My Stroke .org » Return to normal life

Stem cells and stroke

Webmaster — Wed, 21 Jan 2009 11:59:40 +0000

In the past decade, numerous attempts focusing on neuroprotective strategies have been made to rescue neurons in the ischemic brain. Within few hours of an ischemic stroke event, acute injuries are often irreversible. The future point will be focused on how the brain tissues could be repaired. Recently, transplantation of embryonic and adult stem cells has provided new hope to stroke survivors.

The essential players in this rescue mission, stem cells, are characterized by the ability to renew themselves through mitotic cell division and differentiate into a diverse range of specialized cell types. Stem cells can now be grown and transformed into specialized cells with characteristics consistent with cells of various tissues such as muscles or nerves through cell culture.

Six years ago, scientists showed that stem cells had promise in treating strokes. They tracked the body’s own stem cells during brain repair; learned how to target stroke-damaged regions… This year, a new experience is carried in Stanford University on ten stroke-crippled rats with neurons grown from human embryonic stem cells. Scientists observed that the new neurons gathered in damaged brain regions, connecting to healthy cells and to each other. Within weeks the rats could again control their weakened legs.

Though the results are preliminary, it offers a glimmer of hope to millions of people left brain-damaged or crippled by strokes. However, before that can happen, scientists need to refine their methods of encouraging stem cells — either embryonic, as in this study, or adult — to reliably form neurons that don’t turn cancerous. This will still take many years.

Sources:
Stem Cells Journal
PLoS One

Back to work after a Stroke

Webmaster — Wed, 25 Jun 2008 03:28:15 +0000

Although strokes normally affect older people, up to a quarter of all strokes actually occur in people of working age – a time when careers and families are being established. Depending on the severity of the stroke, not all stroke survivors are able to return to full-time employment. There can be many reasons for this:

Forced to retire by employer
Unable to meet expectations
Unable to drive or use public transport
Fear of losing benefits
Not fit enough to work
No longer able to do previous job, face demotion

However, for most of the younger stroke survivors their main objective is getting back to work – not only for financial reasons but also to help to rebuild their confidence, regain their independence and even enhance their recovery. Yet not all of those stroke survivors are able to make the return. Among the ones that don’t make it back to work, many might have been able to re insert themselves, if they had been given better support and followed an adequate rehabilitation program.

Rehabilitation helps
Depending largely on the level of the impediments at the acute phase, a stroke can often lead to long disability periods for the stroke survivors, making the possibility of returning to work fade away. Yet, for many, taking the right action can make all the difference. Long term support and appropriate rehabilitation tailored to the needs of the patient, is crucial for stroke survivors aiming to return to work. The patient’s firm will to return to work, can also serve as the motivational factor needed to initiate an intensive rehabilitation process. Physiotherapy, speech and language therapy, and psychological support all work help achieve faster and more complete recovery.

Continuing disability and the patients’ ability or not, to independently care for him or herself, is obviously an important determinant of whether it is possible to get back to work. Following and intensive and well tailored rehabilitation program will minimize the likelihood of needing to cope with such a situation. On the other hand, depression is one of the major causes of work failure, and has a significant impact of its own, on work status after a stroke. However – as discussed last month – depression is a separate illness that can be treated successfully if appropriately approached.

Make your employer prepared
The attitude and willingness to help shown by the employer is of major importance and can have direct impact on whether or not a stroke survivor returns to work. It is thus very important to contact the employer as soon as possible following the stroke, to agree on reasonable and necessary adoptions to the working arrangements and conditions to make the return to work as smooth as possible. Too many stroke survivors who go back to work leave soon afterwards because their employers have not made the necessary adaptations, making it impossible for them to fit in and perform at their capacity. There are several measures that you might ask the employers to take so as to help you continue your work:

Allowing a phased return to work
Changing working hours
Part-time work
Redeployment
Job sharing
Providing help with transport to and from work
Arranging home working

Adaptations to a job or work environment must also be backed with appropriate training and guidance. For example, if a new tool is provided, the stroke survivor will need to receive training on how to use it.

Finally, negative employers – unwilling to make the necessary adoptions – exist, but mustn’t stop the patient. The sufferer should allow him or herself some time and look for new opportunities with employers that understand their situation and show the required flexibility. To consider a career change could also be an option, not forgetting that there is always life after work.

Sources:
Web MD Stroke News
Stroke Organization UK

Returning Home

Webmaster — Mon, 12 May 2008 10:13:04 +0000

What follows is a short list of critical tips, to start your rehabilitation on the right foot.

1. MAKE ARRANGEMENTS BEFORE YOU LEAVE THE HOSPITAL. Don’t forget to ask your doctor before leaving, to arrange a home visit by an occupational therapist (OT), who is trained to help you manage daily activities and regain your independence. This person will check your home and may suggest simple changes to make everyday living easier, and they also will arrange for changes to be finished before you return home.

2. ACCOMMODATE YOUR HOUSE TO YOUR RECOVERY. Forty percent of stroke survivors suffer serious falls within a year after their strokes. That’s why the OT will suggest you to move extra furniture out of the way either to corners or another room, to move electrical cords out of pathway, to remove loose carpets and runners in hallways and stairwells or to fasten them with non-skid tape to improve traction. Low pile carpeting is better than a thick one because it makes wheelchair or walker movement easier. Try stair glides, stair lifts and platform lifts if you need to use the stairs many times during the day.

3. ACCOMMODATE YOUR BATHROOM. The bathroom usually poses challenges. To make bathing both simple and safe, use sturdy hand rails, grab bars in the tub or shower, non-slip flooring strips installed inside and outside. Don’t hesitate to use them to stabilize and balance yourself. The bathing supplies should be easy to reach and use.

4. ACCOMMODATE YOUR BEDROOM. The bedroom is a place where you should feel safe and comfortable. To make your private world safer, make sure that all the utilities are easy to be reached, like the telephone, the light switch and other personal items. Use a nightlight and clear a path for easy access to the toilet at night. At last, since some accidents are unavoidable, consider placing disposable “blue pads” underneath your sheets, which prevent bed staining, with cloth on one side and waterproof material on the other.

5. GET 100% INVOLVED IN YOUR RECOVERY. After a stroke, home treatment will be an important part of your rehabilitation. You may need assistive devices to help you to eat, to get dressed, to walk, or you may feel like letting a caregiver take charge; however, for a successful recovery, you have to be as involved as possible. The more you can participate, the better. After a stroke, a combination of physical, speech, and occupational therapies can help you manage the basics of daily living.

6. SLOW DOWN AND PLAN YOUR RECOVERY. It is important that you slow down, take time, plan a task and break down tasks into a series of simple steps. Day after day, you will find these little steps add up to a large progress. Furthermore, a regular exercise program for stroke survivors is recommended, including 20 to 60 minutes of aerobic exercise three to seven days a week, a strength training with resistance or light weights two to three times per week and other stretching and flexibility exercises, as well as trainings in balance and coordination.

7. TRY TO ADD FUN TO YOUR RECOVERY. Not only can regular physical exercise improve the quality of life for stroke survivors by increasing their strength and mobility, it can also reduce their risk for a repeat stroke and a heart attack. If you want to have some fun while practicing, try this video game especially designed for home stroke therapy.

8. DO NOT BE AFRAID TO FACE YOUR RECOVERY. A stroke is always stressful for the family therefore; the caregiver needs as much support as possible from others. It would be better if the family members and the caregiver work together in order to ease the stress on everyone. When everything is being prepared, you are still asking yourself thousands of questions, you may be afraid of facing your disabilities. No worry, considering new resources, equipment and therapies which are available each year, just take advantage of them to improve your quality of life. Continue to set new goals for your stroke recovery, and tomorrow will always be a better day!

Source:
National Stroke Association NSA
Stroke Recovery Association NSW
WebMD – Stroke guide
American Heart Association
Youtube

Driving When You Have Had a Stroke

Webmaster — Tue, 01 Jan 2008 09:25:41 +0000

For many stroke survivors, being able to drive is a big step, and a big achievement. It does support a fuller independence. A stroke can affect many of the skills necessary for independent driving. A number of stroke survivors will return to independent driving.

The first objective in evaluating the possibility of independent driving is to ensure safety. Safety is always an issue as soon as someone gets behind the wheel. It’s even more important after a stroke. Injury to the brain can result in deficits in strength, coordination, vision, perception, and cognition – all these will impact the stroke survivor’s safety in driving.

Adaptive aids, such as steering wheel pegs and accelerator extensions, can certainly be incorporated to help compensate for some of the motor deficits. A spinner knob can be attached to the steering wheel to allow controlled steering with the use of one hand. A left gas pedal may be used if you are unable to use your right foot to gas or brake. All these aids will require training to ensure safety with a new adapted driving method.

Before one returns to driving it is advisable to have an Occupational Therapist perform an evaluation of one s driving ability. This can include an assessment of vision, muscle and grip strength test, brake reaction time, and perceptual and cognitive abilities. Driving skills can be tested in a simulator or behind-the-wheel with an instructor. In some case the therapist will recommend additional driver training such as visual scanning and tracking, reaction time, spatial perception, execution of complex actions. Your doctor can guide you on training and evaluation options.

Please note that driving against your doctor’s advice can be dangerous and may be illegal. Some stroke survivors will unfortunately have to cut off or give up driving. They can still keep their independence with some planning ahead to go to the places they want to and meet the persons they want to. They should consider riding with family and friends, taxis, public transportation or even to walking. They also often have access to transportation services offered by senior centers and local service groups.

Sources
MediFocus Guide from Medifocus.com
www.nhtsa.dot.gov
www.driver-ed.org