Archive for the ‘Stroke’ Category

Without brain injury rehab the brain has an amazing ability to adapt to and overcome trauma

Monday, March 2nd, 2009

Conventional methods of brain injury rehabilitation result in certain mainstay methods and steps.

For us transitioning from ICU to a sub-acute facility was painful and difficult. Fully not understanding what brain trauma and brain damage really encompasses we stumbled our way through. I can honestly say that many of the accepted establishments were far from acceptable as they were unsanitary and often smelled of urine. We were left with the challenge of finding a facility that could care for our son, who had experienced a severe head injury ,the way that we would. The search for brain injury rehab would begin. After the must needed visit to over 10 so-called high ranked establishments we finally decided on a hospital based home for our son. They had extensive experience with cognitive rehabilitation and brain tbi.

Entering the 5th floor and exiting to your right you come upon two hallways, each with a two patient room on either side, right or left. The nurses station can be found central to all the patients rooms so that they can monitor the patients who have experienced extensive and severe brain injury. You see, no one really knows what it is like until they’ve experienced it for themselves.  Hopefully they never will.

Brain injury rehab comes in many forms and this form is, believe me, not by choice. It’s what they call sub-acute where you bring your family or friend after they have been severely injured and had neurological damage until they are ready for acute rehabilitation. Most never are.

The age of patients is dominated by men ranging from 18+ mostly due to younger men reckless behavior/risk taking and elderly male stroke.

There certainly is a difference between sub-acute and acute brain rehab. Sub-acute patients rarely are able to participate in the standard 4 hour day of acute therapy. Many are in coma. They are warehoused with a routine of being turned in bed every two hours to prevent bed sores to being placed in a chair for up to four hours.D Very few of the patients have much family support and my guess is that it’s just easier.  They just kind of exist especially after they past the “one year” of possible spontaneous recovery.

(unless they meet Tom Wisenbaker who has been a very successful strength trainer for brain injury.)

Range of motion to prevent more contractions is a common daily practice on each patient. There are the constant room changes due to infection control and in most cases the isolation rooms far out number the non-isolation rooms. The patients with the germs are grouped with the patients with the germs. And once you get the germs it is really tough to get rid of them. Yellow gowns worn by the nurses and family members are seen everywhere.

Brain injury rehab includes a wide variety of exercises and treats a wide variety of brain injuries once the brain MRI is concluded.

Spasticity is common place in the sub acute unit. It is a condition where various muscles are in a continuous state of contraction. This condition results in constant stiffness or tightness of the muscles. It results when there is damage to the portion of the brain that controls voluntary movement. Symptoms of spasticity can include:

  • Increased muscle tone
  • Exaggerated reflexes
  • Muscle spasms
  • Involuntary muscular contractions
  • Crossing of legs when walking
  • Decreased joint movement

    • Spasticity can vary from mild muscle stiffness to severe painful spasms. Stretching can greatly enhance the brain injury rehab process until muscle is developed.

    You can walk up and down the hall and know that each room has a story of it’s own.

    On the other hand the acute facilities are geared more for intensive therapy. There are routines set in motion for the brain injured (if they are capable) such as breakfast, lunch and dinner at certain times during the day. In between these activities there are main therapy’s that focus on the patients deficits.

    The intent is to return them to society after brain injury rehab.

    Insurance plays a huge role in the brain injury rehab process as most insurance companies don’t believe that there is much benefit to the acute rehabilitation phase so they grant a two to six week stay for most patients. You are then released to either a skilled nursing facility which is ranked below sub-acute or to home with your family. Our son went from sub-acute to home bypassing the acute rehabilitation process for the above reasons. How much progress can be made in that much time? Especially since he had been among the fortunate to have had intensive rehabilitation in the sub-acute facility where he stayed.

    There has been a gap in recovery services for survivors. They would be given immediate acute care followed by short term rehabilitation. If they did not improve within a year, they were not expected to. This is no longer deemed to be true.

    Posted in Aneurysm, Caregivers & Nurses, Multiple Sclerosis, Stroke, Symptoms, Therapy, Treatment | 4 Comments »

    If you or someone with you is possibly having a mini stroke, respond immediately!

    Monday, March 2nd, 2009

    According to the National Stroke Association, mini strokes and massive strokes more often occur abruptly. Stroke is the leading cause of disability in the United States and the third leading cause of death.

    STROKE: Remember the 1st Three Letters….S.T.R.

    STROKE IDENTIFICATION:

    During a BBQ, a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics). She said she had just tripped over a brick because of her new shoes.

    They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening. She had experienced some of the more standard signs:

  • Difficulty standing and walking, dizziness, loss of balance, loss of coordination
  • Numbness in his face, arm and leg weakness, particularly on his left side of his body
  • Confusion, difficulty speaking or understanding
  • Vision difficulty in both of his eyes
  • Severe headache

    • There are other signs that are less common stroke symptoms that include:

  • Nausea, fever, and vomiting
  • A brief loss of consciousness.

    When these signs are only temporary and only last a few minutes it is commonly known as mini-stroke.

    Ingrid’s husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 ! pm Ingrid passed away.) She had not suffered a mini-stroke which resolves on it’s own but had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don’t die. They end up in a helpless, hopeless condition and in brain rehab.

    A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke (with proper protocol)…totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

    RECOGNIZING A STROKE

    Thank God for the sense to remember the ‘3′ steps, STR .

    Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

    Now doctors say a bystander can recognize a stroke by asking three simple questions:

  • S *Ask the individual to SMILE.
  • T *Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently)
    (i.e. It is sunny out today)
  • R *Ask him or her to RAISE BOTH ARMS.
  • Ask the person to ’stick’ out his tongue.. If the tongue is ‘crooked’, if it goes to one side or the other, that is also an indication of a stroke.

    • If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and describe the symptoms to the dispatcher.

    In room 508a there lay victim of stroke who was luckier than Ingrid. He had experienced a thrombotic (caused by a clot) stroke and had been admitted just months after our son’s admittance.

    While recovery from strokes is relatively poorly understood, recovery has been theorized to occur by recruiting neighboring neurons (nerve cells) to serve new or additional functions. Brain MRI’s in humans have shown increased activity in both hemispheres as patients improve after a stroke.

    In spite of conventional advancement in acute stroke care, the majority of stroke survivors remain permanently partially disabled with neurological symptoms and limitations. While most patient’s develop some improvement, it is rarely complete.

    Those who have already suffered neurologic impairment caused by mini stroke or ischemic stroke may also consider several drugs. Unfortunately most of these effective drugs are not FDA-approved but are widely used in Europe. European drugs that are not approved for general use in the United States by the FDA can, however, be purchased from offshore pharmacies for personal use and may be obtained by physician prescription through compounding pharmacists.
    The Life Extension Foundation maintains a list of offshore pharmacies that ship European drugs to United States citizens.

    Or the list can be obtained by calling the Life Extension Foundation at (800) 226-2370

    Many stroke victims can achieve a better quality of life with the right protocol and methods.

    Posted in Stroke | 5 Comments »