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Longer term care is needed for Stroke Survivors

This article written by Lisa O’Neill Hill in the recent edition of Stroke Smart highlights an issue that has been bubbling under the surface in the long-term palliative & rehabilitative care of stroke patients.This is an international issue that requires greater consideration and a closer focus to establish more effective, cost effective solutions.

More people are surviving strokes and heart attacks, but survivors’ ability to take care of themselves quickly decreases over time.

Many stroke and heart attack survivors have trouble taking care of themselves in the decade after their medical emergency, the new study found. This includes needing help with dressing, bathing, grocery shopping, and handling their finances.  These challenges get bigger each year and many survivors need long-term help with daily activities.

The study, led by the University of Michigan, also found that stroke survivors are at a higher risk of depression and memory loss. The findings recently were published in Circulation: Cardiovascular Quality and Outcomes.

Over 10 years, stroke survivors gained between 3.5 and 4.5 problems with performing daily tasks, the study found.

Stroke Rehabilitation Affects Long-term Outcomes

The findings shed light on the need for effective and consistent rehabilitation after a stroke or a heart attack and show that long-term care needs for survivors may be greater than experts thought.  A recent study published in the Journal of Rehabilitation Medicine found that numerous factors affect the delivery of stroke rehabilitation, including an appropriate therapeutic environment, where patients aren’t bored and isolated, and a team approach to care.

The University of Michigan study included 370 stroke survivors and 391 heart attack survivors; researchers studied Medicare records from 1998 to 2010 and from a national survey of older Americans funded by the National Institute on Aging.

“Our findings suggest that heart attack and stroke survivors should be screened and monitored for functional disability long after discharge from the hospital because patients may need additional help with activities of daily living over the years after heart attack and stroke,” senior author Theodore Iwashyna, M.D., Ph.D. associate professor of internal medicine at the U-M Medical School and researcher in the Institute of Social Research and the VA Centre for Clinical Management Research, said in a press release.

More Research Needed?

Researchers said their findings show that healthcare professionals need to understand why this is happening and look at, among other things, whether patients received incomplete rehabilitation while hospitalized.

Each year in New Zealand, 2500 people survive strokes but that number is expected to increase by 25 percent over the next two decades. That’s because of advancements in treatment and an aging population. But as these numbers increase, the number of caregivers for older adults is expected to decrease dramatically in the same period of time.

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Stroke detecting software to be rolled out across New Zealand

Health Minister Jonathan Coleman

Health Minister Jonathan Coleman, left, meets with stroke patient Judith Allen at Wellington Hospital, assisted by clinical nurse Lai-Kin Wong.

MAARTEN HOLL/FAIRFAX NZ

Judith Allen was trying to roll over in bed. Instead she fell on the floor, unable to move her limbs.

Six weeks after the stroke, the 75-years-old from Tawa is still in Wellington Hospital with half her body paralysed, recovering.

Her husband, Eddie Allen, said the couple had both been healthy for their age, staying active and watching their diet.

“It just strikes with such suddenness out of blue. There was no indication at all that anything was wrong,” he said.

Judith was rushed to hospital and within hours she had fallen into a drowsy semi sleep that gripped her for more than two weeks, leaving her unable to speak.

“I think the brain just goes into a holding pattern for a while to recover from the trauma,” her husband said.

Judith was one of several stroke patients at Wellington Hospital visited by Health Minister Jonathan Coleman on Thursday.  He was announcing the nationwide roll-out of new stroke diagnosis software for general practitioners, aimed at detecting the early signs of stroke.

These warning signs included transient ischemic attacks or mini strokes. The aim was to identify patients before they ended up in hospital.

About one in five people who suffer a mini stroke have a full-blown stroke within days.

Coleman said stroke was the third biggest cause of death in New Zealand and, while overall rates were not going up, it was increasingly affecting younger people and Maori. Early symptoms of a stroke were not picked up, he said, using the example of former All Black Piri Weepu’s stroke in 2014, which took weeks to diagnose.

“It will save lives … it brings simplicity and clarity to a very complex area,” Coleman said.

Whether the software would have picked up on early signs of Judith’s upcoming stroke is unknown.

Her recovery has been complicated by secondary bowel problem. She is planning to attend a family wedding in Auckland in December but her husband said that is unlikely.

Whether she will ever recovery the use of left side of her body, which she refers to as her “heavy lump”, is also uncertain.

However Judith remains determined to return to her old life, pointing to a teddy bear in the corner of her room holding a “be positive” sign.

“I will get there. The teddy tells me to be positive.”

STROKE IN NEW ZEALAND

* Stroke kills about 2500 people a year in New Zealand, making it the country’s third-biggest killer.

* Nearly one in three people who suffer a stroke die, while another third are left permanently disabled.

* The likelihood of suffering a stroke increases with unhealthy lifestyle choices. Alcohol, high salt intake, a lack of exercise and smoking can all increase your risk.

* High blood pressure is the biggest risk factor for a stroke.

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Crankiness could cause your heart attack.

Careful your tantrum doesn't turn in to a heart attack.<br /><br /><br /><br /> Photo / 123RF
Careful your tantrum doesn’t turn in to a heart attack. 

The risk of having a heart attack shoots up following an outburst of anger, a study among hospital heart patients has found.

The study, published in a European medical journal, found the risk of heart attack was 8.5 times higher in the two hours following an acute episode of anger than during a patient’s baseline levels of anger on a 1 to 7 scale.

Read more: When can you start having sex after a heart attack?

The authors say their findings appear to confirm the indications of earlier research – and experience – that anger can act as a trigger for a heart attack. They advocate considering “strategies to protect individuals most at risk during times of acute anger”.

The researchers studied patients suspected of having a heart attack who were admitted for primary angioplasty treatment at Royal North Shore Hospital in Sydney between 2006 and 2012.

Anger during the 48 hours preceding symptom onset was self-assessed by the 313 patients’ reporting from on the scale on which 1 was “calm”, and 7 was “enraged, out of control, throwing objects, hurting yourself or others”. The threshold of acute anger in the study was defined as level 5 – “very angry, body tense, maybe fists clenched, ready to burst”.

Seven of the confirmed heart attack patients (2.2 per cent) had reached an anger of at least level 5 within the two-hours before their symptoms began.

Based on the subjects’ usual patterns, the relative risk of onset of heart attack symptoms occurring within two hours of reaching anger level 5 or above was calculated as 8.5 times greater than that associated with normal levels on the anger scale.

The trigger events for the 313 patients included road rage, work stress and family rows.

One of the researchers, Dr Thomas Buckley, said the absolute risk of any one anger episode triggering a heart attack was low, but the study showed the danger was real.

The increased risk of heart attack following intense anger or anxiety probably resulted from increased heart rate and blood pressure, tightening of blood vessels and increased clotting – physiological changes that were all associated with triggering of heart attacks.

By Martin Johnston

New Zealand Herald 24/2/2015.

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Controllable Risk Factors – Atrial Fibrillation

Controllable Risk Factors – Atrial Fibrillation

Artriall FibrillationAtrial fibrillation (AF) is a major risk factor for stroke, making a person five times more likely to have a stroke. About 15 percent of all people who have strokes have AF, too. People who have been diagnosed with AF have already taken the first step to preventing AF-related stroke. Unfortunately, many New Zealanders’ who have AF don’t know it. Three out of four AF-related strokes can be prevented — if you are already diagnosed, beat the odds of having a stroke due to AF by understanding stroke symptoms, response and available treatments to control AF.

Most New Zealanders’ over the age of 40 are at risk for having AF. Take preventive steps by self-testing for an irregular heartbeat with:

Atrial Fibrillation (AF) and Stroke 

What is AF and how is it related to stroke?

AF is a type of irregular or “racing” heartbeat that can cause blood to collect in the heart and potentially form a clot, which can travel to a person’s brain and cause a stroke or brain attack.  This condition increases a person’s risk for stroke by 500%. Plus, three out of four AF-related strokes can be prevented. AF-related strokes are also more deadly. In fact, more than 70% of AF patients who have strokes will die as a result. The prevalence of AF increases with increasing age, particularly from age 50 years. The overall prevalence of AF is approximately 1%, increasing to approximately 10% in people aged ≥ 80 years.1, Approximately one-third of the estimated 35,000 people in New Zealand with AF will be asymptomatic.2

 Who is most likely to have AF?
While it can occur at any age, AF is more common as you grow older. About five percent of people 65 years old have AF. One in every 20 people over the age of 70 has AF and it’s more common in those with high blood pressure, heart disease or lung disease.

What are the symptoms?
A normal heart beats 60 to 100 times per minute. Patients with AF can experience heartbeats as fast as 450 times per minute. Often, AF has no visible symptoms. Some people with AF describe fluttering, racing or pounding sensations in their chests. Others may only experience dizziness, fainting or lightheadedness during an episode.

How can I tell if I have AF?
The simple “Check Your Pulse” test can be done once a month. The test checks for an irregular pulse – a sign of possible AF. Ask your doctor to check as well. Remember you are checking for heart RHYTHM, not RATE. In other words you are checking for how your heart is beating and not how many times it beats in a 60-second period.

Check Your Pulse Test for Irregular Pulse
Step 1.
Turn your left hand so your palm is facing up. Place the first two fingers of your right hand on the outer edge of your left wrist, just below where you wrist and thumb meet.

Step 2. Slide your fingers toward the centre of your wrist until you find your pulse.

Step 3. Press your fingers down onto your wrist until you feel your pulse, being careful not to press too hard. Move your fingers around until the pulse is easy to feel.

Step 4. Feel you pulse for 60 seconds. Don’t count the beats. Just pay attention to whether the rhythm seems regular or irregular. A regular pulse will feel even and consistent. An irregular pulse will feel erratic and unpredictable. 

Treatments for AF
Most AF-related strokes could be prevented with anti-coagulation treatments, yet up to two-thirds of AF patients who had strokes were not prescribed anti-coagulants or blood thinners. Anticoagulation can reduce the risk of first stroke by 68 percent. There are several reasons why current drugs are not being prescribed including interactions with diet and other drugs, the necessity for frequent blood tests and monitoring and concerns about increased risk of bleeding. But, there are new drugs on the horizon that may have fewer complications and will eliminate the monitoring issues associated with current treatments.

The goal for treating AF is to restore the normal, regular rhythm of your heart. Often, this can be done with medications or the use of electrical stimulation. If these efforts are not successful, AF treatment concentrates on protecting you from the blood clots that could travel from the heart to the brain, causing strokes. To reduce the risk of stroke, doctors can prescribe clot-preventing medications, which can greatly reduce stroke risk if taken properly.

Check out http://afib.co.nz/index.html for further information on treatments, explanations of Afib and to hear a pod cast by Harvey White talking on the risks and treatments of AF.

Check out http://www.bpac.org.nz/BPJ/2011/october/af.aspx for further information on treatments, management and the types of Afib.

Common AF symptoms:Heart palpitations.A sudden pounding, fluttering or racing sensation in the chest,   sometimes referred to as “butterflies”.Dizziness or feeling light-headed.

A thorough heart check-up at the doctor includes testing for blocked blood vessels and irregular heart rhythms, including AF. Because AF, like high blood pressure, cholesterol and some other heart diseases, often has no outward symptoms, the only way to confirm the presence of AF is to perform an electrocardiogram (ECG).

normal-ecgDuring an ECG, sensitive electrodes are placed on the chest. These electrodes pick up the electrical impulses generated by the body that cause the heart to beat. The impulses are sent to a T.V. screen or a piece of paper called an ECG strip. By examining the specific pattern of electrical impulses, a doctor can determine whether a patient has AF. Doctors may choose to treat this form of heart disease by prescribing medication or by an electrical shock to the chest to return the beating back to normal.

Talk to a doctor about the best stroke prevention options for you. Then take responsibility and enjoy a healthy lifestyle. The lifestyle adjustments — such as eating healthy foods and quitting smoking — made today may reduce the risk of stroke tomorrow.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke. This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

References

  1. Kannel W, Wolf P, Benjamin E, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N-9N.
  1. Lip G. Stroke in atrial fibrillation: epidemiology and thromboprophylaxis. J Thromb Haemost 2011;9 (suppl 1):344-51.
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TIA

TIA means:

T = Transient

I = Ischemic

A = Attack

A transient ischemic attack (TIA)

A transient ischemic attack (TIA) is an event, sometimes called a mini-stroke, with stroke symptoms that lasts less than 24 hours before disappearing. While TIAs generally do not cause permanent brain damage, they are a serious warning sign of stroke and should not be ignored!

Up to 40 percent of all people who have experienced a TIA will go on to have an actual stroke. Most studies show that nearly half of all strokes occur within the first 2 days after a TIA. In fact:

Within 2 days after a TIA, 5 percent of people will have a stroke.

Within 3 months after a TIA, 10 to 15 percent of people will have a stroke.

What are the symptoms of a TIA? The symptoms of a TIA and stroke are basically the same. Someone having a TIA or stroke may experience one or more of the following symptoms:

  • Sudden numbness or weakness of the face, arm, leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination

If you have any of these symptoms or see them in someone else, even for a short time, call 911 or have someone take you to the hospital immediately. Treatment can be more helpful if given quickly. Stroke strikes FAST. You should too!

What causes a TIA? Blood vessels carry blood throughout the body. When a blood vessel in the brain becomes blocked for a short period of time, the blood flow to that area of the brain slows or stops. This lack of blood (and oxygen) often leads to temporary symptoms such as slurred speech or blurry vision.

TIAs are usually caused by one of three things:

  • Low blood flow at a narrow part of a major artery carrying blood to the brain, such as the carotid artery
  • A blood clot in another part of the body (such as the heart) breaks off, travels to the brain, and blocks a blood vessel in the brain
  • Narrowing of the smaller blood vessel in the brain, blocking blood flow for a short period of time; usually caused by plaque (a fatty substance) build up

How can TIA be managed? The goal of TIA management is to prevent a future stroke. The medicine and therapy used depends on the exact cause of the TIA. In addition to lifestyle changes such as diet and exercise, your doctor may recommend drugs to treat high blood pressure, high cholesterol or heart disease. These changes may reduce your risk of further TIA or stroke.

There are many medicines that help prevent blood clots from forming, reducing the risk of full-blown stroke.

If a TIA is caused by blockage in the main artery in the neck that supplies blood to the brain, called the carotid artery, surgeries may be required to open the artery and prevent a stroke. These procedures are known as endarterectomy and stenting.

Talk to a doctor about the best stroke prevention options for you. Then take responsibility and enjoy a healthy lifestyle. The lifestyle adjustments — such as eating healthy foods and quitting smoking — made today may reduce the risk of stroke tomorrow.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

 

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Controllable Risk Factors – Tobacco Use & Smoking

How is smoking linked to stroke?
Smoking doubles the risk for stroke when compared to a non-smoker. It reduces the amount of oxygen in the blood, causing the heart to work harder and allowing blood clots to form more easily. Smoking also increases the amount of build-up in the arteries, which may block the flow of blood to the brain, causing a stroke. The good news is that smoking-induced strokes and overall stroke risk can greatly reduced by quitting smoking.

Smoking doubles the risk for stroke when compared to a non-smoker.
Smoking doubles the risk for stroke when compared to a non-smoker.

Smokers often have concerns about quitting smoking. Following are tips for dealing with those concerns

  • “I’ll gain weight if I quit smoking.”
    Weight gain varies from person to person. The average person gains less than 5 kilos. Exercise and a low-fat diet can help. Eat plenty of fruits and vegetables, whole grain cereals and pasta. Low-sugar candy may also help. Try to get enough sleep. Talk to a doctor about how to quit smoking while maintaining your weight.
  • “What do I do when I get the urge to smoke?”
    When possible, stay away from places where others might be smoking. Ask others not to smoke around you. When you do feel the urge to smoke, distract yourself and stay busy. If you can make it three minutes, the urge probably will go away. You can also ask your doctor about prescription medications or nicotine replacement therapy, including over-the-counter patches and gum.
  • “Smoking relaxes me. I get too nervous and anxious if I don’t smoke.”
    First, try to take it easy. It is best to warn those around you that you have quit smoking. Try going for a walk if you get tense. Exercise can help you relax.
  • “I blew it. What do I do now?”
    Smoking cigarettes again does not mean that you have failed. You have already had some success. You got through a number of minutes, days or months without smoking. Don’t let relapses serve as excuses to start smoking again. You are an ex-smoker and can continue to be one.
  • “I’ve tried to quit smoking before. What makes this time different?”
    You can choose to be a non-smoker and be successful. It is important enough to your health to make another attempt. Set a goal for yourself. Think about why you smoke and different ways to handle those reasons without smoking. Help is out there if you ask for it. Ask your doctor or pharmacist for information about local support groups.

New Zealand is recognised internationally as having a comprehensive tobacco control programme, structured around evidence-based interventions proven to reduce smoking. Smoking, however, remains the single largest preventable cause of death and disease, with approximately 5000 deaths attributable to smoking in New Zealand each year. Reduce your risk now!

Tips to quit smoking:

Set a “Quit Date.” Mark calendars at home and at work.

Tell family, friends and co-workers about the plan to quit. Ask for their support.

Ask a doctor about nicotine replacement therapy or medication that can help control the urges to smoke.

Throw away all cigarettes, ashtrays, lighters and matches before the “Quit Date”.

Reward yourself for doing well. Buy something nice with the money saved on cigarettes.

A Head of StrokeA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community.We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.

This is a New Zealand Web site. Its content is intended for New Zealand resident use.This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

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Controllable Risk Factors – High Blood Pressure (Hypertension)

High blood pressure is the most important risk factor for stroke

What is blood pressure? Blood pressure, also called hypertension, is the force of blood pushing against the walls of the arteries.

What is a blood pressure reading? Your blood pressure reading is expressed with two numbers — for example, 120/75. The first number, known as systolic blood pressure, is a measurement of the force your blood exerts on blood vessel walls as your heart pumps. The second number, known as diastolic blood pressure, is a measurement of the force that blood exerts on blood vessel walls when the heart is at rest between beats.

What is high blood pressure? High blood pressure means the heart is pumping harder to move blood through the body. This can weaken blood vessels and damage major organs, such as the brain. Left untreated, high blood pressure can lead to stroke.

High blood pressure
Controllable Risk factors -Blood Pressure can be easy to  monitor and control.

Blood pressure, like a person’s heart rate, will vary occasionally with exercise or stress. For people over age 18, an optimal blood pressure reading is considered 120/75 or lower. A blood pressure reading consistently higher than 120/75 is considered “pre-hypertension.” High blood pressure or “stage one hypertension” is a measurement of 140/90 or higher.

People who have high blood pressure have more than half the lifetime risk of having stroke compared to those who consistently have optimal blood pressure of 120/75. Anyone who has had a previous heart attack, stroke, is diabetic, has kidney disease, high cholesterol or is overweight should speak with a doctor about aggressively controlling and lowering blood pressure. Maintaining a blood pressure reading below 140/90 may reduce the risk of further complications.

Who has high blood pressure? As many as 75% of Adult New Zealanders have high blood pressure. Of the 1 in every 5 adults with high blood pressure, 31.6 percent are not aware they have it.

How is high blood pressure related to stroke?Doctors have long called high blood pressure “the silent killer” because a person can have high blood pressure and never have any symptoms. If left untreated, high blood pressure can lead to life-threatening medical problems such as stroke, heart attack or kidney failure.

High blood pressure is one of the most common causes of stroke because it puts unnecessary stress on blood vessel walls, causing them to thicken and deteriorate, which can eventually lead to a stroke. It can also speed up several common forms of heart disease.

When blood vessel walls thicken with increased blood pressure, cholesterol or other fat-like substances may break off of artery walls and block a brain artery. In other instances, the increased stress can weaken blood vessel walls, leading to a vessel breakage and a brain hemorrhage.

If a person has had a stroke, it is especially important to keep blood pressure controlled to reduce the risk of recurrent stroke.

What causes high blood pressure? In most cases, it’s impossible to pinpoint an exact cause of high blood pressure. There are, however, a number of factors that have been linked to high blood pressure including:

  • A family history of high blood pressure.
  • Age: The incidence of high blood pressure rises in men after age 35 and in women after age 45.
  • Gender: Men are more likely to have high blood pressure than women until age 45. From ages 45 to 64, men and women have similar risk. After that, women are more likely to have high blood pressure.
  • Race: Approximately 41 percent of Maori, Polynesian or Samoan’s have high blood pressure, compared to 28 percent of Caucasians. Nearly half about 44% of Maori women have high blood pressure. Samoan have a slightly higher risk for high blood pressure than Caucasians.

Other factors that can lead to high blood pressure include excess weight, excessive alcohol consumption, diabetes, lack of exercise and a high-salt diet.

How can high blood pressure be treated? In most people, high blood pressure can be controlled through diet, exercise, medication or a combination of all three.

A diet that is low in salt and rich in vegetables, fruits and low-fat dairy products may help lower blood pressure. Recent studies have also shown that increasing potassium intake, (for example, eating fresh fruits and vegetables), may help lower blood pressure.

A program of regular exercise — appropriate to a person’s age and fitness level, and approved by a doctor — may not only aid in weight loss, but also help to lower blood pressure.

Finally, a wide range of medications is available to treat high blood pressure. A doctor may have to try several different drugs before you find one that works best for a person’s needs. This is common problem that doctors are used to handling. It is important to take any medications exactly as prescribed, even when a person feels fine. There are a vast number of prescription antihypertensive drugs on the market from which to choose. In many patients, some antihypertensive drugs may cause side effects such as dizziness or nausea. Doctors can work with patients to select the best antihypertensive for their medical profile and lifestyle. Various antihypertensive drugs work differently some decrease the volume of plasma in the blood or slow the rate of blood flow through the body, while others relax the heart by affecting the passage of certain elements in the blood. Factors to consider in the selection of antihypertensive drugs include cost, convenience, side effects and interaction with other drugs.

Where can I get more information on high blood pressure? Speak with a doctor about how to control high blood pressure. The key to keeping blood pressure within the normal range is for a person to commit to being an active participant in their healthcare with a doctor.

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4 Ways to Train Your Brain for Positivity

Not a natural optimist? Use these simple exercises to train your brain to more easily pick out the positive.

Not a natural optimist? Use these simple exercises to train your brain to more easily pick out the positive.
Not a natural optimist? Use these simple exercises to train your brain to more easily pick out the positive.

You know how when you play Tetris for awhile, even after you stop, you can still see those little falling blocks in your mind’s eye?

The persistence of Tetris isn’t simply an annoying effect of a cleverly designed game, according to scientists. Instead it’s a reflection of something deeply positive about our brains–their plasticity.

That’s a according to a recent post by iDoneThis founder Walter Chen on productivity blog buffer. He cites studies on Tetris (yes, there is such a thing, and yes, this is going somewhere helpful to non-video game addicted entrepreneurs), which found that playing the game for a few hours a week over a period of months, actually changed the brains of players.

“Every time you reactivate a circuit, synaptic efficiency increases, and connections become more durable and easier to reactivate,” Chen writes, before summarising the importance of the findings: “Whenever you do specific tasks over and over again, they take up less of your brain power over time.”

Learning Positivity

That’s probably not a shock to anyone who has learned to play the piano, speak a foreign language or even hit a tennis ball roughly where you want it to go. So what’s the big deal? This same brain plasticity allows you to master simple skills or sports, also allows you to train yourself to be more positive.

Chen quotes Shawn Achor, the author of The Happiness Advantage who has previously spoken about his work on the brain and happiness to Inc. Just like we can train our brains to more easily recognize the patterns of Tetris, “we can retrain the brain to scan for the good things in life—to help us see more possibility, to feel more energy, and to succeed at higher levels,” Achor says, dubbing this ability “the positive Tetris effect.”

Happiness Homework

So how do you do this? Chen offers four very simple interventions that can, over time, actually rewire your brain to see things more positively:
Scan for the 3 daily positives. At the end of each day, make a list of three specific good things that happened that day and reflect on what caused them to happen. The good things could be anything — bumping into an old friend, a positive remark from someone at work, a pretty sunset. Celebrating small wins also has a proven effect of powering motivation and igniting joy. As you record your good things daily, the better you will get and feel.

Give one shout-out to someone (daily). I love this technique. Take the positive things you’re getting better at recognising and let people know you’ve noticed. Take a minute to say thanks or recognise someone for their efforts, from friends and family to people at work. A great way to go about this is by sending 1 daily email to someone. It can be your old school teacher, whose advice you are now appreciating every day. A co-worker or someone you’ve only met. Show courage and say thanks.
•Do something nice. Acts of kindness boost happiness levels. Something as small and simple as making someone smile works. Pausing to do something thoughtful has the power to get you out of that negativity loop. Do something nice that is small and concrete like buying someone a coffee.
Mind your mind. Mindfulness is paying attention to the present moment without judgment. Opening our awareness beyond the narrowness of negativity can help bring back more balance and positivity into the picture.

Looking for more details? Chen’s post has much more on the science and what actually happens physically in your brain. You can also check out Achor’s interview about how happiness affects brain function (hint: it doesn’t make it worse), or get tips on how to reframe situations more positively in the moment from my colleague Geoffrey James. Finally, if you’re looking to add more mindfulness to your day, check out this post on how many entrepreneurs incorporate meditation into their lives.

Do you agree that it’s possible to alter you basic orientation towards the world and become more positive?

I found this great article written a few days ago now by .

Anything that relates to plasticity, brain training or neuroplasticity could be of benefit to those having experienced a stroke. Enjoy!

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What is Stroke?

Stroke is the third leading cause of death in New Zealand (about 2000 people every year) and a leading cause of adult disability.Up to 80% of strokes are preventable; you can prevent a stroke! Around 10 percent of stroke deaths occur in people under 65.

What is a stroke?A stroke or “brain attack” occurs when a blood clot blocks an artery (a  blood vessel that carries blood from the heart to the body) or a blood  vessel (a tube through which the blood moves through the body) breaks,  interrupting blood flow to an area of the brain.  When either of these  things happen, brain cells begin to die and brain damage occurs.When brain cells die during a stroke, abilities controlled by that  area of the brain are lost.  These abilities include speech, movement  and memory.  How a stroke patient is affected depends on where the  stroke occurs in the brain and how much the brain is damaged.

What is Stroke?
A cross section Image of the brain
For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg.  People who have larger  strokes may be paralysed on one side or lose their ability to speak.   Some people recover completely from strokes, but more than 2/3 of  survivors will have some type of disability.
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Welcome to “A Head of Stroke”

A Head of StrokeDedicated to Reconnection after Stroke
A Head of Stroke
Dedicated to Reconnection after Stroke

Welcome to “A Head of Stroke” a New Zealand blog, website & connection dedicated to those affected by Stroke re-contributing to their community.

Having taken the time to research the literature on Stroke, I found that much of the existing  literature  on  the impact  of major life trauma  such as stroke and  its relationship  to work is written  from  an  expert  point  of view.

It focuses on either the factors that contribute to an individual’s  ability to return  to work or on the ways in  which  experts  can facilitate  return  to  work. There is a particular focus on assessment and rehabilitation.  There  is less evidence  from  the  survivors’ point of view, of factors that motivate them to return  to  work;  their  own assessment   of  the  feasibility; opportunities for returning to work; the meaning and importance of work or their experiences  of returning to  work.

More than 40 percent of stroke survivors have reported limited success in meeting their rehabilitation goals, which include the ability walk better and regain their speech
More than 40 percent of stroke survivors have reported limited success in meeting their rehabilitation goals, which include the ability walk better and regain their speech

If rehabilitation services are to be person-centred it is important  that  they  are  based  on  and   take  into account  the personal  experiences  of individuals  who have survived  a stroke.  Without  these  insights  it is likely that important factors which influence recovery from  stroke  will be  missed  and  therefore  efforts to help individuals who have had a stroke may not meet their needs  and aspirations.

A study conducted by an International Stroke Association in the UK; emphasised the needs of the Forgotten Stroke Survivor.  They found that an alarming rate a stroke survivors were not receiving the proper long-term information on rehabilitation and recovery after a stroke.

Is the same situation true in New Zealand?

FAST campaign increases stroke awareness

 

FAST campaign increases stroke awareness

Health Minister Jonathan Coleman says a nationwide stroke awareness campaign has seen more New Zealanders reporting suspected strokes.

“Each year in New Zealand around 9,000 people have a stroke. Early identification and treatment are crucial to reduce the likelihood of brain damage and lasting harm,” says Dr Coleman.

“The successful FAST campaign returned to teach a simple message about how to recognise stroke symptoms, and the need to ring 111 fast.

“FAST stands for Face, Arm, Speech and Time (to call 111) – sudden changes to a person’s face such as drooping, loss of arm strength or impaired speech could all be warnings that they’re experiencing a stroke.

“It is important that campaigns like this can demonstrate they build awareness over time, and not just when they are running.

“The first campaign in 2016 increased calls for suspected stroke incidents to St John Ambulance by around 40 per week.

“During the most recent campaign, the average suspected stroke incidents recorded by St John rose from 160 to 196 per week which is an increase of 22 per cent – peaking at 231 incidents a week.

“Likewise, the average number of ambulance call-outs per week confirmed as strokes increased from 45 before the campaign, to 52 in July.

“This is all good news and it shows that as a result of the FAST campaigns more people recognise suspected strokes.

“St John advises that while all incidents weren’t necessarily strokes, they prefer people err on the side of caution and call 111 if they suspect a stroke at all.

“More will be known about the impact of the 2017 FAST campaign after a full evaluation is completed.”

The successful three-month multi-media campaign was funded by the Ministry of Health. It was developed and supported by the Health Promotion Agency and Stroke Foundation.

Coaching after a Stroke

More than 20 years ago, my husband Paul suffered a devastating stroke. Paul was 36, I was 31. My good friend and supporter was in need. Suddenly, in addition to my full-time job and daily responsibilities, I found myself overwhelmed by taking care of my husband’s responsibilities, personal needs and health. I worried a lot and the care giving took its toll. I stopped taking care of myself. I got too little sleep, drank too much coffee and ate too much comfort food. I became dis-organised, tired and unmotivated. I gained weight and my overall self-esteem plummeted. I needed help. My goals were to find a new job and to get my physical and emotional health back on track. Working with several professional coaches, I went about doing just that.

CBT-model

Career Coaching

Knowing that a new job, at a higher level of management, would increase my self-worth and lighten my mood, I hired a career coach. Career coaches specialise in helping people gain clarity, direction and self-confidence while facing the challenges of career and life transitions. I needed direction and that is just what I got. My coach listened to me, then gave me assignments, deadlines, constructive feedback and support. As a result of her coaching and my newfound determination my career took off again.

Dietary Coaching

Frustrated by my ever-increasing weight and cholesterol, I went to my doctor. He asked, “do you want a lecture or a nutritionist?” I chose the nutritionist. My nutritionist helped me understand portion size and the effect of different foods on my health, stamina and mood. She coached me on eating healthy in all circumstances eating at home, eating out and eating while traveling for business or working late. Every time I reached for a cookie, I saw her face and I didn’t want to report that I hadn’t stuck to my goals for the week. That was my secret to losing more than 35 pounds.
Emotional Wellness Coaching

As I am writing this, I am looking at a handwritten note taped to my computer: “Reminder: done is better than perfect.” My friend and licensed mental health counsellor wrote this to help me overcome one of my personal, emotional issues — being a perfectionist. I am very hard on myself and often worry and feel guilty for not doing enough. Many caregivers have to come face to face with their own emotional issues. Find a licensed mental health counsellor in your area

 

Working with these coaches has changed my life. They helped me make caring for myself a priority. Now I feel good about myself, about my husband and about my life. Instead of being “the caregiver” and “the survivor,” we have returned to being two individuals who simply value each other.
Resources Link to hundreds of free self-coaching articles and tips: http://www.selfgrowth.com/

Coaches Orders

8 tips to help caretakers reduce stress and care for themselves:

  • Take breaks throughout the day, close your eyes and visualize something pleasant for a moment.
  • Breathe deeply.
  • Exercise regularly.
  • Add healthy foods and reduce sugar intake.
  • Listen to soothing music.
  • Laugh more.
  • Participate in a hobby or recreational activity.
  • Write down your feelings in a journal or talk to a trusted friend.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community.

We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, re-connection, tips and tricks that can benefit those most affected by Stroke. This is a New Zealand website. Its content is intended for New Zealand resident use.

This website does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

Mediterranean diet can reduce your Stroke and CVD risk.

New research says a Mediterranean diet high in fresh fruit and veges can reduce the risk of heart attack and stroke by one third. Photo / Getty
New research says a Mediterranean diet high in fresh fruit and veges can reduce the risk of heart attack and stroke by one third. Photo / Getty

New research suggests a Mediterranean diet could help in the fight against stroke and heart disease.

The Auckland study, which has caught the eye of international news giant CNN, found a diet high in fruits, vegetables and fish might help reduce the risk of heart attack and stroke in people who suffer from heart disease.

The study examined 15,000 people around the world, with an average age of 67, and stable heart disease.

Study author Professor Ralph Stewart from Auckland Hospital said the risk of heart attacks, strokes or death from heart disease was reduced by about one-third for those who followed a Mediterranean diet, according to the CNN report.

Stroke Foundation of New Zealand CEO Mark Vivian said there are valuable lessons for locals in the study.

“This underlines the message we, and other health agencies, have been promoting for some time – that a healthy diet can have a significant influence on your life and well-being,” he said.

“And all the ingredients for a healthy diet can be found right here in New Zealand.”

Around 9000 New Zealanders suffer a stroke every year, a number that could be significantly reduced with such better lifestyle choices as a healthy diet, regular exercise, giving up smoking and cutting down on alcohol consumption.

The study’s findings also suggest that adopting a healthier diet was better for people with heart disease than simply cutting out bad food.

“It’s easy to think of cutting out the bad stuff in our diet – but we need to make sure we aren’t replacing it with something equally unhealthy,” Mr Vivian said.

“You can’t go wrong with lots of different fruit and vegetables, fresh fish, and unprocessed foods low in sugar and salt.”
-nzherald.co.nz

Stroke recovery in mice improved by Ambien, study shows

Date: December 18, 2015

Source: Stanford University Medical Center

Summary: Mice that had strokes rebounded significantly faster if they received low doses of a popular sleeping aid, according to researchers. Zolpidem, better known by the trade name Ambien, has long been approved by the U.S. Food and Drug Administration for treating insomnia. But it has never before been definitively shown to enhance recovery from stroke

Mice that had strokes rebounded significantly faster if they received low doses of a popular sleeping aid, according to researchers at the Stanford University School of Medicine.

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More than 40 percent of stroke survivors have reported limited success in meeting their rehabilitation goals, which include the ability walk better and regain their speech

Zolpidem, better known by the trade name Ambien, has long been approved by the U.S. Food and Drug Administration for treating insomnia. But it has never before been definitively shown to enhance recovery from stroke, said Gary Steinberg, MD, PhD, professor and chair of neurosurgery. Steinberg shares senior authorship of the study, which will be published online Dec. 18, 2015 in Brain, with senior research scientist Tonya Bliss, PhD.

Steinberg, the Bernard and Ronni Lacroute-William Randolph Hearst Professor in Neurosurgery and the Neurosciences, cautioned that the study’s results need to be independently replicated in other laboratories before clinical trials of the drug’s capacity as a stroke-recovery agent can begin.

Every year, Americans incur about 800,000 strokes, the nation’s largest single cause of neurologic disability, exacting an annual tab of about $74 billion in medical costs and lost productivity.

A stroke’s initial damage, which arises when the blood supply to part of the brain is blocked, occurs within the first several hours. Drugs and mechanical devices for clearing the blockage are available, but to be effective they must be initiated within several hours of the stroke’s onset. As a result, fewer than 10 percent of stroke patients benefit from them.

After a few days during which tissue death continues to spread to adjacent brain regions due to repercussions from the initial damage, the brain begins slowly rewiring itself and substituting new neural connections for those destroyed by the stroke. Within three to six months, at least 90 percent of all the recovery a stroke patient is likely to experience takes place. No pharmaceutical therapy has been shown to improve recovery after the stroke. In fact, no effective treatments during the recovery phase exist, other than physical therapy, which has been shown to be only marginally successful.

Nerve-cell signaling bolstered

Steinberg and Bliss attributed zolpidem’s effectiveness to its enhancement of a type of nerve-cell signaling activity whose role in recovery unexpectedly appears beneficial. In the study, this signaling was bolstered even though the drug was given at doses well below those at which it exerts its hallmark sedative effect.

Nerve cells signal to one another by means of substances called neurotransmitters. When neurotransmitters are secreted by the nerve cell sending the signal, they dock in receptors situated on abutting nerve cells’ surfaces. Most of this signaling takes place at specialized junctions called synapses, which feature high concentrations of neurotransmitters from the upstream cell that activate receptors on the downstream cell.

Neurotransmitters can be excitatory, triggering propagation of an impulse in the receiving nerve cell. Or they can be inhibitory, temporarily preventing the receiving nerve cell from propagating any impulses. The roughly one-fifth of all nerve cells in the brain that are inhibitory mainly do their job by secreting a neurotransmitter called GABA.

While the bulk of GABA signaling takes place at synapses, scientists have learned that nerve cells can also feature GABA receptors elsewhere on their outer surfaces. These are called extrasynaptic receptors. In 2010, other researchers reported that extrasynaptic GABA signaling impeded stroke recovery in an animal model. But until the Stanford study, nobody had looked into the impact on stroke recovery of the far more common synaptic GABA signaling.

To do that, Steinberg, Bliss and their associates conducted a series of anatomical, physiological and behavioral experiments. Their efforts were assisted by the fact that there are small, structural differences between synaptic and extrasynaptic GABA receptors, so they can be distinguished by various techniques.

Using a high-resolution visualization method, the Stanford scientists examined a region of the mouse brain near the area that had been destroyed by stroke and is known to rewire afterward. They saw a transient increase in the number of GABA synapses. This increase peaked at about a week after the stroke and subsided to baseline levels by one month after the stroke’s damage has been done. The rise and fall of synapse-associated GABA receptors was restricted to a particular layer of the cerebral cortex that sends output to the spinal cord and to other brain areas.

Intrigued by this anatomical finding, the scientists looped in their colleague John Huguenard, PhD, professor of neurology and neurological sciences and co-author of the study. Electrophysiological experiments in Huguenard’s lab confirmed that the transitory increase in GABA synapse numbers in the brain area under scrutiny was matched by an increase, followed by a decline to baseline levels, in synaptic GABA signaling, confirming that the synapses were indeed functional.

Sub-sedative doses

To determine whether the transient increase in post-stroke synaptic GABA signaling was beneficial — and, if so, whether it could be enhanced — the investigators turned to zolpidem, which works by enhancing synaptic GABA signaling. They induced either of two different types of strokes in mice — one type severely damages sensory ability; the other deeply impairs movement — then put the mice on a regimen of either zolpidem or a control solution that did not contain the drug.

The scientists administered the drug in sub-sedative doses. They wanted to see how the mice would perform on tests of sensory ability and motor coordination, so the mice needed to be fully awake. Zolpidem is known to have a much higher affinity for synapse-associated GABA receptors than for their extrasynaptic counterparts. So, low doses were likely to enhance synaptic GABA signaling without having much of an effect on extrasynaptic signaling.

The team delayed zolpidem administration until three days after the stroke in order to ensure that any benefit they observed was resulting from an effect on brain recovery, rather than from the drug preventing initial tissue damage from the stroke.

The researchers subjected these mice to two kinds of tests. One measured the speed with which they removed a patch of adhesive tape from one of their paws (mice ordinarily are quick to do so). The other test gauged their ability to traverse a horizontal rotating beam.

In almost every case, zolpidem-treated mice recovered at a faster rate than control mice did. It took about a month, for example, for mice not given zolpidem to fully recover their stroke-impaired ability to notice the tape stuck to their paw. Mice given zolpidem recovered that ability within a few days of treatment.

While zolpidem dramatically improved mice’s rate of recovery from stroke, its ability to increase the extent of their recovery couldn’t be determined because, unlike humans, mice naturally regain most of their pre-stroke function eventually. So the Stanford researchers intend to test the drug in other animal models, as well as to experiment with different dose sizes and timing, before proceeding to clinical trials.

“Before this study, the thinking in the field was that GABA signaling after a stroke was detrimental,” said Steinberg. “But now we know that if it’s the right kind of GABA signaling, it’s beneficial. And we’ve identified an FDA-approved drug that decisively promotes the beneficial signaling.”


Story Source:

The above post is reprinted from materials provided by Stanford University Medical Center. The original item was written by Bruce Goldman. Note: Materials may be edited for content and length.


Journal Reference:

  1. Takeshi Hiu, Zoya Farzampour, Jeanne T. Paz, Eric Hou Jen Wang, Corrine Badgely, Andrew Olson, Kristina D. Micheva, Gordon Wang, Robin Lemmens, Kevin V. Tran, Yasuhiro Nishiyama, Xibin Liang, Scott A. Hamilton, Nancy O’Rourke, Stephen J. Smith, John R. Huguenard, Tonya M. Bliss, Gary K. Steinberg. Enhanced phasic GABA inhibition during the repair phase of stroke: a novel therapeutic target. Brain, December 2015 DOI: 10.1093/brain/awv360