Take a look at BEFORE and AFTER….

After last weeks event, I am putting this into my presentation. You are looking at how my script looks to me, with the different colors.  If I have BLACK text, it is older text. There is no BLACK text since this is all new to me and will be new few months. If I have GREEN text, it is new so I have to watch it a bit more closely.  If it is RED text, it is NEW so I have to read it for now.  The BLUE text means it have to advanced the slide. Check it out:

Do you think it can be better than that?

Those videos were taken 3 years ago.  On my 10 year anniversary, I was SURE I had improved so I tried this experiment again. (PAUSE) What happened? (PAUSE)  I crushed the cup, spilled water all over myself, and showed absolutely no improvement. (PAUSE)

So here we are at 11 years post-stroke. What do you think will happen this time? 

(PAUSE for applause) (PAUSE)  Isn’t that great? It only took 11 years to be able to drink from a paper cup! (PAUSE)

You can look at me and SEE my PHYSICAL disabilities. (PAUSE) They are awkward and obvious. (PAUSE)  But my most challenging deficits (PAUSE)  are the ones you don’t see. (PAUSE)  The barriers of broken language and cognition are tough to break down. (PAUSE) My ability to think clearly and speak at will (PAUSE) remain my biggest obstacles.

These minor changes takes me months to get right.  I am telling you this because I want you to appreciate the amount of work I put into this task.

A thoughtful blog post….

“Be Kind! ” This is what Jennifer Tyman Williams wrote on her Facebook a few weeks ago.  Her husband was only 41 when he had his stroke…..

6 years ago today our world was interrupted and changed by a blood clot that got stuck in my husband’s brain stem causing a stroke. Ryan Williams has worked so hard to overcome and I cannot be more proud of him. Has changed both of us… But changed me to be more aware.

Know the symptoms of a stroke

Slurred speech
Tongue when sticking out goes to the side
Droopy mouth
Loss of movement in limbs
Dizziness

What To Do If You See Any of These Behaviors

Be aware of the disabled
Stay clear of people walking with canes and in wheelchairs
Cross a street with someone walking with a cane to make them feel safe
Offer to hold a door for anyone
Be patient in the grocery line or any line
Be kind
Host/hostesses – be aware of a cane stop seating the disabled in the back past
open tables just bc that waiter is next
Don’t stare… Don’t stare… Don’t stare – so rude

He doesn’t always realize how far he has come. I remind him everyday when he came home he was in a wheelchair… and that put everything in perspective. My hubby is my hero.

These are beautiful words. It certainly opened my eyes to look at people with my eyes WIDE OPEN.

Oscar-nominated director John Singleton dies at 51 following stroke

Another high profile actor taken at 51!  Tell others who have high risk of stroke to see a physician.  You wouldn’t believe how hard it is hearing that other people having a stroke 51 years (the same age I was) old didn’t make it. Why did I make it? Am I supposed to be warning other of the risk of surviving a stroke???  Should I be telling my story more???

Please read this!!!!

USA TODAY

John Singleton, the Oscar-nominated director and screenwriter behind films like “Boyz n the Hood” and “Poetic Justice,” has died after being taken off life support following a stroke this month, his spokesperson Shannon Barr told USA TODAY Monday. He was 51.

His family said in a statement that Singleton “passed away peacefully, surrounded by his family and friends.”

Singleton’s family said that “in his private life, John is a loving and supporting father, son, brother, and friend who believed in higher education, black culture, old school music and the power of film.”

Earlier Monday, Singleton’s family revealed the director would be taken off life support.

Acclaimed director John Singleton’s stroke: African-Americans face greater risk

“This was an agonizing decision, one that our family made, over a number of days, with the careful counsel of John’s doctors,” the family stated. “We are grateful to his fans, friends and colleagues for the (outpouring) of love and prayers during this incredibly difficult time. We want to thank all the doctors at Cedars Sinai for the impeccable care he received.”

The family also said in the statement that Singleton “like many African Americans … quietly struggled with hypertension.”

His family revealed he’d suffered a stroke on April 17

Singleton was nominated for two Oscars for 1991’s “Boyz n the Hood,” becoming the youngest best director nominee and first black person nominated for the same award.

His other films include “Poetic Justice,” starring Janet Jackson and Tupac Shakur, “Shaft,” “Baby Boy,” “2 Fast 2 Furious” and “Four Brothers.”

Singleton’s recent projects include creating and executive producing the FX Networks TV series “Snowfall,” as well as directing the fifth episode of the network’s “The People v. O. J. Simpson: American Crime Story.”

“We are heartbroken about the passing of our friend and partner, John Singleton,” John Landgraf, chairman of FX Networks, said in a statement. “For almost three decades, John was one of the most important filmmakers in this business, dating back to his masterwork, ‘Boyz n the Hood.’ Over the course of his illustrious career, John remained steadfast in telling stories that illuminate the daily challenges faced by African Americans, particularly those living in the inner city.”

Landgraf said the network was “honored and fortunate to have worked with John … I know that the cast and crew loved John as much as we did, and that they are heartbroken over this news. Today we lost an incredibly talented artist, leader, activist, partner and friend — far too soon. Our thoughts and prayers are with his family at this difficult time.”

When news broke of Singleton’s stroke, prominent celebrities took to social media to wish him a speedy recovery.

“His films helped form me. His kindness lifted me up,” Ava DuVernay wrote. “I remember him coming to the premiere of my indie years ago. Showing love/support for a fellow black director from LA. He is a lovely man. Pray with me.”

Neil deGrasse Tyson, Snoop Dogg and Guillermo del Toro also sent well wishes.

Emilia Clarke, from Game of Thrones, suffered 2 strokes!

Emilia Clarke Suffered 2 Brain Aneurysms

The HBO television series Game Of Thrones is not a romantic comedy. But no matter how harrowing the Game of Thrones fictional plot line may get, it is very unlikely to match the distress that series star Emilia Clark experienced in real life, twice.

Clarke, who has played Daenerys Targaryen in the television series since 2011, penned a piece in the New Yorker describing how she had to deal with complications of her brain aneurysms in 2011 and then 2013. A brain aneurysm is otherwise known as a cerebral aneurysm, because if you want to sound smart you can call your brain a cerebrum. An aneurysm is when part of a blood vessel begins to bulge or balloon. This means that the walls of the blood vessel in that location are weakening. Imagine if a blood vessel were like a garden hose. If you were to see part of a garden hose swell like part of a balloon animal, you would concerned that the hose might begin leak or even burst in that area. That’s the same concern with an aneurysm.

Brain Aneurysm

A brain or cerebral aneurysm is when the aneurysm occurs in one of the blood vessels, usually an artery, that supplies blood to parts of the brain. A brain aneurysm bursting or rupturing is a major emergency. That is what happened to Clarke in 2011.

As she described it in her article, she was about to work out with her trainer on the morning of February 11, 2011, when she “started to feel a bad headache coming on. I was so fatigued that I could barely put on my sneakers.” Her struggles continued through the workout:

Then my trainer had me get into the plank position, and I immediately felt as though an elastic band were squeezing my brain. I tried to ignore the pain and push through it, but I just couldn’t. I told my trainer I had to take a break. Somehow, almost crawling, I made it to the locker room. I reached the toilet, sank to my knees, and proceeded to be violently, voluminously ill. Meanwhile, the pain—shooting, stabbing, constricting pain—was getting worse. At some level, I knew what was happening: my brain was damaged.

She was eventually helped to Whittington Hospital in the United Kingdom, where an MRI of her head revealed that she was suffering a subarachnoid hemorrhage. A subarachnoid hemorrhage is a bleed into the space between the brain and the membranes surrounding the brain. Apparently, she had developed an aneurysm in an artery in her brain, which then had ruptured and started bleeding. Her description of events in the New Yorker piece matched the classic symptom of a ruptured cerebral aneurysm: the sudden onset of the worst headache of your life. Other common symptoms are nausea, vomiting, double vision, sensitivity to light, necks stiffness, seizures, disorientation, and loss of consciousness.

There are “emergencies”, like your TV or Tivo not working when Games of Thrones is being broadcast. There are bigger emergencies like having explosive diarrhea with no toilet in site. Then there are your-life-is-in-serious-danger-every minute-counts emergencies such as a subarachnoid hemorrhage. You can’t just walk off a subarachnoid hemorrhage. If you do not get treatment as soon as possible, you will die.

According to the National Institute of Neurological Disorders and Stroke (NINDS), each year ruptures of cerebral aneurysms occur in approximately 30,000 Americans. About a quarter of these unfortunate people do not even survive longer than 24 hours. Another quarter pass away within 6 months. That means ruptured cerebral aneurysms will kill at least 50% of people. Many of the surviving half will suffer long-term or permanent loss of brain function. It is possible to survive and eventually fully recover, but the likelihood depends on the size and location of the bleed and the speed at which proper treatment can be administered and the blood vessel can be repaired.

Thus, Clarke had to have emergency surgery to repair the artery. While this may sound simple, in real life there’s no CGI, no props, no stand-in brains. As I wrote previously for Forbes, when brain cells can’t get blood and thus oxygen, they die within 5 minutes. Bleeding and the resulting inflammation can cause further damage to the brain. Thus, surgeons have to act quickly to repair things as much as they can while moving delicately enough to not cause further damage. Besides stopping the bleeding and repairing the artery, other typical treatments for a ruptured cerebral aneurysm include giving anti-seizure drugs to prevent seizures and calcium channel-blocking drugs to prevent the blood vessels from having spasms that can then result in a stroke. Clarke wrote:

I remember being told that I should sign a release form for surgery. Brain surgery? I was in the middle of my very busy life—I had no time for brain surgery. But, finally, I settled down and signed. And then I was unconscious. For the next three hours, surgeons went about repairing my brain. This would not be my last surgery, and it would not be the worst. I was twenty-four years old.

This first surgery was “minimally invasive,” lasting three hours. Minimally invasive means not completely opening up the body, in this case the skull, to reach the part that needs fixing. Instead, to reach the artery in her brain, the doctors created a small hole in the femoral artery in her groin and then threaded a tube through her connected arteries up into the affected artery in her brain. They could then push a coil, a spiral-shaped object, through the tube, up to where the ruptured aneurysm was. The coil could then expand like a spring, form a clot, and consequently seal off the aneurysm.

This Cleveland Clinic video shows the different ways to repair an aneurysm:

The recovery after such an emergent procedure is the opposite of a picnic, unless that picnic involves suffering severe pain and other symptoms, having a tube constantly down your throat, and not knowing whether you will live, die, or permanently lose some type of body or mental function. During the first two weeks after such a surgery, a patient could go downhill very quickly, downhill in a bad way and not a skiing way. Therefore, a patient’s progress during this post-operative period really determines which direction he or she will eventually go.

Clarke wrote how she managed to get through these two weeks, making good progress. However, shortly thereafter, another issue emerged. When she was asked to say her name, she couldn’t remember it. Granted her full name is Emilia Isobel Euphemia Rose Clarke, which is at least two more names to remember than what most people have, and four more names than a Brazilian soccer star would have. But her inability to say her name and instead utter what she described as “nonsense”was the result of her suffering a type of aphasia. Aphasia is a general term for an impaired ability to either use or understand words that results from injury to the parts of the brain that control language.

Depending on the amount and location of the brain damage, an aphasia can be temporary or permanent. Fortunately, in Clarke’s case, the aphasia disappeared after about a week. As she described, one month after the surgery, she was able to leave the hospital and soon resume her acting career. One caveat was that the doctors had discovered a “smaller aneurysm on the other side of my brain, and it could ‘pop’ at any time. The doctors said, though, that it was small and it was possible it would remain dormant and harmless indefinitely.”

Fast forward to 2013, when she underwent a brain scan in New York City to do a routine check on her other aneurysm, the doctors, in her words, found that “The growth on the other side of my brain had doubled in size, and the doctor said we should ‘take care of it.’” Doctors first tried another minimally invasive procedure, but when things went awry and she began bleeding in her head, an emergent open surgery was necessary. The recovery from this much more invasive and involved surgery was significantly tougher, according to Clarke. But as she explained, she eventually fully recovered, except possibly that the one thing it may have “robbed me of is good taste in men.”  Her experience has inspired her to develop with others a charity called SameYou that “aims to provide treatment for people recovering from brain injuries and stroke.”

As you can see, Clarke, who is now 32 year old, had a brain aneurysm rupture and another that was at risk of rupturing while she was in her 20’s. How unusual was this for someone so young? Well, no one knows for sure what percentage of people of different ages are walking around with cerebral aneurysms. Most of the time, a cerebral aneurysm that is not leaking or has not ruptured will produce no symptoms. The exception is when the bulge begins pushing on some other structure, like a nerve to cause numbness, weakness, paralysis, or pain. If the aneurysm is near the eye or a structure that affects the eye, eye-related symptoms like a dilated pupil or changes in vision may occur. Currently, the only way to really determine how many people actually have cerebral aneurysms would be to give everyone regular brain scans, which would be ridiculously expensive. Plus, brain scans may not always detect aneurysms and could have false positives that could lead to unnecessary tests and procedures.

Cerebral aneurysms could evolve at any age but are probably more likely the older you get. That’s because an aneurysm forms when the blood vessel wall weakens and becomes thinner and more pliable, which may occur with age. High blood pressure can cause such weakening just as a garden hose may not be able to handle being connected to a fire hydrant. Certain less common infections, trauma to the head, or brain tumors can weaken blood vessel walls as well. Then, there are conditions such as connective tissue disorders, polycystic kidney disease, and arteriovenous malformations, which are abnormal connections between arteries and veins that then change how blood flows and potentially raise blood pressure in parts of the brain circulation.

What may make an existing aneurysm rupture? Anything that weakens the aneurysm walls like high blood pressure and smoking. That means anything that raises blood pressure like cocaine or other stimulant use can lead to rupture. But not all ruptures necessarily need a precipitating event. Aneurysms can just grow bigger and bigger over time until like a balloon that’s overstretched, it pops, and bad stuff ensues.

As Clarke described in her piece, she apparent kept these events quiet until now for fear of repercussions their revelation may have on her career. Such concerns are natural. Nonetheless, her revealing her medical history may now bring more needed attention to these silent time bombs. More attention could help more people get proper treatment in a more timely fashion. It could bring more attention and care to those who have suffered brain injury. It could also galvanize more research to identify better ways to detect and treat cerebral aneurysms. More awareness is especially important in this day and age when science, scientific research, and funding for scientific research are being treated a bit like many of the Game of Thrones characters in how they are being cut and eliminated.

Follow me on Twitter @bruce_y_lee and visit our Global Obesity Prevention Center (GOPC) at the Johns Hopkins Bloomberg School of Public Health. Read my other Forbes pieces here

More about why Luke Perry’s death is important to you…

KIMT News

The death of Luke Perry, after the actor suffered what his publicist said was a massive stroke, is evidence that the disease can affect people of any age, the American Heart Association said.

Perry, who starred in “Beverly Hills 90210” and “Riverdale,” died Monday. He was 52.

“Although stroke often affects older individuals, it is not only a disease of the elderly,” said Mitchell S. V. Elkind, chair of the American Stroke Association Advisory Committee. “There is evidence that stroke rates among young people are increasing in the United States and this requires additional research.”

A 2017 report by the American Academy of Neurology found that 15% of all ischemic strokes happen to young adults and adolescents. But a lack of research, awareness and frequency makes diagnosing the symptoms early on a challenge.

Ischemic strokes account for 87% of all stroke cases. They occur when a blood vessel becomes blocked by fatty deposits and blood has trouble passing through to the brain.

Other types of strokes include thrombotic ischemic stroke — triggered by a blocked vessel — and a hemorrhagic stroke, caused by weakened blood vessels that rupture and bleed into the brain.

The cause and type of Perry’s stroke has not been revealed. But Elkind said it’s important to know risk factors and symptoms.

The risk factors

Stroke is the second leading cause of death worldwide — and high blood pressure is the leading cause of stroke, according to the American Stroke Association.

Smoking, diabetes, high blood pressure, high blood cholesterol, obesity and other cardiovascular diseases put people at greater risk for stroke, the heart association said. Avoiding diets with high calories, lots of saturated fat, trans fat and sodium can reduce the risk, as can getting 150 minutes of activity each week, the association said.

The symptoms

The American Heart Association recommends using the acronym F.A.S.T. to remember how to catch the warning signs of a stroke:

Face is drooping.

Arms are weak.

Speech difficulty.

Time to call 911.

D you Want Proof?

I can’t believe it: these are the results of my “Luke Perry died of a stroke”!  of March 4…. more than QUADRUPLED my normal results and March 5 DOUBLED what I usually had.

From this:

To this:

Get Disability Insurance Now!!!!! If you are unsure who to call, send me a note and I will give you some names.

Luke Perry died of a stroke….

 

I don’t know why this is so upsetting.  Was it because he was about my age when he suffered the stroke?  Was it because he didn’t have any risk factors? Was it because he was living his life …and it just happened?

This CAN happen to any of us.  I hope you have disability insurance to protect yourself if it happens to you.  This past year, I have heard of A LOT of people going though a stroke. The reason: they know I had a stroke and thy are calling me for advice and See if I can offer any assistance of what they can do.

When they get me on the phone, I quickly get Jill on the phone.  After 11 years, I still can not get the words to come out correctly.  I suffer from that as a result because of MY stroke.

BUT, they don’t know that. Friends see me interacting with Jill and they think I am fine. I am not…I am just good at hiding it.  When they talk to me, I just smile, and laugh. Only Jill and I know that I can’t interact with people.

We are still blessed to have friends who understand my limitations.

So please get disability insurance TODAY!  I hope this is a wake up call for you.

Recovery IS a TEAM sport….

I don’t know why that statement is in my head…but it is!  My wife ALWAYS says that to people who are aiding others who are recovering from a stroke. She doesn’t mince words and she tells it like it is…with total honesty.   I like that.  She involved my family in lot of the things I did during my initial recovery.

Would YOU like to participate in YOUR long term goal setting?  Would YOU like to monitor YOUR progress? Would YOU have great satisfaction from that experience?

Following is another post from my wife:

A Great Response

I always say Recovery is a Team Sport.  Every sport requires scheduled practices, specific drills, and a goal.  Successful recovery takes the same discipline.  I suppose the first question is does she want to be on the team? Does she want to recover? Is she willing to work to make it happen?

For me and my husband (11 years post stroke), we first agreed on the goals. I made the practice schedule and the therapists gave us the drills.  I scheduled our exercise time and put it on the calendar. We did not deviate from the schedule. Depending on the day, we had an hour or two to devote to therapy then we always did something fun. Luckily for us, walking was always our main source of fun and connection so post-stroke we always walked (I pushed him in the wheelchair in the beginning).  Walking had a huge effect on his recovery–happy, oxygen to the brain, increased bloodflow, strength.

We were wildly aggressive in our goals and we did not hit a single one BUT we recovered far more than anyone thought we would.  What did this mean? We became much closer as a couple. We were in agreement about what we wanted to accomplish and we were in it together.  Win win win.

If you can’t be there for all the exercises, is there someone who can join the team? Is there someone who can commit to certain days and helping with certain exercises at a certain time?  Can your little boy be involved with some of the work? LIke, can he sit on her foot when she is working on leg raises? Silly things like that?

The great thing is that recovery is always possible–as long as you are willing to put in the work. Our brains are amazing and our bodies are resilient. Working on recovery can be slow but so what? Make it fun, include friends, family, music, anything to keep the momentum.  Good luck.

Hurry up…and wait!

It was like this the past few days…hurry up and wait!

We left for our meeting in Denver on Wednesday, because I NEVER want to be late when speaking on the following day. We got to the hotel at 4:30pm and we quickly went to dinner.  We got back to the room at 6:00pm and just relaxed the rest of the night.

We got up at 9:00am, and had an enjoyable breakfast. Our ride wouldn’t be picking us up until 1:30pm, so my wife and I had a truly enjoyable time talking.  It was great to relax while talking with my wife; REALLY talking with my wife was truly memorable.

Then, our ride came and got us to the event at 2:00pm. That is when the fun started. It’s fortunate, I had everything I needed. The presentation was going to be viewed on GOTO Meeting, which mean my sound didn’t work. I DID have my presentation backed up to Powerpoint, so we were ok.

Then we gave our talk (which was fabulous) and we had to get to the airport IMMEDIATELY!   We rushed down the stairs and found 2 other guys waiting for their rides.  Fortunately, my ride came first..and we rushed to the airport. The was a lot of traffic, but the Lyft driver went 90 on some parts of the freeway where there  wasn’t top much traffic.

We got there 30 minutes before my flight boarded.  Not bad. We had TSA Precheck, so we breezed thru the line. We took the train to my gate and we decided to grab a meal before we took off.

Unfortunately, the cashier was new and didn’t know how to ring up my order. We FINALLY got the receipt, and we rushed to our gate. 2 minutes lates, we boarded!

If anything had NOT worked out, we wouldn’t have made our flight.

 

Comprehensive Speech Language Therapy Services

After a stroke, patients can experience a wide range of symptoms depending on where the stroke occurred in the brain and how severe it was.

Patients who experience facial paralysis and speech impairment after a stroke typically need ongoing speech therapy. At Memorial Regional Hospital, Speech Language Pathologist Joan Parnell works with doctors and patients to develop specialized treatment plans. The treatment begins by understanding the area in the brain where the stroke has occurred.

“Every patient is different, so it varies patient to patient,” Parnell said. “Their age, prior level of function, severity of CVA (cerebrovascular accident), and a patient’s motivation all have an affect on how the treatment is provided and the outcome of treatment.”

A stroke happens when blood flow to an area of the brain is cut off. Brain cells are then deprived of oxygen and begin to die.

“When brain cells die during a stroke, abilities controlled by that area of the brain, such as memory and muscle control, are lost,” according to the National Stroke Association.

When a stroke happens in the left side of the brain, the right side of the body is affected, and when a stroke happens in the right side of the brain, the left side of the body is affected.

The left side of the brain involves speech and language. The left frontal lobe, or Broca’s area, involves speech production. Impairment here usually means the patient can’t form words properly and has slurred or slow speech but can typically understand, she said. The left temporal lobe, or Wernicke’s area, is responsible for comprehension of language.

“When someone has facial paralysis, typically, a speech therapist would have the patient do exaggerated lip, face, tongue exercises, such as smiling, puckering of lips, protruding, lateralizing, and elevating tongue,” Parnell said. “The patient’s prior level of health, severity of CVA/TBI, and motivation/diligence of performing treatment tasks will affect outcomes. Speech therapy is just like any other task — if you don’t practice outside of the treatment room, then typically, your progress is not as great as someone who does.”

Beyond speech

Following any brain injury, some patients may experience depression and feel their intelligence has been taken away, Parnell said.

“I typically educate them that they haven’t lost their intelligence, but that a storm has come through their brain and damaged some of the lines/wires, like electrical and phone wires would be damaged in a bad storm,” she said. “They then need to perform therapy to improve the damaged wires of their brain. They may not only feel ‘dumb’ — as they often say to me — or they are embarrassed, so I celebrate the smallest successes to improve their confidence and keep building from there.”

Because these patients have experienced this storm within their brains, it’s important for friends, family and other caregivers to be patient. Parnell suggests keeping commands and directions simple, allowing the person plenty of time to communicate and not answering questions for them.

“Continue to treat them as a loved one, not as a patient.”

For more information about stroke treatment at Memorial Regional Health, visit memorialregionalhealth.com.

One more speech before the year ends…

The year was closing out…but I had one more opportunity to present my speech to MY insurance company.

But let me back up to when I met JR, my rep.  I met JR about 6 years ago.

He called me on the phone…4 years later…a cool-warm call at best.  He said he wanted to meet with me to discuss our Auto Insurance.  I had this company since 2001 and I didn’t like the service I was getting, so I agreed to meet.

He showed me what he had and he made a convincing case to switch…so I did. Since switching, I had to call JR one time for my daughters car. As soon as I called him, he picked up on the third ring and answered my question!  This was the service that I had been waiting for!!!  JR, you are the man.

Anyway, I made a luke warm call to HIM, and said I was looking to speak at one of their COMPANY events and do you think you can help. (OK, I think BIG.)  A few weeks passed and I got a call from Christi and she wanted me to speak at her upcoming sales meeting.   And Christi told me she lived on the same BLOCK as me (about 12 houses down)! I gladly accepted, but now I had to practice my speech again.

I thought “how hard came that be? I gave this speech over 500 times.” Well, it was hard.  The first time thru the speech, I was terrible!!!  Luckily, I had a few weeks to practice and I THINK I did ok.

I have to ask my wife Jill….to give me the truth…no holding back.  In the past, these were tough to hear, but I think this time, I gotten better.  I will ask her one the post is done…so she can’t change it!