Saturday, May 25, 2013

Recumbent Bicycle - ICE (Inspired Cycle Engineering)



Recumbent Bicycle From Wikipedia, the free encyclopedia.

SSTattler: We will concentrate with a type of "tadpole" model made by ICE (Inspired Cycle Engineering) - it is very fast and very easy to modify for limitations required of stroke survivors. It is a LONG article so I included a useful sub-set. 

A recumbent bicycle is a bicycle that places the rider in a laid-back reclining position. Most recumbent riders choose this type of design for ergonomic reasons; the rider's weight is distributed comfortably over a larger area, supported by back and buttocks. On a traditional upright bicycle, the body weight rests entirely on a small portion of the sitting bones, the feet, and the hands.

Most recumbent models also have an aerodynamic advantage; the reclined, legs-forward position of the rider’s body presents a smaller frontal profile. A recumbent holds the world speed record for a bicycle, and they were banned from racing under the UCI in 1934, and now race under the banner of the Human Powered Vehicle Association (HPVA).

Recumbents are available in a wide range of configurations, including: long to short wheelbase; large, small, or a mix of wheel sizes; overseat, underseat, or no-hands steering; and rear wheel or front wheel drive. A variant with three wheels is a recumbent tricycle / tadpole.

Description

Recumbents can be categorized by their wheelbase, wheel sizes, steering system, faired or unfaired, and front-wheel or rear-wheel drive.

Wheelbase

Long-wheelbase (LWB) models have the pedals located between the front and rear wheels; short-wheelbase (SWB) models have the pedals in front of the front wheel; compact long-wheelbase (CLWB) models have the pedals either very close to the front wheel or above it. Within these categories are variations, intermediate types, and even convertible designs (LWB to CLWB) - there is no "standard" recumbent.

Wheel Sizes

The rear wheel of a recumbent is usually behind the rider and may be any size, from around 16 inches (410 mm) to the 700c (or 27" on some older models, as on upright road bikes of that time) of an upright racing cycle. The front wheel is commonly smaller than the rear, although a number of recumbents feature dual 26-inch (ISO 559), ISO 571 (650c), ISO 622 (700c), or even 29 x 4" oversize all-terrain tires. Larger diameter wheels generally have lower rolling resistance but a higher profile leading to higher air resistance. Highracer aficionados also claim that they are more stable, and although it is easier to balance a bicycle with a higher center of mass, the wide variety of recumbent designs makes such generalizations unreliable. Another advantage of both wheels being the same size is that the bike requires only one size of inner tube.

The most common arrangement is probably an ISO 559 (26-inch) rear wheel and an ISO 406 or ISO 451 (20-inch) front wheel. The small front wheel and large rear wheel combination is used to keep the pedals and front wheel clear of each other, avoiding the problem called "heel strike" (where the rider's heels catch the wheel in tight turns). A pivoting-boom front-wheel drive (PBFWD) configuration also overcomes heel strike since the pedals and front wheel turn together. PBFWD bikes may have dual 26-inch (660 mm) wheels or larger.

Steering

Steering for recumbent bikes can be generally categorized as:
  • over-seat (OSS) or above seat steering (ASS);
  • under-seat (USS); or
  • center steering or pivot steering.
OSS/ASS is generally direct—the steerer acts on the front fork like a standard bicycle handlebar — but the bars themselves may extend well behind the front wheel (more like a tiller); alternatively the bars might have long rearward extensions (sometimes known as Superman or Kingcycle bars). Chopper-style bars are sometimes seen on LWB bikes. USS is usually indirect — the bars link to the headset through a system of rods or cables and possibly a bell crank. Most tadpole trikes are USS. Center steered or pivot steered recumbents, such as Flevobikes and Pythons, may have no handlebars at all.

Drive

As with upright bicycles, most recumbents are rear wheel drive. However, due to the proximity of the crank to the front wheel, front wheel drive (FWD) can be an option, and it allows for a much shorter chain. One style requires the chain to twist slightly to allow for steering.

Another style, Pivoting-boom FWD (PBFWD), has the crankset connected to and moving with the front fork. In addition to the much shorter chain, the advantages to PBFWD are use of a larger front wheel for lower rolling resistance without heel strike (you can pedal while turning) and use of the upper body when sprinting or climbing. The main disadvantage to all FWD designs is "wheelspin" when climbing steep hills covered with loose gravel, wet grass, etc. This mainly affects off-road riders, and can be ameliorated by shifting the weight forward, applying steady pressure to the pedals, and using tires with more aggressive tread. Another disadvantage of PBFWD for some riders is a slightly longer "learning curve" due to adaptation to the pedal-steer effect (forces applied to the pedal can actually steer the bike). Beginner riders tend to swerve along a serpentine path until they adapt a balanced pedal motion. After adaptation, a PBFWD recumbent can be ridden in as straight a line as any other bike, and can even be steered accurately with the feet only. Examples of PBFWD recumbents include Cruzbike, Flevo Bike, and Python Lowracer.

Yet another drive-train variation is on rowing cycles where the rider rows using arms and legs.

Fully Suspended Bikes

Modern recumbent bikes are increasingly being fitted with front and rear suspension systems for increased comfort and traction on rough surfaces. Coil, elastomer, and air-sprung suspension systems have all been used on recumbent bikes, with oil or air-damping in the forks and rear shock absorbers. The maturation of fully suspended conventional mountain bikes has aided the development of these designs, which often use many of the same parts, suitably modified for recumbent use.

Fairings

Main article: Bicycle Fairing
Some riders fit their bikes with aerodynamic devices called fairings. These can reduce aerodynamic drag and help keep the rider warmer and drier in cold and wet weather. Fairings are also available for upright bikes, but are much less common.

Seats

The seats themselves are either of mesh stretched tightly over a frame or foam cushions over hard shells, which might be moulded or assembled from sheet materials. Hard-shell seats predominate in Europe, mesh seats in the USA.

Tandem Recumbents


Just as with upright bicycles, recumbents are built and marketed with more than one seat, thus combining the advantages of recumbents with those of tandem bicycles. In order to keep the wheelbase from being any longer than absolutely necessary, tandem recumbents often place the stoker's crankset under the captain's seat. A common configuration for two riders in the recumbent position is the "sociable tandem", wherein the two riders ride side by side. There are also hybrid recumbent designs such as the Hase Pino Allround that utilize a recumbent stoker in the front, and an upright pilot in the rear.

Recumbent Tricycles

Recumbent tricycles (trikes) are closely related to recumbent bicycles, but have three wheels instead of two. Trikes come in two varieties, the delta, with two rear wheels, and the tadpole, with two front wheels.

Characteristics of recumbent trikes include:
  • The rider does not need to disengage from the pedals when stopped.
  • The trike can be geared very low to enable mountain climbing while heavily loaded and at a slow speed, without losing stability.
  • Trikes are capable of turning sharply without leaning, producing lateral "g forces" similar to sports cars. 
  • Recumbent trikes may also be more suitable for people with balance or limb disabilities.
The popularity of trikes has grown significantly over the years as aging baby boomers discover the benefit of continued riding without the issues of balance and pain mostly associated with traditional upright bikes.

Folding

Several manufacturers offer folding bicycle recumbents to facilitate packing and travelling.

Performance

Main article: Bicycle Performance.
Over distances recumbent bicycles outperform upright bicycles as evidenced by their dominance in ultra-distance events like 24 hours at Sebring. Official speed records for recumbents are governed by the rules of the International Human Powered Vehicle Association. A number of records are recognized, the fastest of which is the "flying 200 m", a distance of 200 m on level ground from a flying start with a maximum allowable tailwind of 1.66 m/s. The current record is 133.284 km/h (82.819 mph), set by Sam Whittingham of Canada in a fully faired Varna Diablo front-wheel-drive recumbent lowracer bicycle designed by George Georgiev. The official record for an upright bicycle under IHPVA-legal conditions (but at sea level, not high altitude) is 82.53 km/h (51.29 mph) set by Jim Glover in 1986 with an English-made Moulton bicycle with a USA-made hardshell fairing around him and the bike.

The IHPVA hour record is 90.60 km (56.30 mi), set by Sam Whittingham on July 1, 2009. The equivalent record for an upright bicycle is 49.700 km (30.882 mi), set by Ondřej Sosenka in 2005. The UCI no longer considers the bike Chris Boardman rode for his 1996 record to be in compliance with its definition of an upright bicycle. Boardman's Monocoque bike was designed by Mike Burrows, whose Windcheetah recumbent trike (see above) also holds the record from Land's End to John o' Groats, 861 miles (1,386 km) in 41 h 4 min 22 s with Andy Wilkinson riding.

In 2003, Rob English took on and beat the UK 4-man pursuit champions VC St Raphael in a 4000 m challenge race at Reading, beating them by a margin of 4 min 55.5 s to 5 min 6.87 s - and dropping one of the St Raphael riders along the way.

In 2009 Team RANS won the Race Across America (RAAM) on recumbents.

See the full article:
      Recumbent Bicycle From Wikipedia, the free encyclopedia.

NOTE: 
Last year SSTattler articles about Catrike - Recumbent Bike: Human Powered Vehicle and Cycling Comfort At Its Best. This year we will concentrate with the model ICE (Inspired Cycle Engineering). Made in the UK but available in Canada, USA, and most other countries. In Edmonton see:
      Revolution Cycle,  15103 Stony Plain Road
      Edmonton, AB T5P 3Y2
      Phone (780) 486-3634
Revolution Cycle are very comfortable with repairing/sales of recumbent bikes.


ICE Tech Guide

Published on Mar 21, 2013

The "ICE Tech Guide" is the first instalment of a short film series. This guide will briefly cover all the key features of the ICE Adventure and Sprint range showcasing why ICE is still at the forefront of all things recumbent/trike.

This film covers technical features like the C.F.T Fold and the Road Response System that separates ICE from all the others.

Standard YouTube License @ Icetrikes's channel





End of an Era

Published on Jan 4, 2013

On December 21st ICE (Inspired Cycle Engineering) moved out of their rented premises and into their very own home. But what do you do with an empty workshop after you've moved out?.....RACE!

Comments:
magna59 Congratulations on the new pastures ........ please ensure that the grass is greener on your side ........ and that more put their metal to your pedal . Regards Bob
simonkellett Ah yes: another hard day at the office :-)
Keith McRae Nice work guys, loving it, I managed to get mine up and running before xmas and was "drifting" in mud :)


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The 20th Annual Midwest Recumbent Rally will be held August 9-11, 2013! Events on Friday & Saturday will be held @ the Hostel Shoppe! Sunday's "SUPER TOUR" starts @ The Jensen Center in Amherst, Wisconsin.

Events, prices, dates and times are subject to change. Last updated 4-16-13. 2013 event information will be highlighted in red when it becomes available -- Click-it.





Midwest Recumbent Rally 2012

Published on Aug 15, 2012

Reply ICE were kindly invited the Midwest Recumbent Rally by Hostel Shoppe, there is nothing better than riding with new found friends off we went. Here is a short film that was put together while at the rally.

Comments:
Zachariah West Questions: With the wheel fairing/cover, can they be put on any of the models I.C.E. makes? Is there an actual fairing option available for the I.C.E. trikes?
Reply Icetrikes Hi, I am not sure which fairing you are talking about. The one on the back of Dan's trike in this video is an Ocean cycles tailbox. These are available direct from Ocean cycles and fit any trike or bike with a flat top rack. They also make and sell a velomobile shell for the Sprint model called the Challenger which is a completely enclosed shell. Let me know if I have not answered your question. Thanks Patrick.
Stan Shipkowski Bitchin'film guys. I'm the old hippie on the TerraTrike right in front of you wearing the purple tie dyed shirt. This was my second rally. I plan to go every year. Bent folks are the best.
Reply Icetrikes Dan was particularly happy with this film as he did it in one evening to show the next day at hostel shoppe. Thanks for coming along though this was our first rally and we enjoyed it so much it certainly wont be our last. See you next year :)
Graham Williams How can I get on the next one?
Reply Icetrikes You can subscribe to Hostel Shoppe's Email List to ensure your kept up to date with when the next one will be. You can do that via their Web-site or Facebook.

Standard YouTube License @ Icetrikes's channel




Tim Parker Becomes 2012 World HPV Junior Champion 

         in an ICE Full Fairing

Published on Jul 2, 2012

Tim Parker becomes 2012 World HPV Junior Champion at Fowlmead cycle park in an ICE Full Fairing built in a matter of days!.


Standard YouTube License @ Icetrikes's channel






ICE - Dedicated Innovators

Published on Jun 12, 2012

At ICE, trike riders are our inspiration. We create recumbent trikes around you, perfecting our designs to ensure the best possible ride.

Comments:
youshone Top notch company. I love my trike :-)

Standard YouTube License @ Icetrikes's channel





ICE Trike Build

Published on May 22, 2012

We though it might be nice to show you a Trike build from picking the parts to shipping the trike to one of our many ICE dealers.

This was shot as a time lapse and covers approximately 1.5 to 2 hours real work time.

Comments:
David Massey What? Without giving away trade secrets, it would fantastic to see the build of a trike from start to finish. "Com' on, Man!"
CitizenOvTheWorld I bought a trike some time back for someone whom as it turns out, passed-away suddenly and it was sadly handed back to me by the mourning family. I was too devastated by the loss of a lovely human being to even begin building, not that I would know how, but I'd certainly use the adorable thing, since I would've bought one for myself soon enough anyway. It would just be so much easier with my limited time to have a spectacular, step-by-step and constantly updated, BUILD DVD for ICE trike buyers.

Standard YouTube License @ Icetrikes's channel






ICE Fold Instructional Film

Published on Mar 5, 2012

Welcome to the second of Inspired Cycle Engineering's instructional film. This film shows you how to fold your ICE Adventure and Sprint using ICE's Compact Flat Twist (C.F.T) system.


Standard YouTube License @ Icetrikes's channel




Air-Pro Seat Pad Fitting

Uploaded on Feb 20, 2012

Welcome to the first Inspired Cycle Engineering instructional film. This film shows you how to fit your ICE Air-Pro Seat Pad set, which comes with all ICE Air-Pro Seats.

The Pad System is designed to tailor the fit of your ICE Air-Pro Seat making it the most customisable hardshell seat on the market.

Comments:
Icetrikes Any suggestions of what you would like the next instructional video to be about?
Reply ThomasBaluWalter How about some maintenance videos? E.g. how to do a "spring inspection" to make sure your bike is in shape for the saison? Or what you should doto make your bike ready for winter.

Standard YouTube License @ Icetrikes's channel





Make ICE AirPro Seat Cover

Published on Mar 13, 2012

A quick timelapse of our Air-Pro seat cover being cut.


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ICE 2012 Promo Film Reel

Uploaded on Jan 13, 2012

Comments:
Jim Self I like the suggestion of low flying aircraft at the ends of this video. It reminds me that I generally feel more connected to the sky when riding my trike. My head is more comfortable looking up at trees and clouds and it feels much safer looking at the scenery in every direction. Although riding fast is fun, I love riding slowly taking in the view on a beautiful day.
billiondollardan IDK about the vortex but mine is something like 300+ pounds. Most trikes hold a lot of weight since people use them to carry tents and gear for long trips. I weigh a lot, so it's nice for me. 250 lbs on a regular bicycle can be ungainly.
billiondollardan It's extremely nice. I like it far more than my traditional bicycles for road riding. I haven't made the effort to get out as much as I would like, but the trike is fantastic! Get the vortex if you want more speed though. I just enjoy the ride.
billiondollardan I just ordered my first trike from a dealer. It's an Ice Sprint RSX and I cannot wait to try this thing! I did a lot of research and ICE seems to make one of the best tadpole trikes out there. Maybe I should get a Union Jack flag to show my support lol

Standard YouTube License @ Icetrikes's channel






2011 ICE Vortex Recumbent Trike Film

Uploaded on Jan 11, 2011

Film of the 2011 ICE Vortex recumbent trike.

Comments:
lonelycyclist I'd love to fly down hillon that, what a beautiful trike.
ltsobond NICE!!!
ltsobond Really? I'm looking for a fold up trike, but I want it to be fast, are Greenspeeds fasterthen the ice trikes? I'm pretty much sold on the Vortex, but another trike with better performance can easily overrule that.
Kathleen McCall I have a Greenspeed GT3, with little tires, an I.C.E. Vortex, an I.C.E. Trice, and somehow those little Greenspeed tires go faster than the big tires on the Vortex. Ian at Greenspeed said it would be like this! They are all great trikes!
peddlerstrikes Absolutelyawesome trike.
James Adames Best Trikeever.
Daren Page Did I just see that back wheel flex!?
killianred01 BitchinTrike.

Standard YouTube License @ Icetrikes's channel





ICE on Ice - Recumbent Trikes in the Snow and Ice

Uploaded on Nov 30, 2010

The from ICE playing on ICE trikes in the ice.

Comments:
zenner2000 You need some studded tires.
ajrecumbent I hope no trike's where harmed in the making of this movie lol.

Standard YouTube License @ Icetrikes's channel





Ice Recumbent Trikes & Bikes - The Last 8 Months

Uploaded on Aug 9, 2010

We've had a busy 2010, here's some of the highlights so far! First shown at the Midwest Recumbent Rally.


Standard YouTube License @ Icetrikes's channel




Ice Trikes 2010 - Front and Rear Suspension.

Uploaded on Jan 15, 2010

ICE 2010 Trikes Road Respose Suspension film. For the Ultimate in recumbent trikes visit the ICE trikes website: http://www.icetrikes.co.uk

84 Comments:
Juan Fernando Arroyave Salazar Cuanto cuesta tu bicicleta con el envío a mi país?
Translate to English (by Google): How much is your bike with shipping to my country?
Icetrikes It depends what your country is. We have pricing on our website and you can contact us by email for exact shipping costs.
SquirrelFromGradLife If I had that rig I simply couldn't resist putting an electric assist drive on there and load a LiPo battery pack into the frame... then it would really make sense.
Icetrikes You certainly would feel the benefits from the suspension with the extra weight the electric assist adds.
Icetrikes Hi, We do ship these suspension units as retro fit kits. Please could you e-mail us direct for a quotation including shipping to your area. There are 2 types of Velomobile shells available for the Sprint. One of which is sold direct from Canada - The Borealis from (velomobiles.ca/Borealis.html) or the UK from Ocean Cycle - the Challenger )(oceancycle.co.uk.) We do sell retro fit Motors, again could you please contact via email for a quotation. sales@icetrikes.co / Thanks / ICE HQ
1SCHUTZSTAFFEL What is the track to this video called?
Icetrikes The track is called the Staunton Lick by Lemon Jelly.
YellowLionsHunter We would like to see a wheelie.
ecomunky Cool. Only power needed to use that is a frozen Blueberry / Razzberry / Mango/emer­gin-C powder Smoothie with ice and water blended in the morning andoff you go.
MrEdysama New transmission CVT design by BitRaptor. Is a continuously variable transmission CVT gear only (the only one functional in the world), very compact and lightweight, and which could replace the current systems both for efficiency, simplicity and not least the costs. Because this CVT work only with pinions is better the all other systems by efficiency and high torque transmission. In the web page bitraptor com you will find more explanations, drawings and a short video of a basic prototype.
1SVAV 2 Какую максимальную скорость реально развить на таком аппарате, кто-нибудь знает ?
To English (by Google): What is the maximum speed to really develop this phone, does anyone know?
Juan Fernando Arroyave Salazar Ok. My E-mail address is juanferarroyave@gmail.com.  My country is Colombia. Regards
See the full 84 comments ICE Trikes 2010, Front and rear suspension on YouTube.


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Saturday Comics



For Better and For Worse
Lynn Johnston - 2008-03-28

"Gram's wedding dress fits you like a glove!"
Dilbert
Scott Adams - 2013-05-19

"The new system is called gamification..."

Garfield
Jim Davis - 2013-05-20

"...a better place if spiders were in charge!"

Betty
Delainey & Rasmussen - 2013-05-24

"...to kick in a power song."






  
*For Better and For Worse" is a serious topic of stroke but with a very nice cartoons. It is all about Grandpa Jim had a stroke and 88 further cartoon "strips" that happened to Grandpa Jim. (See as well 
 the author Lynn Johnston).
** I tried to get low or free price at the people http://www.UniversalUclick.com/ 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 low. Fortunately, you will have to do only 1-click more to see the cartoon image, it is legit and it is free using GoComics.com and Dilbert.com.
*** Changed from "Pickles" to "Betty" -- "Betty" is a excellent cartoon and Gary Delainey & Gerry Rasmussen are authors/artists/cartoon-strips and they live in Edmonton.

Eclectic Stuff & Articles

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

Welcome a New Blog Author - Andrea

Welcome Andrea! She will write in Stroke Survivors Tattler (SSTattler) based on her three other blogs:
  • A Year of Living In My Head - "In July of 2011 I had a stroke. In November they found a head tumor. How I manage doctors, family, friends, and my kids without coming undone."
  • Blue Shoe Farm - "We changed homes and moved from the city to the country (well sort of... three acres.) bought a tall old farmhouse. stories of that house, maintenance, horses, chickens, family, friends... or whatever I am getting feisty about at the moment -- you can find here."
  • Farmhouse Still Standing - "Bought an old 1904 farmhouse in August of 2008. I will not be 'restoring' it to Architectural Digest, This Old House or even Mother Earth News quality, just keeping it upright and weather resistant for my family -- with a little flair added in. These are the tales of keeping it in shape on a budget."
Most her blog for stroke survivors is based A Year of Living In My Head.  Blue Shoe Farm and Farmhouse Still Standing are very interesting as well. Please take a look at all three blogs (above) and look at her biography About Us.

Ring My Bell: New Bike Reads Your Mind

Dean Reinke
Deans' Stroke Musing
Friday, December 2, 2011

Tell your therapist you want to test one of these out, although shifting gears is probably the least of our worries in trying to ride a bike, I would guess balance would be. And if it reads the motor cortex it won't work for people like me whose motor cortex is dead. Just a slight caveat/problem. Ring My Bell...

"It's just like riding a bike" takes on a whole new meaning with a concept bike from Parlee Cycles and Toyota. That's because this bike isn't like all the others: It possesses the power to read your mind.

Even though the bike looks completely normal, the headgear is a dead giveaway. Like something out of a sci-fi movie, the "neurohelmet" comes equipped with plastic "tentacles" and metal sensors that are oh-so-comfortably pressed against the cyclist's scalp.

With minimal training -- and perhaps a little sweet talking? -- a cyclist can shift the gears on the bike with just a thought. One type of brain wave instructs the bike to shift downward, while another type causes it to shift upward. It definitely takes some practice, so until your mental powers are refined, prepare to be tossed over the handlebars, steered into a giant pile of leaves or flung into the side of a parked car.

What's novel about this mind-reading bike, however, is not the technology itself, but the way all of the technologies have been mashed together. Here's the equation: a smartphone + a widely-available app (which monitors the rider's heart rate, pace, speed, brain waves, and even cycling habits) + some geeky-looking neuroheadsets (made by Neurosky and Emotiv) = 21st century tech wizardry.

And for this specific project, a lightweight laptop was slipped inside the back of the cyclist's jersey so that it could "talk" to the neuroheadset, the smart phone app, and the wiring inside the bike.

Rest assured, there is a built-in failsafe, too: If the brain waves are ever misinterpreted, the cyclist can switch a setting on the smart phone app to manually control the bike.

While this "PXP" design will not be sold on the market, "neurocontrollable" things -- including future bikes, gadgets and even prosthetics -- will likely become more commonplace. In fact, Parlee plans to release a new road bike in 2012 or 2013 inspired by the PXP design.

What the bike cannot do is read the minds of the motorists that pass by your two-wheeler on busy streets. But we all know what those minds are thinking.

See the original article:
      Ring My Bell: New Bike Reads Your Mind
      in Deans' Stroke Musing


The Toyota Prius X Parlee Concept Bike

Toyota reached out to Parlee Cycles and Deeplocal to build an aero-road bike imbued with the same forward-thinking that went into the design of the Prius. Benefiting from a monocoque carbon-fiber frame, built-in smartphone dock, countless wind-tunnel-tested aerodynamic tweaks and its unprecedented mind-powered shifter, the PXP concept bike has emerged as a purpose-built machine that blends the simple with the complex to become a better and more efficient version of itself.

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Pharmacopia

Andrea
A Year Living In My Head
Thursday, May 2, 2013

I was prescribed standard "post-ischemic stroke of unknown origin" drugs.  So: statin-blood pressure-blood thinners to add up to a anti-stroke cocktail that "studies have shown" will deter that other stroke.  Will lessen the chances.  Even though my chances are elevated because I already had one.

Thing is. Those drugs suck.  I took them for one year, 3 months.  Daily.  Religiously.  Because. I. Did. Not. Want. Another. Stroke.  And that is the only way I was told was proven. Yeah. Exercise.  Yeah. Weight loss.  Yeah, diet.  Did those inadvertently because I was so freaked out.

I did not want my kids to experience another stroke.  They are still dealing with the ramifications of July 2011, it drastically changed how we all see life.  It put fear in their life when honestly, I wish they did not have it.  (But we don't control lives now, do we?)

Those drugs.  Made me dizzy. Gave me dozens of gallstones.  Thing is: when you have a dead zone in your head how do you know you are recovering from a head injury vs. side effects from a prescription?  I did not know. I blamed it all on stroke recovery.  I am off Plavix and the statin.  I have no dizziness. I have no jerky muscle movements.  I have no firework sparks going off in my skull randomly.  I was blaming all that on the stroke and the bullshit thing is it was the drugs.  Which every doctor denied "that is not a usual response to this drug" but the pharmacist confirmed as a possibility.  There is a strange loop we get into.  The insurance. The doctors. The "norm".  Pre-stroke I did not drink.  I barely took aspirin because I really don't like drugs.  When I was put on an overabundance of pharmaceuticals it makes sense my body had difficulty navigating both head repair and drugs.

My liberty is I can say this all because my cholesterol is low. My blood is thin. Honestly, if I was in a risk zone, I would still be on them.  And yes, I am going against doctors wishes my dropping these drugs, but whether that is for litigious self protection on their part or a true belief that drugs help... I need to listen to another voice.  And that voice is not based on studies that are not my demographic, not my physiology. Sucks, but there it is.

5 comments:

J.L. Murphey May 2, 2013 said... GMTA (great minds think alike). I also blogged today about my daily medicine intake which has quadrupled since my stroke. Drugs hamper and help at the same time. 

Just because you don't have the side effects listed for that drug, but have others should not matter...it's the drug that is causing them.

I was allergic to all of the drugs they put me on after my heart attack and even had an allergic reaction to an allergy drug! My body has its own mind when it comes to medication. It sounds like yours does too.

Blue Shoe Farm May 2, 2013 said... I added you to my list so I could read it... GMTA! Those sound like wicked drugs you were on. Especially since you were allergic.

J.L. Murphey May 3, 2013 said... My drug allergies are the bane of every medical professional I've dealt with. When admitted to the hospital my red allergy bracelet fills two of them with 8 entries on each one.

Karen Anne May 15, 2013 said... I think many more patients have medication side effects that the statistics reflect. When was the last time you knew of a doctor who actually reported a patient's side effect to the FDA. I'm thinking never.

Blue Shoe Farm May 16, 2013 said... I am so with you on this. It is because it is so subjective, how do they know my side effects are from the drug and not a dozen daily donuts, or bottle of wine, or stroke, etc etc. So they don't report.

See the original article:
      Pharmacopia
      in A Year of Living In My Head

Exercise Helps Recovery Because It Strengthens What?

Peter G Levine
The Stroke Recovery Blog
Tuesday, May 14, 2013

Interesting video, below, by one of my favorite neuroscientists, Dale Corbett.  For the record: There is no one I know up doing a better job of translating what neuroscientists have to offer to stroke recovery. Have a watch. The insights really start at 1:40 in. I'll post my critique below the video.


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The overall message is important. Exercise is essential. It is unfortunate that the message is sort of convoluted in this video. They're talking first about TIA, and how if you have a TIA you should use exercise as a way to lessen the chance of a full-blown stroke. Then the discussion takes an obtuse tangent into how exercise is important to recovery, and then with no real explanation doubles back to talking about TIA again. Still, while maybe the messages should have been separated, both are important.

1:50 Another person, besides Corbett, whose interviewed in this video is William Mcillroy, who like Corbett is a PhD. I quibble a bit with Mcillroy's statement that exercise can be started "...as short as two weeks after stroke." Charitably, this is highly debatable. Once a patient is medically stable, intensity should be increased to tolerance. There is no one-size-fits-all timeline for every survivor that is rigid enough to predict that someone can start exercise "as short as two weeks after stroke." In fact, it could be much shorter. For instance, in a survivor who is medically stable day 4, waiting another 10 days to start a progressively rigorous exercise program would allow learned nonuse to take hold.

2:20 Both PhD's talk about how exercise is good for the brain. Corbett talks about how exercise helps cognition, and points out exercise also helps sensory motor recovery. I would remind anyone who is willing to listen: sensation and motor behavior are cognitive. We learn sensation and movement the same way we learn French, or trumpet, or algebra. That is, changes in motor and sensory behavior happen involve the same brain processes as any other kind of learning.

2:50 I'm not sure that there should be such an unequivocal endorsement of balance retraining using biofeedback. Certainly the research is not there yet.

Having said all that, I think this is a really great video with some really essential points. Interviews can be misrepresented because the person being interviewed is not doing the editing. The points these guys were making may have been a ton more cogent in the original interviews.

The best line is by Dr. Corbett:
 "It's still early days and you know we're nowhere near to the level that I think we can get to. And if we can understand what the mechanisms are then we might be able to optimally better design exercise programs to improve stroke recovery."
"Until then, anyone trying to sell you certainty is after your wallet," he didn't add.
See the original article:
       Exercise Helps Recovery Because It Strengthens What?
       in The Stroke Recovery Blog

Once Again, I Am the Bad Guy

Diane
The Pink House On The Corner
Wednesday, May 15, 2013

Yesterday, we went to see the newest neurologist. I say "newest" because this is the third neurologist Bob has seen. The second neurologist, Dr. K., was absolutely wonderful. In fact, he was one of the best doctors I've ever met. Unfortunately, he is leaving to work for a children's hospital and so we have been referred on to Neuro Doc #3. This neurologist will be handling the Botox treatments for Bob's dystonia.

The appointment started with the nurse/assistant. She looked at Bob's neck and at his left leg (which he can no longer extend straight out) and the curled toes on his left foot. She told me these were all "muscle contractions" and the cause of it was from "being immobile". She said that "evidently" I was not getting Bob enough exercise. And that this type of symptom is often seen in nursing home patients.

Those of you who follow this blog know this is simply not true. I have done my darnest to keep Bob in physical therapy and when he doesn't have professional PT, have been exercising with him at home faithfully--until recently that is. Until this dystonia caused him to drop out of PT. I told that nurse all of this and she looked at me like she didn't believe a word I said...

Then the neurologist came in and looked at Bob and told us that Bob's toes were "too far gone" and that Bob's neck was also "probably too far gone", and that Botox would not help him. Then he said that I should have brought Bob in at the "onset" of these symptoms and I should not have waited an entire year before bringing him in. Because now, it was too late.

I told that neurologist that I did take Bob to see his "old neurologist" immediately after the onset of the symptoms and that neurologist told us the symptoms were due to "neuropathy" and that there "was nothing that could be done about it". And when I asked that neurologist about Botox, he told me that "Botox in the neck would be fatal" and that was the end of the subject.

This new neurologist tells me that the first neurologist was "100% WRONG".

This new neurologist tells me I should have told that first neurologist that he was wrong.

I should have told the neurologist he was wrong? Huh? What do I look like--a freaking doctor?

Though I didn't stop there because the neuropathy diagnosis didn't seem right to me. I asked every single other doctor/therapist that Bob has what they thought of his symptoms and was given diagnoses of everything from "brachial plexus injury" to "torticollis from a drug side effect" to an agreement of the neuropathy diagnosis, to "nerve impingement" to "scoliosis" to a posture complication from keeping Bob's head of the bed elevated to high, to a "possible side effect of his poor vision".... and I even took Bob to a podiatrist to look at his toes and was only given a bunion cushion--- and it wasn't until Bob was hospitalized in February that we met Dr. K. who came up with the "post-stroke dystonia" diagnoses and told us there were treatments out there including Botox--and that Botox would not be fatal if injected into the neck.

So, after much debate, the new neurologist has agreed to "try" the Botox in Bob's neck and also in his hamstring muscles, but will not do the toes--because they are "too far gone".

Botox is set for July 2nd.

And Bob is being referred to a foot surgeon to be evaluated for surgery...

We left that doctor's appointment and Bob was nearly in tears...

And once again, it's all my fault.

Jeepers.

9 comments:

oc1dean May 15, 2013 said... Your new neurologist is an asshole and doesn't know squat. For toes I would think serial casting might be tried before surgery. That nurse/assistant doesn't know how spasticity works. So much wrong in that office and so little brains being used.

Jim Sparks May 15, 2013 said... I know it's easier said than done, but try not to let them make you feel guilty. So many people in the medical field fall prey to the God complex. It takes a strong individual to resist it and it sounds as if the ones you describe have succumbed. No one knows more about Bob's condition than you, and no one else could have cared for him like you have.

Anonymous May 15, 2013 said... Diane, you are not the bad guy and is not your fault. You have done everything to help Bob, and you have trust the Drs. they are the ones who keep throwing the ball to each other and making you go in circles. Never ever aloud them to make you feel down, you are doing as much as you can.
-- Hugs, Yadira

Joyce May 15, 2013 said... Where do these idiots come from??? Nurses do not diagnosis. What the h___ did she think she was doing telling you that crap. Excuse my language. But this lack of insensitivity and brains makes me really angry. Diane, I do not know what else you could have done to seek treatment. Anyway, now that I have that off my chest, I wish you and Bob good luck. Hang in there.
-- Joyce

kdstentzel May 15, 2013 said... Every time I read about one of your doctors I want to take them by the shoulders and SHAKE THEM. Seriously. 

I've been lucky that Mike's doctors have all been mostly on the same page and have been VERY sensitive when we need to change something/do something better. 

I tend to catch more flack about the paperwork stuff, like programs I should have applied for, benefits Mike could have, etc. Honestly, the information that gets dumped on me is enough to bring on an anxiety attack. What I wouldn't give for a program that gave all us caregivers our own personal assistants to deal with all this crap. Sigh.

J.L. Murphey May 16, 2013 said... Diane, Poor, misunderstood doctors. They can't accept fault because their malpractice insurance is too high. Actually they are only human and make misdiagnoses all of the time so they have to blame someone. Often it's the wife or caregiver. We are not to blame or have to take it!

Don't accept the blame. I refuse to after ten years because I know more about what is going on with my husband than they do. So do you. You didn't accept their diagnosis or multiple diagnoses, did you? No, you kept searching and kept on treating Bob. You have no right to accept blame where no blame should be placed. It's a fabulous doctor cop out, "I wish you had brought him to me at onset."

So this doctor won't fix Bob's toes. He is sending him to a specialist for feet and toes. That's a good thing. I know you fear amputation but that's not the case. There are many treatments for spasticity, Dean mentioned a few. I agree with casting. I know if the Botox doesn't work on my ankle and toes that is my next stop...my podiatrist.

As far as Bob's neck being too far gone. That is his opinion. At least he is willing to give him the shots unlike his previous neurologist. I had severe doubts (so did my neurologist) that Botox would work on my fingers and hand, but it did. I managed a slight grip. That's progress. I'll take progress over nothing every time.

Rebecca Dutton May 16, 2013 said... I'm so sorry this doctor and nurse made you feel guilty. Those of us who read your blog know how hard you and Bob work.

Barb Polan May 16, 2013 said... Please do not feel guilty after how hard you and Bob have worked on his recovery. Your "new" neurologist MUST be a moron to tell someone what he/she SHOULD HAVE done; those comments reflect a complete lack of decent interpersonal skills. But, it's results you want, so as long as he's willing to step outside his little box and take the action you think he should, it might be worth it to keep him.

And yes, you are an expert at this, and the "professionals" are apparently not.

Jenn May 17, 2013 said... You've good advice and support from your readers. I ask the Universe to help you and Bob get what you need and ask for when you ask for it. Boldly continue on dearest ones. <3

See the original article:
      Once Again, I Am the Bad Guy
      in The Pink House On The Corner

Sunday Stroke Survival ~ The Pity Pot

Jo Murphey
The Murphey Saga
Sunday, May 19, 2013

Yep, I've been really hopping up and down on the pity pot for the past month with all that has been happening at home and abroad, and it's okay. I allow myself the time so long as it doesn't consume my life totally. Although I have to admit I've got an angry, red ring on my derriere from my long stint on it this time. I said all of these statements on the balloons over and over again over the past month.


Quite a few months ago, I told myself I wouldn't get on it again, but I was only fooling myself. Hey, I'm honest. I usually limit my time on the pot to fifteen minutes but this time I couldn't. Somethings are beyond my control. I have to go with it and ride the wave until it's over. Accepting things I can not change, but this is a hard lesson to learn. I'm fast approaching, the 25th, the one year anniversary of my stroke. What a year it's been too. There was no cop out of "look how far you've come" that would console me.

The truth is while I have achieved great progress, this is not where I wanted to be by now in my recovery. I'm terrified that this is all the recovery I can achieve and will be like this FOREVER. I'm afraid of failure. The stakes are too high for me that this may be my life forever more. There I said it.

I expected more out of myself. Remember I'm the over-everything. I do not settle unless forced to and let me tell you, that's always a fight to the death. Recently, I've been reading anniversary blogs of other long term stroke survivors- five, ten, fifteen or twenty years post stroke. It truly boggles my mind. The courage it takes to be a survivor not just a year but YEARS! To not lose hope along the way and not give up.

Many of the words to the left have been used by others to describe me. Yes, they are all true to the persona I show to the outside world. Many have written me about being an inspiration or being a hero in their eyes.

I'm not any of those things. Okay maybe, a fighter, outspoken, and intelligent, but the rest is conjecture. I fight to recover daily because there is a possibility. I've seen glimpses of what life can be, wouldn't you do the same? I don't want to admit that this is all there is. Given fifteen years there might be an inkling of acceptance. I'm stubborn.

I speak out because it's not in my nature to keep quiet anymore, even when it is in my best interests to do so. Would it be better to stuff my feelings and not give them a voice? I did that for a lot of years and it made me feel worse not better. It explodes in other ways such as drugs and alcohol...been there- done that- and don't want to go there again!

I shouldn't be a role model or hero to anyone. Everyone has it in them to do the same thing. It is their choice not to. Any excuse in a storm, right? And boy, are most people full of excuses. I taught myself and my children to take ownership of their faults and try not to repeat them. It's left some of their bosses with that opening and closing mouth like a fish in the fish bowl look when they take ownership of their mistakes because they are so used to hearing excuses. I don't make excuses I just tell it like it is in my perception.

I choose to live my life as an open book. Well, maybe not totally open, but as open as can be. Because self preservation beats out total honesty every time. In this age of identity theft, I'd be a fool to divulge everything on the net. But still if asked a question, I'll answer to the best of my hair-brained ability from my point of view.

So if I don't keep to my regularly scheduled blog time table, you know why. Real life is just getting in the way. But I'll get there.

Nothing is impossible with determination


See the original article:
      Sunday Stroke Survival ~ The Pity Pot
      in The Murphey Saga

Hunting Is Exhausting

Rebecca Dutton
Home After a Stroke
May 13, 2013

This post is for caregivers as well as stroke survivors.

People who have not experienced a catastrophe think they have lots of time to do what they want.  They also think they will always have lots of energy.  A stroke destroyed the illusion that I have time and energy to waste.  I cannot waste precious energy searching my entire house or even an entire room for an object.  I also cannot afford to have an obsessive-compulsive disorder that makes me agitated every time an object is one inch out of place on a desk or coffee table.  For me, organization has to save time and energy rather than be a goal that drives me crazy.  Here are some examples of what I mean.

I don't mind spending a few minutes searching through a box of Christmas decorations or looking for a hand tool in a small tool box.  I keep certain foods in the door of the refrigerator to shorten my search, but I don't mind if they slide around to different positions.  I have very few music CDs so I keep them in two shoe boxes - one for classical and one for everything else.  I don't buy much canned food so it wouldn't be worth it to turn all the cans so every label faces the same direction.  When I look for a particular can it doesn't take much time to turn 5 or 6 cans around until I find the one I want.

On the other hand, I think it's good to be super-organized when people own hundreds of things.  Remember when computer files were stored alphabetically and you had to know the exact name of a file to retrieve it?  I am meticulous about saving computer files in folders like Finances and Photos.  I used to own at least a hundred fiction books.  To find books in my library, I alphabetized books by author but not by title.  To stop buying extra copies of a book when I went shopping, I carried a folded sheet of book titles organized by author in my purse.  When I froze lots of vegetables and meat in a big chest type freezer, my food was meticulously organized so I didn't have to move lots of packages to find the one I wanted.

For me organization is a choice rather than a compulsion or something that makes me feel guilty.

4 comments:

Linda Cooper May 13, 2013 said... I live in a prety chaotic household and you are so right it is exhausting!!!

I am going to need to work on making people in my home understand.. it is all about the energy. not really about having or not having the stuff around.

I love your line.. "A stroke destroyed the illusion that I have time and energy to waste."

J.L. Murphey May 13, 2013 said...  I'm a disorganized organized mess. I know the vicinity of what I want when I want it... it's in this or that pile or shelf. It drives me nuts if I can't find something...like when my children come over to help poor, old mom out like they did this weekend. I spent four hours looking for the pieces of my crockpot to cook dinner! Then I was too exhausted to cook.

My computer files are broken down into major categories and subcategories so I can find stuff I want with ease, but I started doing that before my stroke because I had various WIPs, Editing (mine and other authors), video productions, etc. I would have ten books of mine in various stages of completion, plus other authors, and collaborations at work at the same time.

For example you use "Finances." Under finances folder I would have "Income" as a major heading inside that folder. In the income folder there would be subcategories for "Ministry," "Royalties," "Consultation," "Husband" and "other." That way if I wanted to pull up my statements from any given job I could find that information quickly like how many marriages I performed in a certain month. Even my photos are categorized.

I tend to group like objects together, but that's as far as my organization goes.

Elizabeth, John and Jack May 14, 2013 said... This post is for me.....I am a reformed OCD neat freak. My former self would die to see how "lazy" I have become. It's not really lazy, its more a better understanding that that stuff is not important. I don't have the time or energy to maintain my former ways. I am still organized, when its important, but I am no longer obsessive about it. That's one of the good lessons for me! Some good did come from all the trauma!

Maggie May 15, 2013 said... As we age, my Dear Husband and I come into conflict more and more. The intersection of his breathing challenges (which often lead to a softer voice) and my hearing challenges ... our mutual difficulties of memory ... and, just lately, the conflict of one of us being 'tired' and the other one liking organization.

This morning we pulled a box out of the storage locker (of course it was on the bottom, so we moved half a dozen bigger boxes to get to it; took an hour). We brought the box home and emptied it, preparing to take a trip with the camping gear it contained. But then ... what to do with the box for the next two weeks? He proposed to put it in a different closet. But that leaves me with two conflicting memories of 'where it is' ... and diminishing likelihood that I'll find it when we return from our trip and want to put everything away again.

We probably have a conversation like that once or twice a day lately. There must be a cure, mustn't there? At least, though, our situation makes clear the attraction of a younger spouse ... someone with energy and memory when I have so little.

See the original article:
      Hunting Is Exhausting
      in Home After a Stroke

Bicycle Trail Review (Florida)

SSTattler: 1) Thanks Carrie for finding the "Why Do Old People Ride Trikes" article!
                   2) We will show Tadpole of 3 of the 65 YouTubes.  Just click BTRflorida to see them all.

Why Do Old People Ride Trikes?

Published on Dec 17, 2012

Contest !!! Answer the question and win!! After the film go to http://www.bicycletrailreview.com/ to enter.


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Catrike Rally 2013

Published on Mar 6, 2013

Welcome to BTR video channel.

Go to www.bicycletrailreview.com for event videos you won't find on YouTube.

Free event listing. Free club listing. Trail listing videos and information.


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Recumbents Can't Climb -- Video Proof ??

Published on Nov 1, 2012

A Few Comments of Many:
Zachariah West You can climb large hills with recumbent cycles/trikes. I have ridden a Bike E across the Cascade Highway, 402 miles in 6 days. 
BTRflorida Hi, i have found over my many years of cycling to go into the climb at a high cadence (95 - 100 now, when i was younger 100+) then as you climb keep down shifting trying to keep high cadence as long as possible. hope this helps 
zoktoberfest Duh!....the camera vehicle and the recmbembent are one in the same. I was waiting to see the recumbent bringing up the rear. Clever way to make your point about recumbent myths, even if, some of us are a little slow in the uptake. Nice!. I'm shopping for a tadpole, but I don't expect to be leader of the pack, for some time, if ever. ;-) 
John Robson Keep cadence - if you have decent cadence the hills will slip by. On a trike you can of course stop for a rest in that comfy chair you brought along, just remember to change down first :)


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Chris Soda Rides The Emotion Rollers

Published on Jun 27, 2012

My friend Chris suffered a traumatic brain injury on 2/24/2012 (his birthday) while we were out on a training ride in West Virginia. He was given a 1 in 10 chance of surviving based on the medics at the scene and spent almost 3 weeks in an induced coma. As a bike messenger and artist, Chris could not afford insurance and had no medical insurance at the time of the accident. While his medicaid application is being processed we have relied on studies, friends, and clinics with discounted rates for outpatient care.

Thanks to Diane from Medstar Rehab, Chris was able to get back on the bike. I brought out my eMotion rollers (look them up, they're great), and in conjunction with the ZeroG harness invented by Joe Hidler, PhD. of Aretech LLC, we were able to give Chris a taste of riding again. Though he had ridden a commuter bike, the rollers were a true test of his anticipatory balance, and a great way to overcome his fears of riding in traffic / out on the road again.

Aretech®, LLC researches, develops, and manufactures cutting edge technologies that promote safe, effective therapies for patients after neurological and orthopedic injuries. The ZeroG® gait and balance training system, which is listed with the Food and Drug Administration, allows patients to practice a wide-range of physical therapy activities early after their injuries in a safe, controlled manner. While individual results may vary, training with ZeroG is intended to promote improvements in balance and walking ability, which may then enhance functional independence.


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Device Helps Stroke Victims Walk Golden Gate

Published on May 10, 2013

A new wearable walking device is letting stroke victims regain their mobility. It's called Kickstart and three early adopters used it to walk across the Golden Gate Bridge on Thursday.

SSTattler: See as well Dec/29/2012 Saturday News - Kickstart! in Stroke Survivors Tattler.


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Things Could Be Worse!

Jackie Poff
Stroke Survivors Tattler
A father passing by his son's bedroom was astonished to see that his bed was nicely made and everything was picked up. Then he saw an Envelope, propped up prominently on the pillow that was addressed to 'Dad.'

With the worst premonition he opened the envelope with trembling hands and read the letter.




Dear Dad:

It is with great regret and sorrow that I'm writing you. I had to elope with my new girlfriend because I wanted to avoid a scene with Mom and you.

I have been finding real passion with Stacy and she is so nice. But I knew you would not approve of her because of all her piercing, tattoos, tight motorcycle clothes and the fact that she is much older than I am. But it's not only the passion... Dad she's pregnant.

Stacy said that we will be very happy. She owns a trailer in the woods and has a stack of firewood for the whole winter. We share a dream of having many more children.

Stacy has opened my eyes to the fact that marijuana doesn't really hurt anyone. We'll be growing it for ourselves and trading it with the other people that live nearby for cocaine and ecstasy.

In the meantime we will pray that science will find a cure for AIDS so Stacy can get better. She deserves it.

Don't worry Dad. I'm 15 and I know how to take care of myself.

Someday I'm sure that we will be back to visit so that you can get to know your grandchildren.

Love, Your Son John 

PS. Dad, none of the above is true. I'm over at Tommy's house. I Just wanted to remind you that there are worse things in life than a Report card That's in my centre desk drawer. I love you. Call me when it's safe to come home.

My Friends Who Need To Smile!

Monty Becker
Stroke Survivors Tattler
Now, this is for my friends and my friends who need to smile!

An older, tired-looking dog wandered into my yard. I could tell from his collar and well-fed belly that he had a home and was well taken care of. He calmly came over to me, I gave a few pats on his head; he then followed me into my house, slowly walked down the hall, curled up in the corner and fell asleep.

An hour later, he went to the door, and I let him out...

The next day he was back, greeted me in my yard, walked inside and resumed his spot in the hall and again slept for about an hour. This continued off and on for several weeks.

Curious I pinned a note to his collar: 'I would like to find out who the owned of this wonderful sweet dog is and ask if you are aware that almost every afternoon your dog comes to my house for a nap.'

The next day he arrived for his nap, with a different note pinned to his collar: 'He lives in a home with 6 children, 2 under the age of 3. He's trying to catch up on his sleep. Can I come with him tomorrow?'

This is one of the best e-mails I have gotten in a while!

Interview Malcolm Gladwell at the Toronto Library

Malcolm Gladwell | Part 1

Published on May 30, 2012

SSTattler: You have to skip 8:20 minutes of nonsense but 8:21 and beyond that is a great interview!

Malcolm Gladwell, bestselling author of Blink and Outliers celebrates 50 years of Jamaica's independence. In conversation with CBC's Eleanor Wachtel. Malcolm Gladwell's books including his latest, Blink are available at Toronto Public Library. http://www.torontopubliclibrary.ca

Some of many comments:
nkcorreia1 11 months ago... 08:27 Gets you to Malcolm Gladwell, skipping the unimportant. 
HakypuJIuTyT 11 months ago... Can't say how much I love Malcolm. I've read all of his books and all of his articles for the NewYorker and I will never get enough of his incredibly clear style and phenomenal command of the written word. I love how he sees things in his unique, sort of breath-of-fresh-air kind of way and overturns long-standing assumptions with the grace of an absolute master storyteller and non-fiction writer. Can't wait for the nextbook!

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Malcolm Gladwell | Part 2

Some of many comments:
Nyamzz01 11 months ago... I could listen to this guy talk all day, and still be genuinely interested in what he has to say. 
aray26 11 months ago... I have a huge man crush on Malcolm. Restores faith in humanity.

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Malcolm Gladwell | Part 3

Some of many comments:
Miguel Valencia 9 months ago... i think steve jobs and bill gates will both be remembered. i dont believe this stupid gladwell guy
Arjun Yadav 10 months ago... The kid is awesome too !


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Malcolm Gladwell | Part 4

Some of many comments:
LuneyTune72 11 months ago... I'm so glad that he said all of Jobs' ideas were from other people. I'm sick of people placing all of the credit on Jobs and blowing everyone else off as "little people."
karamazovapy 11 months ago... He does understand, he just thinks we should draw a clearer distinction between moral and ethical leadership.


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RMR: Rick at Velodrome

Uploaded on Mar 25, 2010

Let there be spandex.


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---------

Saturday, May 18, 2013

Sublaxation - Sling Shoulder (or not)


SSTattler: The motion of the shoulder is very complex; we will give you some examples for your shoulder motion & therapy but you have to ask your doctor or physiotherapy for your specific injury and specific type of therapy. A sling may be necessary for some therapy activities but as the patient begins to recover slings are of no value at this point.

Shoulder Subluxation From Wikipedia, the free encyclopedia.

Glenohumeral (or shoulder) subluxation is defined as a partial or incomplete dislocation of the shoulder joint that typically results from changes in the mechanical integrity of the joint. Subluxation is a common problem with hemiplegia, or weakness of the musculature of the upper limb. Traditionally this has been thought to be a significant cause of post-stroke shoulder pain, although a few recent studies have failed to show a direct correlation between shoulder subluxation and pain.

The exact etiology of subluxation in post-stroke patients is unclear, but appears to be caused by weakness of the musculature supporting the shoulder joint. The shoulder is one of the most mobile joints in the body. To provide a high level of mobility the shoulder sacrifices ligamentous stability and as a result relies on the surrounding musculature (i.e., rotator cuff muscles, latissimus dorsi, and deltoid) for much of its support. This is in contrast to other less mobile joints such as the knee and hip, which have a significant amount of support from the joint capsule and surrounding ligaments. If a stroke damages the upper motor neurons controlling muscles of the upper limb, weakness and paralysis, followed by spasticity occurs in a somewhat predictable pattern. The muscles supporting the shoulder joint, particularly the supraspinatus and posterior deltoid become flaccid and can no longer offer adequate support leading to a downward and outward movement of arm at the shoulder joint causing tension on the relatively weak joint capsule. Other factors have also been cited as contributing to subluxation such as pulling on the hemiplegic arm and improper positioning.

Diagnosis can usually be made by palpation or feeling the joint and surrounding tissues, although there is controversy as to whether or not the degree of subluxation can be measured clinically. If shoulder subluxation occurs it can become a barrier to the rehabilitation process. Treatment involves measures to support the subluxed joint such as taping the joint, using a lapboard or armboard. A shoulder sling may be used, but is controversial and a few studies have shown no appreciable difference in range-of-motion, degree of subluxation, or pain when using a sling. A sling may also contribute to contractures and increased flexor tone if used for extended periods of time as it places the arm close to the body in adduction, internal rotation and elbow flexion. Use of a sling can also contribute to learned nonuse by preventing the functional and spontaneous use of the affected upper extremity. That said, a sling may be necessary for some therapy activities. Slings may be considered appropriate during therapy for initial transfer and gait training, but overall use should be limited. As the patient begins to recover, spasticity and voluntary movement of the shoulder will occur as well as reduction in the shoulder subluxation. Slings are of no value at this point.

Functional electrical stimulation (FES) has also shown promising results in treatment of subluxation, and reduction of pain, although some studies have shown a return of pain after discontinuation of FES. More recent research has failed to show any reduction of pain with the use of FES.

Logical treatment consists of preventive measures such as early range of motion, proper positioning, passive support of soft tissue structures and possibly early re-activation of shoulder musculature using functional electrical stimulation. Aggressive exercises such as overhead pulleys should be avoided with this population.

References

  1. Teasell RW: "The Painful Hemiplegic Shoulder". Physical Medicine and Rehabilitation: State of the Art Reviews 1998; 12 (3): 489-500.
  2. Boyd EA, Goudreau L, O'Riain MD, et al.: A radiological measure of shoulder subluxation in hemiplegia: its reliability and validity. Arch Phys Med Rehabil 1993 Feb; 74(2): 188-93
  3. Brandstater ME: Stroke rehabilitation. In: DeLisa JA, et al., eds. Rehabilitation Medicine: Principles and Practice. 3rd ed. Philadelphia: Lippincott-Raven; 1998:1165-1189.
  4. Chae J, Yu DT, Walker ME, et al.: Intramuscular electrical stimulation for hemiplegic shoulder pain: a 12-month follow-up of a multiple-center, randomized clinical trial. Am J Phys Med Rehabil. 2005 Nov; 84(11): 832-42
  5. Chantraine A, Baribeault A, Uebelhart D, Gremion G: Shoulder pain and dysfunction in hemiplegia: effects of functional electrical stimulation. Arch Phys Med Rehabil 1999 Mar; 80(3): 328-31
See the full article:
        Shoulder Subluxation From Wikipedia, the free encyclopedia.








CVA Stroke Series Preventing Shoulder Pain 

Published on Jan 25, 2013


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CVA Stroke Series Improving Function and Awareness 

Published on Jan 25, 2013


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DeRoyal(R) Arm Slings 

Uploaded on Dec 15, 2009

The DeRoyal(R) Specialty Arm Sling is durable navy canvas construction with deep pocket design. To purchase your own DeRoyal(R) Specialty Arm Sling, just visit us at Rehabmart.com: http://www.rehabmart.com/category/Arm_Slings.htm


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DeRoyal Pro Shoulder Support from Optomo 

Uploaded on Jun 10, 2011

The DeRoyal Pro Shoulder Support is anatomically designed shoulder support is designed to provide stability and focused compression.

This product and others like it are available at: http://www.rehabmart.com/category/Arm_Slings.htm

Video Transcription:
Hi, I'm James, and today I want to show you the DeRoyal Pro Shoulder Support. This is it, wearing it on the left shoulder. But with its unique design, it can be worn on the left or the right shoulder, and you don't need two different sorts of braces. The measurement is taken around the top of the bicep, and then you simply look on the Internet to find the right size for you on the chart. That's all available on Optomo.com.au.
Now the DeRoyal Pro Shoulder Support is made of a material called neotex. It's a little bit like a wetsuit material, and it wicks away the moisture so you can wear it for a long period of time without getting overly sweaty.

Now, the DeRoyal Pro Shoulder Support should be used for warmth and stability. It provides a medium level of structure. I'd feel quite comfortable playing football in this, but I wouldn't want to get out there and have to rely on it to provide 100% stability for a sore shoulder. You might want to use it for arthritis or a little bit of subluxation.

This shoulder support here is simply Velcro, and you can adjust that as you deem necessary. And that's it. That is the DeRoyal Pro Shoulder Support. It's in stock and available now on Optomo.com.au.


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The Comfort Sling Video 

Published on May 18, 2012

Welcome to the comfort sling!

The comfort sling was designed out of necessity earlier this year when my friends sister had a shoulder surgery and was forced to immobilize her arm. Well, if anyone has ever worn those flimsy, confusing emergency room issued slings, you'll know they are extremely uncomfortable! The strap digs into your neck and near impossible to put on by yourself! Besides which, they do NOT immobilize your limbs!

So Theresa set out to make her sister more comfortable and it resulted in this amazing sling!

For the first time in 8 months following surgery, after wearing the comfort sling for just a short amount of time, Theresa's sister was finally pain free. This sling comfortably and completely immobilized her affected arm and she could finally rest without pain.

This sling is made out of approximately 1.5 yards of prewashed 100% cotton and can be adjusted to fit any adult frame easily. It is snug and non-binding across the back and sides. The shoulder strap length is adjustable also. It is completely machine washable, and comes in a variety of colors and patterns. ORDERS can be requested at "thecomfortsling@aol.com". Your request will be responded to within 24 hours.


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CarePlus® Arm Sling User Tutorial 

Published on Aug 12, 2012

CarePlus® Arm Sling provides support for a broken or injured arm https://www.careplusonline.com.au

Features & Benefits:

  • Adjustable Shoulder Strap And Foam Pad For Comfort.
  • Breathable Polyester Mesh To Allow Air Circulation.
  • Allows Injured Shoulder Or Arm Muscles To Relax.
  • Arm Pocket Folds Inward For Shorter arms.


Creative Commons Attribution license @ CarePlus Australia






How to Wear an Arm Sling, How to Make a Sling 

Published on Mar 1, 2012

http://collegeteamdoctor.com - How to put on an arm sling demonstrated by specialists in joint and bone injuries. How to wear your arm sling and maximize comfort.


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Fitting a Donjoy Immobiliser Sling 

Uploaded on Jan 5, 2009

Instructional video showing how to fit a Donjoy abduction immobiliser sling and a cloth immobiliser sling. Useful for patients following shoulder reconstruction and rotator cuff repairs when required to wear a sling. Also shown are techniques to passively move the shoulder when allowed by the surgeon, how to wash under the arm and how to position for sleeping.


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Putting on the Hemiparesis Subluxation Sling (1 of 2) 

Published on Oct 9, 2012


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How to put on the Hemiparesis Subluxation Sling 

Published on Oct 9, 2012

Many people have asked for a video on how to put our sling on... well here it is.


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Physical Therapy Treatments : How to Treat Subluxation 

Uploaded on Jul 10, 2010

To treat subluxation of the shoulder, use a sling and an exercise ball to strengthen the shoulder muscles. Prevent further injury from subluxation with help from a physical therapist in this free video on physical therapy treatments.

Expert: Tricia Trinque MHE, PT Contact: www.seabreezephysicaltherapy.com Bio: Tricia Trinque MHE, PT is a physical therapist with more than 25 years of experience. Filmmaker: Leonora Fishbein

Series Description: Physical therapy treatments are beneficial for many injuries and illnesses, from gout to arthritis and fractured bones. Learn an array of stretches and exercises to relieve pain and tension from illness and injury with help from a physical therapist in this free video series on physical therapy treatments.


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