Some of the concepts in this video could push the envelope a bit and change how we feel about what age the brain fully develops and how we can perhaps some day “upload” more brain function to ward off decline and perhaps correct insults.

By the way, if you took our poll and  just want the simple wiki answer to the brain development poll from a previous post then here it is:

By the Way:

I Just learned that the University of Rhode Island is hosting an upcoming Honors Colloquium beginning later this month called “Are You Ready for the Future?“  Go to http://www.uri.edu/hc to learn more.  Ed Boyden is one of the invited guests.  If you aren’t planning to travel to Little Rhody you can see all the lectures as they will be streamed live and archived.    I might just make the drive back to my old school to see this one “live”.  See the schedule of events, it looks good.

David Dansereau for know-stroke.org

Here were some of the my highlights from ISC 2011:

• PFO/Heart/Brain/Research: MingMing  Ning, M.D., assistant professor of neurology, Harvard Medical School, vascular neurologist, Massachusetts general Hospital, Boston presented “How the Heart Whispers to the Brain: Serotonin as Neurovascular Mediator in Patent Foramen Ovale (PFO)-Related Stroke” With further investigation Dr. Ning’s important research may help explain and quantify how and why unfiltered blood which bypasses the detoxifying lung filters through a PFO may trigger oxidative stress to the brain by way of the heart. I hope we can get Dr. Ning on a call for the PFO Research Foundation soon because her exciting research might be the first to finally quantify and possibly confirm why the heart of a PFO patient could be guilty of “dumping trash” out the “back door to the brain (PFO)”.  I know many patients (including myself) would love to hear more about Dr. Ning’s research to gain a better understanding of the “why” (after PFO closure) they immediately report increased energy and cessation of headaches/migraine.  Congratulations Dr. Ning for your award and great work on this important and potentially ground breaking PFO/stroke-related research!

• Stroke Rehabilitation Research: The results of the largest stroke rehabilitation study ever conducted in the United States were announced at the International Stroke Conference. In this study stroke patients who had physical therapy at home improved their ability to walk just as well as those who were treated in a training program using a body-weight supported treadmill device, followed by walking practice.  The study found that earlier was better when it came to rehabilitation therapy. The patients who were not assigned to a study group until six months after their stroke recovered only about half as much as the participants who received one of the two therapy programs at two months. This finding suggests that either the treadmill training program or the at-home sessions are effective forms of physical therapy, and both are superior to usual care.  This is great news for stroke survivors and physical therapists to think “outside the box” when and how we deliver our services. [personal sidebar] I’m on the right track with my home stroke recovery guide.  For more on this rehab study click here.

David Dansereau wearing Tibion Bionic leg

• Great new technology for stroke recovery: I had the chance to try out the Tibion Bionic Leg as well as other great cutting-edge rehab technologies.  This promising technology (shown in this photo courtesy of Charlie Ungashick) can provide a robotic rehabilitation tool to help retrain impaired gait.  The challenge remains how to get these great tools in the hands of therapists and patients at an affordable price.

• The Food and Nutrition Connection with Stroke Risk: A report that was widely circulated in the news this week that came out of this conference was the increased stroke risk noted with users of diet soft drinks.  The increased risk of stroke was significant (61 percent higher risk of “vascular events”) with only one diet soda daily.  See more press on this study by clicking here.

• Dilemmas in Childhood Stroke: A study showed the symptoms and signs of acute ischemic and hemorrhagic stroke are similar in adults and children, but in children stroke is not considered early enough and patients do not receive brain imaging early enough. Rapid recognition, response and treatment of children with stroke will start with the development of pediatric brain attack protocols in the emergency department and pre-hospital setting. This presentation described how adults and medical professionals dismiss stroke warning signs in kids “because kids can’t have strokes” and points to the need for better awareness and community education as a first line defense in pediatric stroke.  [personal sidebar] ASA-Fund my grant and I’ll make it happen.  For the complete slide show of this presentation click here.

• Ok, what does Justin Bieber have to do with Stroke Awarness? Nothing as it turns out but my 10 year old daughter certainly thought this should be included as a highlight of my trip to LA.  When I arrived in LA I walked out the back door of my hotel and unexpectedly stepped right out on the LA premier of “the Bieb’s” new movie “Never Say Never” and along with it about a couple thousand screaming young girls.  BTW, I haven’t heard the end of it because I didn’t get a photo (or autograph) for my daughter, I just wanted to find a place to eat.

David Dansereau (Know-Stroke.org)

David Dansereau

Know-Stroke.org

Quick Reminder from the National Stroke Association:

Webinar:

Advocacy 101 and Introducing the Stroke Advocacy Network

Thursday, December 9, 2010 4:00 PM – 5:00 PM EST

Register

I’ve tested this easy web assessment tool  recently and am sharing my report below because I believe it is one of several great web tools to help you assess your cardiovascular and brain health that you probably didn’t know existed.   I’ve been researching many of these new tools to possibly integrate in with my grant proposal for the American Stroke Association (ASA) kids stroke education project, entitled Bright Minds.  I thought you’d like a quick overview of this free health assessment tool here.  I’d suggest you should try to perhaps incorporate your assessment results in with your health resolutions for the New Year to identify health behaviors you can improve upon.

I’ll bring you several tools, including a great one to improve kids awareness about healthy food choices in my next post, but here’s one I think the adults will find helpful.  It is called My Life Check (AKA- Life’s Simple Seven) and this “virtual” check-up will take only a few minutes of your time.

The American Heart Association’s My Life Check empowers Americans to take a big step toward a better life.   In just a few minutes, you can get your personal heart score and a custom plan with the seven simple steps you need to start living your best life.   You can click on the link above or visit http://www.heart.org/mylifecheck to start your new life resolution.

Life’s Simple 7 Summary:

To find out where you stand with the simple seven, just take the My Life Check assessment. In a few minutes, you will know how you’re doing with each one of life’s simple seven; you will also get your own personal heart score and life plan. Your results will include seven recommended areas of focus and an action plan that is customized to your lifestyle and health outlook.  Your last step is a promise: a resolution to make healthy positive changes step-by-step, for a long, healthy future.

Here’s a sample report from the Life’s Simple 7 Assessment:

a screenshot of my heart score summary

Go Get Your Own Cardiovascular Health and Stroke Risk Assessment Now!

Review by David Dansereau for Know-Stroke.org

Know-stroke.org-Exercise Guidelines for PFO Patients Needed

The PFO Research Foundation recently met in Washington, DC for its first PFO Summit.  I attended the event and was hoping for both practical and selfish reasons to get some clarity on exercise guidelines from some of the world’s top authorities on PFO.  Instead, what I learned in one of the breakout sessions aimed at developing better guideline documents and educational materials for patients with PFO disorders is that we have a great deal more work to do to get better patient information out there.  I reference a recent post to my blog from Sept. 28, 2010, at know-stroke.org to illustrate this point:

“I just found out I have a PFO after a cerebellar stroke and ministroke in 27 months. I am 45. Should I be scared to do cardio, how much, how long, what should I avoid? Thanks Dave, I appreciate reading something from someone who seems a lot like me.”

What should this person do?  Known PFO, positive TIA/stroke and would like to continue exercising/working out.  Is cardio fine?  Are weights OK?  What about swimming?  Climbing at altitude?  Diving?  We know these situations may present increased risk but where do you draw the line?

Patients are turning to the web and patient forums for guidance clearly because they are not getting answers from their physicians or device manufacturers.  It’s simply not enough to tell patients “you can’t avoid the valsalva maneuver*” in daily life.  No kidding doc, really?  Is that the best advice we can give?

I learned “off the record” after running a marathon that perhaps (running long distances) was not the best decision for me “down the road” with a PFO occluder on board.   This inside information was shared with me by a physician recently after my primary cardiac physician had cleared me and stated after more than one year post PFO closure “if my legs could carry me that far and my brain was crazy enough to talk my body into 26.2 miles then my heart would be fine”.  OK, so, what is safe?  What should PFO patients be doing for exercise  (or not doing) 1-3 weeks after closure?  How about after 6 weeks?  What is really so special about 6 weeks?  Why not 1 year (or more)?  Should every occluder device have its own post-op protocol based upon the design?  Perhaps.   What about exercise guidelines for known PFO/stroke confirmed without closure like the recent post on my blog I illustrated above.  What about known PFO, no stroke, no closure but enrolled in clinical trial related to migraines?  What about guidelines for that same patient sent home on meds or  following sham closure procedure.  Follow me?

[Personal Sidebar] I had contacted the device manufacturer that built my heart plug several years ago after I had PFO closure.   I asked them, -NO-I challenged them to get their patient education website completed and build a useful patient resource to assist patients that were in my shoes.  That was well over 3 years ago.  The result: Still no website for patient education.  Nothing.  I’m still waiting…

Who’s to Blame??

Blame the FDA, insurance companies, poor clinical trial enrollment, whatever excuse we want to make, this is certainly not “best medical practice”, it is not acceptable and is in fact poor medical practice. As a practicing physical therapist, if I sent someone home after a total hip replacement and didn’t remind them that there were clear post operative hip precautions that they should be aware of following their procedure (and based upon the technique and specific device they had implanted in their body), I could be fired and sued if they went home and blew out their hip because I didn’t educate them.  That is simply part of my job!  Why are heart plugs different?  The last time I checked they were still being inserted directly in the center of our most vital organ.

“Patients can’t continue to afford to be the pigs here.  Patients are literally putting their “hearts on the line” and deserve so much better.  When I ran the Boston Marathon in 2009  I didn’t recall any pigs passing me with a clinical trial advertisement on their bib.”-DP Dansereau

I certainly hope this post serves as a challenge to industry and physicians to be more responsible and get our collective acts together to set things straight for patients.  At least that is why I continue to write this blog, and yes, industry, this blog creation was and remains my direct response to your failure to step up and do something.  Truth is, I write most of my content on lunch breaks and late on Friday evenings after my responsibilities as a dad and business owner are complete. (This is at least my excuse why I frequently have typos in my posts.)  I write this blog because in some way it helps patients ask more educated questions and hopefully make their medical care takers stay on their toes, at least that’s what  I’ve been told.  I have no financial disclosures to report, don’t know any venture capitalists, and have no potential gain if PFO closure proves to be a slam dunk for stroke prevention or migraine relief.  I just own the peace of mind that I did something.  Now, I must get back to my patients, and then perhaps go out for a run later this evening when I get done here at work.

Or should I ?   Who knows?   I’d love for you to comment here if you do….

Better Exercise Guidelines for PFO Patients

By David P Dansereau

For know-stroke.org

* Valsalva maneuver: A maneuver in which a person tries to exhale forcibly with a closed windpipe so that no air exits through the mouth or nose as, for example, in strenuous coughing, straining during a bowel movement, or lifting a heavy weight. The Valsalva maneuver impedes the return of venous blood to the heart.

With 60,000 Australians expected to suffer from a stroke this year alone, a new study aims to find the best approach to rehabilitation to help sufferers recover more quickly and reduce their stay in hospital.

After a stroke, people going through rehabilitation need as much physical therapy as possible to achieve the best results. Now UniSA researchers have been awarded a grant by the National Health and Medical Research Council to investigate a variety of approaches so that patients recover independence and get home as quickly as possible.

Read the full stroke recovery article at HealthNews

Post by David Dansereau for Know-Stroke.org

This is one exercise I sometimes  still visualize in my sleep and continue to work on to improve my balance post  stroke.  I’ve since been able to give it a boost by trying it with heavier weights, with my front leg on a Total Gym glideboard,  and at times even successfully with my eyes closed.

Use caution and modify to your level of fitness / rehabilitation when needed*

Intensity Level:  Moderate Difficulty with disc as shown

Lunge with Balance Disc
1) Stand with feet hip width apart. Take leg and step back approximately 2 feet standing on the ball of the foot. Place the front foot on a balance disc (or use the floor without disc for beginners).
2) Start position: Feet should be positioned at a staggered stance with head and back erect and straight in a neutral position.  Hold medicine ball in front of your chest for added challenge.
3) Lower body by bending at hip and knee until thigh is parallel to floor. Body should follow a straight line down towards the floor.
4) Return to start position while raising the medicine ball overhead and repeat. Alternate or switch to other leg after prescribed reps.

5)Stroke Rehab Tip:  Use a mirror and focus on a central point straight in front of you and always train both sides

This exercise is from my PT coaching site-My-Physical-Therapy-Coach.com

*You should follow a rep and set sequence that makes sense for your level of rehab or conditioning.  If you are working with a physical therapist or qualified trainer consult with them first about adding this full body balance exercise to your  stroke recovery training.

Heart disease and stroke are the number one and three causes of death in the United States.  Inflammation has been shown to be a primary factor in the development of atherosclerosis, the major cause of cardiovascular disease.  But did you ever think you could be “digging your grave with your teeth”.

If you keep up with the articles and posts from my nutrition site, my-nutrition-coach.com you might naturally think I’m referring to the heart disease and stroke risks associated with all the poor food choices we make.

While studies show dietary choices do contribute to the disease process and can lead to an early grave, the focus of this post is on the link between heart disease and gum disease.

A private comment on my stroke blog recently asking me about what meds one would need to take after PFO closure initiated this post.  I generally leave specific medical advice to the docs, and most of the controversy and need for better patient guidelines post PFO closure surround the topic of continued blood thinning. One very important medication, and the one most often minimized after PFO closure, is the need to take some form of prophylaxis by antibiotics before dental procedures.  Why?

Some surgical and dental procedures can cause a brief bacteremia (bacteria in the bloodstream).  No big deal, right?  Well, if you have abnormal heart valves, prosthetic cardiac valves, congenital heart disease or have had cardiac procedures like stenting or occluders (PFO closure devices) placed then these bacteria can become lodged on these abnormal surfaces.  The life threatening medical condition that results is called bacterial endocarditis and it is a heart risk that occurs when this normal bacteria from your mouth (source can also come from the respiratory tract, intestines or urinary tract) enters the bloodstream and causes inflammation in heart tissue.

Bottom line:

The people with the highest risk for bacterial endocarditis include those who have:

• Prosthetic cardiac valve
• Previous endocarditis
• Congenital heart disease
• Cardiac transplantation with cardiac valve abnormalities

For all others:

The obvious-Avoid periodontitis by brushing and flossing regularly and get those regular checkups and cleaning from your dentist-to help your cardiovascular system and keep you from “digging a grave with your teeth”.

[Sidebar and Quick Tip for those new members of the “heart plug club”]

Keep an extra dose of antibiotics on hand in case of dental emergencies and remember to take your dose as prescribed before you arrive at your dentist for your regular check-ups.

Article by David Dansereau for know-stroke.org

Sources:

Ide M et al,J of periodontology,2004

Yong-Hee P et al, J of Periodontal Research,2007

Making progress for stroke /migraine / PFO awareness but many gray areas remain

I’m working on an article for my nutrition site my-nutrition-coach.com . The topic for this article is Omega-3 oils and  I am researching the latest nutritional science and what (if any) advice medical professionals are giving to suggest alternate methods to keep your blood thin.   I am especially interested in the nutritional advice given for those at risk of a repeat stroke or who might be  on a prescription med, for example post-op after PFO closure).

How you can help me with your 2 cents:

If you are on a prescription medicine protocol of any kind after your event, what dietary advice was offered to you (in addition to traditional blood thinning meds)?

Please take this 2 second nutrition/medication poll:

I’d appreciate your feedback.  I’ve had many readers ask me what are my thoughts on Omega-3′s, so I’ve provided this link to a recent article on the Omega3  I use.

As you may know it is buyer beware with all supplements so here’s what you should know to review your own brand.

I’ll keep you posted when the results from this poll roll in.  Thanks for helping me tackle these PFO/Stroke/Migraine “Gray Areas” one  topic at a time.

David P. Dansereau

Know-Stroke.org

Why not? It’s free and full of diet reviews,tips to boost your nutrition IQ, and a quack list of products to avoid! In addition it provides quick therapeutic exercises suggestions related to your condition. You’ll also be granted a free access pass to my webinars on timely stroke rehabilitation and technology topics of interest. As a bonus, get free access to back issues with links to hundreds of my training and rehab articles. Don’t miss out-it will not be free forever… Get it now!