Scared Straight: Stroke

[ninevirtues]

Score on neuro patient management midterm.... 88%.

Whew! That was a nitpicky, hard, detail-oriented test about things that, fundamentally, I have no interest in. In the hallway, after the test--- you should have _heard_ the whining. sheesh.

We did get a chance to listen to an occupational therapist who deals with stroke patients. I was prepared for two hours of soul-crushing boredom, but... he brought video.

Let me just say, right now, that I was correct to choose PT over OT. In the video, a man who's two weeks post-stroke is out of bed, and the OT is coaching him through brushing his teeth.

The man looks in the open drawer next to his rehab hospital bed.
"Now, pick up the toothpaste. (pause) Pick up the toothpaste, sir. The toothpaste."

After a pause, the man reaches into the drawer, fumbles around for a long moment, picks up a can of shaving cream, and begins to fumble with the cap.
"Sir, what's that you're holding?"
Pause.
"Sir, is that toothpaste?"
Pause.
"Sir, look at what's in your hand. Is that toothpaste?"
Pause.
"It's shaving cream, huh? Let's try again-- where's the toothpaste in the drawer?"

The man puts the shaving cream back in the drawer. After a long pause, he fumbles in the drawer again and comes out with a can of spray deodorant. After another significant pause, he begins to take the cap off the deodorant and starts to spray it on his toothbrush.

(There was another ten minute sequence after this, that involved getting the man to recognize that he was, in fact, holding deodorant and that he did, in fact, need to use toothpaste for this project. Yes, I really did see this. It was, in fact, on video. He was not acting-- the stroke took out the parts of his brain that remember that stuff, so he had to learn it again. The man was a 56-year-old plumber who hunted in his spare time. He got way better later, but it took six months of intensive therapy in a rehab hospital.) I'll spare you the details, and instead point out that a massive stroke is a bad deal.

Here's where I go all pointy on ya: Stroke is a lifestyle disease. If you are not physically active; if you are overweight; if you smoke; if you have uncontrolled high blood pressure, high cholesterol, or diabetes-- you are risking having this exact scenario happen to you. (But these are all things you can fix! Got it?) Should you have a stroke, I will help you, but I will be very bummed that you are sick, and so will you.

Comments

[sugarplumkitty.livejournal.com]

Stroke can also be a hereditary weakness in blood vessels. Oddly, the taller, thinner side of my family has an aneurysm problem. Both of of my maternal aunts had brain bleeds. One died because it burst, the other survived because it only leaked, was clamped and is mildly impaired. The oldest son of the aunt who died had aneurisms fixed in his groin. I'm not sure if the other four surviving kids have been checked out.

My mom had a scan to check her brain after her second sister had her aneurysm burst, and as best they can tell without iodine (she's allergic) she doesn't have any. Talk about lucky genes for me! I hope it doesn't skip generations.

It might though. One of my second cousins had an aneurysm leak when she was in her 40's. She survived but is disabled. It's sad that she remembers she used to be smart. She was quite brilliant, multilingual and a real math geek. Her ex had to take their twin sons to finish raising them.

Well, there are two kinds of stroke...

[ninevirtues.livejournal.com]

... hemorrhagic (aneurysms) and thrombotic/embolic (blood clots that block blood flow to parts of your brain). Thrombotic/embolic ones are the ones that you can do a lot about by changing your lifestyle.

You were right! I appreciate your pointing that out.