Good News – Bad News

Posted by Steven Reinberg, HealthDay Reporter

While progress is being made in reducing the number of stroke deaths, it seems that more people who experience these brain attacks have significant stroke risk factors, a new study reveals.

The rates of high blood pressure, diabetes, abnormal cholesterol, smoking and drug abuse have all been on the rise in stroke patients over recent years, the study authors said.

The study included over 900,000 people hospitalized for stroke between 2004 and 2014. Each year, prevalence of high blood pressure went up by 1 percent, diabetes rose by 2 percent, high cholesterol went up by 7 percent, smoking increased by 5 percent, and drug abuse jumped 7 percent, the researchers found.

“The risk of dying from a stroke has declined significantly, while at the same time the risk factors are increasing,” said researcher Dr. Ralph Sacco. He’s a professor of neurology at the University of Miami Miller School of Medicine.

“We are not exactly sure why these increases are occurring,” Sacco said.

It’s possible that doctors are getting better at diagnosing risk factors. Or certain lifestyle factors may play a role, Sacco suggested. These include obesity, lack of exercise, poor diet and smoking.

The increase of drug abuse among younger patients is especially concerning, he added.

Although the increases in risk factors were seen in all racial and ethnic groups, increases in high blood pressure among blacks and diabetes among Hispanics stood out, Sacco noted.

He stressed that patients need to know their blood pressure, blood sugar and cholesterol levels. “There are great medications that can be used to treat those conditions,” Sacco said.

“We need to go further in controlling risk factors, like diet and exercise,” he advised.
According to Dr. Salman Azhar, director of stroke at Lenox Hill Hospital in New York City, “The challenge now is to prevent strokes, and if they have had a stroke, trying to prevent a second stroke. This is where the importance of these risk factors comes in.”

The responsibility to reduce risk factors lies with patients, but also with the community, he continued.

“It’s up to communities to provide access to better food and places to exercise. We have a responsibility as a community and a health system,” Azhar said.

The 922,000 people included in the study had been hospitalized for an ischemic stroke, which is caused by a blocked blood vessel in the brain. These are the most common types of stroke.

The number of stroke patients who had one or more risk factors increased from 88 percent in 2004 to 95 percent in 2014, the findings showed.

For hospitalized stroke patients during the 10-year study period, high cholesterol rates more than doubled, from 29 percent to 59 percent, and the rate of diabetes went from 31 percent to 38 percent.

In addition, high blood pressure rates increased from 73 percent to 84 percent, and the prevalence of drug abuse doubled from 1.4 percent to 2.8 percent. Also, kidney failure increased each year by 13 percent, and plaque buildup in the carotid (neck) arteries rose by 6 percent each year, the investigators found.

Dr. David Katz is director of the Yale-Griffin Prevention Research Center in Derby, Conn. He said the improvement in stroke survival “suggests we are relying on advances in treatment while neglecting prevention.”

Katz, who is also president of the American College of Lifestyle Medicine, said, “Treating disease is never as good as preserving health and vitality. This study is a precautionary tale of the questionable and costly choices we seem to be making as a culture.”

The report was published online Oct. 11 in the journal Neurology.

Copyright © 2017 HealthDay. All rights reserved.

How Did I Do at University of Portland?

 

 

 

 

First thing: I spoke THREE times in one day; I have never done that before!  This was another milestone for me.

I love the University of Portland because I can deliver the same speech, varies ways, to test certain things out.  But THIS time, I delivered the SAME speech, the same way, to all three groups to see if there was any variation in the way certain people view my presentation.

You would think if I didn’t do anything different, all threes groups would behave the same way.   WRONG!  Each of the three groups behaved differently!

To me, I was blown away. How could three groups be so different?I gauge the groups by the laugh I get at the beginning.  If they don’t laugh, I know it will be a tough group.

All three group responded the same way to my questions before I ask before the speech.  I thought if I started with these questions, I would urge them to listen.

I worked up to my first laugh:

I was a young, healthy, active, non-smoking, non-drinking- mostly non- drinking – normal cholesterol man,….. just like this guy! (point, Laugh)

 

 

 

 

 

There were no laughs!   I looked at Jill, thinking I didn’t say my line write.  Nope…I said it correctly!  So I continued on, with maybe a chuckle  or two at a few points. Then at the end, they asked a bunch of questions!  Were they the same group that heard my talk?

Then I had the second group.  They REALLY loved the picture!  I had to wait before I could continue because they were laughing so much!  When the end came, they didn’t ask ANY questions…but they stated to thank me…and we had to give another book to someone who didn’t look like she was paying attention but she was actually moved by my talk!

The third group had a few chuckles.  They asked a few questions at the end.  You never know what kind of impact you will have on a group until the very end of the talk, when they are leaving the room.

It must be tough being a stand up comic!

Stroke at 30??

Stroke at 30-something: You Can Come Back.  The Right Attitude, Therapy and Caregiver Support is Vital to Successful Rehabilitation

Stroke survivor Jessica “Jess” McNair can joke about it now—one of the reasons, in fact, she is convinced that it’s her sense of humor that helped her recover from a series of strokes this year. At 32 years old, Jessica experienced what doctors described as “cascades of multiple strokes” resulting from irregularly formed arteries in her neck. The event left the San Rafael, Calif., resident unable to walk, talk or care for herself.  The prognosis was bleak and Jess’ team of doctors predicted she had a five percent chance of living.  Her road to recovery started with a grueling schedule of occupational, speech, and physical therapy.

“I had overwhelming amounts of denial from the very beginning,” said Jess describing her first reaction to the news given to her at the hospital. Although Jess was preparing to move to London and bartending to save money, she doesn’t see herself as a victim: “I consider myself strangely pessimistic in an optimistic way.”

This is where Jess’ older sister Kate comes in.

The Caregiver’s Life is Changed

No individual or family is ever prepared to fulfill the role of a full-time caregiver. Looking back, Kate recalls that both her and Jess were overwhelmed with emotion. “We were both crying, but immediately started joking,” says Kate who feels that maintaining a good sense of humor is a necessary coping skill for everyone – but especially for stroke survivors. “When I walked into the hospital I told her that there are other ways to get a day off – you don’t have to have a stroke!”

A fulltime sales professional, wife, and expectant mother at the time, Kate knew early on that she had to deal with the situation personally. The then 34 year-old recalls the vagueness of the doctors and nurses in answering her questions, which emphasized how important it was for her to take control of the situation. Shouldering the responsibility of work and the physical demands of pregnancy, Kate now had the added role of primary caregiver to her younger sister.

Thankfully, Kate was able to rely on her husband and friends who helped deal with insurance companies, meal preparation, and physical therapy.

“There was a lot of planning. We had to plan how to watch her. It was pretty scary and the frustrations were there,” Kate remembers.

When it came to working as a team, Kate recalls Jess’ determination, “She was really determined. We would make a diary and everyday have these little goals.” This helped support the efforts of her rehab.

A Great Rehab Team

For stroke survivors, rehabilitation options depend on the severity of their stroke, their level of disability, and the intensity of rehabilitation exercises they are able to endure. The goal of rehabilitation is to improve the survivor’s function so that they can regain independence and live life without relying on a caregiver.

Upon suffering a stroke and calling the ambulance herself, Jess was admitted to the Intensive Care Unit at Marin General Hospital where she had two more big strokes. She was then accepted to the rehabilitation program at California Pacific Medical Center (CPMC)—Davies Campus while she still had a tracheotomy. At the time, Jess couldn’t speak or make a noise. Through their sisterly-bond, Kate was the only person who could read her lips and understand her. “I guess you could refer to me as a vegetable at that point—I was not moving at all,” Jess points out. This marked the beginning of her three-month stay at CPMC’s inpatient rehabilitation facility, before being transferred to their outpatient program.

“I had three amazing people working with me—I call them my heroes,” referring to her occupational, physical, and speech therapists with whom she remains friends to this day. During her recovery, the skilled professionals got her standing up and walking again with assistive technology such as the EksoGT™, a wearable exoskeleton that helped train her body to walk with a proper gait, and an electronic stimulation machine that enabled her to relearn vocalization.  With these devices, both Jess and Kate noticed improvement, providing Jess the much needed confidence and motivation to continue her therapy.

A Time for Independence

Jess is still in recovery and has been able to regain some of her independence with the help of Kate and her army of “heroes.” The sisters, who will be separated in the upcoming months due to Kate relocating to Minneapolis, feel that this experience has brought them closer and made their relationship stronger.

“Before, we were close – we saw each other on an everyday basis, but now our bond has been reinforced. Silly arguments don’t seem to matter anymore,” mentions Jess.“I love her—she’s one of my most favorite people on earth. I feel like I’m abandoning her, so I’m going to miss her a lot, but I am confident in her progression,” Kate adds.

Jess is maintaining her positive attitude and currently focusing on regaining enough independence to be able to make the move to London.

To encourage others on their own personal comeback journeys, Jess and Kate recently participated in a podcast. The podcast is available through Connected Social Media, Ekso Bionics and iTunes.

To learn more about the advanced exoskeleton technology Jess used during rehab, visit Ekso Bionics.

Stop Sitting!!!

I just got this email from one of my friends at Deloitte; it maybe useful to a number of people who sit through the day…like me!

Dear Gordon –

Thanks for posting the article about “sitting too much.”  About two years ago I read several similar articles, and was disturbed when I read that “sitting is the new smoking” – meaning that sitting to much is very dangerous to our health.

As a result, I purchased a “standing desk” and “leaning stool” for my home office.  See the attached photo.  I’ve used this setup for two years, and love it.  FYI, here is the manufacturer’s website:  www.focalupright.com.

Best wishes to you, Jill, and your family.

Pete

My talk….

As I was preparing to write about my experience and ask for a reference letter, I got this note from Ken Kolosso.  I have to tell you, I was impressed with what he said, but even MORE impresses with the timing.  The event was just a week ago and I already had a reference letter!

Do you know how long it takes me to get a referral?  Not 1 week!  I have a rule: the second that a referral comes in, I will post it.

Meeting Ken’s 2 teams was an experience.

We arrived in Omaha at 11:35 PM…and still got an Uber driver (love that service). We got checked in,  jumped into bed by 1:30pm and was up at 5:30am to get ready for the trip…only 4 hours of sleep.  I don’t have to tell you this: I NEED my sleep…and so does Jill!

We got up and meet Dylan at the lobby. He arrived early; I have to admire that trait in him. Dylan, my navigator, rented a Ford Expedition so we went in style.  He set cruise control at 81 and we FLEW…for 1.5 HOURS!

We got there early…so I had time to set things up. Case in point: when they introduced me, I usually open up my speech by attempting to tie my tie. I totally blanked out and got  right into my speech. The audience didn’t know about the sequence, so that was ok.  But then I got to a slide, and couldn’t remember what I was supposed to say.  What felt like 2 minutes…was probably a few seconds; I flubbed a little. I said I would do better at the speech tomorrow.

Then, we had to wait, as the other presenters gave their talk.  During one part, I just couldn’t keep my eyes opened for a part of it; I kept dozing off.  I felt bad for the speaker; I just couldn’t help it. I wanted to say something, but he left as soon as he was done.

This time, we went to bed at 10:00pm!

We got up and met Dylan at 7:15am (again, he was early) and we made it there in record time:  28 minutes.  The speech the next day went GREAT.  A portion of Ken’s quote:

After hearing from Gordon and Jill, people will come away inspired and truly blessed.  Financial advisors will have a renewed passion and desire to share the need for disability insurance (aka income replacement insurance) when doing holistic planning for their clients.

I feel blessed to have meet Dylan and Ken; they were fantastic to deal with and I feel honored to have worked for them.

Another reference!

In September 2017, I invited Gordon and Jill Vigianno to speak to 70 of my financial advisors at our regional meeting in Nebraska.  What an impactful story we heard!  We saw and heard, firsthand, how a disability can strike at any time.  In Gordon’s case, this was a massive stroke that nearly killed him on his 51st birthday.  If it wasn’t for his disability coverage, the Viggiano’s would have been financially ruined.

Gordon and Jill have experienced great hardship and many trials since Gordon’s stroke, but their perseverance, faith and love for one another helped them conquer these great storms.  After hearing from Gordon and Jill, people will come away inspired and truly blessed.  Financial advisors will have a renewed passion and desire to share the need for disability insurance (aka income replacement insurance) when doing holistic planning for their clients.

The book they distributed following their presentation, Painful Blessings, written by Jill is outstanding.  I started reading and couldn’t put it down.  I finished it in one night!

Ken Kolosso, ChFC® , CLU® , MBA
Managing Partner
Nebraska Region
Thrivent Financial®

Truth about Atrial Fibrillation

 

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The Truth about AFIB

Your heart beats more than 100,000 times every day. However, not all heartbeats are the same.

Your heart may beat abnormally—it may flutter and beat fast. If so, you might have a heart condition called atrial fibrillation or AFib. AFib is the most common heartbeat disorder but AFib can be tricky— you may have it and not even know.

Fact: Medical experts estimate that 15% of strokes are a result of untreated AFib.

During National Atrial Fibrillation Awareness Month we are raising awareness about this serious health condition and its strong connection to stroke. Don’t let AFib overwhelm you. Take control. Act.

The first step to take charge of your health is to learn more about AFib:

  • Know the Signs and Symptoms
  • Discover Treatment Options
  • Access Resources and Tools

This September don’t take your heartbeat for granted.

AFIB and Stroke

In action,

Amy Herron
Senior Coordinator, Programs

 

Stopping Statins After Stroke May Raise Risk of Another

Stroke survivors who stop taking cholesterol-lowering statins are at increased risk for another stroke, a new study finds.

Researchers studied more than 45,000 ischemic stroke survivors who were prescribed a statin within 90 days of leaving the hospital. Ischemic stroke is caused by blocked blood flow to the brain. It is the most common type of stroke.

Compared to those who continued taking statins, patients who stopped three to six months after their stroke were 42 percent more likely to suffer another stroke within a year, and 37 percent more likely to die from any cause.

There was no increased risk of another stroke or of death during the study period among patients who continued taking statins at a lower dose, the investigators found. Statins help prevent cholesterol from building up in the arteries.

The study was published Aug. 2 in the Journal of the American Heart Association.

“Based on our findings of this large group of patients in the ‘real world,’ we believe that statins should be a lifelong therapy for ischemic stroke patients if a statin is needed to lower the patient’s cholesterol,” study lead author Dr. Meng Lee said in a journal news release. Lee is an assistant professor in the department of neurology at Chang Gung University College of Medicine in Taiwan.
Even though the study included patients in Taiwan, the results should apply to patients in the United States and other countries, according to Lee.

“Discontinuation of statin treatment in patients with ischemic stroke should be strongly discouraged in any stage—acute or chronic—of stroke,” Lee said. “Shifting to low-intensity statin therapy could be an alternative for stroke patients not able to tolerate moderate or high-intensity statin therapy in the years following a stroke.”

Copyright © 2017 HealthDay. All rights reserved.

Another milestone!!!

You would not think putting on sunglasses would be that tough.

But it is!

I just got back from a weeks vacation visiting my brother and his wife.  I took the clip on sunglasses with me… and had to get in front of a mirror each time to put these on.  If I didn’t, the following would occur:

I was in front of a mirror MANY times. But on day 3 of my vacation, I did it!

I know it doesn’t sound like much, but I was impressed.  I also got my brother to admit HE was impressed.  Wait…did I say anything to him? I don’t remember.  The effects of a stroke!

Avocados ARE healthy!

I PERSONALLY don’t eat them…but her is a tip from people that DO eat them.  Plus, this is from a neighbor of mine!

Spotlight on Healthy Avocados

Healthy fats are critical for our brains, and avocados are a great choice! They are so much more than a great source of healthy fats though. They are packed with nutrients, fiber, and antioxidants. In fact, they have twice as much potassium as a banana.

Benefits
The antioxidants (carotenoids) in avocados have important roles in cell function and support our body against vascular, inflammatory and neurological damage. The fats in avocados actually help us to absorb these antioxidants. In fact, foods that contain carotenoids such as sweet potatoes, carrots, and leafy greens, are low in fat and but by adding in avocado you improve the antioxidant absorption anywhere from two to six times.

How to Open
Many nutrients are located right next to the skin, so it is better to peel the skin off instead of scooping out the avocado. To get the pit out, first slice the avocado in half lengthwise then firmly strike the pit with the heel of a chef’s knife. Then gently twist the pit to dislodge and lift it out. Then, with the pit stuck to the knife, rest the pit against the edge of the sink or a bowl and gently pull. The pit will slide right off.
How to Eat: Guacamole
Serves 4-6

Ingredients – rough estimates
2 avocados, peeled, pitted, and smashed
1 fresh lime, juiced/squeezed
1/2 cilantro bunch, leaves roughly chopped
1/4-1/2 onion, diced small
1-2 cloves of garlic, minced & let rest for ten minutes
1/2 tomato, diced
Salt

Directions: Place smashed avocados in a bowl. Add the juice of 1/2 of the lime, about 1/2 of the chopped cilantro, 1/4 of the diced onion, 1 clove of the minced garlic, and the tomato in a bowl. Stir, sprinkle with salt to taste, and add more ingredients as you deem necessary. Serve as a dip, on eggs, or on toast. When you bring guacamole to a party, it’ll be an instant hit every time.

Also, if you leave out the avocado, you can make pico de gallo salsa!

Let her know how it turns out.

Christa Knox, MA, MScN, is a stroke survivor and holistic nutritionist in Portland, Ore. Visit Christa’s website BrainFoodForThought,com.