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31
Aug

Melatonin

I use melatonin supplements frequently.  Melatonin is a naturally occurring hormone made by the pineal gland that helps with regulating sleep patterns.  They do help me fall asleep.  I was told to use melatonin by my PCP.  Now, I certainly don’t trust everything a PCP says.  I always say that PCPs(internal medicine docs, general practitioners) know a little about a lot.  As opposed to specialists, who are supposed to know a lot about a little.  Sometimes specialists don’t give good advice though.  (Can you tell I’m disillusioned with the medical field)?  Anyway, I mentioned to my PCP that I was having trouble sleeping.  He said to try melatonin supplements.  They did help me sleep.  Help, sometimes they don’t do a thing.  I have read that melatonin helps after an ischemic stroke to promote neurogenesis(making new nerve cells) and to protect against future blood clots.  Here’s an example.  I have also read the opposite.  I have read that you shouldn’t use melatonin after a stroke.  Read this  This isn’t a study from a peer-reviewed journal though.  The overwhelming evidence seems to say that melatonin can be beneficial.  Sooooooo, I don’t know!  You can find whatever you want to find on the internet.   You just have to know what’s best to believe and not believe.  I use the supplements, so far no complications.  As with everything else, I suggest you do your own research and make up your own mind about what to use/ not use!

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28
Aug

NSA

I was on www.stroke.org, the National Stroke Association’s website, and read this…. “Stroke touches approximately 795,000 people a year in the U.S., and only four percent of patients are appropriately treated.”  4%????????  Really?????????  Let’s get that number up America, strokes are devastating.

27
Aug

Locked-In Syndrome

Warning: really depressing post.  Locked-in syndrome means that every single muscle is paralyzed except the muscles that move your eyeballs but your mind is fine.  Your mind wasn’t damaged at all.  You are literally trapped in your own body.  You can’t even take your own life.  I was told by my neurosurgeon that most people that have my kind of stroke end up with locked-in syndrome.  I came out of this thing extremely lucky compared to what could have been.  Knowing what you want to say and not being able to say it is a different kind of torture.  I can’t for a second imagine what hell it must be to be locked-in.  There was this guy in England, Tony Nicklinson, who had locked-in syndrome and asked the courts to make euthanasia legal.  He asked that it be OK for a doctor to end his life.  He should have had that choice, he didn’t.  He lost his case in court.  But he died a few days later, you can find out why here.

26
Aug

Back and Neck Pain

Back and neck pain used to be my specialty.  I was really good at helping most pain related to the spine.  After a stroke, a lot of people have back and neck pain.  Your posture goes to shit, that’s the main reason.  If the pain is caused by inflammation or something internal going on, I wouldn’t be able to help it.  But if it’s caused by something weird happening in the spine, I probably can help.  Most back pain, contrary to popular opinion, has nothing to do with the muscles being too tight or too weak.  It’s a good thing to keep those muscles stretched out and strong but they’re probably not the source of your back pain.  Don’t get me started on chiropractors and getting ‘adjusted.’  That won’t help you at all – in the long term.  The number one thing you can do to help back/neck pain and help your spine is to have good posture.  Obviously, it won’t fix everything but being aware of your posture will seriously cut down on future back pain episodes.  I have really good posture, I never slouch.  I almost never have back or neck pain.  It’s so so so much better to use your own muscles to get into proper posture than a posture shirt.   If you’re having back or neck pain, I highly recommend you look for a McKenzie certified therapist.  You can find one here.

25
Aug

Tendonitis

After a stroke you may be diagnosed with tendonitis for a variety of reasons. A tendon is what attaches the muscle to the bone. Ligaments attach bone to bone. ‘Itis’ means ‘inflammation of’ so tendonitis is inflammation of a tendon. Like I said, this can happen after a stroke for a number of reasons. To treat tendonitis, I always used eccentric contractions. Think of a bicep curl. Everyone knows what that is. In a normal bicep curl, the forearm is getting closer to the upper arm so the bicep muscle is getting shorter. This is a concentric contraction. An eccentric contraction is the opposite, the muscle gets longer. So slow and controlled lowering of a weight in a bicep curl is an eccentric contraction. The forearm is getting further away from the upper arm so the bicep muscle is getting longer. Ever hear of ‘negatives’ in the gym? That’s an eccentric contraction. If you have tendonitis anywhere use eccentric contractions, works like a charm.

20
Aug

Range of Motion

I lost no range of motion after my stroke.  I can still move my arms, legs, and feet every way they want to go.  It looks funny because it’s lacking coordination but I can do it.  Most of the time however, a stroke is going to cause a loss of range of motion(ROM).  ROM consists of 2 things: joint ROM and flexibility.  Joint ROM is how much motion that there is in the joint, so how far your elbow joint can bend.  Flexibility is a muscle thing.  Flexibility is how long a muscle can stretch out before tightening.  A good example of this is at the hips.  You may be able to bend forward at the hip joint a whole lot but have really tight(inflexible) hamstrings that prevent you from actively going through your full ROM.  That’s why you can bend forward a lot more when you knees are bent.  When your knees are bent the hamstrings are on slack so you take them out of the equation, they won’t prevent any forward bending.  A stroke will often cause tone and/or spasticity in a muscle.  Tone means a muscle is always contracted.  Spasticity is a form of tone that gets worse when you try to move it.  Well, when you try to move it faster.  If nothing is done about all this tone, a contracture forms.  That’s when your muscle permanently shortens and there’s little hope of it ever being full length again.  So that’s why it’s so important to stretch.  Keep your muscles as long as possible.  If you can’t do it yourself, ask someone else to.  Ask a physical therapist what needs to be stretched and how.  There are principles in stretching called creep, load relaxation, and hysteresis.  Creep is the ability of a tissue to elongate over time.  The load relaxation principle means you can use less force, then relax, and still over time deform the muscle(stretch it out).  Hysteresis is how much a tissue stays deformed(stretched) after you stop stretching it.  Use these principles and keep your muscles long!  I’ve used this post before but it’s a really good one!

19
Aug

HTN

Hypertension, or HTN, is high blood pressure.  A normal blood pressure is around 120/80. I’ve even read things that say the powers that be are lowering the standard BP to 110/70.  The top number is called your systolic blood pressure.  This number measures how much pressure is in the arteries when the heart beats, so how much pressure there is against blood going out of the heart to the body.  The bottom number is called diastolic pressure.  This number measures how much pressure there is in your arteries when the heart is at rest and refilling with blood.  So this number measures the pressure when blood is going into the heart.  The diastolic pressure is more important.  If that number is too high or gets bigger with exercise that’s a big problem.  I have really good blood pressure.  Throughout my whole ordeal, my blood pressure never wavered.  It was always perfect.  I always had great vital signs.  Don’t ask me why.  The first thing they taught us to do in PT school when someone felt off was to take their blood pressure.  It’s usually an indicator of something unusual happening in the body.  If you have high blood pressure, there are all kinds of medications you can take but it’s SO MUCH better to lower your blood pressure by losing weight and exercising.

10
Aug

Flight

I’m blogging from the sky right now.  I’m going to Florida for a week to visit a friend.  This is my first flight since my stroke.  So far, so good.  I got to board before everyone else because of my medical condition.  So in order to do that I had to stand in a line of 7 old people in wheelchairs.  That was fun.  The lady looking at handicapped tickets walked right past me and my mom.  To look at me, you wouldn’t know anything was wrong with me.  In fact, I look pretty good so I’m sure there were a lot of people who saw me standing in that line that were thinking “what the….”  I think that sometimes.  One of my biggest pet peeves now is people that park in handicapped spots that aren’t handicapped so I’m always looking for handicap parking passes and looking to see if that person looks disabled.  But I don’t look disabled, so you never know.  My friend goes “it was only 7?  I’m surprised it wasn’t 17.  Seven is a low number for a flight to Florida.  They don’t call us Heaven’s waiting room for nothing.”  That made me laugh.

8
Aug

Foot Drop

Foot drop is a very common condition caused by stroke.  I don’t have it, somehow I lucked out and don’t have any strength issues, just severe lack of coordination.  You may have heard foot drop or drop foot or foot slap.  Foot slap is maybe a little different but they all involve weakness of the same muscle.  This muscle is called the tibialis anterior.  Lift your foot up, feel on the front of your lower leg the part that gets hard, pops out/ moves.  That’s your tibialis anterior.  This muscle is responsible for an action called dorsiflexion.  Dorsiflexion is lifting the foot, bringing the toes closer to the shin.  When this muscle isn’t working right, that action doesn’t happen and your foot drags.  The foot isn’t being lifted up properly.  Strokes cause this a lot.  This is the reason someone will get an AFO(ankle foot orthotic).  An AFO is something you wear on your lower leg and it keeps the foot lifted at all times.  This makes it easier to walk.  A tip – a PT will say you need an AFO and think they’ve fixed the problem.  Now you can walk – success!  Not so much to a stroke survivor.  Whenever you’re wearing that AFO, it’s doing the work for you.  I would wear it to walk outside for safety’s sake and less embarrassment but as soon as you get home, take it off and try to do everything yourself.  AFO

7
Aug

The Church Lady

When I was in the hospital, there was this lady that visited me every single day to offer me communion.  Every day, for a month.  I always said no.  I’m not into organized religion.  Anyway, later I found out that she was a nun.  That made me feel pretty bad.  At the time, I feel like I was pretty mean to her and I acted very annoyed every time she came into my room.  She once said to me “God strikes down only those he knows can handle it.”  REALLY???  Then you deal with this.  You have a massive stroke at the age of 30.  I didn’t want to hear something like that then, actually I don’t want to hear that now.  But it was super nice of her to come see me every day.  She didn’t have to.  And it wasn’t just to offer me communion, she would stay and visit and wanted to be updated on my condition.  That’s really nice.  My dad called her The Church Lady because she wore a ton of make-up and  had lipstick on her teeth.  It reminded him of Dana Carvey’s character The Church Lady on SNL.

4
Aug

Knowledge

There’s this guy, his name is Dean.  He’s pretty famous in the stroke survivor community.  He’s done an incredible amount of research about stroke recovery.  I have a link to his site over on the left there.  He has this one post called “what my doctors should’ve told me.”  You can read it here.  I 100% agree with everything he says.  Learn as much as you can about what happened to you or a loved one.  Learn the anatomy of the brain, then learn what artery/arteries was/were involved in your stroke and what area of the brain is damaged.  Learn what that area of the brain controls.  Learn about strokes and what caused yours, a blood clot or a bleed.  I know personally it’s pretty annoying to talk to someone who has absolutely no idea what they’re talking about, especially people that haven’t taken the time to learn more.  The more you know the better you can talk intelligently about your condition to doctors and others.  As  with anything else, the more you know the better.

3
Aug

Passive Movement

Passive  movement means someone or something else moving your limbs, hands through their available range of motion.  Or you can do it yourself with the “good hand.”  So you’re not doing any work with the affected area, an external force is doing the movement for you.  A therapist will write this as PROM(passive range of motion).  There are studies that say that PROM after a stroke can induce changes in the brain.  So if you lost a movement, that movement should be accomplished passively until you can do it yourself again.  I didn’t lose any movements after my stroke, they were just extremely uncoordinated and shaky.  So I never had to have any PROM done, but most people will.  I had a really rare stroke, but most strokes will result in the loss of movements.  PROM will also help to keep the muscles at the appropriate length and not allow a contracture to form around the joint.  A contracture is a permanent shortening of the muscles around a joint.  So if you can’t straighten out your elbow the whole way, the muscle may not be long enough and a contracture may have formed.  As soon as you can do the movement by yourself though do it.  A lot.  Read this  And this  And this

2
Aug

Stroke Center

Did you know that not every hospital is able to treat a stroke patient?  The first 2 hospitals I was taken to were not certified stroke centers.  I’m kind of angry about this.  Any hospital should be able to diagnose a stroke but once diagnosed, not every hospital is equipped to treat it.    Here’s the thing, if you have even the slightest, smallest, tiniest inkling that something is happening in the brain, don’t just go to any hospital, go to one of these hospitals.  Every second that you’re not getting treatment equates to more brain damage.  Stroke Centers

1
Aug

Fatigue

Post stroke fatigue is weird.  Everyone knows what it feels like to get tired but this is different.  When I get tired it’s like my whole body shuts down.  I just stop working.  I hear things weirdly, like I actually hear a noise when someone talks.  It’s so weird.  I just have to lay down sometimes.  Right after the stroke and for a few months I slept a ton.   I think I was asleep for like 3 months straight.  About 6 months later I started experiencing insomnia, that was new for me.  The Kangen water fixed that.  Now I’m on a normal sleeping schedule but I have to take a nap everyday.  I have to nap, I have no choice.  I mean I sleep more than the average bear.  I wake up everyday at about 9, sometimes earlier, sometimes later.  I go to bed around 11.  Again, sometimes earlier, sometimes later.  I’ve learned not to make plans with someone to do 2 things in one night.  Like dinner and a movie…usually both things will be too much, I’ll get too tired.  So I’ll do one or the other.  Sometimes it’s fine though, and it’s getting a lot better.  It’s hard dealing with this because people that have never had a brain injury don’t understand how tired I get but for the most part I’m around pretty understanding people.  I really really hope I don’t have to deal with this fatigue forever but I imagine it will continue to get better.