Saturday News

Contents of This Week:

• Headline - Anosognosia (Denial)
• Comics   - For Better Or For Worse, Dilbert, Mayes, Doonesbury
• Eclectic - Many articles from many guest bloggers
• TEDTalks -  Technology, Entertainment and Design
• TadpoleUpdate -  Spokes Fighting Strokes
• RickMercerReport - Intelligence, humorous, politics, ...

Index of Eclectic Stuff This Week

1. Denial
2. Sunday Stroke Survival ~ Anosognosia Is It Me?
3. Stroke and Living
4. The Stroke(s)
5. My Social Media Story for Webicina
6. Anosognosia
7. Quick Action, Right Action Can Turn Lives Around
8. Stroke After Stroke: A Rower's Pilgrimage
9. The Most Important Tool for Speech Recovery After Stroke and Aphasia
10. Have You Been to ‘Hell’s Gates?’ #InvictusGames #strokesurvivor
11. Spasticity I: The "Magic" "Cure" for Spasticity Reduction?
12. Outpatient Rehab Continues
13. Escaped Convict
14. SOMEBODY Please Teach Us to Turn
15. Hans Rosling and Ola Rosling: How Not to be Ignorant About the World
16. Development and Control of a Robotic Exoskeleton for Shoulder, Elbow and Forearm Movement Assistance
17. Tadpole Update - Spokes Fighting Strokes - Sep/20/2014
18. RMR: Rick Installs Solar Panels

Definition: Anosognosia (Denial)

Anosognosia From Wikipedia, the free encyclopedia

Anosognosia (/æˌnɒsɒɡˈnoʊziə/, /æˌnɒsɒɡˈnoʊʒə/; from Ancient Greek ἀ- a-, "without", νόσος nosos, "disease" and γνῶσις gnōsis, "knowledge") is viewed as a deficit of self-awareness, a condition in which a person who suffers certain disability seems unaware of the existence of his or her disability. It was first named by the neurologist Joseph Babinski in 1914. Anosognosia results from physiological damage on brain structures, typically to the parietal lobe or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere. Whilst this distinguishes the condition from denial, which is a psychological defense mechanism, attempts have been made at a unified explanation. Both anosognosia and denial are almost always connected with damage in the right hemisphere. Split-brain research suggests that this asymmetry points to a neurological answer. Anosognosia is sometimes accompanied by asomatognosia, a form of neglect in which patients deny ownership of their limbs.

Causes

Video: Anosognosia (Denial)

SSTattler: Very common in recent stroke patients for a couple of weeks but some people have anosognosia (denial) for a long time...

Dr. Vilayanur Ramachandran's Lecture on Anosognosia

Uploaded on Dec 17, 2011

SSTattler: A nice lecture but it takes about 50 minutes...

Anosognosia: The interface between neurology, psychiatry and psychoanalysis. The 5th Neuro-Psychoanalysis Congress, Rome 2004 on Splitting, Denial and Narcissism: Neuropsychoanalytic Perspectives on the Right Hemisphere.


Standard YouTube License @ AtheistKharm

Daily Comics

For Better and For Worse
Lynn Johnston

Canada Family Events

Dilbert
Scott Adams

Dilbert Office Events

Edmonton Journal
Malcolm Mayes

Politics Views from Canada

Doonesbury
Garry Trudeau

Politics Views from USA

  

** 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, 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, Dilbert.com and EdmontonJournal.com.

Eclectic Stuff

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

Denial

Amy Shissler
My Cerebellar Stroke Recovery

May 2, 2013

Denial is a strong, strong, strong, strong, strong thing.  Having a massive stroke at the age of 30 – kind of a big deal.  I had some people in my life that wanted to act like everything was OK after a few months and that I just got kinda sick.  NOPE.  Everything not OK.  Everything might never again be OK.  I mean I’ll be OK – I don’t know about some other people who I know.  If you had something life changing happen to you, especially something awful and devastating and traumatic, you have to deal with that shit.  Don’t pretend like things are fine, they’re so not fine.  One of my favorite things that Dr. Phil says is “you can’t change what you don’t acknowledge.”  I love Dr. Phil, although lately that show has been annoying me because I wanna beat up all of his guests.  Anyway, some people I know need to acknowledge some stuff.

See the original article:

Denial

in

My Cerebellar Stroke Recovery

Sunday Stroke Survival ~ Anosognosia Is It Me?

Jo Murphey
The Murphey Saga

Sunday, September 14, 2014

When the subject of anaosognosia came up in the data base I wondered: What is it? And after reading about wondering if it was me? It sure sounds a lot like me in a lot of ways.

You know me. If I don't recognize something, I have to look it up. Blame it on my parents who made me look up words I didn't know or just inquisitive minds want to know.

Definition -

1. Ignorance of the presence of disease, specifically of paralysis. Most often seen in patients with nondominant parietal lobe lesions, who deny presence of hemiparesis. The information shown above for anosognosia is provided by Stedman's.

It's basically denial of your current illness. A hear, see or speak no evil type of existence. I'll admit most of the time, I'm in this thought mode.

Maybe, it's just my stubbornness. "I can do everything, but I just have to figure out how." So I really don't have this because I KNOW I have hemiparesis (paralysis of half the body or half paralysis). But it's not on my mind dwelling and stewing up front and always present. Mainly because I have figured out how to do most things I want to do already.

Stroke and Living

Steven H. Cornelius
Music and Stroke 

May 23, 2012

The psychiatrist Elisabeth Kübler-Ross, an expert on death and dying, developed a model in which she outlined five stages of grief: denial, anger, bargaining, depression, and acceptance. Other thinkers have modified the list or brought in additional aspects, including (for those having passed through nadir of depression): reconstruction and hope.

Perhaps it is self-centered for me to frame my stroke in Kübler-Ross’ terms, but losing control of half of my body and mind was plenty traumatic.

With that caveat in place, in this post I work through Kübler-Ross’ categories in terms of my own recovery. Perhaps the exercise will offer some useful insights.

Stage 1: Denial. Clearly I experienced denial. On the night of the Big Event something was definitely wrong, but it didn’t sink in for me that it might be serious. After all, I was in perfect health. Wasn’t I?

Even at the hospital, at the point they tried to give me an MRI, I was semi-functional. Refusing to go inside, I pulled myself out of the machine, found a way to sit up on the gurney, and threatened to leave the hospital.

I wasn’t as functional as I thought, however. My next clear memory comes three days later.

The Stroke(s)

Robin
Rocky Mountain Stroke Survivor

February 3, 2013

My first noticeable stroke… well, let me just stop there a moment.  It took some practice to be able to connect myself with a stroke.  It’s oddly reminiscent of when we first saw those two pink lines on the pregnancy test.  I practiced over and over before I told anyone, “I’m pregnant.”  Saying, “I had a stroke” was more difficult and I had less time to practice before I had to start telling the family.  There were no twelve weeks of preparation to get used to the idea; we heard the news and moments called my sister to come help with the kids.  And that was the first thing I learned about strokes: they are not only unexpected, they are sudden.  Fine one moment, stroked the next.

Anyhow, my first noticeable stroke happened at 4 in the morning.  We don’t know which morning because, denial being the powerful thing that it is, I didn’t go to the emergency room or tell anyone about it outside my husband and two small children, all of whom believed me when I said I was fine.  We know it was early January.

I woke up with a tension headache and muscle spasms in my neck, a common problem after working at an office that was built before the ergonomics of personal computers were a consideration, and did what I always do: I stretched my neck.  My neck pain and headaches had been excruciating all through the month of December, so I was used to waking up with headaches.  I remember pushing my chin to the left to get just a little more stretch out of it, hoping that it might even “pop” and relief the spasm, allowing me to go back to sleep.  And then suddenly I was spinning to the left.  Spinning and spinning and spinning.  I felt like I was going to throw up but didn’t.  I felt like maybe if I did I’d feel better, but I thought maybe I wouldn’t.  I was cold and clammy and apparently something in my voice told my husband that this was serious because he actually woke up as soon as I called for him.  Unfortunately, so did our baby whose cries then woke our three-year-old.  Hubby held the two little ones and they sat and watched while knelt on the bed, clinging to the sheets and describing the sudden acceleration of my world.

My Social Media Story for Webicina

Dean Reinke
Deans’ Stroke Musing

Monday, November 21, 2011

There is a competition at http://www.webicina.com on uses of social media to empower patients and medical staff. This is my story.

As a 5 year stroke survivor, there is a lot to be thankful about; I’m alive and slowly rehabilitating. May 21, 2006 was the day it started. I had just returned from a 6 day strenuous whitewater canoeing trip on the Dog River in Ontario. This included a 1.5 mile portage so I was definitely in shape and excellent health. I drove home alone thru the UP of Michigan. I collapsed the next morning walking across my bedroom floor, called to my wife to help me get up but she was already calling 911. It was a massive stroke leaving me in critical condition. I received tPA within the hour but still ended up with huge dead spot in my brain and left side paralysis.

I was waiting for my medical staff to give me some concrete information on rehabilitation and then I could follow that and recover. That never occurred, I don't think my doctors in 30+ years of practice had ever figured out anything about stroke rehab. Since my cognitive abilities were spared, as soon as I got access to a computer I found a number of stroke forums and everyone on them was looking for information that no-one had gotten from their doctors. It became painfully obvious that all stroke survivors are on their own, they need to figure out their own therapy protocols.

Anosognosia

Barb Polan
Barb’s Recovery

22nd June 2010

When my cognitive abilities were evaluated after the stroke, one of my identified problems was called Anosognosia, a condition my neurologist defined as "generally used to signify not understanding the extent or significance of one's deficits." In other words, I suffer from the inability to recognize my limitations caused by the stroke. In some brain-injured people, this phenomenon results in some significant risk-taking behaviors - like continuing to drive after having a stroke.

My reality was that even the morning I had the stroke, I didn't recognize any drastic change from what was normal inside my head. Sure, I had trouble putting weight on my left ankle so that I fell over whenever I stood on my own and my ability to squeeze with my left hand came and went, plus I had a headache right behind my right eye ( when I never had headaches before that). But those were all physical issues; everything inside my brain - thinking, feeling and logic - felt normal and has continued to do so. That's a symptom, I suspect, of the agosognosia condition - I don't feel incapable of thinking clearly and figuring out things as I used to - I have retained my ingrained "How hard can it be?" attitude. I observe that I make more mistakes now and for a while, calendars were far more baffling than they used to be. Maps and spatial relationships, as always, continue to confound me. Recovering cognitively is much harder for me to assess compared to recovering physically - if I can lift the yellow ball with both arms, I can see that today I am capable of more than I was in December, but, if all along I have been clueless about the whack my cognitive skills took, how do I assess progress? I am pleased that I can usually complete the daily crossword puzzle in the Gloucester Daily Times and I can often complete the Crytoquote, but the I was not able to come anywhere near completing the crossword puzzle in the Sunday Globe, something that I did regularly before the stroke - it might have taken me the whole week, but I generally completed it every week.

See the original article:

Anosognosia

in

Barb's Recovery

Quick Action, Right Action Can Turn Lives Around

Jeff Porter
Stroke of Faith

Monday, March 07, 2011

Darrell Figy certainly didn't plan for a stroke that day. But quick action turned his life around. From a story in the Springfield (Mo.) News-Leader:

"You would never know just looking at me that I ever had a stroke, the way I talk, the way I walk, the way I dress," Figy said. 

Only about 5 percent of stroke patients receive the drug Figy got -- tissue plasminogen activator, or tPA. The U.S. Food and Drug Administration has approved tPA for stroke patients if given within three hours of the patient showing stroke symptoms. Many don't get to the hospital in time. 

"A lot of people don't complain," [Dr. Scott] Duff said. "It's painless. They're in a state of denial, or the stroke has taken away their ability to recognize that there's a problem."

See the original article:

Quick Action, Right Action Can Turn Lives Around

in

Stroke of Faith

Stroke After Stroke: A Rower's Pilgrimage

Publication Date: September 5, 2014

Stroke After Stroke is the personal story of a recreational gig rower who survived a stroke at age 52, and of her relentless pursuit of recovering from the resulting hemiparesis (the loss of the use of her left side) even 5 years later, despite the medical establishment's stance that recovery for her has already ended.

Based on the blog she started 6 weeks post-stroke, the book chronicles how Barbara Polan has faced the losses concomitant with her injury, and the struggles of incorporating current recovery therapies into her attempts to resume her pre-stroke life. In the process, she re-shapes her new life into one that better suits her.

She has written the book she had hoped to read immediately after having a stroke.

Barbara has first-hand experience with the relentless repetition needed to establish new neural pathways that are needed to regain lost functions, and promotes investigation and optimism as necessary ingredients in any recovery. In addition, she offers helpful information and insight into the logistics and the emotional reality of survivors' altered lives, along with helping survivors understand that they are not alone.

This book will be appreciated by anyone whose life has been affected by stroke - survivors and their caregivers, family members and friends.

SSTattler: See as well The Murphey Saga by Jo Murphey -- New Release~Stroke After Stroke: A Rower's Pilgrimage by Barbara Polan.

The Most Important Tool for Speech Recovery After Stroke and Aphasia

September 12, 2014

There is not a day that goes by that I don't receive information about a new app, piece of technology, diagnostic big $ machine that is supposed to either do the therapy, help the therapist do the therapy, or a piece of software that is designed for the patient to improve speech if he sits down behind a computer or I Pad or does the therapy exercises out of a manual or book.

Isn't it amazing the comparison of  public school resource materials and equipment for therapy, versus home health, private practitioners, "world's greatest rehab hospitals" and college/university clinics?  These settings can have every app, test, computer program, standardized test, therapy equipment and the "latest and greatest," while other settings have a minimum of computers, i pads, workbooks, and technology.   Is one setting better than the other? 

Then there are the "intensive" programs sponsored by Universities and colleagues where people with aphasia and their caregivers go for 1-4 weeks.  Is this the answer for those looking for the "latest and greatest?"

So what is the best therapy machine, app, program, or "Method?"  Does all the technology, intensive programs, apps, software, etc really make a significant difference in speaking improvement?

Have You Been to ‘Hell’s Gates?’ #InvictusGames #strokesurvivor

Kate Allatt
Stroke Recovery Tips

September 13, 2014

Watching the truly remarkable Invictus Games Prince Harry has so brilliantly pioneered, made me think, ‘bloody hell those ex-servicemen and women have also been to Hell’s gates and back, big time.’

Everyone has tough times but when you hear of the physical and emotional traumas these people have suffered, you can only imagine (in your worst nightmare), if we really understand what a tough life really is? Should we put ourselves more out for others?

Do we moan unnecessarily in life? Should we be more grateful for what we have each day?

This is ABSOLUTELY not to say people can’t OR shouldn’t suffer mental illness for lesser experiences at all, as we all have different coping thresholds, but we must celebrate the inspirational way these people choose to cope with their massive set-backs.

Spasticity I: The "Magic" "Cure" for Spasticity Reduction?

Peter G. Levine
Stonger After Stroke

Tuesday, August 26, 2014

Why do I have spasticity? What can I do to get rid of spasticity? When will it go away?"

People who have any number of pathologies can suffer from spasticity. Spinal cord injury, multiple sclerosis, amyotrophic lateral sclerosis (Lou Gehrig's disease) and other pathologies have spasticity as a sequela. This column will discuss spasticity as it relates to acquired brain injury which includes traumatic brain injury, cerebral palsy and stroke.

Most clinicians provide patients with overly simplified, incomplete and often inaccurate information about what spasticity is, its etiology and its cure. Therapists generally believe that patients don't want detailed explanations. But patients need to understand their spasticity. Why? Having patients understand their spasticity is essential because spasticity will only reduce if executive control over the spastic muscles, by the brain, is restored. And executive control over muscles will only happen with repeated firing of the muscle in question, and repeated firing will only happen if the patient wants it to happen.

Spasticity II: The Explanation

So how can you explain spasticity to patients and their significant others in a way that is easy to understand and scientifically valid?

Outpatient Rehab Continues

Diane
The Pink House On The Corner

Sunday, September 14, 2014

We are still going to Outpatient Rehab twice a week, though now, I drive Bob there in the Bobmobile, which is so much easier, I must say, then pushing him there six blocks!

Therapy days are Mondays and Wednesdays, and Bob starts with an hour of Speech Therapy. The ST has really been challenging Bob and he really loves the process. They are now working on getting Bob to form complete spontaneous sentences, instead of his usual one or two words. She works with photos and pictures and a chart reading "Who" "Action" and "What", basically trying to get Bob to come up with sentences like "The guys (who) are playing (action) football (what)". She is also working a lot on "categories", having Bob say as many words in a category as he can think of, example: "animals".  Speech Therapy is fun, filled with lots of laughter, and Bob tries really hard to impress the ST.

Escaped Convict

Jackie PoffStroke Survivors Tattler

A man escapes from prison where he has been for 15 years. He breaks into a house to look for money and guns and finds a young couple in bed.

He orders the guy out of bed and ties him to a chair, while tying the girl to the bed he gets on top of her, kisses her neck, then gets up and goes into the bathroom.

While he's in there, the husband tells his wife: "Listen, this guy's an escaped convict, look at his clothes! He probably spent lots of time in jail and hasn't seen a woman in years. I saw how he kissed your neck. If he wants sex, don't resist, don't complain, do whatever he tells you. Satisfy him no matter how much he nauseates you. This guy is probably very dangerous. If he gets angry, he'll kill us. Be strong, honey. I love you."

To which his wife responds: "He wasn't kissing my neck. He was whispering in my ear. He told me he was gay, thought you were cute, and asked me if we had any Vaseline. I told him it was in the bathroom. Be strong honey. I love you too!"

SOMEBODY Please Teach Us to Turn

Rebecca Dutton
Home After a Stroke

September 14, 2014

The photo shows the turns I take to prepare a glass of iced tea and a bowl of cereal with a sliced banana for breakfast.  I put the banana on a paper plate to hold the banana still while I slice it.

The photo is so complicated that I omitted the turns I make to get out yogurt to take my pills.  I will not even try to diagram the turns it takes to prepare a hot meal.  Walking in straight lines in the PT gym and walking around the block at home did not prepare me for this.  After I fell and broke my forearm while turning I got scared.  I learned to take itsy bittsy baby steps until I complete a turn before taking normal size steps in the new forward direction.

Help is emerging.  Chen and associates trained stroke survivors on a straight or a turning-based treadmill (1).  See the parallel bars in the diagram on right. Subjects who trained on the turning-based treadmill were significantly better at turning 360 degrees in place and standing on a cushion with both eyes closed and arms crossed over their chest.  Turning away from a kitchen counter is done by stepping backwards as you turn so information from the inner ears about how far from vertical you have stepped back is crucial.  Paradoxically, the turning-based treadmill group also walked significantly faster in a straight line with more equal time weight bearing on each foot as they walked.

PTs and OTs need to incorporate these findings into clinical practice.  Learning to turn needs to begin with how to turn around after you shut the bathroom door and again after you flush the toilet.

1. Chen, I, Yang, Y, Chan, R, Wang, R. Turning-based treadmill training improves turning performance and gait symmetry after stroke. Neurorehabilitation and Neural Repair. 2014;28 (1):45-55.

See the original article:

SOMEBODY Please Teach Us to Turn

in

Home After a Stroke

Hans Rosling and Ola Rosling: How Not to be Ignorant About the World

Published on Sep 11, 2014

How much do you know about the world? Hans Rosling, with his famous charts of global population, health and income data (and an extra-extra-long pointer), demonstrates that you have a high statistical chance of being quite wrong about what you think you know. Play along with his audience quiz — then, from Hans’ son Ola, learn 4 ways to quickly get less ignorant.

Standard YouTube License @ TED