a neurologist about, say, migraine is a mistake. How many pathologies do neurologists treat? Countless, that’s how many. Will they be an expert on migraine? Maybe.

So what does this mean to you, dear survivor? It means you have to do your own research, and find your own experts.

There is a bit of good news…if you are willing to work a bit. If you go to PubMed and ask it your questions (i.e.: aphasia stroke recovery) articles by scientists who are experts will bubble up and from there it’s just a hop-skip and jump to their email address. Ask the scientists on the bleeding edge your question. (Hint; be clear, specific and respectful for the best results.) Hack through the pseudo-scientific gobbledygook of medicine (haven’t you exhausted that already anyway?) and get to the extraordinary.

Off you go… 

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