Monday, June 30, 2014

Vision Problems After Stroke

Two great resources if you have vision problems caused by stroke. 

Both of these are presented by the University College London. Both are free!

The first one is for a disorder called Hemianopic Alexia (HA). 

HA is difficulty tracking along a line of text to find the next word in a sentence. If you have this problem, click on the image, below.

The same organization has options for hemianopia (loss of vision to one side) and spatial neglect (loss of attention to items on one side).  You can find training for those here.

Sunday, June 22, 2014

You Done Yet?

I'm always pretty confused about when recovery ends. I haven't had a stroke, so I only know what I've heard. For some people recovery ends when therapy ends. In fact it's pretty common that once therapy ends survivors actually decline to various degrees. But some people seem to trudge onward. I hear this a lot; "I've been at it for three years, and I'm still making progress. It's a long road – but it's worth it."

Some survivors believe that recovery ends when they're able to do so much with their life that you're too busy living to continue working on recovery.

But just like an athlete trying to get better, a little means a lot. This is the thing that clinicians often don't know. Clinicians think that the world is binary – that you're either functional or nonfunctional. That is you're either able to do the task (i.e. walking, dressing, etc.), or you're not. I've always thought it should be more nuanced than that; little bits of movement are important irrespective of the function. It probably comes from my involvement in research. In research you measure little bits of "better" movement.

What good is "better" movement? What does it get you?
Better movement means …

less spasticity
better blood flow (when muscles contract there is "venous return" of blood back towards the heart)
better cardiovascular health (the more you move, the stronger your heart gets) 
You get the idea. More movement generally means more health. And health is measurable. It's measurable in terms of... 
•a reduced heart rate
•less chance of falling
•the ability to fight infection better etc. etc.
So call it what you will. Recovery. 

Sunday, June 15, 2014

Recovery is done in four phases.


[Note the timing of all phases are highly variable based on the individual survivor.] 

1. The hyperacute phase (the first 6 hours ). Time is brain. Get to the hospital, asap. The most important reason is outlined here.

2.  The acute phase (~day 1 to day 7 [note all time periods are highly variable]). This is usually done in the hospital. In terms of recovery your main responsibility is to keep yourself healthy. Therapists will typically focus on helping you do what you can do. This is a time for convalescence.

3. The subacute phase (~day 7 to 3 months). This is usually done with some help from therapists. You will experience the most recovery during this phase. This is the time that rehabilitation should "put the pedal to the metal." This is where the hard work begins. During the subacute phase the brain is "primed" to recover. Make the most of this phase because it is a window of opportunity to reach the highest level of recovery.Squander it and squander the highest level of potential recovery.

4. The chronic phase (~3 months to the end of life). Typically the survivor has very little contact with rehabilitation professionals during the chronic phase. This is the time to implement a "do-it-yourself" plan for recovery. Recovery comes at fits and starts and is much more difficult than during the subacute phase. Still, important gains can be made during this phase. Up to very recently it was thought that no recovery could be made during the chronic phase. We now know that essential progress can be made during the chronic phase.

Sunday, June 8, 2014

Gifts for Stroke Survivors: A list compiled with the help of the stellar Young Stroke Survivors Facebook group!

The most important gift you can give a survivor is your time.  Often months and years later, the thing survivors remember
most is the company they received. A phone call, a visit, a text.... seems so simple but not to the stroke survivor whose mobility is limited. Social interactions will also help the survivor recover.

For survivors with children, organizing play dates for their kids can be a big help!

Gift that survivors often cherish include

  • The gift of Food and Drink!
  • Chocolates or any other delicious food. However, be aware that stroke can often affect the ability to swallow so yummy food will be a tease!
  • Survivors often worry about their family eating well. Friends can organize and help by over dinner for my husband/ wife and kids every night.  
  • Clothes
•Baseball cap to wear (to cover unwashed hair)
•sweats with the person's favorite team logo
•Comfy therapy clothes
•New comfy pajamas
•Comfortable snugly sweat pants (elastic waist!)
•Shoelaces that you don't have to tie like the Yankz! Sure 
Lace System

The gift of help

Survivors will certainly appreciate the little services you can provide. These include...

    A manicure/pedicure (A trip to the hair salon for a cut, color and pedi is often a favorite post-stroke gift. Survivors often feel so much better after a trip to the salon)
    Massage of the affected with a hand/body cream
    Hair styling
    Clean clothes
     Useful gifts
    • A journal for all the millions of thoughts that buzz around the survivor's head... great stress management
    • Stuffed animals, especially ones that remind the survivor of their own pets
    • A "grabber" to pull tray over, pick up the phone, or pull the tv over. Survivors are sometime left alone for extended periods.
    • Video games
    • Dry shampoo and leave in conditioner
    • a new toothbrush
    • Electric shaver for face or legs. Survivors are often afraid to use a razor
    • Flowers
    • A fluffy comforter
    • Books and for survivors with trouble reading, books on tape. Or, read to the survivor!
    • Photos of loved ones. A photo album with lots of pictures, where they were taken etc. (Survivors often forgot a lot!) Positive sayings in there as well as written prayers and messages from other friends
    • An attractive medical ID bracelet that fits with the person's personality (jewelry-style, paracord, beaded, Velcro (like Road ID).

    Music gets its own category because music helps recovery, especially during the acute phase (~the first 7 days after stroke)

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