Hey, we are speaking again!!!

Nobody likes to think about the “What If’s” in life…that’s why its good to have a plan BEFORE something bad happens.

Come listen how the Viggiano family overcame overwhelming odds and LEARN what you can do to be better prepared.

4.30 – 6.00pm ~ Thursday, May 18, 2017
Oregon Wine Reserve – 600 State St. Lake Oswego.
FREE Admission. First 50 people get an autographed copy of the book written by Gordon Viggiano and Jill Krantz Viggiano.

RSVP to save a seat with Alex Sloy 503.603.3334 or alex.sloy@primelending.com

#haveaplan
#whatifs
#beprepared
#nosurprises
#stuonthat

 Image may contain: 5 people, people smiling

Younger Americans Are Experiencing Strokes!!

Posted by Steven Reinberg, HealthDay Reporter 

The study looked at a sample of data from some U.S. stroke hospitalizations. From 2003 to 2004 in this sample, more than 141,000 people from 18 to 65 were admitted to hospitals for stroke. By 2011 to 2012, that number had risen to more than 171,000, researchers found.

“Our results stress the importance of prevention of stroke risk factors in younger adults,” said lead author Dr. Mary George. She’s a senior medical officer with the U.S. Centers for Disease Control and Prevention’s division of heart disease and stroke prevention.

“Young adults, ages 18 to 54, are experiencing a small but sustained increase in stroke and in the prevalence of traditional stroke risk factors, such as high blood pressure, diabetes, high cholesterol, tobacco use and obesity,” George said.

Up to 80 percent of strokes are thought to be preventable, she said.

George said the study’s findings “should prompt a sense of urgency to promote and engage young adults in practicing healthy behaviors, such as exercising, eating a healthy diet that includes plenty of fruits and vegetables, avoiding smoking, and maintaining a healthy weight.”

The impact of a stroke is significant at any stage of life, she said.

But George added, “It is uniquely complex when younger adults in the midst of careers, serving as wage earners and caregivers, may suffer disability that can impact their lives and the lives of family members and loved ones.”

Stroke is the fifth leading cause of death in the United States. Each year stroke kills more than 130,000 Americans. Stroke is also a leading cause of disability, George said.
To study trends in stroke, the researchers used a database of some U.S. hospital stays gleaned from billing records. The 2003-2004 data included more than 362,000 stroke hospitalizations. The 2011-2012 information included nearly 422,000 stroke hospitalizations.

There are two types of stroke: ischemic and hemorrhagic. An ischemic stroke, sometimes called a brain attack, is a stroke that occurs when a blood clot blocks the blood supply to the brain. Hemorrhagic strokes are caused by bleeding in the brain from a ruptured blood vessel.

Men between 35 and 44 years old saw a striking increase of 41.5 percent in hospitalizations from ischemic stroke over the two study periods.

The researchers found that the rate of hemorrhagic strokes remained basically stable during the study period. The one exception was in the 45 to 54 age group. There was a slight decline in hemorrhagic strokes for men and blacks in that age group, the study showed.

The researchers think an increase in stroke risk factors, such as high blood pressure, diabetes, high cholesterol, obesity and smoking, are behind the rise in strokes among younger adults.

During the study, the percentage of people with three or more stroke risk factors roughly doubled for all age groups.

“Preventing and controlling stroke risk factors among young adults can save lives, reduce disability, decrease health care costs and improve the quality of life for tens of thousands of people and their families,” George said.

The study was published online April 10 in the journal JAMA Neurology.

One specialist questioned the use of billing data to uncover trends in stroke and isn’t sure a real increase in strokes among younger adults is occurring.

“The systems for counting stroke in the United States are extremely limited,” said Dr. James Burke, an assistant professor of neurology at the University of Michigan.

“Credible alternatives may explain what appears to be an increase in stroke among young men and women, but is not,” said Burke, who co-wrote an accompanying journal editorial.

“MRIs are more widely used, which can lead to an increase in diagnosis of stroke,” he said.

“MRIs are being used for all kinds of things, and so when you put lots and lots of people in MRI scanners, for example for headaches, we will find asymptomatic brain injury that is stroke-like, and how much classifying of these as stroke is not clear,” Burke said.
In addition, the United States doesn’t have extensive databases that track patients and medical conditions, he said.

“Our ability to make strong conclusions is surprisingly limited since we don’t have national health data on everybody. When we are making these measurements, we are looking at a small chunk of the population,” Burke said.

Copyright © 2017 HealthDay. All rights reserved.

Am I a Disability Guru?

I am beginning to think I am!  Why, you may ask?  Let me tell you my thoughts.

First of all, it’s kind of cool to start being thought of in that way.  When people see me, they respect me for all I have been through. I have my disability and I’m happy for that.

But I don’t want to be respected. (After I said it, I thought about it and wish to renege that.)  I want to give hope and encouragement to all of those people who may be effected by a heart attack, kidney failure, loss of a friend, cancer, stroke…or anything else.  You can live life as you choose: with regret and pity…or with happiness for each day you have.   It is your choice.

  • You can choose to be happy with your disability
  • You can choose to live life to the fullest with your disability
  • You can choose to be happy for each day you have with your disability

I will tell you my secret: you can choose whatever you want!  My choice is to be happy.  Some people I know have LOTS of THINGS…and I don’t begrudge them; I am HAPPY for them; good for you! It’s not WHAT you have. It’s this:  are you happy?

A while back (9 years ago), I had lot of THINGS.  But when they were all gone, it didn’t matter. Everyday that I wake up to see my beautiful wife, I feel blessed. I have nothing to complain about…I am truly the happiest man on earth.

 

Jill is just amazing! Come see her speak….

Jill Viggiano headshot

Business Men And Women of
PORTLAND BUSINESS LUNCHEON
Invite you to Downtown April 26 with

Jill Viggiano

 You are invited to join us for our Downtown PBL luncheon, on Wednesday, April 26th at the University Club in downtown Portland. Our guest speaker will be Jill Viggiano.
Jill Viggiano spent 19 years working in commercial real estate before retiring to become a full time mom. As an active volunteer, Jill couldn’t help but raise her hand and take on leadership roles in the community.
The opportunity to form and advance philanthropic organizations and their causes kept her engaged in both local and national efforts. Jill’s style is to create a team environment where cooperation and accomplishment happen while having fun.
When her husband survived a massive stroke in 2008, Jill focused her skills on his recovery. She now assists him in his day-to-day needs as well as in his speaking career.
Jill wrote Painful Blessing, a book about her spouse and caregiver experience shedding light on the real life impact of acquired brain injury, and providing hope and encouragement to those facing significant challenges.
Jill’s story will touch your soul and inspire you to press through any circumstance. The cost of lunch is $25.00. Register today and invite a friend.
LUNCHEON DETAILS
RSVP REQUIRED
UNIVERSITY CLUB
1225 SW 6th Ave. Portland, OR 97204
WEDNESDAY APRIL 26TH
11:45 AM- 1:15 P

 

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

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.”

Source:

National Institute of Biomedical Imaging and Bioengineering

NIH Stroke Scale

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The NIH Stroke Scale

Medical professionals and even the public have been trained to recognize basic signs of stroke. These include three features of stroke: slurred speech, drooping of one outstretched arm, and drooping of one side of the face when attempting to smile. When one of these signs is present it’s a fairly sensitive indicator of stroke. When all three are present, sensitivity for stroke is approximately 90%. However, when evaluating patients for inclusion in stroke protocols and prior to fibrinolytic stroke treatments, medical professionals use a slightly more sophisticated series of questions. They often use the NIH stroke scale.

The NIH offers training and certification in the administration and scoring of the stroke scale. An overview of the scale is listed below.

The stroke scale items should be presented in order and the score should be reported after each numbered category has been assessed. The score should be based on the patient’s actual performance and what is witnessed by the examiner. It should not be a reflection of what the examiner thinks the patient is able to do. Remember, the patient could be experiencing an acute stroke, so time is of the essence. The examiner should work quickly. On the other hand, the patient should not be coached or aided by anyone, including the examiner. If the patient cannot perform one of the items, indicate the corresponding score, and move onto the next item.

National Institutes of Health (NIH) Stroke Scale

1a. Level of consciousness 0 = Alert and responsive1 = Arousable to minor stimulation

2 = Arousable only to painful stimulation

3 = Unarousable or reflex responses

1b. Questions

Ask patient’s age and month. Must be exact.

0 = Both correct1 = One correct

2 = Neither correct

1c. Commands

Ask patient to open/close eyes, grip and release non-affected hand.

0 = Both correct1 = One correct

2 = Neither correct

2. Best gaze

Horizontal extraocular movements by voluntary or reflexive testing.

0 = Normal1 = Partial gaze palsy; abnormal gaze in one or both eyes

2 = Forced eye deviation or total paresis which cannot be overcome by oculocephalic maneuver

3. Visual fields

Test by confrontation or threat as appropriate. If monocular, score field of good eye.

0 = No visual loss1 = Partial hemianopia, quadrantanopia, extinction

2 = Complete hemianopia

3 = Bilateral hemianopia or blindness

4. Facial palsy

If stuporous, check symmetry of grimace to pain. Paralysis (lower face).

0 = Normal1 = Minor paralysis (normal looking face, asymmetric smile)

2 = Partial paralysis

3 = Complete paralysis (upper and lower face)

5a. Left motor arm

5b. Right motor arm

 

Arms outstretched 90° (if patient is sitting) or 45° (if supine) for 10 seconds. Encourage best effort, note paretic side.

0 = No drift1 = Drift but does not hit bed

2 = Some antigravity effort, but cannot sustain
3 = No antigravity effort, but minimal movement present

4 = No movement at all X = Unable to assess due to amputation, fusion, etc

6a. Left motor leg

6b. Right motor leg

 

Raise leg to 30° (always test patient supine) for 5 seconds.

7. Limb ataxia

Check finger-nose-finger; heel-shin; score only if out of proportion to weakness.

0 = No ataxia (or aphasic, hemiplegic)1 = Ataxia present in one limb

2 = Ataxia present in two limbs X = Unable to assess as above

8. Sensory

Use safety pin. Check grimace or withdrawal if stuporous. Score only stroke related losses.

0 = Normal1 = Mild to moderate unilateral sensory loss but patient aware of touch

2 = Severe to total sensory loss, patient unaware of touch (or bilateral sensory loss or comatose)

9. Best language

Ask patient to describe cookie jar picture, name objects, read sentences. May use repeating, writing, stereognosis.

0 = Normal1 = Mild-moderate aphasia

2 = Severe aphasia (almost no information exchanged)
3 = Mute, global aphasia, or coma

10. Dysarthria

Ask patient to read or repeat a list of words.

0 = Normal1 = Mild-moderate dysarthria

2 = Severe, unintelligible or mute

X = Intubation or mechanical barrier

11. Extinction and inattention

Simultaneously touch patient on both hands, show fingers in both visual fields, ask patient to describe deficit, left hand.

0 = Normal, none detected (or severe visual loss with normal cutaneous responses)1 = Neglects or extinguishes to bilateral simultaneous stimulation in any sensory modality (visual, tactile, auditory, spatial, or personal inattention)

2 = Profound hemi-inattention or extinction in more than one modality

Most people receive a score 0 after taking the NIH stroke scale. Scores as low as one to four could indicate a mild stroke. The highest possible score is 42 which would obviously be consistent with a profound stroke. The NIH stroke scale can be administered in less than 10 minutes in skilled hands. It provides excellent baseline for stroke treatment assessment and can be used for prognosis.

Images used with the NIH Stroke Scale:

stroke-img1

You know how.

Down to earth.

I got home from work.

Near the table in the dining room.

They heard him speak on the radio last night.

stroke-img2

For more information:  https://www.aclsmedicaltraining.com/

I think I rather have heartburn!

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Study: Could Heartburn Drugs Up Stroke Risk?

Posted by Dennis Thompson, HealthDay Reporter

A popular category of heartburn medications—including Nexium, Prevacid, Prilosec and Protonix—may increase your risk of stroke, a new study suggests.

Known as proton pump inhibitors (PPIs), these drugs increased people’s overall stroke risk by 21 percent, said study lead author Dr. Thomas Sehested.

However, the risk appears to be driven by people who take high doses, added Sehested, research director at the Danish Heart Foundation in Copenhagen.

“People treated with a low dose of PPIs did not have a high risk of stroke,” he said. “Those treated with the highest doses of PPIs had the highest risk of stroke.”

The extent of risk also depends on the specific PPI taken.

At the highest dose, stroke risk ranged from 30 percent for lansoprazole (Prevacid) to 94 percent for pantoprazole (Protonix), the researchers said.

Takeda Pharmaceutical, the maker of prescription-only Protonix, did not respond to a request for comment.

PPIs specifically affected risk of the most common type of stroke, ischemic stroke, which occurs when a clot blocks blood flow to the brain.

Proton pump inhibitors treat heartburn by blocking acid-producing cells in the lining of the stomach.

Prior studies have associated PPI use with heart disease, heart attacks and dementia, Sehested said.

However, because of its design, the new study can’t establish a direct cause-and-effect relationship between these heartburn drugs and elevated stroke risk. The research only shows an association.

For this study, researchers analyzed the records of nearly 245,000 Danish patients, average age 57. All had undergone an endoscopy, a procedure used to identify the causes of stomach pain and indigestion.

During about six years of follow-up, nearly 9,500 patients had their first ischemic stroke.
Researchers checked to see if the stroke occurred while patients were taking any of these PPIs: omeprazole (Prilosec), esomeprazole (Nexium), Prevacid or Protonix. The researchers also asked about another class of antacids known as H2 blockers, which include Pepcid and Zantac.
The research team found increased risk from PPIs, but none from H2 blockers. The relationship held even after researchers adjusted for other risk factors for stroke and heart disease, Sehested said.

No one is sure why PPIs may have a harmful effect on heart health, Sehested said. He noted that PPIs might reduce levels of biochemicals that are important for the maintenance of blood vessels. Without those biochemicals, people could experience hardening of the arteries, he theorized.

Most PPIs are now available over the counter, and doctors are concerned that people are taking the drugs when they shouldn’t, said Dr. Philip Gorelick, medical director of the Mercy Health Hauenstein Neuroscience Center in Grand Rapids, Mich.

“A lot of people continue to take these medicines for prolonged periods of time, or use these medications for indications that are suspect, or not approved by the FDA,” Gorelick said. “So one has to be careful about that.”

Using the drugs for a shorter period or at lower doses may prove to be safer, he added.
People who need PPIs and have been prescribed one by a doctor should continue using them, Sehested said.

However, people who started using a PPI without a doctor’s guidance, or kept using one after the prescribed period, should talk with their physician about whether they should cut the drugs out.

“A lot of people are using these drugs without a clear indication, such as a clear diagnosis showing they should use these drugs every day,” Sehested said. “They should think about quitting those drugs.”

Copyright © 2016 HealthDay. All rights reserved.