Showing posts with label ▷ 2015 Jan 24. Show all posts
Showing posts with label ▷ 2015 Jan 24. Show all posts

Saturday, January 24, 2015

Saturday News


Contents of This Week Saturday News:

Definition: Stroke

Stroke From Wikipedia, the free encyclopedia


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

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

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

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

Video: Stroke

What Is A Stroke? - Narration and Animation

Published on Jan 28, 2013

by Cal Shipley, M.D.

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

Standard YouTube License @ Cal Shipley, M.D.



Eclectic Stuff

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

A Beginning ...

Jeff PorterStroke of Faith
Wednesday, December 14, 2005

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

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

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

How?

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

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

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



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in

Living With Aphasia: Carrie Lewis' Story

Carrie Lewis
Stroke Survivors Tattler
Sunday, January 01, 2012

"Carrie Lewis is a remarkable woman".

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

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

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

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

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

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

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

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

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

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

My Story :)

Amy
My Cerebellar Stroke Recovery
April 22, 2012

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



See the original article:
in

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.

Justification

Barb Polan
Barb’s Recovery
29th December 2009

On Nov. 12, I woke up and got ready for work as usual; nothing was amiss until I got downstairs and tried to walk across the kitchen to where my husband, Tom, was standing; at that point, my left ankle started curling out so that I was dragging my left foot across the linoleum floor. I was wearing Dansk clogs, which I sometimes roll my ankles in, so I dismissed the problem. I got my make-up bag out of my purse and immediately dropped it on the floor. When I picked it up, it immediately dropped to the floor again. "What's wrong?" Tom asked. "Nothing." I definitely considered nothing wrong.

I picked up the bag for the third time and dragged me and my left foot to the half-bath near the kitchen, where I applied my make-up. Those of you who know me or see me regularly know that the make-up application could not have taken more than two minutes. At the end, I straightened up and fell over to my left, knocking my head into the window trim and knocking the toilet paper roll onto the floor (the toilet paper holder in that bathroom does not involve a spring or any complicated rod - it's just a bar that curves from against the wall forward to create a place to slip on the roll; it's the toilet paper holder that is absolutely the easiest onto which to replace an expired roll - no excuses for leaving the next user without paper!(one of my pet peeves)

At the sound of my fall(or was it the very loud "shit!, shit!, shit, shit!, shit!" that followed that tumble?), Tom appeared at the bathroom door and asked if I was okay."Yes, but can you please put the roll back on the holder?"

"No," he said, "I want to see what's wrong with you."

What my Doctor Should Have Told me About Stroke Recovery

Dean Reinke
Deans’ Stroke Musing
Thursday, August 12, 2010

After four years this is what I expected during my hospital stay, with my therapists working on pieces to meet those needs. I received no information on stroke rehabilitation or even what the damage from stroke consisted of from my physiatrists. This is what I believe I should have received. If the medical profession is not willing to critique their own information delivery then we will have to do it for them. Some of these references probably didn't exist 4 years ago but if the same stroke happened today this is what a good doctor should be able to give you.

If your doctor doesn't give something like this to you, Point blank ask him/her 'Who can I go to that will give me hope/answers?' Remember the detriment of the nocebo effect.

You had a massive stroke affecting your right cerebral cortex, a clot plugged your middle cerebral artery at this location - shows me a three dimensional map of a brain and points out the location. This area here is the epicenter of the stroke, it includes the motor cortex, the part that controls your muscles on the left upper half side of your body. The pre-motor cortex was also destroyed, this does the planning for complicated muscle movements. The sensory cortex does not seem to have died. Your cognitive abilities were spared.

Because you had an ischemic stroke(clot) you will be started on warfarin, a blood thinner, eventually we will get you down to just using aspirin.

There are two types of damage to the brain, First is the epicenter, this area is dead, the second is called the penumbra, which is the area surrounding the epicenter that was partially damaged during your stroke. Recovery of the penumbra area usually spontaneously recovers in 6-12 months. This does not mean you can sit back and just wait for recovery to happen. The ability to move muscles in this area is fairly limited, in order to recover them to something close to pre-stroke levels, you will need to try very hard to move them even if they barely work. This may require thousands to millions of repetitions. The statement you will sometimes hear in regard to this is, 'Use it or lose it'. Any minimal movement you have will need to be diligently worked at. This is what can be called the easy neuroplasticity

First Post.

Andrea
A Year of Living In My Head
Wednesday, November 16, 2011

Okay first off I think it very telling in my description of this blog that I am"managing" doctors, friends, etc etc. I am not managing any of them... they are off doing their own thing and I am just trying to keep up. My regular pre-stroke doctors are all low key and calm and know me... my new neurologists and surgeons are all revved up and fast talking about things that I don't necessarily follow.

I don't know if this is common but I have been very "in my head" of late. Insulating, isolating myself from the present... in a way ignoring that which I cannot ignore. And no, that is not working for me.

Last night I got out of my little shell and went to a gallery opening at Wilder's school. It was the best ever--just to remind me that AGAIN the world is still rolling along full of normal stuff. It helped that everyone was very outgoing and talkative and I love that. I also have to keep in mind that people deal with this sort of crap (tumors, cancer, illness) daily and hourly and by the minute... so I just need to get over my Why Me complex and deal. I have options, I am not dead. Stark reality works well for me. Sometimes. When I am not putting on rose colored glasses and putting my head in the sand.



See the original article:
in

Blindsided

Marcelle Greene
Up Stroke
Thursday, May 19, 2011

I awoke in the middle of last night to utter blackness. No display from the digital clock, no nightlight from the bathroom. I blinked and blinked but could not clear the darkness.

I'm blind! My God, I've gone blind!

Heart racing, I woke my husband …who determined we were having a power outage.

An extreme reaction? Maybe. But, that's how it happened before. I went to sleep on Good Friday 2010 with the full physical and mental capabilities of a fit 45-year-old, and woke the next morning unable to move my left arm or stand on my left leg.

On that morning there was no panic – only confusion. It didn't occur to me that my life could change overnight. Stroke. When I returned home from the hospital a month later, I would look at the bed that had once been my haven, and I would think "the scene of the crime."

Perhaps the biggest change since that morning one year ago is the way I see things.



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in

Welcome to the Revolution.

Pamela Hsieh
Rehab Revolution
14 April 2010

Chicago, IL. 7 July, 2003: A healthy nineteen-year-old girl is at a work conference. She used to be a cheerleader, a volleyball player. She sprinted and hurdled in track, went to England to learn how to row. She was also active in her high school drama club. Never been sick in her life, save the stomach flu once when she was eight. She's now on school break, the summer before her sophomore year at undergrad. She's working, and hard, this summer so she can save up enough spending money to splurge with during her upcoming year abroad in Florence, Italy. She's made over $1000 so far and still has two months to go.

Suddenly, she gets a headache worse than she has ever known. Unbeknownst to everyone around her (who think she's merely dehydrated), and to her, her brain is under attack: an abrupt, massive cerebral hemorrhage has erupted within her right frontal lobe.

Why? An arteriovenous malformation -- a clumpy mess of veins and artery mistakenly connected in her brain prior to her birth -- never previously discovered, perhaps because she hadn't been to the doctor since the stomach flu, has ruptured.

She is having a stroke. A stroke that wipes out every minute movement her brain has recorded and learned since her birth, from the left side of her body.

This hemiparalysis, which affects all movement down that half of her body, has now turned this girl who was athletic and exceptionally coordinated into a handicap.

Never Give Up

Juli
A Stroke of Luck
October 30, 2013

So this is the first true entry of what I hope will be a place to continue to chronicle Alex’s journey. These pictures were taken this morning at 5:30 AM. You might wonder why in the world Alex would be doing physical therapy at that time – she is a teenager after all!

The question should really be “where” in the world… Alex is doing physical therapy with a therapist in Israel. We continue to try to get more from Alex’s right arm and hand. She lost most use of it during her stroke 3.5 years ago. Our latest venture is with the Arm Tutor and HandTutor. This program is based in Israel. We purchased the equipment (without insurance coverage of course) and we use Skype and a program where the therapist in Israel controls our computer during the sessions. It seems promising so far. I’ve posted a video from Alex’s session this morning on our Facebook page linked to this website.

My husband, Marc, works with Alex on this therapy. Just another example of how it takes a village to help raise a child — we are very fortunate to have a big village

Alex’s school schedule and the zone difference between us and Israel leave no other option but for Alex to have therapy at this crazy early hour. Just another example of the lengths to which Alex goes to recover.

Truly inspirational.



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in

Memory Aids Let Old Brains Trump Young Brains

Rebecca Dutton
Home After a Stroke
January 24, 2011

I started to worry when the number of things I forgot to do kept growing.  My usual memory aids weren't working.  I live alone so there is no one to remind me not to screw up.  Out of desperation I put objects that must be taken care of immediately next to the stove.  When I cook I remember to retrieve a pillbox I place on top of my recipe box.  A Post-It note I stuck on the bottle of maple syrup reminds me to pick up ingredients I forgot to buy for a new recipe.  The pill bottle reminds me I'm out of allergy medicine.  The black mini-tripod reminds me to take photos for posts on my blog.  The stack of envelopes reminds me that bills had to be mailed ASAP so I wouldn't have to pay late charges.   My post office is across the street from my grocery store so you would think that remembering to mail things would be easy.   I keep telling myself I'll stop at the post office the next time I go to the grocery store and then I don't do it.

I beat myself up when I saw this pile.  Then I realized a child would never do what I had just done. Young brains are superb at learning new information quickly.  Yet every parent knows that children are not good at retrieving information when it would be useful.  Old brains have a mature frontal cortex behind the forehead that tells other parts of the brain what to do.  "Executive function" is the fancy name for what the frontal cortex does.  Unfortunately the frontal cortex doesn't mature until 21 years of age so adult brains have an important skill that sparkly young brains lack.



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in

It's Been A Month

Diane
The Pink House On The Corner
Wednesday, February 2, 2011

Bob's been home a whole month now. He was discharged from Acute Rehab on New Years Eve. We've finally settled into a routine, but, by God, it hasn't been easy. There have been times when I've been ready to throw in the towel, believe me. Bob is still not able to walk. Has difficulty speaking. He's on a feeding tube and can't have anything by mouth because his swallow is too weak. No movement in his right arm, at all, but his his right leg is coming back slowly.

Our daily routine: Up at 6:30 (me), walk the dog. Back home, disconnect the 12-hour nightly feeding. Quick bath (me). 8:00 a.m. first medications for Bob (all his pills have to be crushed and dissolved in water before syringing them into his peg tube). 10-10:30, first of three "bolus" feedings, 11:00--bed bath, get Bob dressed for the day. 12:00 second dose medications. 2:00 p.m. second bolus feeding, 4:00 p.m. third medications, 6:00 p.m. third bolus feeding, 8:00 p.m. last medication dose and connect overnight 12-hour feeding. In between all of this, visits from therapists (he has three, Speech, Occupational and Physical) and if no therapists are due that day, I do the therapy with him. Meanwhile, get him up in the wheelchair, change sheets, do laundry, empty urinal, change diapers, put TENS unit on for his electrical stimulation on his right arm, work on reading and writing (we are up to One Fish, Two Fish, Red Fish, Blue Fish and he is learning again to sign his name and print some words) or on slow days, playing Scrabble.  At night, we watch a movie together on DVD's from the library. Then to bed around 9:30 and if I'm lucky, I won't be up three or four times with him.

Last night was a good one. I got to sleep until 5:00 a.m. A first!!

Today, the Physical Therapist is going to show me how to help him up to a standing position with the walker. He's been able to stand for 3 to 4 minutes. I've been to scared to attempt this on my own, afraid that he will fall and no one will be around to help me get him back up.

This is my first post here. I'm going to try to post regularly for those of you who would like to hear an update on Bob's progress. Time now for me to go and do his first feeding. Bye!



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in

Where to Begin?

Steven H. Cornelius
Music and Stroke
January 20, 2012

There is so much to tell, I hardly know where to start. At the beginning, seems the logical advice. That would work well enough for a book, but I suspect that format would fail for a blog. So, instead, I begin with the here and now, then look backwards and try to weave threads of meaning into a broad tapestry of experience.

I begin with last Sunday’s MET Orchestra concert (Fabio Luisi conducting w/ Renee Fleming, and clarinet soloists Anthony McGill, and Stephen Williamson) at Carnegie Hall. It was a concert wonderfully performed and, for me, vividly experienced.

Indeed, for me it was a revelation. For the first time since the stroke, I truly experienced music.

For some months I have been doing extensive mental musical practice. Sitting in a chair or lying in bed at night, sometimes for hours art a time, I imagine pushing the keys of a piano and playing drum rhythms. With every key I push or every drum stroke I make, I imagine as richly as possible the sensations of touch and movement, and the instrument’s sound.

This is not a new idea. Most successful musicians do extensive mental practice.* I did too, when I made my living as a performer. But it was some time before I came to understand its benefits for stroke recovery.

Instead, since I could barely move my fingers, I thought I needed to work to actually move them. The work was so exhausting that at first I could only maintain it for a few minutes. I wonder now if it was too exhausting. Maybe even counter productive.

About two weeks ago, I began doing mental typing. I imagine the keyboard. Then I imagine moving my fingers through the alphabet and firmly pressing every key. I write this blog today with ten fingers. The left hand is slow, stiff, and clumsy. And using it is extremely uncomfortable. But I can do it. Two weeks ago, I would have used only my left hand index finger to type this entry.

Much more on all of this later.

For now, I need to finish the Met Orchestra story. As I listened, I engaged in more mental practice. I put the music into various parts of my body—a finger, a wrist, my skull, my chest. I imagined each finger dancing to Copland, the wrist’s nerves awakening to Mozart, and my brain making rainbows of energy to Mahler.

I have never felt more alive.

(See: Doidge, Norman. The Brain That Changes Itself. NY: Viking 2007. pp.200-204.)



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in

Oops! It is a Mistake Lord!

Ramon Florendo
Life after a "STROKE"
Saturday, August 15, 2009

Wow! It has been a fast 20 months since I suffered a “stroke”. I just wonder how time flies by so fast. Vividly I can still remember that early chilly morning, on November 20, 2007, approximately 5:30 am. , while leisurely driving home from my part time job. Suddenly I felt some numbness on my left arm, teary and blurry eyes and could hardly see the road. Less than ten minutes from my job, traversing a downhill one way bridge, which was under repair ,where only one car can go through, my left hand just fell from my hold from the steering wheel, completely immobile on my side. Because of the sudden loss of control, the left front side of my minivan hit the railings of the bridge Worried that there would be much damage with my van; I took control with my right hand, but miraculously, the front tire exploded and the van suddenly stopped. I said miraculously, for if my tire did not explode I would have tried driving to the nearest hospital, and I could have hit somebody or could have been hit. I have the wrong notion that I was having a heart attack, for every part of my body that gave up was my left side. My car stopped right in the middle of the one way downhill street, so I opened my door with the intention of checking the damage, but to my surprise I could no longer move. I was very scared that I would be hit by another car, so I started the engine of my van and slowly parked downhill safely by the side. Funny that at that point and time I was more concern of my van. Then I started drooling and I felt the left side of my face completely numb, felt nauseous, and ready to past out. I would be lying if I say I was not scared, for I feared so much thinking that I would die that morning. This was when the small miracles that saved my life kicked in. I can be a living testimonial of those very weird feelings that some people experienced when they were on a near death situation. I felt complete helplessness. Very scared that nobody would be able to help me if I lose consciousness, so I would die.

CareGivers No Longer in the Dark:
         Speech Therapy for Aphasia

Mark A. Ittleman
The Teaching of Talking
January 22 / 2015

“Thanks for the mentoring.
It occurred to me today that one of the reasons I like The Teaching of Talking Method (other than it is working) is that I finally feel like I can do something to help my husband speak better.”

The above comment was sent to me from the wife of a gentleman who had a stroke. She has been learning The Teaching of Talking Method which involves reading our book, listening to the audio book from audible.com, and online mentoring.

She, like many caregivers was not well versed or instructed in how to stimulate speech and language "on the fly" or throughout the day during activities inside the home, or when out and about. In my opinion speech and language are best learned when they are taught in the context of the situation, when speaking is necessary in the moment. That is how foreign language is learned. One goes to the speaking environment and gets subjected to the everyday language and is stimulated to speak the important words when they are needed. Comprende? (Now say “Comprende…”)

Stroke Self-Management Tweet-chat

Sharon D. Anderson
Stroke Survivors Tattler
January 21 / 2015

When: 


Tweet Chat Questions:

  • T1: What do you think about self-management after stroke? 
  • T2: How relevant is self-management after stroke?  Do you think that stroke survivors can manage stroke by themselves?
  • T3: What preparation and support do survivors need if they are to self-manage stroke? 
  • T4: What are the barriers to self-management after stroke? 

History