Chris DeWald: Strokes and friendships
So many items around you when you have your first stroke go astray. Besides physical inabilities to conquer, you have to face true friendships and future friendships. What did I just say? When I had my strokes in May 2006, I discovered that people I thought were my friends distanced themselves from me. From what I hear from my “new” stroke friends, this has occurred to them when met with a deadly life-changing event.
What is the common root of this loss of close friends? I feel friends in sheep clothing cannot withstand being around people that are ill, or have changed. Some of our physical attributes changed and are “ugly” to some. The clenched fist from the muscles getting atrophic; muscle tone tighter than a mosquito’s rear end looks unusual to those seeing it for the first time. Angry pathetic words are made up like lobster boy and claw man for this condition. Their IQ might be superb, but outward appearances derive negative connotations.
According to
http://onlinelibrary.wiley.com/doi/10.1111/j.1460-6984.2011.00079.x/abstract:
Outcomes and Results: 29 participants were recruited of whom 10 had aphasia. The main reasons given for losing friends were: loss of shared activities, reduced energy levels, physical disability, aphasia, unhelpful responses of others, environmental barriers, and changing social desires. The subset of participants who experienced the most extensive loss of friends were those who described a sense that they were closing in on themselves leading to a withdrawal from social contact and a new preference for meeting only close friends and family.
Those with aphasia experienced the most hurtful negative responses from others and found it more difficult to retain their friends unless they had strong supportive friendship patterns prior to the stroke. The factors which helped to protect friendships included: having a shared history, friends who showed concern, who lived locally, where the friendship was not activity-based, and where the participant had a ‘friends-based’ social network prior to the stroke.
I would score this high. I feel there are more direct causes. Fear from your ex-friends is one. The article above should be laced with “Son, you have had a brain injury”. Once we understand that the “brain” injury caused the above, we have a basic start. Here comes the negative connotation again. Since he has a brain injury, we sometimes get lumped into being “less” intelligent. I have been trying to get employed at a menial part-time position. I see prospective employer’s looks and I feel the. I’m sorry…you appear “stupid,” or other words associated with being mentally inefficient. I scored high on all their employment exams, but never get called. I see others getting jobs, but not me.
All right, we have had a brain injury. As survivors, we need a social group/club to express our concerns. You shall find many of your best friends are now stroke survivors. Why? They have been “there.” Their failures and triumphs are shared and you learn from mistakes and also productive successes.
Now, have you changed to warrant friends leaving? Since my injury, I have tried to compensate my weaknesses in the wrong manner. I lie to myself and then it transfers to others. Failure to accept the “new” you can lead down the wrong path of life. Be knowledgeable and understand what is going on now. One of my issues was I was on the wrong medication for six years. I was being treated for depression from day 1 of the brain stem strokes. I was not depressed. The pieces missing in my injury was needed to have a mood suppressant. I was not depressed. The wrong medication turned me down the wrong path. If you had issues before, the wrong med can intensify your mode of operation.
So without help, you do what you believe is the answer to everything in your new life. No direction is prominent and you suffer as well as others. I had a devastating result to me handling things without help. I am so happy it was found and is now being treated responsibly. But your past of doing weird things for six years takes its toll on you and others. When do you stop saying sorry? When does “sorry” become a word that no one believes anymore.
Kim Anderson, from Irvine, Texas, tells me the following:
Most friends desert us after a stroke because we are not the same person we once were to have fun with. I have had a true friend for over 30 years, she has been there for me through thick and thin, when my youngest was born, my stroke and when my hubby died. No matter the circumstances. Now that is a true friend, she doesn’t treat me any different either. not one we thought were our friends, those were just acquaintances I think a lot of people don’t know how to act around us after we have a stroke or what they can do to help, they realize their own morality maybe.
Family members even have a hard time in knowing what to do around us. No one really does, I guess, unless they have walked in our shoes, no that is it in a nutshell.
Kim is a survivor, and I am indeed proud of her. Although she is a Cowboy fan and her other stroke buddy is a Steeler fan. I find them to be very intelligent, funny and strong willed.
Now we have an insight on the personal feelings and one type of anguish felt by survivors. If you are a friend, help yourself to understand. Help your friends to understand. It is a two way street. True friends are forever. Thanks, readers.
Column by Chris DeWald
Chris DeWald: Strokes/neuropsychological evaluations
As always, I have something happening to me. This results in having information for you. From my last article, I left you with the next step in my fight with severe vascular disease. This test was designed to reveal my strengths as well as my weaknesses. You may be scheduled for one and not know what to expect. First it is painless unless you think too hard with vascular disease and it results in headaches. Please, if only I had headaches I’d be filled with overwhelming joy.
My evaluation starts with:
Reason for Referral and Background Information: States reason for “why” they need one. Mine happens to be memory loss, misperceptions of events, brainstem strokes, seizures, vocal and motor tics, headaches and dizziness. Here’s another sentence about me having vision loss and fatigued that has to serve a purpose. I do experience “clonus” as well as spasticity. Cognitive issues and current memory loss are mentioned.
So the first part is why I am there for the evaluation. See, does not hurt unless you want to conceal issues and that would be counterproductive.
Medical History: Brings about a clear picture of what has transpired to bring about this visit. It lists my strokes and severe vascular disease. It also lists my current medications and dosages
Psychiatric Substance Use history: Not too painful physically. If you had even thought of suicidal type scenarios tell him. He shall ask. Be truthful for everyone’s good. I do not currently use any illicit drugs or smoke. I do not consume alcohol either. All of my current meds forbid the use of such.
Family/Social History: This reached deep into my soul and was difficult revealing. The edgy and jumpy that includes tolerating situations and environments was the easy part to reveal. This has been ongoing since my First 2 Brainstem strokes in 2006. Then I believe it hits the root of my issues with the reveal of “physical abuse” during my preteen years by a family adult. This has been in and out of reminders dealing with myself for years. Reveal it to the Doctor. Don’t think it will go away and it has no effect on your future life. It goes on to my education and GPA.
Methods of Assessment: Clinical Interview, Review Medical Records, Oral Word Association, Finger oscillation Test, Halstead Category Test, Hooper Visual Organization Test, North American Adult Reading Test, Personality Assessment Inventory, Rey Auditory Verbal Learning Test, Rey Complex Figure test, Trailmaking Test(Parts A and B), Wechsler Abbreviated Scale of Intelligence(WASI).
Behavioral Observations: This is what he sees while interviewing you. If you believe in Spirits, you might have some issues as you are dealing with a man of science. Motor tics and verbal tics are noted on the copy. I had some whoppers that day.
Test Findings
Intellectual Functioning: Well it’s nice to start off with a plus after revealing your abuse over 49 years ago. My Full scale IQ score is 122. This has not changed since 2006. All prior intelligence tests remain the same as 2006. Now here is a new medical term for me and I shall explain it. I was scored on a NAART. This is an estimate of premorbid intellectual efficiency. I had an estimate of full scale. Now premorbid was an ominous word for me. So let’s see what this means.
According to:
http://ajp.psychiatryonline.org/cgi/content/abstract/154/2/165
I had to read the bottom of this article where it spoke “English” for the common man. CONCLUSIONS: The results suggest that higher levels of premorbid ability are associated with greater pathophysiological effects of Alzheimer’s disease among patients of similar dementia severity levels. These findings provide support for a cognitive reserve that can alter the clinical expression of dementia and influence the neurophysiological heterogeneity observed in Alzheimer’s disease. So I guess I am a fish because I have full scales. Glub,Glub Sponge Bob.
Attention/Concentration: No changes since 2006. Now this is after my initial strokes. Is this bad or good? I’ll take no changes.
Visuospatial Functions: I have a segmented and inefficient constructional approach. In other words, I did the task but went about it the wrong way. My life story revealed for sure even before strokes. I can draw a clock. Tick-tock away.
Reasoning/Cognitive Flexibility: This measures performance on visual reasoning. I passed something.
Motor Functions: My dominant hand was above the average person. Reminds me of Yogi Bear, I’m faster than the average bear eh Boo-Boo. My left hand which is my affected side was a total reveal. I received a low average that being no surprise.
Language Functions: Verbal fluency solidly average. Thanks to Woodrow Wilson Rehab, as I was at ground zero when I had my strokes in 2006.
Learning and Memory: Immediate recall of noncontextual auditory/verbal information was low average. My visual memory with complex geometrical designs was severely impaired at both recall conditions. What can I say? Yikes comes to mind…
Personality/Emotional Functioning: The only reason I write is to provide my readers with up front information. This is why I promised to help others although it is difficult for me to “open” myself as to what goes on after a stroke to many.
I responded to items on the PAI in an open and honest manner sufficient to yield a profile of scores. The advantage of the PAI is that it assesses a broad range of psychological conditions, including anxiety, depression, mania, schizophrenia and some character logical disorders. It also has three normative samples including a census matched community sample, a psychiatric patient sample, and a college sample, which provides a broad basis for comparison. It also has four validity measures. The PAI subscales do seem to be especially useful for more detailed analysis.
All right here we go; I harbor significant concerns about thinking and concentration as well as somatic and physical health concerns. My test reveals some degree of manic symptomology and a significant depressive experience. It reveals I get involved in various activities in a disorganized fashion. Oh how true this is and I have hurt too many people who care about me.
This part also discovered that my suppression of childhood events carried on through my adult life. So there were things already present and all of my medical issues were a toxic mix of chemicals.
Summary Impression: I feel this is akin of an evaluation at work. You sprinkle in the good parts of the test then slammed on the bad. I should say “informed” as it is for my good, but still feel exposed. I am basically warranted for psychiatric consultation and psychotherapeutic “monitoring”.
Diagnosis Consideration: There are three considerations named Axis 1 through 3.
http://quizlet.com/5960525/axis-i-through-axis-v-global-assessment-functioning-gafscale-flash-cards/
Ruled out was being Bipolar.
Axis III was severe cerebrovascular disease.
He has made a request to my neurologist for medical intervention immediately. So my readers, there I lie exposed for you to see. I want to bring hope and understanding to those scared to see or request and evaluation. After you are evaluated with no lies…repeat no lies, you shall actually see yourself as you are or seen by others. Get the help you need. Try folks, never give up. Next article will be what transpires next.
Column by Chris DeWald
Chris DeWald: Strokes, vision and cerebral vascular disease
My world is turning out information for you as if you are going upstream with no motor. I figured not saying paddle as most have only one good working hand. First, what is cerebral vascular disease?
According to http://www.vasculardiseasesymptoms.com/cerebral.html:
Cerebral vascular disease refers to the brain abnormalities caused by diseases of the blood vessels that supply the brain. The most important cause of a cerebral vascular disease is hypertension. Due to hypertension, blood vessels deform, they become narrow and uneven which makes them vulnerable when the blood pressure fluctuates. Other risk factors are obesity, diabetes and smoking. A cerebral vascular disease increases the risk of suffering a stroke, especially in older people even though it can occur with younger patients as well, especially if they have a history of diabetes, heart disease and they smoke. However, strokes are not common in patients younger than 40 years old but the risks increase exponentially with the age.
The stroke is the result of a cerebrovascular condition and it occurs when a blood vessel within the brain is completely blocked or when these blood vessels rupture. Usually the blockage is caused by a blood clot in the cerebral arteries (also known as thrombosis). It may also be due to a an embolism, which means that the blood clot was caused by a piece of tissue, cholesterol or other several substances in the blood. When a thrombosis or an embolism occurs, the blood supply to the brain may be completely blocked or it can lead to blood vessels ruptures that will bleed into the brain. Both of these situations may result in a stroke. An embolism can cause a transient ischemic attack (or a TIA) because it blocks the small arteries in the brain which will cause losing the brain function in the specific area. After the blockage moves on and the blood flows again, the affected area of the brain will regain its functions. Dementia may be a result of a cerebrovascular disease due to the progressive destruction of brain tissue caused by repeated blockages of the arteries.
All right friends, those are the basics. The blood vessels get plugged with various junk and become smaller. In my case, genetics played a significant role in having smaller arteries in my head. I have been told since 2006, I am lucky to have survived at all and that this is a progressive disease. I do not have just one area they can stent but so many small paths that any operation will do not good. Yes it shall, I am here to tell you what happens.
At approximately 3 months ago, I started to notice my vision becoming unclear. I could see objects as usual, but I could not read the shows on my TV. Hey, a man and his remote control? Now we are in the danger zone. My usual visit, to the Neurologist, set a landslide of more doctors. But I am here to talk about vision today, so let’s focus on that. Did I type focus?
According to http://www.britannica.com/EBchecked/topic/199328/eye-disease/65013/Arteriosclerosis-and-vascular-hypertension:
The eye is the one structure in the body in which the blood vessels are easily visible to the examiner. Changes observed in the retinal vessels mirror changes that are taking place in other parts of the body, particularly those in the brain. In arteriosclerosis, degenerative changes occur in the walls of arteries that lead to thickening of arterial walls and narrowing of blood vessels and may give rise to complete occlusion (blockage) of a vessel. If the central retinal artery that supplies blood to the inner retina is affected, loss of vision is profound and sudden and, unless the obstruction can be relieved right away, permanent. Occlusion of the retinal veins is more common than arterial occlusion and also has dramatic effects caused by the damming up of blood in the eye. Blockage of retinal veins results in the bursting of small vessels, retinal swelling, and multiple hemorrhages scattered over the retina. Some degree of recovery of vision is usual but depends on whether a branch of the central vein or the central vein itself is occluded.
Profound and sudden I can see with my bifocals and with the screen at a higher degree of enlargement. It was sudden to me and profound. My vision is uncorrectable at 20/200 and my arteriosclerosis is visible to the “Medical Physician”. This is not a lens technician, but one who deals with diseases of the eyes. No matter what lens corrections, I cannot read with regular lenses. What does 20/200 vision mean?
Levels of Vision
20/20 – Normal vision. Fighter pilot minimum. Required to read the stock quotes in the newspaper, or numbers in the telephone book.
20/40 – Able to pass Driver’s License Test in all 50 States. Most printed material is at this level.
20/80 – Able to read alarm clock at 10 feet. News Headlines are this size.
20/200 – Legal blindness. Able to see STOP sign letters.
The point to remember is that the progression of this disease may reach your vision center and it is “quick” and profound. I can tell you, yes it is. One day, all clear. Next day “what’s on TV”?
You can follow me and this progressive disease as I was also sent to a neuropsychiatrist. Neuropsychiatry is the medical specialty committed to better understanding brain-behavior relationships, and to the care of individuals with neurologically based cognitive, emotional, and behavioral disturbances.
What is a neuropsychiatrist? A neuropsychiatrist is a physician (M.D. or D.O.) qualified to practice neuropsychiatry by virtue of either 1) primary training in psychiatry or neurology followed by a period of at least one year of fellowship training in neuropsychiatry/behavioral neurology, or 2) formal residency training in both psychiatry and neurology. Psychiatrists or neurologists with many years of extensive clinical, educational, and scientific experience in the field of neuropsychiatry may also merit this specialty designation.
Which patients are best served by neuropsychiatric consultation or treatment? The Neuropsychiatrist treats people with neurologic illness and cognitive, emotional, or behavioral problems; individuals with combined psychiatric illnesses and neurologic conditions; and individuals with atypical or refractory primary psychiatric disorders in which there is concern that an underlying neurological condition may be causing the “psychiatric” symptoms.
So, I am now at this level. Tune in next time, same Bat Channel…
Column by Chris DeWald
Chris DeWald: Stroke and emotional changes
Hello, my friends and also my religious enemies. What a way to start an article besides with friends. Seems I made some religious enemies from my article on melanoma, and my immediate reaction was not favorable. That shall be revealed later, but is relevant to how we as stroke survivors deal with complex emotions.
According to one source, http://www.paxilprogress.org/forums/showthread.php?t=20421
What is Emotional Lability?
Emotional lability is the term used when someone is more emotional and/or has difficulty controlling their emotions. It can happen with many neurological conditions and often happens after a stroke. Some people describe feeling as though all their emotions are “much nearer the surface” or more exaggerated after their stroke. For example some people may become upset more easily, or cry at things they would not have cried at before their stroke. Their emotional response is in line with their feelings, but is much stronger than before the stroke. For other people the symptoms can be more exaggerated, and some people find that they cry for little or no reason. Less commonly, people laugh rather than cry, but again the emotion is out of place and does not match how they are feeling at the time.
What causes emotional lability?
Emotional lability is caused by the damage done by the stroke. Chemical changes within the brain can cause psychological and emotional changes. Frequently, difficulties with swallowing and tongue movements coincide with emotional lability. If this is the case a Speech and Language Therapist may help to accurately identify emotional lability.
Here I am again !!! Now that I just provided you one term, the following information is more prevalent. http://www.tree.com/health/stroke-emotions.aspx
Surprises Stroke Emotional Aspects: Depression, Anger?
Having a stroke causes emotional difficulties for both the patient and family members. Anger and anxiety are common responses to the permanent limitations and loss of independence caused by a stroke. Further, the slow and sometimes tedious pace of rehabilitation can cause lack of motivation that, if left unchecked can develop into depression.
This is not just out of facts, I had it. The anger was mean and powerful. Being told I could not be employed anymore at 50 years old was impossible. Being told I was lucky I was saved for a reason and should be dead was not a compromise. Telling yourself, This was not true, and in a week all will be well, did not come about. I confirm the first part of this article.
Personality Type and Stroke
Surprisingly, personality type plays a large role in stroke rehabilitation. People who react well to stress, control anxiety, and are generally optimistic about life before a stroke are most likely to react well to life after the stroke. People whose personality type makes them prone to anger, anxiety, or depression, or who lack motivation usually find stroke rehabilitation difficult and discouraging.
On the other hand, personality type is vulnerable to change after a stroke. While any stroke victim is at risk of depression, sudden signs of anger, anxiety, and uncontrolled crying in people who were previously adept at handling stress may indicate that the stroke has caused a personality change.
Lack of Motivation and Signs of Depression
Stroke rehabilitation can be slow, painful and frustrating. When stroke survivors do not see the improvements they hope for, they are more likely to lose motivation. Lack of motivation is a normal reaction to setbacks. However, when a lack of motivation persists and impairs progress in rehabilitation or if the lack of motivation spreads to other areas of life, it may indicate depression.
Signs of depression in stroke survivors should be reported to health care professionals as soon as possible. If depression is left untreated, stroke survivors may become suicidal.
Signs of depression include
•lack of motivation
•increase or decrease in appetite
•sadness
•fatigue
•memory difficulties
•personality changes
•sexual problems
•suicidal thoughts
•insomnia
•feeling “hopeless
Now, this list is fine, I feel, as a general rule. But as a “stroker,” I did not have lack of motivation. I wanted to get back to work … and you, as a stroke survivor, will get busted by a neuropsychologist if you try to lie yourself on a work release. I did lie, and that is not good. An Increase or decrease of appetite occurs? Hello, hospital jello stinks. Had a brain stem injury? Enjoy liquid IV fluids. Have sadness? Really? You just lost half your body somewhere. You can see where I am headed. I feel these are normal serious stroke reactions. So bring them anyway to your physician’s attention. Tell your caregiver, they need to know from you.
Anger, Anxiety, and Depression in Caregivers
Anger, anxiety, and signs of depression are common in caregivers as well as stroke patients. The restrictions and changes to routine and family life can cause frustration and anxiety in any family member. A stroke patient whose personality tends towards anger and depression, or whose personality changes radically, can leave caregivers feeling angry and resentful. This anger at times turns into guilt (“How can I be angry at him? He’s the one who’s sick . . . “), which can result in increased stress and depression.
See that, caregivers. You deserve a hand and lots of praise.
Time To Share
They mystery feelings I had when I began this article shall now be revealed. I was not the only one to be singled out by a person or people that I now forgive. I thought you readers should see what is out there as food for thought.
There was this first strike at me. I want to warn the readers. The article can be highly offensive. It contains pictures that may be offensive. It also contains racial hatred.
http://collectiveunderground.wordpress.com/category/chris-dewald/
They even photoshopped my melanoma.
Was I alone? The answer is no, and they struck out at a deceased young lady also.
http://andgodmadelight.blogspot.com/
This stroker went through all the emotions mentioned. I contacted via e-mail every form of government, state and federal, as I felt that no person should be subjected to this agenda. Tax-exempt status? Good Morning, America … I love you, readers, and I do forgive them. I just wish the government had a set.
A set of what? Sorry, I am a forgiving man.
Column by Chris DeWald
Chris DeWald: Recurring strokes
It is so good to be back to writing articles. Nothing had happened to me to write about until April of this year. I had not been feeling well for about three months leading to April 2011. My blood pressure was out of control in elevation and also in sudden drops. It was necessary for me to see my General Physician once a week to attempt to regulate it. One visit turned into a setback. My body talked to me and I fell out at her office. All said and done, I spent a week back at Augusta Health with another stroke. So let’s explore this. Caregivers and survivors alike need to just be aware of this.
According to www.stroke.org/site/DocServer/NSAFactSheet_RecurrentStrokerevised.pdf?docID=998:
After stroke, survivors tend to focus on rehabilitation and recovery. But, preventing another (or recurring) stroke is also a key concern. Of the 795,000 Americans who have a stroke each year, 5 to 14 percent will have a second stroke within one year. Within five years, stroke will recur in 24 percent of women and 42 percent of men.
Having one or more of these factors doesn’t mean you will have a stroke. By making simple lifestyle changes, you may be able to reduce the risk of a first or recurrent stroke.
These simple lifestyle changes can greatly reduce your chance of having a stroke:
Control your blood pressure
Find out if you have atrial fibrillation (an irregular heartbeat that allows blood to pool in the heart and cause blood clots)
Quit smoking
Limit alcohol
Monitor your cholesterol levels
Manage your diabetes
Exercise often
Eat foods low in sodium (salt) and fat
Monitor circulation problems with the help of your doctor
Gee, right off the top we see blood pressure. Now I don’t want you to be afraid of living. Yes, strokes are a scary life changing event. They often end up with disabilities and a hard journey for any recovery no matter to whom. My first ones took place in the brain stem. I had two at once on each side of the brain stem. I did not just one being alone in my head. It is lonely up there.
This recent stroke took me through situations I had forgotten. Laying on the gurney in the ER and not caring about IV insertions. Not me for sure in that respect. Getting run to the CAT scan and getting sick from any type of movement. Just lying there and being pushed caused such horrible vertigo. I did not care about the MRI scan and being claustrophobic. My words were slurred again, my left side went on a vacation somewhere and I wanted my world to end.
Yes, I admit that my initial feelings were “no more,” how long do I have to fight you, Mr. Stroke? I was lucky again. Within two days, I regained my voice and my ability to walk. I had to fight and I did not want to give up after regrouping my thoughts. My motivation was the hospital Jell-O. I was not staying there for that anymore. When I left, I had the clonus again and the spasticity returned to the status of my first mean strokes of 2006. That has cleared up from physical therapy. My left arm has become the victim of having less power. My left hand is still numb and I can’t find the re-boot button for my hand…LOL.
I told you about me and getting depressed because I believe it is a natural thing to do. If it is justification for me on the way I felt. Granted … But I left my Superman tights at home that day … Yikes, erase that image, OK … It is what you do next when you know you are getting depressed that counts … Now, I may be that exception to the rule because I do have severe cerebral arteriosclerosis.
In other words, I am hard headed (lol) with limited blood flow supplying my brain the nutrients for survival. So this does not mean you are going to have another stroke in five years. The statistics from a good organization are not made up. I do not drink, smoke or have issues with my cholesterol. I was having issues leading to this controlling my blood pressure. The brain stem controls your heart and breathing rates and I believe this sign was warning me.
People that have had strokes, don’t let that monster get you. Oh, it bites and leaves scars. Just bite back harder. See you readers next time.
Column by Chris DeWald
Chris DeWald: Stroke deficits – the gifts that keep on giving and giving and giving
Hello, again. I am going to introduce you to another stroke survivor. I feel another voice would be beneficial to survivors and also caregivers.
Donna was the first stroke survivor I had met online that was a base of information for survivors and caregivers on strokes. Not from doctors, but from someone who shared your same path. This allowed me to feel that I was not alone. She gave me inspiration to keep going and played a major part in my decision to write. Without further ado, allow me to introduce Donna.
Hello, Readers; my name is Donna, and I’ve been a stroke survivor since 1-1-05. My stroke deficits include spastic hemiplegia. This means that one side of my body was affected by the stroke. In my case it was my entire left side.
After six years, one would think that over time, my body would have stabilized and I would be more apt to getting up from a sitting position independently. Not so fine, friends and readers. My experience has been that my deficits decide to act up and cause me embarrassment and a source of laughter and entertainment to myself and those around me. The saying regarding “Murphy’s Law” happened in real life to me as recently as this past Saturday (4-1-11) when a attended a 1-year-old’s birthday party.
I thought my only challenge would be gaining access into the home as there are open steps and no railings. That challenge I succeeded at with help from my daughter and friends. Once in the home, I parked myself on the sofa where I would be out of everyone’s way. No, I did not sit on the right side of the sofa against the armrest. I had to pick the left side, which of course meant that I did not have usage of my left arm/hand to stand up.
After a period of time, I decided that it would be better for me to sit in the dining room on a solid chair rather than the soft and low to the floor sofa. When an arm was extended to me to help me get up, of course I said, “I can do it. No thanks.” I haven’t revealed to you that I am a stubborn, bullheaded Irish/German/English gal, so of course I didn’t want help. I pushed off with my right arm and got elevated about six inches, and my bad leg gave out and I plopped back on the sofa. After three more attempts on my own, my daughter heard laughter and came to see what was going on. She, on the count of three, pulled me up. Once again my bad leg gave out and down I went onto the nice soft sofa. By this time I was really attracting attention as others came into the room.
It was then decided, if someone was on my left side and someone on my right side, they’d pull me up at the count of three. I was helped up into a standing position; however, my left side decided it liked the sofa – again and down I went pulling the person on my left side down with me. By this time I and everyone else were laughing so hard we had tears. Thankfully the camcorder was not running, nor were any pictures snapped.
Eventually I was assisted, and walked unaided to the chair waiting for me in the dining room.
Geez…..maybe I need standing up lessons from the 1-year-old little boy, haha.
Column by Chris DeWald
Chris DeWald: Stroke/heart stress test
Hello, readers. This is another adventure in my world that allows me to share information to you. I am going to be utilizing information from this website and tell you about “my time” and how fortunate we have such a great staff at Augusta Health: www.nvcardiology.com/nuclear_imaging.htm.
Now, how did I end up doing this test? I sure did not get an award for it. My general physician, Dr. Margaret Siman, felt it was necessary as I had sharp pains in my chest that would extend towards my arm. Since I had a previous myocardial infarction as well as a stroke, this seemed to be a safety net for me. Safety net indeed, I had just fallen the previous weekend and fractured my T-12 spinal bone. I missed my computer chair upon sitting. Sound familiar, anyone?
Let’s move along now, As coronary artery disease (CAD) progresses, the heart muscle may not receive enough blood supply when under stress. This often results in chest pain (angina pectoris) or shortness of breath. On the other hand, there may be no outward physical signs of significant disease. If CAD is limiting blood flow to part of your heart, the nuclear stress test may be useful in detecting the presence and significance of CAD.
A nuclear stress test is a diagnostic nuclear imaging study that uses radioactive tracers, called technetium and thallium, to produce images of the heart muscle. When combined with the stress component, either through exercise or use of an intravenous pharmacological agent, the nuclear stress images can help determine if the heart muscle is getting sufficient blood supply. After the radioactive tracers are injected through an IV, they travel in the bloodstream through the coronary arteries until they are picked up by the heart muscle. The areas of the heart that have an adequate blood supply pick up the tracer right away and more completely while areas that do not have adequate blood supply pick up the tracer very slowly or not at all. The radioactive isotopes give off a small amount of radiation that is detected with a nuclear scanning camera. If an area receives less blood than the rest of the heart (because of a blocked or narrowed artery), it will pick up a lower level of radioactivity and will show up as a lighter area, called a “defect.” This is how we can tell whether or not there might be a blocked artery in the heart.
At Augusta Health, I went to the cardiology department and had the most pleasant receptionist. I wish I had taken her name, but she was extremely busy. I think she runs the show. I then was met a nuclear medicine technologist by the name of Jeffrey Byrd. This was my first chain of what I perceived as a scary procedure. He was very assuring and knowledgeable of the procedure and explained everything and anything I wanted to know. This is how I want to be treated as a patient. Jeffrey inserted an IV after painstakingly trying to find a useable vein. Why try? The previous day I had gone to the VA Outpatient for my yearly blood withdrawal. Do I need to tell you how many times I was stuck? OK, you guys can surmise the “point”…
That’s where the first injection of the radionuclides took place. It started out with the feeling of cold rushing into my arm. It then got warm but was gone in about 30 seconds. I had to sit for 30 minutes for the jungle juice just inserted in me to be into all my heart vessels. So I sat watching Dr. Oz with some laser hair removal system. Oh my, where is that remote?
Roberta Garrett, a medical medicine technologist, then removed my tortured TV vision self and brought me to the scanner. She was very informative and went over the procedure in detail. The scanner look similar to a CT scanner but it has openings that when it is close to your head, you have enough clearance in the instrument that no fears should arise if you have fear of close spaces as in an MRI. In an MRI,
I have to be highly sedated. I never was before my stroke, mind you.
The first part was simple. Then my IV was removed, a beautiful cosmetic bandage was applied and I was off until 7:30 the next day.
The next day I arrive and met with another nuclear medicine technologist by the name of Hunter Kline. Again, I was met by another very knowledgeable and thorough tech. I was led to the same “injection” room where another IV was secured. At least they had news on and the death of Liz Taylor was on the television so I had something to watch, but not long. I was then tossed into the hands of a pleasant tech by the name of Birdie. The name was so pleasant I felt she should be known as such. It seemed everyone else knew her. I knew my chest hair would not survive as she was going to hook me up to the heart sensors. She informed me of the procedure and what was to be done. First, the medicine to be injected into me was discussed.
What is Lexiscan?
Lexiscan, a substance engineered based on a naturally occurring substance in your body, when injected acts as a vasodilator. It increases the blood vessel circumference of the coronary arteries (arteries that feed the heart) in order to increase blood flow to the heart. We have selected Lexiscan to replace the previously used Adenosine because of the fewer associated side effects and its ease of use. Any side effects you may experience will be generally predictable, short-lived, and easily tolerated. Side effects can include: chest pressure, dizziness, shortness of breath, flushing, headache, lightheadedness, nausea, or numbness. Lexiscan should not be used in patients who have a hypersensitivity to this drug and in patients who have known severe bronchospastic or bronchoconstrictive lung disease (e.g., asthma or COPD and are using regular inhalers or wheezing is heard on examination of your lungs prior to the procedure). Each patient will be evaluated on the day of the procedure prior to the start of the stress test.
She was very thorough on this and especially the side effects. It seemed they really stressed this in the stress test (sic). Of course I had one of the side effects, why not? Mine was the flush feeling and a headache. My doctor monitoring the test was Dr. Gary Murray of Blue Ridge Cardiology. What a fantastic medical physician he was. He told me in 15 seconds the feelings would be gone. He was spot on. He had a nice reassuring smile like Norman Rockwell would paint.
I was then released for one hour to eat as I was told the eating made the next test easier to see. It was the same scanner I initially went through. I was told they compare the heart at rest taken the previous day to the one stressed out. I think the IV stressed me out more. After the scan, I was sent on my way. Would I go to this facility on a heart issue again, you betcha. But leave me alone hospital for now.
Thanks, readers.
Column by Chris DeWald
Chris DeWald: Stroke-severe arteriosclerosis, Part II
It has been three weeks since I have been taking an old medication called pentoxifylline. My first article about this subject centered on me and what was happening to my body as a result of this disease.
To recall some first concerns as to why I do not go the route of surgery is important. I am not a surgical candidate as all my vessels carrying nutrients, oxygen and fluids are so severely clogged, there is no beginning or end. This reminds me of Marty Feldman playing” Igor in “Young Frankenstein” substituting a brain with “Abby Normal.”
According to the National Institute of Health, pentoxifylline is used to improve blood flow in patients with circulation problems to reduce aching, cramping, and tiredness in the hands and feet. It works by decreasing the thickness (viscosity) of blood. This change allows your blood to flow more easily, especially in the small blood vessels of the hands and feet. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Please note, pentoxifylline controls the symptoms of circulation problems, but does not cure them.
Other uses for this medicine
Pentoxifylline also is used for leg ulcers, strokes, high-altitude sickness, eye and ear disorders, and sickle cell disease and to treat pain from diabetic neuropathy. Talk to your doctor about the possible risks of using this drug for your condition.
First, I was having issues with what is described as the loss of blood flow upstairs in the cranium. My vision was fuzzy and I had severe pains that lasted maybe 15-30 seconds from on top of my head as if someone was drilling for brains. If they were brain eaters, they starved for sure.
Now, again, for me as the patient, I did not have as many as the side effects as noted. The first was a concern that it would further thin my blood as I am on warfarin (coumadin). Warfarin is a medication that thins the blood reducing the possibility of further clots. Pentoxifylline was mentioned on other websites for doing this also. This did not occur. Three weeks post, and my pro-time and INR stayed the same.
Please take me med with more than a cracker. When it says with food, it means with food. When I “crackered” it, I did have some stomach issues. Flatulence was another item mentioned. I am of the male variety, so I could not tell. Headaches were another possible side effect. I did not experience any other than I already had. I was and still am taking three pills a day each with a 400-mg dosage.
My benefits
Three weeks post, my vision has become clearer. The fuzziness around the letters has more clarity. I have more time and the ability to do more with my mind than before. Now this is not much as it is only three weeks. It is noticeable as I do no nap as long as I did before. The drilling devices on top of my head looking for brain material have ceased. I do not have those debilitating pains.
I used 3 vocabulary games to try and exceed my previous scores. I also have three mathematics testing games. All are timed to obtain a score. There is no change, so I guess this is part of the brain that disintegrated.
So in conclusion, I feel this medicine is allowing more oxygen into the capillaries by creating more flexible red blood cells that can squeeze between the barriers of scale and cheese fry grease. My vision is clearer, and my headaches on top of my head are gone so far. Now every patient is different from the next. Willpower, other medical conditions, may not make you suitable for this drug. It does not hurt to ask. This is far gratifying than not having tried this medication. I was going downhill faster than I wanted to, but this gives me more time on this planet to write for you. My friends.
Column by Chris DeWald
Chris DeWald: Stroke, severe arteriosclerosis, possible assistance
Good day to the readers of my articles. Follow me on another adventure with a possible solution for those with low or no blood flows in the cerebral area. No blood flows or wisps of blood contain little oxygen for the brain to remain active for long periods of time.
This is me. I have severe hardening of the arteries where that squirrel turns the wheel to keep me alive. I am not a surgical candidate due to the constant need for a drug called warfarin (Coumadin). Another clot would be fatal due to the blockages starting from both the vertebral and basilar arteries.
Today was my three-month visit with my neurologist. His name is Dr. David M Karaffa from Shenandoah Neurological Associates located in Fishersville. Dr Karaffa has been my neurologist since my brain-stem strokes. He saved my life and guided me to a better and helpful outlook on life.
Dr. Karaffa researched symptoms in to all the different issues since my blood flow is lacking. I am starting a new regimen of a medication. The brand name of the medication is Trental. It has a generic name of Pentoxifylline.
According to the National Institute of Health, Pentoxifylline is used to improve blood flow in patients with circulation problems to reduce aching, cramping, and tiredness in the hands and feet. It works by decreasing the thickness (viscosity) of blood. This change allows your blood to flow more easily, especially in the small blood vessels of the hands and feet. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Please note, Pentoxifylline controls the symptoms of circulation problems, but does not cure them.
Other uses for this medicine
Pentoxifylline also is used for leg ulcers, strokes, high-altitude sickness, eye and ear disorders, and sickle cell disease and to treat pain from diabetic neuropathy. Talk to your doctor about the possible risks of using this drug for your condition.
Mode of Action
Pentoxifylline and its metabolites improve the flow properties of blood by decreasing its viscosity. In patients with chronic peripheral arterial disease, this increases blood flow to the affected microcirculation and enhances tissue oxygenation.
Tissue oxygen levels have been shown to be significantly increased by therapeutic doses of pentoxifylline in patients with peripheral arterial disease.
Indications and Usage for Trental
Trental is indicated for the treatment of patients with intermittent claudication on the basis of chronic occlusive arterial disease of the limbs. Trental can improve function and symptoms but is not intended to replace more definitive therapy, such as surgical bypass, or removal of arterial obstructions when treating peripheral vascular disease.
So there we have it friends. There is always hope for those who seek it and “Don’t you quit” looking. I am not a surgical candidate for all that fancy dancy surgery. There is some sunshine in the dark portals of your tunnel. Follow me with my “Incredible Journey”…Wait, I think they made a movie with that title…Oh, just follow my articles.
I shall give you an honest answer what this does and how I feel. There are many websites that give time limits for the medication to react. The shortest is two(2) weeks. I shall advise you then. Mr. Guinea Pig, signing off!
Column by Chris DeWald
Chris DeWald: Stroke-cerebral arteriosclerosis-part two
I am wearing down from this diagnosis. I would like to describe what is happening to me through my thoughts. I wrote an article about this disease that is also called hardening of the arteries. It is a diseas that is progressive, and it is keeping pace where I read the symptoms in a book.
I am so lucky to have severe cerebral arteriosclerosis (yeah, right). My MRI does not see a blood flow due to all the accumulating plaque whisping through my brain. I have been told I have no flow but clouds going through this brain. I also have been told I am being kept “in the batter’s box.”
I do believe the count is 3-and-2 right now. Let me give you the official book “thought” views of this progressive disease. I want to go over this section of a web page: http://chestofbooks.com/health/psychiatry/Manual/3-Psychoses-With-Cerebral-Arteriosclerosis.html.
Psychoses with cerebral arteriosclerosis
The clinical symptoms, both mental and physical, are varied, depending in the first place on the distribution and severity of the vascular cerebral disease and probably to some extent on the mental make-up of the person.
I am writing this for you caregivers to see the symptoms of your loved ones. My comments are the way many of your close friends and relatives might fear, feel or act. Is the book true? There are so many questions to answer. But I’ll tell you how it is affecting me. Here we go.
Cerebral physical symptoms, headaches, dizziness, fainting attacks, etc., are nearly always present and usually signs of focal brain disease appear sooner or later (aphasia, paralysis, etc.).
The most important mental symptoms (particularly if the arteriosclerotic disease is diffuse) are impairment of mental tension, i.e., interference with the capacity to think quickly and accurately, to concentrate and to fix the attention; fatigability and lack of emotional control (alternate weeping and laughing). Often a tendency to irritability is marked; the retention is impaired and with it there is more or less general defect of memory, especially in the advanced stages of the disease, or after some large destructive lesion occurs.
Pronounced psychotic symptoms may appear in the form of depression (often of the anxious type), suspicions or paranoid ideas, or episodes marked by confusion. To be included in this group are the psychoses following cerebral softening or hemorrhage if due to arterial disease. (Autopsies in state hospitals show that in arteriosclerotic cases softening is relatively much more frequent than hemorrhage.)
Differentiation from senile psychosis is sometimes difficult, particularly if the arteriosclerotic disease manifests itself in the senile period. The two conditions may be associated; when this happens preference should be given in the statistical report to the arteriosclerotic disorder.
High blood pressure, although usually present, is not essential for the diagnosis of cerebral arteriosclerosis.
Here we go, as I am concerned:
Cerebral physical symptoms. Headaches indeed are mentioned. Mine are different than a forehead ache. Mine seem to be likened to an oil drill on the top area of my head drilling downwards. They seem to be short-lived, but cause me to become dizzy and then lethargic. They come on faster if I am doing heavy thinking or trying to do more than the doctors tell me. I have fainting spells but I do feel when they are coming and have enough time to lie down. Coming to terms to do this and know you can have this helps the anxiety. I have had enough time to think over the “batter’s box” scenario. I stink at baseball too. The aphasia is coming back stronger.
What is aphasia? Aphasia is a disorder that results from damage to portions of the brain that are responsible for language. For most people, these are areas on the left side (hemisphere) of the brain. Aphasia usually occurs suddenly, often as the result of a stroke or head injury, but it may also develop slowly, as in the case of a brain tumor, an infection, or dementia. The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia may co-occur with speech disorders such as dysarthria or apraxia of speech, which also result from brain damage.
The most important mental symptoms: I was just shy of a master’s degree in public administration when I was struck with my stroke. I am witnessing a slowdown of doing puzzles, games of thought, simple quizzes, first names or last names of friends. Concentration is all over the thought process. I cannot keep thought processes on one subject for a length of time. I get confused over the points I try to make. Then forget what I was doing in the first place. My lack of emotional control is most recent. Crying to my son while I exhibit the need to tell him I love him and then cry. I am also having a sudden bout with sudden laughter for no reason. I feel like the Joker in “Batman.” Due to this happening, I am anxious about nothing and everything. It is so bad I have to take an extra klonapin (calming medication) to keep from getting up and just getting on a bus to nowhere. This is happening way too much. Although I know that my condition will not allow me to survive on the streets, I want to do this in my mind.
The one good thing is it has nothing to do with high blood pressure. I have to keep and elevated pressure to push what blood I can muster through the smaller arteries that feed this brain.
I felt the need to tell mostly you caregivers to watch this condition, try to understand it. It does happen. Tell his physician that you suspect he might be a little off. Most of all, love him as much as you can. Do not take the physical abuse that I have read in this.
Tell on him. Call his doctor or even case worker if you are lucky to have one. Thank you.
Column by Chris DeWald
Chris DeWald: Diabetic test strip recall
Hello, readers. Many of us depend on using diabetic sugar numbers for keeping us healthy. Before I go further about diabetes, let me inform you of a product recall. I just received this today – Jan. 3, 2011. It is from Abbott Diabetes Care in Alameda, Calif. Here are the test strips’ names:
- MediSense Optium Blood Glucose Electrodes
- OptimumEZ Blood Glucose Strips
- Precision G3b Smartblue Blood Glucose Strips
- ReliOn Ultima Blood Glucose Strips
- Medisense Optium Blood Glucose Strips
- Optium Blood Glucose Strips
- Precision Xceed Pro Blood Glucose Strips
- Precision Point of Care Blood Glucose Strips
- Precision Xtra Blood Glucose Strips
- Precision Xtra Blood Glucose and Ketone Monitoring System.
There are lot numbers associated with this recall. Please go to www.precisionoptimuminfo.com.
There is also a number to contact Abbott: 800.448.5234.
I verified by letter and by phone that I am one of those recalled. The phone conversation with a customer service representative that I had was “rude,” but I don’t sound “desirable.”
I shall go into diabetes in another story. I needed to get this out.
Column by Chris DeWald
Chris DeWald: Psychopharmacologic management and stroke survivors
Posted by afp on December 12, 2011 · Leave a Comment
Getting your medications correct for your survivorship is important. Most of us have multiple doctors that may not be in communication with one another.
OK, what the heck is psychopharmacologic management? Besides being a tongue twister? The program provides answers to difficult behavioral health pharmacy challenges, including medication non-adherence, contraindicated prescriptions, supra- and sub-therapeutic dosing, and other problem prescribing patterns. Continue reading “Chris DeWald: Psychopharmacologic management and stroke survivors” »
Filed under Blogs · Tagged with brain injury, chris dewald, Psychopharmacologic management