Saturday, January 31, 2015

Saturday News

Contents of This Week Saturday News:
The role of an Occupational Therapy/Therapist is to work with a client to help them achieve a fulfilled and satisfied state in life through the use of "purposeful activity or interventions designed to achieve functional outcomes which promote health, prevent injury or disability and which develop, improve, sustain or restore the highest possible level of independence." A definition from Wikipedia and video clips from YouTube/Vimeo.

Definition: Occupational Therapy/Therapist

Occupational Therapy From Wikipedia, the free encyclopedia

Occupational Therapy (OT)
Occupational therapy (OT) is the use of assessment and treatment to develop, recover, or maintain the daily living and work skills of people with a physical, mental, or cognitive disorder. OTs also focus much of their work on identifying and eliminating environmental barriers to independence and participation in daily activities. Occupational therapy is a client-centered practice that places emphasis on the progress towards the client's goals. Occupational therapy interventions focus on adapting the environment, modifying the task, teaching the skill, and educating the client/family in order to increase participation in and performance of daily activities, particularly those that are meaningful to the client. Occupational therapists often work closely with professionals in physical therapy, speech therapy, nursing, social work, and the community.

History of Occupational Therapy

Early Therapy

The earliest evidence of using occupations as a method of therapy can be found in ancient times. In c. 100 BCE, Greek physician Asclepiades initiated humane treatment of patients with mental illness using therapeutic baths, massage, exercise, and music. Later, the Roman Celsus prescribed music, travel, conversation and exercise to his patients. However by medieval times the use of these strategies with people considered to be insane was rare, if not nonexistent.

In 18th-century Europe, revolutionaries such as Philippe Pinel and Johann Christian Reil reformed the hospital system. Instead of the use of metal chains and restraints, their institutions utilized rigorous work and leisure activities in the late 18th century. This was the era of Moral Treatment, developed in Europe during the Age of Enlightenment, where the roots of occupational therapy lie. Although it was thriving abroad, interest in the reform movement waxed and waned in the United States throughout the 19th century. It re-emerged in the early decades of the 20th century as Occupational Therapy.

Video: Occupational Therapy/Therapist

Occupational Therapy as a Career

Uploaded on Mar 17, 2010

Occupational therapists work in many different roles and settings. This short film will help you find out what a rewarding career you could have as an occupational therapist, helping people to live life their way.

Standard YouTube License @ BAOTCOT

Eclectic Stuff

Definition: Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

Part of OT is Hidden

Rebecca Dutton
Home After a Stroke
January 17, 2015

Some people think OTs are the dressing or handwriting guys.  Yet OT's official slogan is Living Life to Its Fullest ®.  The disparity between what people think OT is and how OTs see themselves occurs because OT is like an iceberg.  An important part of what OTs are trying to accomplish is hidden.  There are three components of OT treatment, but you see only two in an OT session.

1. The Preparation.
Preparation addresses each client's individual deficits.  Examples include exercises to open the hand while reaching, scanning strategies for visual neglect, learning what the parts of a memory notebook are for, and learning how to stop negative self-talk.

2. The I Shoulds.
Many people have the same shoulds.  We all should get dressed so we can leave the house, do laundry so we have clean clothes, write legibly so we can sign credit card slips, and have good memory strategies so we get to appointments on time.  OTs call "I shoulds" functional outcomes.  Insurance companies will not pay for therapy if clients do not show some functional gains.

3. The I Want Tos.
"I want to" is personal, like petting a beloved cat.  Valued activities occur outside of therapy so clients may not see how they are connected to OT.  OTs need to make linking statements so clients understand the full value of OT.  A linking statement might be "don a bra so I will not be embarrassed when I eat lunch with friends."  I live alone so donning my bra enhances my social life.  If a client wants to feel the sun on his or her face, pointing while saying "leg brace - patio" can make a client's face light up.

Preparation and functional training are essential but they do not sustain our commitment to action when we recover slowly.  Practicing a tip pinch so I can zip my coat needs to be followed by "because I want to..........."  Valued activities help us maintain the physical, cognitive, language, and social skills we work so hard to regain.  Living life to the fullest does not mean going to Paris.  It means satisfying deep human needs like feeling needed and having fun.  It means turning "I should" into "I want to."

See the original article:

SOAP Notes

Amy Shissler
My Cerebellar Stroke Recovery
June 7, 2013

SOAP notes are what physical and occupational therapists call their daily notes.  I don’t know if that’s what speech therapists call their notes.  Every time you have a PT or OT appointment, the therapist will write a SOAP note.  I don’t know if this information can be helpful in any way but here ya go.  SOAP is an acronym for subjective, objective, assessment, plan.  The subjective is whatever you say.  So if I go into my OT appointment and say “I’m still writing really crappy,”  she’ll write on her note “patient reports she is still writing crappy.”  She’ll use the word ‘crappy.’  It’s whatever the patient says.  I remember one time I wrote patient reports “I feel like Superman.”  That boosted my ego a bit.  Objective means whatever you did during the session.  So when I’m in OT and put the pennies in the piggy bank 3 times, she’ll write that down – that I did that 3 times.  It’s whatever you do during the session.  Assessment is weird.  It’s supposed to be how the patient did during the session but often it ends up being objective.  A good assessment would be “due to decreased strength, the patient had trouble standing up today.”  This is an assessment of the situation.  Much better than “the patient had trouble standing up today.”  That’s objective.  Then plan is what you plan on doing next session.  If you plan on adding an exercise, you write “add leg press” or whatever.  If you plan on doing a re-evaluation, the therapist would write “do re-eval.”  Ok that’s SOAP notes for you.

See the original article:

Modified Constraint-Induced Movement Therapy

Grace Carpenter
My Happy Stroke
Sunday, March 27, 2011

For the last two weeks I went to Spaulding everyday to try to recover more movement for my right hand. I did a program called Modified Constraint-Induced Movement Therapy (M-CIMT).

Warning: this post is much longer than usual. I wrote this summary since some stroke survivors I know were curious about this program, especially since the price is so reasonable.

The program

Every day from 1 - 3pm, five stroke survivors, including myself, gathered around a big table. After our occupational therapist (OT) led us in some stretching (both hands), we were asked to put our less-affected hand in our lap.

Then the fun began.

The [CIMT] Challenge

Pamela Hsieh
Rehab Revolution
16 April 2010

CIMT. Constraint-Induced Movement Therapy. This is a therapy technique in which a glove, mitt, or any kind of constraint is used to cover the unaffected hand at all times, which requires the forced use of affected hand. This should be done in conjunction with regular occupational therapy, which in theory should compensate for the inevitable poor form that will result from the forced use. It's also traditionally done with supervision, which makes it an even more challenging process, especially when you're by yourself.

Recently here in Chicagoland, an occupational therapist specializing in CIMT began a research project on modified CIMT practice. In this study, she had roughly twenty volunteer patients do CIMT for six hours per day for two weeks (I believe this to be called mCIMT, for modified). There is an activity log to fill out and a motor test right before and right after the program to test for results.

The CIMT program is promising because it forces your healing practice both by inducing your weaker side's movement and increasing your awareness of it (something that really fades over time), and by making you accountable to others. It's still a system in progress, and I've got a lot of feedback from the first time and current trial --

Don’t Let The Bastards Get You Down

Sas Freeman
June 16, 2014

My OT & Physio had realised I spent far too many weeks simply sitting in the same chair in the same room all day and every day until being put to bed at night.

To break the monotony it was decided to give me a huge lift emotionally by arranging a trip in a car to a local forest tea room. The coffee shop and car park were disabled friendly enabling me to attempt such an outing.

After finding a table Jane, my OT, ordered our lunch and drinks and I was enjoying every moment of fresh air, people watching, listening to voices all around me, children running around in a near by play area. Jane cut my lunch up to manageable sizes so that I could eat with my left hand. This was something I had now grown quite used to and didn’t think anything of until noticing the faces of mothers around me, showing their shock, disgust even as they were doing the same for their toddlers and here was Jane doing it for a woman of her own age! This was the first of many uncomfortable emotions, that said four years on I don’t bat an eyelid.

I was exhausted after this trip and slept on the way back home but it had done everything Jane & Marianne had intended and more, it increased my confidence too.

However, the next uneasy feeling from that day which didn’t actually catch up with me until the following week, reduced me to tears in my fragile state. I was at that time fragile in every sense of the word. If I see the couple I am about to refer to, although I no longer feel upset, my emotions revert back to this occasion.

After my fabulous lunch I needed to visit the disabled toilets before returning to the car ( this reminds me of a time visiting the same with my mother’s help whilst I was in control of a disabled scooter, I got us all trapped inside, this is for another blog but until then visualise a Mr Bean sketch).

“Therapy” Without Insurance

Rocky Mountain Stroke Survivor
March 19, 2013

Many people with stroke have such devastating injuries that they feel blessed to be able to feed themselves.  Cerebellar stroke is a little different.  I can move everything, do everything…just in the wrong place and at the wrong time.  And when I fatigue I can’t get messages through.  It’s not that I’m weak…it’s that the communication between my brain and body is off.

Because of this quirk of cerebellar stroke, I simultaneously feel really guilty for complaining and also generally misunderstood.  In general, the best therapy I can have at this point is to do coordinated movements over and over and over.  Compared to someone with a more normal stroke, this is easy.  Compared to how I was before, this is very, very hard work!  Because I’m cognitively fine, I also find activities like tapping cups or cones (common occupational therapy) not only boring, but somewhat irrelevant.  I learn tapping cups very quickly…but tapping cups isn’t what I need to fully function.  Cognitively speaking, I can function as a doctor but I need to practice language and memorization and could probably due to improve my focus as well.  Playing computer games just doesn’t do it for me.

A few weeks back I started an art therapy class at the local non-profit stroke center.  It was an amazing experience!  I have never been noted for my artistic ability.  My mom’s infamous comment when we were sitting around doing an art project together as a family: “Well, dear…medicine is your art.”  But no one at the therapy class cared about my abilities.  It was all about learning to use my hand and being able to express myself in another way.  I’m on a huge tree kick right now.  I’m working on my third set of trees and have several more in my mind’s eye.  Doing the art is exhausting!  I hold my poor, tired hand in my lap several times during the class just to rest it and then need a nap when I get home.  But it is so much fun and has been a huge help in using my hand.

Saebo in the News...

Peter G. Levine
Stronger After Stroke
Tuesday, November 20, 2012

I'm a fan of one of this blog's advertisers, Saebo. The two guys who started the company are brothers, both occupational therapists. (Find another set of brothers that are both occupational therapists and I'll send you a free copy of my book.) I like the culture that Saebo brings to stroke recovery. Everything they make has a commonsensical perspective engineered in.

Saebo makes the SaeboStretch. Unlike static splints which hold the hand in a static position, the SaeboStretch allows the fingers to flex when they need to (often to protect the joints of the fingers). The 'Stretch then slowly pushes the fingers back to the desired position.

Link here.

And, as it turns out, Gabrielle Giffords sports one! (Read my early take on Giffords recovery here)

See the original article:

Location, Location, Location

Marcelle Greene
Up Stroke
Wednesday, November 14, 2012

My affected side has been very stiff and sore lately. My therapists tell me it’s because of the change in the weather. I live in Los Angeles and despite daytime temperatures this fall often registering above 80°F, there is a chill in the air at night.

I think about my stroke friends who live on the East Coast or in Canada and wonder how they contend with the snow and freezing temperatures. It's so much more than the dangers of walking or driving on ice, or the effort required to put on and take off extra layers. It's the way the cold settles into the muscles and makes them less effective and more painful than usual.

It reminds me how lucky I am to be where I am in dealing with life post-stroke. It's not just the weather — it's the depth of medical help available to me that isn't available to others. I know a Canadian survivor whose nearest neurologist is a two-hour drive away. From the rural Midwest, a reader of my blog contacted me with questions about how to help her husband regain functionality in his hand; the only occupational therapist within driving distance had dismissed her husband, saying there was nothing more to do for him.

I am not only geographically closer to my medical team, I have a choice whom to work with: I had the luxury of firing both my first occupational therapist and my first neurologist.

I hope that I’m not making survivors who are not located as beneficially as me feel bad. (If it makes you feel better, I’ve paid for it in traffic jams, air pollution and skin cancer.) I just wanted to point out that location is one more factor that has an impact on our recovery.

See the original article:

Not Accepting Everything

A Year of Living In My Head
Sunday, July 15, 2012

So I am almost to the point of looking for a position that more fits my training.  My concern is I could be a bit delusional that I can still produce the same quality of work as pre-stroke. I just don't know.  I know when I started my garden job that absolute crazy feeling in my head when my boss gave me run on instructions as in : Do This, Do That, Move This, Look for This, etc etc.  I could feel my brain actually scrambling and freezing and locking... it did not know (or that part of my brain is "gone") where to put a series of quick instructions-- so it would just go blank and not remember any of them.  My short term storage has been impacted, and it feels as though it has been misplaced.   It is very wierd being in my head when it is missing something.  You ever have that?  It's like there is some sort of memory of what was, what I could do, but there is no way to touch it. I have a memory of being very competent and accomplished, but I feel kinda bumbling and floaty sometimes.  I also cannot trust my "gut" as much, as I have discovered errors in my instincts--and I am a very "gut instinct" person!  With work over 3 months my memory has changed & improved so that I actually can remember a string of instructions (at least the first 3 or 4).   Last week I made a appointment with an occupational/speech therapist to work on memory.  I also notice the muscles on the left side of my body have a different consistency than others.  They are always very flaccid-loose-relaxed as if I just had a year long massage and they are jelly.   I am not really complaining, just noticing.  Pre-stroke I always loved learning new things, and new ways to see things.  I thank the lovely heavens that my  appreciation of the diverse ways we can navigate through a life is not diminished.

See the original article:

Babies and Strokes

Dec 9, 2012

This is a brain. It is also the unfortunate outcome of a baby whose mother experimented with cocaine, resulting in a premature birth and a bleed in the baby's brain. A bleed in the brain means the baby had a stroke. Hey! Wait a minute! Babies and strokes don't go together, or do they?

Note: for all you baby-makers out there, I'm not trying to scare you from having kids. This post is just a dose of reality.

You probably don't know the name Duncan Guthrie. He started a charity in 1952 for his daughter, Janet, who had polio, and he was determined to find a cure for the disabling disease. With money funded by the charity, research, in time, led to the first oral polio vaccine which wiped out new cases of polio in the UK. Now called Action Medical Research, the charity encompasses so many other afflictions, and that leads us to babies and strokes.

In 2009, Action Medical Research estimated at least one baby out of 2,300 in the UK born full-term were victimized by a stroke. These strokes often were unexpected at the time of birth or before, i.e. some developing babies had strokes in utero. The researchers didn't know if the babies, who are now barely three years old, had trouble using language because they hadn't matured to the point where anybody could tell the difference between a three year old saying gibberish or not.

Brain Therapy Might Help Stroke Rehab

Jeff Porter
Stroke of Faith
Thursday, December 12, 2013

Photo from the University of Wisconsin
School of Medicine and Public Health
Stroke is the leading cause of permanent disability in the United States. So many people need physical, occupational and speech therapy to recover. I recently read about research that might lead to better tools to help stroke patients to recover.

This article describes how brain therapy helps rehabilitate stroke patients:
A new interventional therapy that uses a brain–computer interface appears to change brain activity in patients with stroke, new research has shown. 
The therapy alters specific areas of the brain that correlate with both the affected and unaffected hands. The activation of these areas of the brain appears to correspond to executed and imagined tasks of the affected hand, and may represent neuroplastic recovery. 
"Brain activity fed back to the patient is key for the therapy," explained Vivek Prabhakaran, MD, director of functional neuroimaging in radiology at the University of Wisconsin in Madison.

See the original article:

The Small Yellow Ball

Barb Polan
Barb’s Recovery
16th April 2010

Success today took the form of a small yellow ball at occupational therapy. As I was lying down, OT Stephanie had me put my hands on either side of it and push it toward the ceiling until both arms were fully extended, then lower it to my chest and/or abdomen, then up again. To do it, I recruited every arm muscle I could remember looking at in Dr. Netter's atlas of human anatomy. Up, down, 10 times, then 10 more. When she asked me how that felt, I said,"Like my right arm was doing most of the work."

"Your left arm was working, too, though, or it would have flopped back down, which it didn't," she said. "How did it feel?"

It occurred to me that my left arm - that stupid recalcitrant one - had finally successfully accomplished something. Instead of my OT asking me to do something and having my left arm fail, my arm did it! How did that make me feel? I burst into tears; she patted me on the shoulder and asked me whether I was getting any counseling to help me with my ordeal. I said no, because I thought I was all right dealing with the whole thing. Given, though, how fragile I have become for being such a strong person, she had a good point and I'm thinking that next week I'll look into my counseling options.

See the original article:

New Stroke Therapy Shows Promise on Kids - Magnetic

Dean Reinke
Deans’ Stroke Musing
Monday, December 19, 2011

This one was interesting because the magnetism was on the healthy side - New Stroke Therapy Shows Promise on Kids

Using non-invasive electronic stimulation, coupled with occupational therapy, researchers say they are hoping kids can increase hand function.

At Gillette Children's Clinic in Burnsville, Maddy Evans of Lakeville puts on the cap she wore during her electric brain stimulation therapy two years ago. On the table is the cast that was put on her dominant hand for two weeks so she would be forced to use the hand that was affected by the stroke. She credits the therapy for helping her make better use of both hands: i.e. the ability to put on a cap with two hands instead of relying on the one dominant hand.

Photo: Richard Tsong-Taatarii, Star Tribune
Is it possible to experience elation putting in your own ponytail or firmly shaking hands with a stranger?

Just look at Maddy Evans' beaming face for the answer. Maddy, 16, completed a study at the University of Minnesota and Gillette Children's Specialty Healthcare, using a combination of brain stimulation and occupational therapy to help children who have had a stroke increase their hand function. Maddy now buttons her coat with both hands, can put in her own ponytail and, yes, reaches for a stranger's hand with her right one. She never used to use her right hand.

Tips to Remember Names and Words:
         Aphasia Speech Therapy

January 28, 2015

Here is a little video I made today on the subject of memory and remembering.  The ability to remember words, phrases and sentences is crucial for those with aphasia.  However one has to begin at basic levels when helping someone speak again.  In this video and the one that will be published next week, I will discuss how remembering names has some similar methods to remembering words for those with aphasia.  In these two video blogs, I will give you tips and fundamentals for memory.  I hope you enjoy!  Please share with friends and other Facebook sites where there are people who would greatly benefit from this INFORMATION.  Do not hesitate to contact me should you have any questions or concerns.

Standard YouTube License @ Mark Ittleman

See the original article:

4 Years Post Stroke and A Squeeze!

The Pink House On The Corner
Thursday, January 22, 2015

Yesterday, at therapy, the PT was trying to get Bob to squeeze his right hand. Now, most of you know, Bob has had no movement what-so-ever in that right hand/arm/shoulder since the stroke. So, I'm sort of sitting there, rolling my eyes, because man, we've done this a million times with about a million other therapists with no luck. And I, too, have tried this a million times...

So imagine my surprise when the PT states that he has felt Bob squeeze his hand! I tell you, I didn't believe him. So the PT had me take Bob's hand and he asked Bob to squeeze it.

And to my amazement, I felt a squeeze. A little squeeze. But a squeeze! It felt like an "inner squeeze" sort of coming from inside his hand. I couldn't believe it, I really thought I just imagined it, because I didn't see Bob's hand move, only felt this little squeeze. Then, Bob did it again, on command.

All I can say is "WOW!" After four years of no movement, this is nothing short of a small miracle!

The technique the PT used was this: He had Bob lean back as far as he could in the wheelchair, hold his head as upright as he could, shoulders back -- this position, the PT says, "opens the nerve pathways to the brain". He told Bob to visualize energy flowing from his brain and "zapping" his right hand. Then, he also had Bob visualize the actual activity of squeezing his hand. Here's a video I took after that first, phenomenal, squeeze:

Standard YouTube License @ Pink House

Mediterranean Diet and Aging

Bill Yates
Brain Posts
Jan 19 / 2015

There is a growing research body of evidence to support beneficial effects of a Mediterranean diet on brain health.

In previous posts I have reviewed research on the Mediterranean diet and:

Cognitive Decline

Alzheimer's Disease Prevention

A recent study adds an important element in potential mechanisms for the beneficial effects of the Mediterranean diet.

Marta Crous-Bou and colleauges from Harvard University and the University of Washington published a study of the Mediterranean diet and chromosome telomere length.

This analysis used the large Nurses' Health Study cohort, blood samples and dietary questionnaires. Blood samples were analyzed for chromosome telomere length.

Chromosome telomere length has emerged as a biomarker of aging. DNA chromosome telomere lengths decline with age and shortened telomere lengths are associated with shortened life expectancy. 

The natural process of telomere shortening appears accelerated by inflammation and may be modified by lifestyle behaviors including dietary composition.

My Thoughts on Self-management for Stroke.

Sharon D. Anderson
Stroke Survivors Tattler
Stroke specific self-management programs are a research topic in the United Kingdom and Australia.  As governments try to reduce spending, health and social or community care budgets are reduced. Self-management seems like an idea whose time has come as resources become even scarcer.  So how will self-management work in stroke?

I come to this as wife of a stroke survivor and a PhD student. I returned to university after John’s stroke because I hoped to make getting on with the rest of your life easier for stroke survivors and families.  Certainly as I wrote about in my masters, post stroke communication to survivors and families can be improved:  How Effective Communication of Information Is Crucial to Restructuring Post-Stroke Life.  I also think that navigators would be useful - Community Navigation for Stroke Survivors and Their Care Partners: Description and Evaluation. I believe that stroke self-management programs would be useful for stroke survivors and their families. So much so, that I helped instigate Dr. Kate Lorig’s visit to Ottawa to speak a combined conference for Professionals, Stroke Survivors and Families in Ottawa.  Janet McTaggart and several stroke survivors from the Stroke Survivors Association of Ottawa took Dr. Lorig’s Chronic Disease Self-Management course.

Self-management programs increase self-efficacy and help people to take control of their health.  The programs focus on the things that people can control—the amount of exercise we do, the food we eat, and the medications that we take. The groups are run by a professional and a peer with a chronic disease, so you get professional and practical advice.   Meeting other people with the same condition is useful too.  After six or eight weeks, some of the people become friends. Making friends and increasing your social network may be one of the best ways to improve your health.

Despite my enthusiasm, I have a couple of concerns. First, stroke self-management should not be a substitute for other services as health programs downsize. I believe that communication with stroke survivors and their families can and should be improved. Research by William Levack in New Zealand shows that goal setting with stroke survivors could be significantly improved and that most of the time families are not included in goal setting.  From my current research with stroke survivors and their spouses, I am hearing similar complaints. Wives and husbands have been peripheral to information and goal setting, thus are uncertain about how to manage once the survivor is home. Navigators to find scarce services and support would still be useful. It is well documented that stroke survivors do not have access to rehabilitation that would improve their functioning once they are discharged from hospital.

Second, self-management implies that the stroke survivor can self-manage stroke by themselves. There are many survivors who do self-manage and do a stellar job.  However, there are many more that don’t. Just as we now know that an acute stroke management team and dedicated stroke rehabilitation team produce better results, shouldn’t we be encouraging team approach after discharge home to produce equally stellar outcomes? Is self-management even the correct name for long-term management of stroke? The stroke survivors in my masters research told me that It Takes A Community To Manage Stroke.

So these are my thoughts—it will be good to hear yours in the Feb 10th #strokerecovery Tweet-chat.   The March Tweetchat will be on technology.

Weekly Columnists

Sunday Stroke Survival: OT - The Other Therapy

Jo Murphey
The Murphey Saga
Sunday, January 25, 2015

I've always thought of OT (occupational therapy) as the other therapy. I've even discounted the need for it because has to do with adapting rather than recovery. There. I said it. I apologize to Rebecca and Amber, both truly gifted OTs.

I'm a results orientated person. While I'll study the steps to get to a certain point, it's getting to that point that's important not settling for less. In this respect, PT (physical therapy)is king while OT is the lowly jester. OT gives you a sense of accomplishment while on your way to the bigger goal. It also catches you when you tumble while shooting those bigger goals.

For example, I'll use my spastic arm which I've been in OT for over a year. Mainly we are doing stretches to ease my spasticity. If the spasticity can be reduced, then there is hope for recovery of my upper arm function. That's a major goal for me. The relaxation and extension of my elbow is either all on or all off at this point. But we are working on this.

OT is learning how to function while on your way to your goals. In my mind it's a stalemate action. Functioning while waiting for the next breakthrough.So it's settling for what you got.  Well not totally, but still it's like plateauing in progress. Nobody really wants it but you have to deal with it.

Occupational therapy deals with ADL (activity of daily living). How to adapt. I don't want to adapt but recover, but until I do I need to know how to take care of my daily needs. The longer I go post stroke, I find all sorts of show-me-how type questions to ask my OT. They aren't basic ADL type questions either. Most of the basic ones have already been answered. Unfortunately, she doesn't have the answers for me. Like washing the outside of my glasses. But what she does do is allow me to use her as a sounding board for possible answers. We bounce ideas off each other until we come up with a plan that works for whatever I want to do.

Jackie The Jester: Ranching Sisters - Mea Culpa...

Jackie Poff
Stroke Survivors Tattler
Two sisters, one blond and one brunette, inherit the family ranch. Unfortunately, after just a few years, they are in financial trouble. In order to keep the bank from repossessing the ranch, they need to purchase a bull so that they can breed their own stock.

Upon leaving, the brunette tells her sister, 'When I get there, if I decide to buy the bull, I'll contact you to drive out after me and haul it home.'

The brunette arrives at the man's ranch, inspects the bull and decides she wants to buy it. The man tells her that he will sell it for $599, no less. After paying him, she drives to the nearest town to send her sister a telegram to tell her the news.

She walks into the telegraph office, and says, 'I want to send a telegram to my sister telling her that I've bought a bull for our ranch and I need her to hitch the trailer to our pickup truck and drive out here so we can haul it home.'

The telegraph operator explains that he'll be glad to help her, then adds, it will cost 99 cents a word.

Well, after paying for the bull, the brunette realizes that she'll only be able to send her sister one word. After a few minutes of thinking, she nods and says, 'I want you to send her the word “comfortable."'

The operator shakes his head. 'How is she ever going to know that you want her to hitch the trailer to your pickup truck and drive out here to haul that bull back to your ranch if you send her just the word comfortable?'

The brunette explains, my sister's blonde. The word is big.

She'll read it very slowly... 'com-for-da-bul'

TED Talks - Elliot Krane: The Mystery of Chronic Pain

Uploaded on May 19, 2011

We think of pain as a symptom, but there are cases where the nervous system develops feedback loops and pain becomes a terrifying disease in itself. Starting with the story of a girl whose sprained wrist turned into a nightmare, Elliot Krane talks about the complex mystery of chronic pain, and reviews the facts we're just learning about how it works and how to treat it.

Standard YouTube License @ TED

Rick Mercer Report:
         Rick at Variety Village & The Whistler Sliding Centre

Rick Mercer Report: Rick at Variety Village

Published on Jan 21, 2015

Rick spends a day checking out the programing and state-of-the-art equipment at this Toronto facility dedicated to people of all abilities.

Standard YouTube License @ Rick Mercer Report

Rick Mercer Report: Rick at the Whistler Sliding Centre

Published on Jan 21, 2015

Rick pilots a bobsleigh down the world’s fastest track in Whistler, BC with some of Canada’s top Olympic bobsledders.

Standard YouTube License @ Rick Mercer Report

Laid-Back Administration: Vanish Articles?

Dr. Beagle C. Cranium
Stroke Survivors Tattler

Well, articles will not “vanish" and they are there but the problem is the labels:

Now (from Google...) there is limit of 20 articles for “Contents of This Week Saturday News:” per week. But we have maximum 30+/- articles per week! For example, display with the label "▷ 2014 Nov 08” they will show only 20 articles.  Before there was no limit but it was weird and inconsistent  i.e. they drop articles #21 or #22 and show #23, #24, ... As well, using the label “⌘ Headline” (maximum 3 or 4 articles per week) or "▶ Weekly Columnists” (max 6) or "▶ Eclectic” (usually it is less 20 articles) have the same problem.  I think the problem is every new page start with a new day (or SSTattler has per week). So they have on the specific day, say have e.g. 22 articles from SSTattler, then display 20 articles, then drop 2 articles, and then they will display the next page, and so on,... (Maybe it is my problem... hmmm... but I don’t think so.)

I think it is relatively easy to fix and I will tell you the Google Solution as soon as possible.

Jury-rig start Jan/31/2015 and beyond:
  1. The main centre column “Saturday News” is OK i.e. they display about 35+/- articles (or approximate 1.5 +/- weeks).
  2. Older articles you can using the label but:
    1. We well drop with the label "▷ 2015 Jan 31” and beyond for "Contents of This Week Saturday News:”. The label is still in the software but you can not use until the Google Solution appeared.
    2. Using the "⌘ Headline" - 3 articles - Saturday News, Definition, Video. Basically, the "Contents of This Week Saturday News:" will show all of indexes of Eclectic, Weekly Columnists, Daily Comics.
    3. Using the "▶ Eclectic" - header Eclectic Stuff + up to 19 articles it is OK. More than 20+ articles will most probably not appear. Try ⌘ Headline with Indexes instead - it does work.
    4. Using the "▶ Weekly Columnists" - Show the header Weekly Columnists and up to 6 articles. But usually they have (6 articles x 4 weeks) modulo 20 ≡ 4 reminder - obvious problem i.e. drop the last 4 articles! Try ⌘ Headline with Indexes instead - it does work.
  3. You can use ▶ Weekly Index / Future (TBD) but, again, use ⌘ Headline to find the desirable article.

Daily Comics

For Better and For Worse
Lynn Johnston

Canada Family Events
Scott Adams

Dilbert Office Events

Edmonton Journal
Malcolm Mayes
Politics Views from Canada

Garry Trudeau

Politics Views from USA

** I tried to get low or free price at the people for the images for the cartoons. It was too high for Stroke Survivors Tattler i.e. we are not a regular newspaper and our budget is very, very low. Fortunately, you will have to do only 1-click more to see the cartoon image, it is legit and it is free using and


Saturday, January 24, 2015

Saturday News

Contents of This Week Saturday News:

Definition: Stroke

Stroke From Wikipedia, the free encyclopedia

CT scan slice of the brain showing a
right-hemispheric ischemic stroke.
A stroke, sometimes referred to as a cerebrovascular accident (CVA), cerebrovascular insult (CVI), or colloquially brain attack is the loss of brain function due to a disturbance in the blood supply to the brain. This disturbance is due to either ischemia (lack of blood flow) or hemorrhage. As a result, the affected area of the brain cannot function normally, which might result in an inability to move one or more limbs on one side of the body, failure to understand or formulate speech, or a vision impairment of one side of the visual field.

Ischemia is caused by either blockage of a blood vessel via thrombosis or arterial embolism, or by cerebral hypoperfusion. Hemorrhagic stroke is caused by bleeding of blood vessels of the brain, either directly into the brain parenchyma or into the subarachnoid space surrounding brain tissue. Risk factors for stroke include old age, high blood pressure, previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, tobacco smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke.

A stroke is a medical emergency and can cause permanent neurological damage or death. An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"), and some hemorrhagic strokes benefit from neurosurgery. Treatment to recover any lost function is termed stroke rehabilitation, ideally in a stroke unit and involving health professions such as speech and language therapy, physical therapy and occupational therapy. Prevention of recurrence may involve the administration of antiplatelet drugs such as aspirin, control of high blood pressure, and the use of statins. Some people may benefit from carotid endarterectomy and the use of anticoagulants.

Stroke was the second most frequent cause of death worldwide in 2011, accounting for 6.2 million deaths (~11% of the total). Approximately 17 million people had a stroke in 2010 and 33 million people have previously had a stroke and were still alive. Between 1990 and 2010 the number of strokes decrease by approximately 10% in the developed world and increased by 10% in the developing world. Overall two thirds of strokes occurred in those over 65 years old.

Video: Stroke

What Is A Stroke? - Narration and Animation

Published on Jan 28, 2013

by Cal Shipley, M.D.

An in depth review of the causes of stroke (CVA - cerebrovascular accident), including blood supply and vascular anatomy of the brain. Animation and narration by Dr. Cal Shipley.

Standard YouTube License @ Cal Shipley, M.D.

Eclectic Stuff

Definition: Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

A Beginning ...

Jeff PorterStroke of Faith
Wednesday, December 14, 2005

This blog has come about after a long period of soul-searching – more that seven years. My own stroke came on May 8, 1998. A colleague and I, both newspaper reporters, were digging through documents in a semi-hostile government office in Arkansas. I suddenly lost the ability to speak and movement on the right side of my body. My right hand fell limp. I could not stand. A strange dazed feeling came over me.

That day, I nearly died. Thanks to my colleague, an ambulance came. Thanks to the ambulance crew, the hospital was ready. Thanks to the doctors and nurses, a drug called tissue plasminogen activator cleared the clot. Thanks to my wife, colleagues, fellow believers, and a speech therapist, I regained my ability to speak and, eventually, write.

And most importantly, thank God. He gave me all those people and the strength to get through some struggling recovery times. God returned my ability to speak and write. He returned my body to me. As this is being written, I ran five miles this morning, will run 10 miles this coming Saturday and am seriously considering a marathon next spring.
It’s been a long time since May 8, 1998. And please understand that this blog is not about my personal history or struggle. It is about faith. It’s about a very specific task of sharing experience and faith with stroke survivors and their families, to help them if possible.


Honest answer: Uncertain. This is a start. Where this leads, at the moment, isn’t obvious. All I can say is that I’m led to do this.

Stroke survivors and families are invited to share comments or stories with me and, by extension, others.

Comments will be moderated, and all I ask is that you respect the purpose of this blog. It’s not about politics or general religion topics. It is about and for stroke victims and their loved ones, and the faith we can share.

See the original article:

Living With Aphasia: Carrie Lewis' Story

Carrie Lewis
Stroke Survivors Tattler
Sunday, January 01, 2012

"Carrie Lewis is a remarkable woman".

This isn’t because she lives in Edmonton, Alberta, or because she’s 49 years old, or even because she has lived with aphasia in the four years since her stroke; what makes Carrie instantly likeable is her sense of humour and obvious enthusiasm for life.

I am feeling pretty good, now,” Carrie wrote when asked to talk about herself. “I like my independence, being able to walk and drive. Make things, do things like sports, games, talk, see new things, places, people.

Carrie experienced her subarachnoid hemorrhage as “the worst head- ache I ever had”. The stroke left her with aphasia and other changes – “I saw the clock numbers backwards” – as well as a weak left side. She has learned to walk again, but her “left arm is taking longer, with no feeling, but works quite well, anyways.

She is honest about the daily challenges that accompany aphasia. “It is tough some days. I am getting used to my slow answers and bad pronunciations.” However, with typical optimism, this has helped her “appreciate those who have English as a second language.

In addition to working each weekday, Carrie attends group speech classes, goes bicycle riding, and has joined a darts group. “All of us try to get other Stroke survivors to come out and play, and socialize. At Darts, we did a lot of talking, and everyone feels comfortable.

I have a great support from my family and friends. Old friends and new. All of us are a bit smarter, about Stroke and Aphasia.

As for this workbook, Carrie found it to be “a good idea” during her initial stroke recovery, and believes “I will use it” continuously in the future – “I am a work in progress still.

When asked to address other people living with aphasia, Carrie’s message comes through strongly and clearly.

Keep up all your hard work. You can do it!

See Getting on with the Rest of Your Life after Stroke and many more articles by the Canada Stoke Network.

My Story :)

My Cerebellar Stroke Recovery
April 22, 2012

Hi everyone! The story of my stroke begins a little over a year ago.  I was at work as a physical therapist.  I had a very promising career ahead of me as I had just become “Mckenzie certified” after only 4 years of practice.  That’s a big deal in the PT world.  Then everything changed.  I had just arrived at work and I felt/heard something in my neck.  I thought it would go away but it didn’t.  It all happened very fast.  The next thing that happened was my legs stopped working and I collapsed.  Then I got really nauseous and vomited on the floor, several times.  Then I passed out.  Next thing I knew I woke up in the ICU 3 days later.  I had had a massive cerebellar stroke that affected both sides of my brain.  Really it was 2 strokes.  I was 30 years old.  I had a cranial decompression to allow my brain to swell.  So I was bald.  I knew right away – a bald head only means one thing – brain surgery.  I was more upset at the time about losing my hair, I had really nice hair.  :)  I have a lot of deficits.  I have poor balance, an intention tremor, ataxia, and my speech is very messed up. However, I have made a ton of progress in a year because I worked hard.  I refuse to settle for anything less than a full recovery.  I’m doing this blog because it will be therapeutic for me and I want other stroke survivors to know that there is hope if you work hard.  The brain is constantly changing and adapting, even as an adult and it happens forever.  So don’t believe anyone telling you that the way you are in 6 months/a year/2 years is how you’re going to be forever.  That’s malarky!  The reason I named this blog what I did is because there is a lot less information on the internet about cerebellar strokes.  I think this blog will help all stroke survivors but I especially want cerebellar stroke survivors to have this as a resource.  Here’s a good site.  Happy reading!  :)

See the original article: