Posted by Lynn Bronikowski  

Study: Marijuana use associated with increased risk of stroke!  Using marijuana raises the risk of stroke and heart failure even after accounting for demographic factors, other health conditions and lifestyle risk factors such as smoking and alcohol use, according to new national research.

Coming at a time when marijuana, medically known as cannabis, is on track to become legal for medical or recreational use in more than half of U.S. states, this study sheds new light on how the drug affects cardiovascular health. While previous marijuana research has focused mostly on pulmonary and psychiatric complications, the new study is one of only a handful to investigate cardiovascular outcomes.

“Like all other drugs, whether they’re prescribed or not prescribed, we want to know the effects and side effects of this drug,” said Aditi Kalla, MD, Cardiology Fellow at the Einstein Medical Center in Philadelphia and the study’s lead author. “It’s important for physicians to know these effects so we can better educate patients, such as those who are inquiring about the safety of cannabis or even asking for a prescription for cannabis.”

The study drew data from the Nationwide Inpatient Sample, which includes the health records of patients admitted at more than 1,000 hospitals comprising about 20 percent of U.S. medical centers. Researchers extracted records from young and middle-aged patients—age 18-55 years— who were discharged from hospitals in 2009 and 2010, when marijuana use was illegal in most states.

Marijuana use was diagnosed in about 1.5 percent (316,000) of more than 20 million health records included in the analysis. Comparing cardiovascular disease rates in these patients to disease rates in patients not reporting marijuana use, researchers found marijuana use was associated with a significantly increased risk for stroke, heart failure, coronary artery disease and sudden cardiac death.

Marijuana use was also linked with a variety of factors known to increase cardiovascular risk, such as obesity, high blood pressure, smoking and alcohol use. After researchers adjusted the analysis to account for these factors, marijuana use was independently associated with a 26 percent increase in the risk of stroke and a 10 percent increase in the risk of developing heart failure.

“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” Kalla said. “More research will be needed to understand the pathophysiology behind this effect.”

Research in cell cultures shows that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system. It is possible that other compounds could be developed to counteract that mechanism and reduce cardiovascular risk, Kalla said.

Because the study was based on hospital discharge records, the findings may not be reflective of the general population. The study was also limited by the researchers’ inability to account for quantity or frequency of marijuana use, purpose of use (recreational or medical), or delivery mechanism (smoking or ingestion).

Kalla suggested that the growing trend toward legalization of marijuana could mean that patients and doctors will become more comfortable speaking openly about marijuana use, which could allow for better data collection and further insights into the drug’s effects and side effects.

The research was scheduled for presentation at the American College of Cardiology’s 66th Annual Scientific Session.


Sometimes, people send me an article worth reading…

Pain Relief?


Posted by Lynn Bronikowski 

I had my stroke 14 years ago and suffered from post-stroke chronic shoulder pain. I tried anything to help with the pain. After seven years of PT/OT rehabilitation, I said, “This is it—this is the best I’m ever going to get” so I stopped. I had to just suck it up when it came to the pain.

I tried everything you can think of though—I had a sling to stop my shoulder from moving but that was useless. I tried pain med after pain med but nothing succeeded. All of it was to no avail.

One day my stroke doctor sent me to a pain management doctor who introduced me to StimRouter™. I had to laugh at first; I thought nothing can take this pain away. But I had tried everything else so I said, “Let’s give it a shot.” Once the StimRouter was implanted, everything was pretty much OK with my pain. I can say the stimulator is working very well for me.

I was programmed by the doctor two weeks after the implant and after a day of using the StimRouter system with my remote control my pain started to go away. I would keep it on for about two hours and then I wouldn’t need it for the rest of the day because the pain relief carried over. I was really impressed with how fast it worked.

Before StimRouter, I would say my pain went off the scale—above a 10 for sure—because my pain was really bad. Sometimes it hurt to breathe. Now with the help of StimRouter, my pain is only a 2 or 3 at the most.

I wear my system all day but I only turn it on every six to eight hours depending on what I’m doing that day. The patches stay on well but come off just as easily. When it’s on, it feels like a massage chair on your arm.

The StimRouter works well for me; I feel very lucky. I can lift my arm enough to put on deodorant now and I’ve picked up some new hobbies. It’s a process and I still have goals—like being able to ride my bike—but I would recommend StimRouter to people in pain without a doubt in my mind.

I didn’t expect much at first but was quite surprised, very happily surprised. The StimRouter is great. If anyone asked me, I would tell them straight out—it works and it works well for me.

For more information on StimRouter, visit the Bioness website.

National Stroke Association provides educational information about treatments for post-stroke issues through real-life stories. Promotion of these stories does not imply endorsement of any product or service and it is recommended that patients ask a healthcare professional before using any product, medicine, or therapy.

Nerve ‘zap’ treatment may speed stroke recovery

Healthday Copyright © 2017 HealthDay. All rights reserved.

An implanted device that provides electrical stimulation of the vagus nerve leading to the brain enhanced arm movement in a small group of stroke patients, researchers report.

Evaluating 17  with chronic arm weakness who also received intense , scientists found that three-quarters improved with vagus nerve stimulation (VNS), while only one-quarter of those receiving “sham” nerve stimulation did.

“Arm weakness affects three of every four of our  patients and persists to a disabling degree in at least 50 percent of them, so it’s a hugely important problem in the long term,” explained study author Dr. Jesse Dawson. He’s director of the Scottish Stroke Research Network and a clinical researcher at University of Glasgow.

“A unique aspect of this [device] is that patients can deliver the brain stimulation technique in their own home during exercise . . . which is an important breakthrough that opens a huge number of possibilities for increasing patient access to this potential treatment,” Dawson added.

The study was funded by the VNS device’s manufacturer, MicroTransponder Inc., based in Texas.

About 700,000 Americans suffer a stroke each year, two-thirds of whom need post-stroke rehabilitation to help them regain skills lost due to stroke-related brain damage, according to the U.S. National Institute of Neurological Disorders and Stroke.

The vagus nerve is the longest nerve leading to the head, which passes through the neck and down into the abdomen. Surgically implanted just below the collarbone, the VNS device stimulates the brain with small electrical pulses through an internal wire as patients simultaneously move.

All 17 study participants (average age nearly 60) had the device implanted, but Dawson and his team randomly assigned half to receive VNS and half to receive “sham” stimulation. All had suffered clot-caused strokes and took part in six weeks of intensive physical therapy. Their strokes had occurred up to five years prior to the study and had caused chronic arm weakness.

Not only did more patients receiving VNS experience enhanced , but those patients continued to improve throughout the 90-day study period, Dawson said.

Stimulating the vagus nerve, Dawson said, triggers the release of various chemicals in the brain, two of which are known to increase the brain’s potential to recover after injury.

“We can conclude that VNS does drive a change and have an effect for patients recovering from stroke, but we can’t [yet] conclude there’s magnitude enough to introduce it into clinical practice,” he said.

A larger clinical trial enrolling 120  from the United States and the United Kingdom will begin this summer, Dawson added.

Dr. Daniel Labovitz is director of the Stern Stroke Center for the Montefiore Health System in New York City. He said the new research was promising, but the study’s design and small number of participants made it difficult to discern if results are “sustainable.”

“I think it’s exciting to at least be working toward proof of concept—that we can influence the brain to organize itself and enhance recovery long after a stroke occurs,” said Labovitz, who wasn’t involved in the new research.

“This is the holy grail of rehabilitation,” Labovitz said. “And this technique may be the first time where we can actually get the brain to heal itself better than just having the patient move their limb around [during physical therapy].”

Dawson pointed out that implanting the VNS device does carry certain potential risks, such as infection around the device; anesthesia complications; and temporary hoarseness due to vocal cord trauma.

The study was presented at the recent International Stroke Conference in Houston. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

Explore further: Study shows stimulation helps stroke patients

More information: Jesse Dawson, M.D., director, Scottish Stroke Research Network, and clinical researcher, University of Glasgow, Scotland; Daniel Labovitz, M.D., director, Stern Stroke Center, Montefiore Health System, New York City; Feb. 24, 2017, presentation, International Stroke Conference, Houston

Read more at: https://medicalxpress.com/news/2017-03-nerve-zap-treatment-recovery.html#jCp

Find Your Inner Power

Contact me @ keith@strengthafterstroke.com

What are your Inner Powers?

We all have them. But sometimes we need to rediscover them.

Living a happier, more productive and successful life is why we need to strengthen our Inner Powers.

Here are three things you can take action toward gaining some strength on your Inner Power.

1. Define What They Are

Focus: Can you focus your attention on one major goal?

It is so easy to get off track these days. Things such as your computer and phone are notorious for taking your valuable time away from what is most important to you.

Being aware of this alone can be a huge benefit.

Also, once you have your goals defined, then carving out specific time to work on that goal, without any distraction, is key. Put it in your planner! Stay accountable to your planner.

Motivation: A driving power that is directing you toward moving ahead.

This is a key inner power that will move you in the right direction. Motivation is what will give you the push to take action toward what is most important.

You can create smaller goals and/or actions for the day. Once you attain them, it will motivate you to keep going.

Desire: Do you have the need to live a better life?

Wishful thinking isn’t enough for you to take action. Do you NEED to live a more productive and happy life?

Think about what will be said when you leave this planet…will others know that you moved forward despite your circumstances in life? What needs do you have that will push you to change and move forward?

Persistence: Continue in spite of difficult times.

Everyone has difficult times in their life. We all need to move forward. It is the people who move forward that endure to have a great life.

Finding your determination in continuing to move forward despite the troubling times is what will separate you from the average. Being persistent is the key to moving the needle upward in your life.

Discipline: It takes time and effort to achieve a productive life.

Once you have the discipline to set your goals (whether daily, weekly, monthly or annually) and take action toward them, you will be amazed at how they work out.

Yes, it takes time and effort, but that time is going to move whether you are moving toward a successful life or not. Intentional, dedicated practice is the key.

2. Build On Them

Think about what you wrote in the previous “Define What They Are” steps. Now, take these items and list what achievements you have had in each.

You might want to start by asking yourself “WHEN DID I HAVE THE MOST (Focus/Motivation/Desire/Persistence/Discipline) IN LIFE?”

What did you accomplish that had the biggest impact on your life?

Why did you achieve this?

Did you do something special?

Was it because it had an impact on another person?

What was the impact it had on you?

This is critical to discovering your own motivation and what is most imortant to you.

When did I have the most Focus in life? Why?

When did I have the most Motivation in life? Why?

When did I have the most Desire in life? Why?

When was I the most Persistent in life? Why?

When was I the most Discipline in life? Why?

3. Invest In Yourself

Just as you can rehabilitate your body after having a stroke, you can Strengthen Your Inner Power…But, you have got to invest in yourself.

Don’t leave this up to anyone else.

This is your life; let’s keep moving forward. You can change your thoughts. You can change how you feel. You can change the choices you make.

It’s time to “TAP” into yourself (Time/Accountability/Planning)

Time: Are you spending quality time investing in yourself?

Are you important? Of course you are! But it seems that we all spend so much time on non-important stuff.

I catch myself looking at my iPhone, or getting on the computer, just as a random thing to do at times. I realize that we can’t work all the time, but I want you to ask yourself if you are investing quality time in you.

Think through this past week…or better yet, track your time this week, to see what it looks like. Then, make some adjustments. Make a goal and take action.

Accountability: Have you created a way to take control of your own success?

In order to grow your long-term achievements, you need to build a culture of accountability.

At the end of the day, we must be accountable to ourselves. It takes a strategy to develop an accountability process that is personal and creates a way for you to effectively follow through.

·         Responsibility: Take Ownership – You have 100% Control on this!

·         Share your goals: Be specific and clear. Share with someone you can trust.

·         Measure it: There are many ways. Understand what works best for you.

·         Be willing to change: Know that it will take work and effort.

·         Build trust with yourself: This will happen as you make progress.

Planning: Have you developed a strategy in order to accomplish your goals?

Have you invested time in creating actions that will take you forward in life? And, are you doing this faithfully each quarter?

Without a plan, you will meander through life thinking you are making progress. Even if you are making progress, think of how much more you could do if you had a plan developed and stayed true to it.

Let’s get busy building your INNER STRENGTH!


Walking can help improve stroke recovery

Computational walking model could help stroke patients achieve optimal recovery

by News Medical Life Sciences

After a stroke, patients typically have trouble walking and few are able to regain the gait they had before suffering a stroke. Researchers funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) have developed a computational walking model that could help guide patients to their best possible recovery after a stroke. Computational modeling uses computers to simulate and study the behavior of complex systems using mathematics, physics, and computer science. In this case, researchers are developing a computational modeling program that can construct a model of the patient from the patient’s walking data collected on a treadmill and then predict how the patient will walk after different planned rehabilitation treatments. They hope that one day the model will be able to predict the best gait a patient can achieve after completing rehabilitation, as well as recommend the best rehabilitation approach to help the patient achieve an optimal recovery.

Currently, there is no way for a clinician to determine the most effective rehabilitation treatment prescription for a patient. Clinicians cannot always know which treatment approach to use, or how the approach should be implemented to maximize walking recovery. B.J. Fregly, Ph.D. and his team (Andrew Meyer, Ph.D., Carolynn Patten, PT., Ph.D., and Anil Rao, Ph.D.) at the University of Florida developed a computational modeling approach to help answer these questions. They tested the approach on a patient who had suffered a stroke.

The team first measured how the patient walked at his preferred speed on a treadmill. Using those measurements, they then constructed a neuromusculoskeletal computer model of the patient that was personalized to the patient’s skeletal anatomy, foot contact pattern, muscle force generating ability, and neural control limitations. Fregly and his team found that the personalized model was able to predict accurately the patient’s gait at a faster walking speed, even though no measurements at that speed were used for constructing the model.

“This modeling effort is an excellent example of how computer models can make predictions of complex processes and accelerate the integration of knowledge across multiple disciplines,”says Grace Peng, Ph.D., director of the NIBIB program in Mathematical Modeling, Simulation and Analysis.

Fregly and his team believe this advance is the first step toward the creation of personalized neurorehabilitation prescriptions, filling a critical gap in the current treatment planning process for stroke patients. Together with devices that would ensure the patient is exercising using the proper force and torque, personalized computational models could one day help maximize the recovery of patients who have suffered a stroke.

“Through additional NIH funding, we are embarking with collaborators at Emory University on our first project to predict optimal walking treatments for two individuals post-stroke,” says Fregly. “We are excited to begin exploring whether model-based personalized treatment design can improve functional outcomes.”


National Institute of Biomedical Imaging and Bioengineering

Avoid stress…if you don’t want a stroke!

How stress may increase risk of stroke

Posted by Lynn Bronikowski 

While more research and larger studies are needed to confirm the mechanism, the researchers suggest that these findings could eventually lead to new ways to target and treat stress-related cardiovascular risk.

Smoking, high blood pressure and diabetes are well-known risk factors for cardiovascular disease and chronic psychosocial stress could also be a risk factor.

Previously, animal studies identified a link between stress and higher activity in the bone marrow and arteries, but it has remained unclear whether this also applies to humans. Other research has also shown that the amygdala is more active in people with post-traumatic stress disorder (PTSD), anxiety and depression, but before this study no research had identified the region of the brain that links stress to the risk of heart attack and stroke.

In this study, 293 patients were given a combined PET/CT scan to record their brain, bone marrow and spleen activity and inflammation of their arteries. The patients were then tracked for an average of 3.7 years to see if they developed cardiovascular disease. In this time 22 patients had cardiovascular events including heart attack, angina, heart failure, stroke and peripheral arterial disease.

Those with higher amygdala activity had a greater risk of subsequent cardiovascular disease and developed problems sooner than those with lower activity.

The researchers also found that the heightened activity in the amygdala was linked to increased bone marrow activity and inflammation in the arteries, and suggest that this may cause the increased cardiovascular risk. The authors suggest a possible biological mechanism, whereby the amygdala signals to the bone marrow to produce extra white blood cells, which in turn act on the arteries causing them to develop plaques and become inflamed, which can cause heart attack and stroke.

In a small sub-study, 13 patients who had a history of PTSD also had their stress levels assessed by a psychologist, underwent a PET scan and had their levels of C-reactive protein — a protein that indicates levels of inflammation in the body — measured. Those who reported the highest levels of stress had the highest levels of amygdala activity along with more signs of inflammation in their blood and the walls of their arteries.

“Our results provide a unique insight into how stress may lead to cardiovascular disease. This raises the possibility that reducing stress could produce benefits that extend beyond an improved sense of psychological wellbeing,” said lead author Dr. Ahmed Tawakol, Massachusetts General Hospital and Harvard Medical School. “Eventually, chronic stress could be treated as an important risk factor for cardiovascular disease, which is routinely screened for and effectively managed like other major cardiovascular disease risk factors.”

The researchers note that the activity seen in the amygdala may contribute to heart disease through additional mechanisms, since the extra white blood cell production and inflammation in the arteries do not account for the full link. They also say that more research is needed to confirm that stress causes this chain of events as the study was relatively small.

Dr. Ilze Bot, Leiden Academic Centre for Drug Research, Leiden University in The Netherlands, said: “In the past decade, more and more individuals experience psychosocial stress on a daily basis. Heavy workloads, job insecurity, or living in poverty are circumstances that can result in chronically increased stress, which in turn can lead to chronic psychological disorders such as depression.”

She says that more research is needed to confirm the mechanism but concludes: “These clinical data establish a connection between stress and cardiovascular disease, thus identifying chronic stress as a true risk factor for acute cardiovascular syndromes, which could, given the increasing number of individuals with chronic stress, be included in risk assessments of cardiovascular disease in daily clinical practice.”

Stable marriage boosts stroke survival

Posted by Amy Norton, HealthDay Reporter 

 Stroke patients may have better odds of surviving if they’re in a long-term stable marriage, a new study suggests.

Researchers found that among more than 2,300 stroke sufferers, those who’d been “continuously” married had a better chance of surviving—versus both lifelong singles and people who’d been divorced or widowed.

The long-term marrieds’ outlook was better even compared to people who’d gotten remarried after divorcing or losing a spouse.

The reasons for the findings aren’t completely clear, and the study doesn’t prove a cause-and-effect relationship. But researchers said the study highlights the potential importance of “social support” in stroke recovery.

“This implies that the support of a lifelong partner has benefits,” said Dr. Ralph Sacco, a professor of neurology at the University of Miami and a past president of the American Heart Association.
A spouse can give emotional support, he said, as well as help with day-to-day basics—such as eating a healthy diet and remembering to take medications.

“People sometimes consider it ‘nagging,’ but it can help,” said Sacco, who wasn’t involved in the study.

“What we don’t know,” he added, “is whether other forms of social support might have similar benefits.”

In a previous study, Sacco and his colleagues did find that older stroke patients who had friends generally fared better than those who were socially isolated.

But it’s not clear whether friendships directly aided people’s stroke recovery. And no one knows whether unmarried stroke patients would live longer if they joined a support group, for example.
Those are important questions, according to Matthew Dupre, one of the researchers on the new study.
It’s known that “social support” can help people stick with their medication regimens or change unhealthy habits, said Dupre, an associate professor of community and family medicine at Duke University in Durham, N.C.

So it’s possible that unmarried stroke patients could benefit from resources that connect them with other people, according to Dupre.

“More research is needed, though, to know the full implications of our findings, and to identify possible avenues of intervention,” he said.

The findings, reported Dec. 14 in the Journal of the American Heart Association, are based on 2,351 U.S. adults who’d suffered a stroke. Their health was followed for about five years after the stroke, on average.

During that time, 1,362 people died — leaving just under 1,000 survivors. Among those who survived, 42 percent were in a stable marriage with their first spouse. That compared with 31 percent among patients who died.

Overall, Dupre’s team found, lifelong singles were 71 percent more likely to die than stroke patients in a stable marriage.

Much of that disparity seemed to be explained by “psychosocial factors,” the researchers said — including depression symptoms and a lack of children or other close relationships.

It wouldn’t be surprising, Sacco said, if depression were a key reason that unmarried people tend to fare more poorly after a stroke.

“Depression is common after stroke, and it’s been shown to be a predictor of stroke outcomes,” he said. “Depression needs to be recognized and treated.”

Dr. Paul Wright, chief of neurology at North Shore University Hospital in Manhasset, N.Y., agreed.
He said stroke patients at his center are routinely screened for depression. But the new findings, he said, suggest that unmarried patients may need closer attention in general — including extra help with lifestyle changes that can improve their outlook.

“We may need to bring them in for follow-up earlier, and start monitoring them more closely,” Wright said.

Lifelong singles were not the only ones at higher risk in this study. People who’d been divorced or widowed were more likely to die after their stroke — particularly if they’d lost more than one marriage.
Patients who’d been divorced or widowed more than once were about 40 percent more likely to die than those in stable marriages. And those who were currently remarried fared no better.
Certain practical factors, such as income and access to health insurance, seemed to explain part of the risk — but not all of it.

“It may be that patients with a history of marital instability experienced more severe and debilitating strokes — and in turn have fewer economic resources and social support to use toward their recovery,” Dupre said.

For now, Sacco suggested that stroke survivors “reach out and interact with other people” if they feel isolated. Many hospitals have support groups, he said.

People could also try community or church organizations, or even online groups, Sacco said — though, he added, “we don’t know whether computer connections can replace face-to-face human connection.”
Wright agreed that unmarried stroke survivors should reach out for help. But in reality, he added, many do not — so their family members should be proactive.

“Be the ‘nudge’ who makes sure they’re taking care of themselves, even if they say they’re OK,” Wright said.

Copyright © 2016 HealthDay. All rights reserved.

Do you dream?

Do you dream?   I started to remember my dreams 2 years ago.  FYI, this is what I said:

Did you ever stop remembering your dreams?  I did…almost 7 years ago.

From time to time, I would remember a dream… after I woke up, but I couldn’t articulate what happened in my dream. This is the FIRST time I dreamt and I was remember what was happening in my dream.  I did something and I remembered it.  This is HUGE!  I almost want to go out and celebrate.

What next???  Will I start being able to articulate my thoughts?  Will I think before I  speak?  Will I be able to walk on my hands?  OK, I can not be walking on my hands… again, but who knows!

I had a dream just the other night…and I think it was in color!  I woke up and was going to tell my wife about it.   I WAS SO EXCITED! I planned the sequence of the dream…the beginning, the middle and the end…and I decided to write it down so I could easily articulate the dream.  I was so excited.  Was this the FINAL barrier I was going to face before getting back to work?  I was also thinking maybe I should take my wife out and spring it on her during our dinner.

I WAS SO excited.  I pulled out a piece of paper and began to write.

I wasn’t able to write ANYTHING.  The minute I started, my mind was racing to find the correct word and nothing would leave my pen.  Darn!   Maybe I should wait another year before I attempt the dream thing.