Stroke talk

Restoring speech and communication after a stroke.

http://bit.ly/q5DHkx

Sharon (not her real name) suffered a stroke. On our first meeting, I remember vividly her body language, which was much more expressive than any sentence she could put together. It displayed total openness, and her eyes said it all – “Can you help me?”

Although she understood all that took place around her, and showed this by her head nods and hand gestures as we spoke, she had significant trouble when she attempted to speak.
Rehabilitation is an essential part of the life of a person living with stroke. This not only applies to motor functioning, but also to speech and language skills.

As with a few of my other patients, without asking, she gestured me to listen to her speak. “Bow (one), bu (two), tatatata (three), orh (four) ,” she counted one to four, raising each functional left finger as she spoke.

She then raised her hands in exasperation, and gestured, “Can you fix this?”

My first thought was, “Here is a remarkable woman, a fighter,” and our journey to recovery began.

Surviving a stroke brings a new facet of life, not only to the stroke survivor, but to their loving caregivers as well.

“Stroke” by definition means “sudden”. It is commonly used in daily language, such as a stroke of luck, a stroke of lightning, and such. It is aptly use by laypersons to depict a cerebral vascular accident (abbreviated as CVA).

A stroke is the sudden death of a portion of the brain due to the lack of oxygen. A stroke occurs when blood flow to the brain is hampered, resulting in abnormal function of the brain. It is caused by blockage or rupture of an artery in the brain.

Sudden are all its changes. A stroke leads to challenges in walking, eating, everyday self-help skills, speaking, communicating, thinking, information processing, judgement, personality change, and much more.

Needless to say, the magnitude of change and the challenges it poses are different for each person, and so is its recovery.

Frightening is often a word that describes the feeling of many.
Encourage the stroke-affected person to maintain his social life. A good social life builds up one’s confidence and motivation to regain speech, language and communication skills.

Recovery after a stroke

After a stroke, some spontaneous recovery takes place for most people. Abilities that may have been lost will begin to return.

This process can take place very quickly over the first few weeks, and then, it may begin to taper off.

This can be a very frustrating time for the stroke survivor as they become aware of their limitations from the stroke.

Often, this is the period where anger or depression can set in.

During this period, and even months after, it is helpful to begin intensive rehabilitation to help with regaining lost skills.

In more recent times, researchers and clinicians have been studying and documenting the evidence of what we now know as brain plasticity (plasticine-ness if there is such a word). Although not fully understood, it is certain now that the brain is able to change, reorganising itself following damage such that the remaining healthy cells of the brain are able to take over jobs that were previously carried out by brain cells which were destroyed.

This means that certain lost functions, such as speech and language, can re-emerge as the result of intensive rehabilitation. One way to do this is to practise your speech, language and thinking skills on a DAILY BASIS.

Speech disorders after a stroke can take the form of dysarthria – commonly referring to speech problems due to weak muscles; dyspraxia – referring to the inability to coordinate and perform speech and oral movements in spite of having no paralysis or muscle damage.

Language deficits are known as aphasia. Aphasia affects all modes of expressive and receptive communication, including speaking, writing, reading, understanding and gesturing.

This can be loosely grouped into either receptive aphasia (understanding skills) or expressive aphasia (expression skills).

Needless to say, this means a myriad of possible combinations of the above challenges.

It is NOT helpful to compare Mr Ahmad to Mr Ali in the hopes of encouraging our loved ones to work hard. Constant, reliable support is a great accompaniment to stroke recovery.

Restoring speech

Speech language pathologists are qualified professionals who can assist your family by assessing, planning, working individually or demonstrating what you can do to help with restoring speech and language skills at home.

In Malaysia, most government hospitals have at least one attending speech language pathologist today.

Others can be found at private hospital set-ups, private centres or home-based visiting clinicians.

Every person can be an element of support and encouragement. Here are a few things to bear in mind:

1. Reassure the person that he/she is still needed and important. Include him/her in family activities and decisions even if the verbal output is minimal.

2. Encourage the person to maintain his social life. A good social life builds up one’s confidence and motivation to regain his/her speech language and communication skills. Invite his/her friends over (with permission) for casual chats.

3. Make speaking a pleasant experience and provide stimulating conversation. Tell him/her what’s been happening, share with him/her no matter what sort of response you get. Ignore errors when possible and avoid criticisms/corrections.

4. Take a calm, friendly, respectful approach when communicating. Remember that you are speaking to an adult.

5. Find a quiet place to talk. If not, minimise or eliminate background noise (such as television, radio, other people).

6. Allow time for the person to understand what you say and to formulate his responses.

In Malaysia, we have a growing prevalence of stroke. It has been reported that six Malaysians experiencing a stroke EVERY hour, and about 52,000 Malaysians suffer a stroke annually.

Act FAST

After countless therapy sessions and the sheer hard work that she put in daily with the support of her loved ones, Sharon now enjoys communication, speaks confidently, and is actively giving back to society in her own way.

Albeit needing more time than others, she is now back on both the mobile and email network, is able to cook, read, and drive herself places (after having her car suitably modified).

If you suspect someone of having a possible stroke, act F.A.S.T.

F – Face: Ask them to smile and see if it’s even.

A – Arms: Ask them to raise both arms and notice if one drops, or can’t be raised equally well.

S – Speech: Ask them to repeat a sentence and note if it’s perfect.

T – Time: Time is off the essence to prevent further damage, so get them to a hospital FAST.

If we have family members or colleagues at work who are at risk of having a stroke from an unhealthy sedentary lifestyle, obesity, smoking, and a failure to control their hypertension, diabetes and high cholesterol, paste this reminder on your fridge or your office billboard. You may just give them a second chance at life.

> Pamela Thomas Joseph is a speech language pathologist and a member of the Malaysian Association of Speech Language & Hearing (MASH). She will be running a workshop for caregivers on September 24, 2011, in Petaling Jaya, Selangor. For details, contact Coreen at 013-3301728 or email her at coreen@trainingtrack.biz.

Authors@Google: Dr. John Ratey

Psoriasis may increase stroke risk

Diane Alter – AHN News Trivia Writer

Copengagen, Denmark (AHN) – A new Danish study says psoriasis may increase stroke risk.

A new study published online Aug. 12 in the European Heart Journal found that people who suffer with psoriasis had three times the increased risk of atrial fibrillation, and a 2.8 times increased risk for stroke. The findings add to the growing research linking the skin disorder with heart and vessel problems, including heart attack and cardiovascular disease.

Psoriasis is a skin condition that causes rough, red, itchy, dry and flaky skin. It is a common condition thought to be passed down through families, but is not contagious. It also causes inflammation in the body and may lead a host of other health related problems.

According to the National Psoriasis Foundation, about 7.5 million Americans, or 2.2 percent of the U.S. population, and 12 million people worldwide, suffer with this auto-immune skin disease.

The mother of missing estate agent Suzy Lamplugh has died aged 75

The mother of an estate agent who disappeared 24 years ago has died after a lengthy battle with Alzheimer’s disease.

Women's safety campaigner Diana Lamplugh OBE, of East Sheen, died in her sleep at the age of 75 yesterday, after suffering her second massive stroke in the past nine years.

Mrs Lamplugh’s daughter Suzy, who was living in Putney at the time of her disappearance, went missing in 1986 after going to meet a client for a house viewing. She was never seen again.

The traumatic event led parents Diana and Paul Lamplugh to establish the Suzy Lamplugh Trust, which made a name for itself as a national charity that championed the importance of personal safety.

Paul Infield, chairman of the charity’s board of trustees, paid tribute to the inspirational mother of four.

He said: “Diana was one of those people who contributed energy, focus and commitment to everything she did.

“With her husband, Paul, she was tireless in establishing, through the trust, the concept of and discipline for personal safety – now a household expression - as a positive life skill for people of all ages and occupations.

“Her message is as relevant today as when she started campaigning following Suzy's disappearance. While she will be sorely missed, the trustees and staff of the Trust are determined that our work will continue to fulfil Diana's vision of improving people’s personal safety.”

Before her illness Diana led the trust in campaigning for changes in law and procedures regarding safer working practices, safer travel in minicabs, and safer travel on trains and safer stations.

She also championed greater safety in car parks, stricter treatment and sentencing of sex offenders, better systems of helping vulnerable young people and victims of crime, protection from stalking and harassment, and changes in the treatment of young offenders.

For more information about the trust visit suzylamplugh.org.

Test for Calcium Buildup May Spot Heart Attack, Stroke Risk Scan may help predict which patients deemed at moderate risk would benefit from statins: study

THURSDAY, Aug. 18 (HealthDay News) -- A calcium test performed with the assistance of a CT scanner seems to provide insight into the likelihood that certain patients at moderate risk of heart problems will have a heart attack or stroke, researchers say.
Click here to find out more!

The test to detect coronary calcium can help physicians determine whether the patients should take cholesterol-lowering drugs to reduce their cardiovascular risks, the study authors explained.

At issue are people who fall into the middle area between those who are at high risk of heart problems due to factors like high blood pressure and those who are at low risk. People in the so-called "gray zone" may have risk factors, such as being overweight or having high blood sugar levels, but they aren't considered in great danger.

The question is: Should those in the middle range of risk -- an estimated 6 million people in the United States -- be prescribed the anticholesterol drugs known as statins, which often work well but have side effects?

The study, published in the Aug. 19 issue of The Lancet, sought to determine whether a test of calcium in the arteries is more helpful at estimating risk than a blood test that examines levels of C-reactive protein.

The researchers tracked 2,083 people for six years. They found that 13 percent of those with the highest levels of calcium in their arteries had a heart attack or stroke during that time period. But just 2 percent of those with high levels of C-reactive protein -- and no calcium buildup -- had a heart attack or stroke.

Not everyone needs a calcium test, said lead study author Dr. Michael J. Blaha, a cardiology fellow at the Johns Hopkins University School of Medicine. However, he stated in a Hopkins news release, "we believe looking for calcification in coronary vessels in certain patients makes sense in order to predict who may benefit from statin therapy, because the test gets right to the heart of the disease we want to treat."

"Our data support recent American Heart Association guidelines, which say it is reasonable to order a coronary calcium scan for adults who are considered to be at intermediate risk of a heart attack over the next 10 years. A high coronary calcium score would indicate that statin therapy would likely be a useful strategy to lower that person's cardiovascular risk," study co-investigator Dr. Roger Blumenthal, director of the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University, said in the news release.

Commenting on the study, cardiologist Dr. Vijay Nambi, an assistant professor at Baylor College of Medicine, said that most insurance companies don't cover the calcium tests, which cost in the range of $200-$400. "Sometimes people have to pay for it out of pocket," said Nambi, who thinks it's a useful test. "It helps physicians in a lot of respects."

Test results can also help patients make decisions when they're worried about taking anticholesterol drugs, Nambi added. http://bit.ly/q8MtPP

Memory Problems May Be Sign of Stroke Risk

Memory Problems May Be Sign of Stroke Risk

TEHRAN (FNA)- Findings of a new study showed that people who have memory problems or other declines in their mental abilities may be at higher risk for stroke.


The study is scheduled to be presented at the American Academy of Neurology's 63rd Annual Meeting in Honolulu April 9 to April 16, 2011.

"Finding ways to prevent stroke and identify people at risk for stroke are important public health problems," said study author Abraham J. Letter of the University of Alabama at Birmingham.

"This study shows we might get a better idea of who is at high risk of stroke by including a couple simple tests when we are evaluating people who already have some stroke risk," Letter added.

For the study, researchers gave tests to people age 45 and older who had never had a stroke, then contacted them twice a year by phone for up to 4.5 years to determine whether they had suffered a stroke.

The average age of the participants was 67. Strokes were then confirmed by medical records. A total of 14,842 people took a verbal fluency test, measuring the brain's executive functioning skills, and 17,851 people took a word recall memory test.

The study was part of a larger study called the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. During the study, 123 participants who had taken the verbal fluency test and 129 participants who had taken the memory test experienced a stroke.

Those who scored in the bottom 20 percent for verbal fluency were 3.6 times more likely to develop a stroke than those who scored in the top 20 percent. For the memory test, those who scored in the bottom 20 percent were 3.5 times more likely to have a stroke than those in the top 20 percent.

The difference in stroke incidence rates between those with the bottom and top 20 percent of scores was 3.3 strokes per thousand person-years. In general, the differences remained after researchers adjusted for age, education, race and where participants lived.

At age 50, those who scored in the bottom 20 percent of the memory test were 9.4 times more likely to later have a stroke than those in the top 20 percent, but the difference was not as large at older ages. more read...

Fighting heart disease and stroke

Liverpool, NY (WSYR-TV) The American Heart Association held its annual Heart Walk Saturday at Long Branch Park in Liverpool.

The walk raises money for lifesaving research, programs and education, while celebrating survivors of heart attack, heart surgery and stroke.

About 5,000 people took up the cause.

"Well it's encouraging to see this and there is certainly a need for this kind of event to support the cause and to make sure this is top most in people's minds,” said AHA volunteer James Jerose.

more read...