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Often we tend to think of "patients" and "providers." While sometime we may accuse medical teams of forgetting that their patients are whole human beings and not just a wrist band and chart in a hospital bed, it works the other way, too. We sometimes forget that our doctors are more than white coats adjusting out medications and asking who the president is -- again. But doctors are, in fact, human. And they can create art. And they can have strokes. Dr. Bevan Choate, MD, was a surgeon and urologist just enter the heart (or kidney) of his career. One morning, everything changed. He shares his story of the past 18 month in this episode. (If you don't see the audio player below, visit http://Strokecast.com/Bevan to listen.)   Click here for a machine-generated transcript Who is Dr. Bevan Choate, MD? Bevan was bornin 1985 in San Angelo, TX.  What do you do when you are born in San Angelo, TX? You grow up on a horse. As Bevan says: "I grew up in a cattle ranching family.  Cowboying since I could ride a horse but perhaps due to the Waylon and Willie song, they didn’t want me to grow up to be a cowboy. So, I was given all the odd and less glamorous jobs. https://www.youtube.com/watch?v=RePtDvh4Yq4&ab_channel=kdn3249 I realized about midway through undergrad that I wanted to be a doctor.  I was always a science geek at heart, and figured medicine to be a pure and noble application of science. I excelled in medical school and completed my five-year Urology residency in Albuquerque at the University of New Mexico Hospital.  It was the roughest five years of my entire life.  Being a sleepless subordinate for almost two thousand days is a tough pill to swallow.  Nonetheless, I persevered and began practicing Urology in Albuquerque.  It was my calling.  I love it.  I love my patients and some of them even love me.  I did quite a bit of oncologic surgery and got good at robotic surgery using the Da Vinci robot. " Things changed for Bevan on December 3, 2020. That's when a left vertebral artery dissection threw a clot that lodged in the left part of his cerebellar and proceeded to kill millions of valuable brain cells. The dissection has no "attributable etiology." That's how doctors write a shoulder shrug emoji. No one knows why it happened. Bevan just got lucky. The surgeons who were not Bevan got to work. His procedures included a ventricular shunt, a craniectomy, and a left cerebellar strokectomy (surgical excision of infarcted brain tissue post-stroke with preservation of skull integrity, distinguishing it from decompressive hemicraniectomy). As Bevan says, "Yep, I have about 80-85% of a brain.  Not playing with a full deck" Following this adventure, Bevan contended with: Acute Deficits Double vision Visual impairment Vertigo Left-sided ataxia Loss of left fine motor function Inability to walk or balance Chronic Deficits Loss of left fine motor function Balance issues Right sided stroke neuropathy Left-sided ataxia Since then, he's accomplished some impressive things, not the least of which are living and walking. He's also become a published author and a professional artist. He's also still practicing medicine and seeing patients. The laser may need to wait a little while though. It's been quite the year and a half. Typing around a Stroke People approach their stroke recovery in different ways. Bevan and Michael Schutt both launched their writing projects to learn to type with their affected side again. My approach to typing was the opposite. Instead of forcing my left hand to the keyboard, I wanted to get faster more quickly. I taught myself to type more quickly with one hand. I'm currently at about 34 wpm (average for two-handed typists is about 44 wpm). Has that slowed my recovery? Maybe. Recovery is a delicate balance of accepting a disability and fighti

June 3, 2022, was my fifth Strokeaversary. It's an important milestone. My risk for a second stroke is now statistically lower, but that not why this matters. It's not about celebrating experiencing a stroke. It celebrating survival and recovery. It's about coming back from a battle with my own blood vessels both damaged and enriched. It's complicated. But that blood clot on the morning of June 3, 2017, changed the direction of my life for good. In this solo episode I share some more thoughts and feelings about my experience. If you don't see the audio player below, visit http://Strokecast.com/Five Click here for a machine generated transcript. Don't get best…get better I end every episode and nearly every blog post with this line, but what does it mean? It means that constantly trying to be the best is a flawed path. To be the best at something means that everyone else has to be worse. It is an approach that actively discourages people from working together to help one another. The experiences of these past few years show us just how much we do need to work together and support one another. Instead of focusing on being the best, focusing on just being a tiny bit better every day. Make the effort to consistently improve just a tiny bit. Help others to improve just a tiny bit, too. Those little bits of improvement -- of growth -- add up over the days, weeks, months, and years. It can take you so much further that just focusing on the win/lose yes/so succeed/fail dichotomy that a focus on being the best promotes. Where is my recovery today? My recovery is ongoing. It didn't stop at the 6 month mark. Or the 12 month mark. Or the 24 month mark. Recovery doesn't stop on some artificial timeline. My fingers are still getting better. I'd say I have about 15% of the use of my left hand back at this point. I can use it for practical stuff. Not in the same way I did before the stroke of course, but it will get there given enough time and work. Right now my legs are tired because of an unplanned Costco shopping excursion where they were out of electric mobility carts. And since it was unplanned, I didn't wear my AFO so it was a lot more work. But I did it. And I wouldn't have been able to 3 years ago. I also recently got my latest thrice yearly Dysport injection (a BOTOX alternative) . This medication treats the tone and spasticity in my left arm. My doctor was able to use less this time and treat fewer muscles. Again, it's another example of progress. It's not all perfect, of course. I'm still living with fatigue, exacerbated by my recent COVID experience. So that's fun. And it's part of the reason I'm getting this episode out a week later than I had planned.  Adapting is what we do, though. Going forward I still have lots of projects to pursue as I go forward. I'm working on a book right now. Actually, I've been working on it for a year and a half and had to start over somewhere in the middle. I look forward to sharing more details on that later in the year. I've also been doing more talks with survivor groups, students, and more to share my story and to help others share their stories. I plan to do more of that in the coming year. If you're looking for a speaker for your support group, reach out and let me know. Storytelling That brings me to the importance of storytelling. It's a theme that comes up again and again in my work. Professionally, I help journalists use Microsoft tools to tell stories more efficiently. I tell stories as part of that training process. Strokecast itself is built around empowering survivors and professionals tell their stories to educate and encourage the entire stroke community. Those stories help build connections across the silos of expertise and experience we find ourselves living in. In sales and marketing, we say, "Facts tell; stories sell." Talking about stroke isn’t

Deb Shaw was at the top of her career, selling cybersecurity technical products to government customers for a silicon valley powerhouse. Things were going great. Then she had a stroke. And then she had another stroke. And then she had a third stroke, paired with a concussion. Since then, she started a nonprofit with her husband and has produced more than 10 booklets for stroke survivors to help them navigate their new lives. Recently, the American Heart Association named Deb their latest Survivor Hero. Deb shares her journey in this conversation. If you don't see the audio player below, visit http://Strokecast.com/deb to listen to the conversation.   Click here for a machine-generated transcript About Deb Shaw Deb Shaw is an inspirational three-time ischemic stroke survivor and the Founder & President of a nonprofit who remains steadfastly upbeat, despite her ongoing difficulties. Deb channeled her energy into creating “Champion the Challenges,” a nonprofit organization that helps motivate stroke survivors to pursue her three P’s of a successful recovery: Patience, Positivity, and Practice. Be patient in everything, have a positive outlook, and practice your exercises every day. Deb founded and launched ChampiontheChallenges.org, a rapidly growing 501c3 focused on helping stroke survivors reimagine their stroke rehabilitation journey.  The website is filled with inspirational content, therapy ideas, and success stories all designed to encourage.  Deb has written 11 Quick Read Booklets ™ that are geared to inspire and educate the stroke community. The booklets are available on-line as flipbooks, or in print editions, all compliments of Deb. “Champion the Challenges” was started during Covid because she wanted to share the inspiration, motivation, technology, and helpful stroke ideas, all in one website. This is her way to give hope to many people needing to discover their inner strength. 3Ps Deb's approach to recovery is based on the three Ps: Patience Positivity Practice Patience with yourself is critical. While we are all trying to recover, it doesn't always happen as quickly as we would like. Sometimes we can't do things yet that we feel like we ought to be able to do. That's okay. It happens. Getting angry and frustrated with ourselves may be natural in the moment, but ultimately is not helpful. We need to be patient with our brains and our bodies to give them the space they need to heal and to relearn our lives. Positivity helps us get through the day. Negative feelings are natural and okay in the moment, and long term they can become a problem. Living in and dwelling in the negative is not going to get us where we need to be. A positive attitude and approach to our tasks and lives may not guarantee success, but I have never heard of someone succeeding while dwelling in a cloud of negativity. Practice is the other key element. A positive attitude may make recovery a possibility, but it's practice that can turn that possibility into actual success. Neuroplasticity is a powerful force in recovery, and building those new neural pathways requires thousands of repetitions of activities. It takes practice and then more practice. 2022 Stroke Hero Awards: Survivor Hero – Deb Shaw https://youtu.be/T7n4qx1JR-g Llamas and Alpacas For my Girlfriend's birthday, we went to Topstall Farm to visit play with llamas and alpacas. It's a short 1.5-2 hour drive from Seattle. The person who runs the farms limits groups to 6 people so we get a personal experience. She told us all about the critters and explained how they care for them.   Then we got up close and personal. We walked into the paddock and got to feed them by hand. One thing that amazed me was how soft the alpacas lips were as they took the pellets right from my palm. They were aggressi

Sophie Salveson survived a stroke at 19. It's not the way any freshman wants to end their first year of college. She was a writer, actor, and singer. The stroke stole her right side limbs, her speech, and her access to language. Over the past 10 years she fought back through PT, OT, speech therapy. She learned to stand, walk and speak again. And she continues to make progress. In the previous episode (http://strokecast.com/ExpandedPractice) I spoke with Marabeth Quinn, Sophie's Mom, and Danielle Stoller, one of Sophie's Physical Therapists. This week, we hear from Sophie and Marabeth and learn more about Sophie's journey. If you don't see the audio player below, visit http://Strokecast.com/Sophie.   Click here for a machine-generated transcript Song Many people with aphasia find it easier to sing than to speak. Early treatment sometimes involves getting folks to sing their name or sing a greeting. Or even sing a song deeply embedded in their memory, like Happy Birthday. It has to do with the way music and song live in different part of the brain. Aphasia isn't the only place music as an impact. In episode 106, I spoke with Brian Harris of Medrhythms about his work using music to bypass limitations of the motor cortex and help people significantly improve their gait. This is an amazing video of Sophie from 2020. You can hear her sing, "A Change in Me" from Beauty and the Beast. Now, I really want to hear Sophie's Eponine. Maggie and Michael Sophie isn't the only stroke survivor with a passion for theater. I talked with Maggie in episode 38. Since then she has acted in a theater company fill with folks with disabilities. She continues to make progress on her documentary, The Great Now What. Here's the trailer: Michael Schutt was on the show in episode 124 talking about creating his solo show to share his stroke story. COVID lock downs meant planned performances didn't happen. He pivoted it into a radio play available on line. You can listen at http://ALessonInSwimming.com. Sophie's Book Recommendations The first book Sophie really read for pleasure after her stroke was "Shatter Me," by Tahereh Mafi.* It came with a powerful endorsement -- her sister's. And connecting about the book with her sister was a powerful incentive to read it, no matter what it took. Sophie's current favorites include "Good Girl's Guide to Murder," by Holly Jackson and "Elsewhere," by Gabrielle Zevin. * Pick up a copy or find them at your library and tell Sophie what you like about her favorites. Hack of the Week Keep trying. Speaking with aphasia is tough, but the only way out is through the key is to keep trying and to keep working on it. I've found it best top to try doing a thing with my affected hand three times before switching to my unaffected side. By trying three times, I'm reminding my brain that my left hand is still there and has a job to do. By stopping after three failed attempts, I stave off frustration and can try again another day. Links Where do we go from here? Connect with Sophie on Instagram or email and check out the links above. Share Sophie's story with someone you know by giving them the link http://Strokecast.com/Sophie Subscribe to the Strokecast newsletter at http://Strokecast.com/New Don't get best…get better.

"Communication is the process by which shared meaning is created."  CO 101 That's the first lesson we learned in Communications class back in college. Communication isn't spoken words or written words of photos or symbols or sounds or touches. Or even scents or tastes.  Those are all just vehicles for communication. They are the trucks intended to carry the freight of meaning from one person to another. After stroke, some of those trucks are no longer available. Aphasia and dysarthria may interfere with speech. Hemiparesis may interfere with writing or gestures. Sensory overload and attention challenges may interfere with listening. And yet communication continues. Because the other lesson we learned in the class CO101 is, "You can't not communicate." Combine those principles with the idea that your actions always speak louder than your words, and we have deeper understanding of how important it is for clinicians to think deliberately about the things they say and do when working with clients. Marabeth Quin and Physical Therapist Danielle Stoller joined me in this episode to share their stories and how they came to develop Expanded Practice -- a training program for clinicians that helps them tune their communication strategies to build better relationships with their patients. Note: This isn’t the first time I talked about communication in an academic context. This was also something I talked about with Drs. Sara Parsloe and Patricia Geist-Martin in episode 111 at http://Strokecast.com/process. If you don't see the audio player below, visit the original post at http://Strokecast.com/ExpandedPractice.   Click here for a machine-generated transcript Who are Danielle and Marabeth? Danielle Stoller is a neuro physical therapist who helps stroke and brain injury survivors improve their lives through a holistic rehab approach.  Marabeth Quin uses the experiences and insights she has gained from her daughter’s stroke recovery to improve therapist’s understanding of the mental and emotional aspects at play in the recovery process.  Together they co-founded Expanded Practice. Expanded Practice Expanded Practice is the training organization that Danielle and Marabeth started  once they saw the need to help therapists connect more effectively with their patients. Their goal in part is to go beyond the technical details of the tasks that go into a session and to help therapists think more about the client experience -- to connect to the clients as individuals with specific therapeutic, emotional, and psychological needs. That's not about providing counseling per se; it's about understanding the patient and building a trusting relationship with them to promote a more effective session. In some ways it parallels the work I've done as a corporate training help folks learn how to sell technology products. It's not about the high-tech features of the product. It never is. It's about what those features and those products will do for the customer. Effective salespeople ask themselves, "How will this product or service make THIS customer's life better? How will this benefit them?" To answer that, they have to talk to their customers and ask questions. They put the focus on the customers' lives. That focus on the client is something Danielle and Marabeth teach to. As we talked about in the episode,  they teach therapists about the environment they create. If the therapist appears rushed or tense, that will affect the client's perception of what is happening. That increase in tension makes a session less effective. Here's how Marabeth and Danielle describe the program: Expanded Practice teaches physical, occupational, and speech therapists to start utilizing the power of positive mindsets and expectations in the recovery process so they can connect with their patients on a more significant level and hel

Olga and her husband were having the vacation of a lifetime. They hooked up a teardrop trailer to their Subaru in NJ and headed out west. The planned to explore the gorgeous landscapes of the Washington State parks before jumping on ferry to Alaska. On July 19, 2021, at a campground in Deception Pass State Park on the Washington State Peninsula, things started to unravel. Olga had a brain stem stroke. She felt tingling up and down one side of her body and could not stop vomiting. She felt it was a stroke. Her husband called 911 and they made it out of the woods to a fire house. The EMT said she wasn't having a stroke. The ambulance that arrived said she wasn't having a stroke. The ER staff said she wasn't having a stroke. The neurologist said she probable wasn't having a stroke and specifically discouraged the tPA that could have solved the problem And no one sent her to the more advanced hospitals in Seattle for stroke treatment. The window for tPA came and went. This whole time, Olga was having a stroke. Olga shares her story in this conversation. If you don't see the audio player below, visit http://Strokecast.com/Olga   Click here for a machine-generated transcript. Who is Olga Wright? Olga is a married mother, grandmother, and recently retired educator. She lives in central New Jersey, where she practices extreme gardening. She and her husband recently returned from a six-month, 24,000-mile road trip to Alaska and back, with their ultra-light, solar-powered camper. Her goal is to educate the public and medical professionals at all levels to recognize nausea, vomiting, and tingling as stroke symptoms so that no one else is misdiagnosed as she was. Olga can be reached at [email protected] Deception Pass Deception Pass State Park is a gorgeous corner of the state. It's filled with hiking trails (including accessible trails), lakes, salt water shoreline, and campgrounds. It's also just an amazingly beautiful part of the state. It seems remote but it's also within just a couple hours of Seattle to the Southeast and 90 minutes from Canada to the north. It's easy to see why Olga and her husband chose to camp there. Zofran and the Brain Zofran is a medication I was not familiar with, and it's what finally got Olga's vomiting under control. It's typically used to help treat nausea associated with chemotherapy. In Olga's case, it was used to treat a malfunctioning brain that was sending the signal of, "OKAY! Everyone out the way you came in!" even though there was nothing left. The brain tries to protect us in lots of ways. Sometimes those threats are real and sometimes they are not. In Olga's case, her dying brain stem knew something was wrong but didn't know what. It went to an early reflex for poison and just kept trying the expulsion solution because it didn't know what else to do. Meanwhile, Olga's higher level brain functions were still working and trying to seek medical treatment for the stroke. And this conflict is an illustration that the brain is not one, cohesive unit. It's different parts grabbing different pieces of data and attempting to execute a solution based on the tools at its disposal. The brain does not always work as a single unit. But back to Zofran. One of the interesting things I learned while reading about it is that Serotonin, one of the brain's "happy" chemicals is also responsible for the vomiting function/command. Zofran works by suppressing Serotonin. And that makes me wonder how its use as an antiemetic impacts things like depression. I suppose that will be a future research project. Swedish ARU The reason Olga and I connected is that she spent her inpatient rehab time at Swedish Medical Center. It's the same place I lived for the month following my stroke. You can learn more about the Acute Rehab Un

More than 80% of strokes are caused by blood clots. These strokes are called "ischemic" because the clot block the flow of blood through a blood vessel, starving brain cells of oxygen and nutrients. My own stroke was ischemic. There are new treatments to clear the clot and restore blood flow and we talk about them a lot on this show. What we don't usually discuss is the nature of clots themselves and how that impacts patient recovery. So this episode is a little different. We go deep into understanding the biologfy of blood clots with Michael Gilvarry and Dr. Patrick Brouwer from Cerenovus, a Johnson & Johnson company. Cerenovus commits a lot of research and resources to understanding clots because they make equipment used in Mechanical Thrombectomy and reduce the impact of stroke on thousands of patients a year. You can listen to the conversation here or in your favorite podcast app. If you don't see the audio player below, visit http://Strokecast.com/Clots Click here for a machine-generated transcript Meet Dr. Patrick Brouwer and Michael Gilvarry Dr. Patrick Brouwer, Head, Worldwide Medical Affairs - CERENOVUS Dr. Patrick Brouwer is a clinician and scientist who has made significant contributions in the field of interventional neuroradiology and endovascular surgery. Before joining CERENOVUS as Head of Worldwide Medical Affairs, he served in senior staff positions for over 20 years as a neurointerventionalist at various university hospitals in Europe. As a key opinion leader in his field, Patrick has published close to 100 scientific papers and book chapters and lectured, including for invited professorships, on more than 400 occasions around the world on a variety of topics related to neurointervention. Patrick has additionally contributed by serving in various board positions across key societies, such as the European Society of Minimally Invasive Neurological Therapy (ESMINT) and the World Federation of Interventional and Therapeutic Neuroradiology (WFITN). He received his medical degree, with honors, from the Free University in the Netherlands. Connect with Dr. Brouwer on LinkedIn. Michael Gilvarry, General Manager, CERENOVUS Galway Michael Gilvarry is the General Manager of CERENOVUS in Galway. With a distinguished career in research and development (R&D) spanning over 20 years, Michael leads the CERENOVUS campus in Galway which is a key hub for producing world-class leading research on stroke and clot science, as well as R&D for the business’ product pipeline. He leads a distinguished team who informs new innovations and the development of medical devices to address real-world challenges faced by neurovascular physicians in the treatment of stroke. This work has led to many international research projects in collaboration with universities and hospitals in the field of acute ischemic stroke. He is the recipient of a Johnson Medal, the most prestigious award for R&D excellence within Johnson & Johnson, and is a named inventor on over 60 U.S. patents. Connect with Michael on LinkedIn. Cerenovus CERENOVUS, part of Johnson & Johnson Medical Devices Companies, is an emerging leader in neurovascular care. Our commitment to changing the trajectory of stroke is inspired by our long heritage and dedication to helping physicians protect people from a lifetime of hardship. CERENOVUS offers a broad portfolio of devices used in the endovascular treatment of hemorrhagic and ischemic stroke. For more information, visit www.cerenovus.com and connect on LinkedIn and Twitter. Nature of clots Most folks who encounter clots only experience them on the surface of the body or when they come out of the body, but we don't think too much about their nature, especially wqhen they stay inside the body. At the most basic levels, the structure of a clot is determined by the ratio of fibrin

Again and again, we learn the secret to stroke recovery is repetition. It's about doing the same movement or behavior again and again -- tens of thousands of times. In a typical session with an OT or PT, a patient might do the same exercise 30-60 times, which is a good start. But what if a therapist could crank that up to 1,000 reps an hour, or one every four seconds? Now you've got some interesting possibilities for recovery. Bionik, Inc makes devices and software that do just that. This week I talk with CEO Rich Russo about the InMotion Hand and InMotion Arm devices and how they work in conjunction with a therapist to help patients recover. Listen to the conversation here or in your favorite podcast app. If you don't see the media player below, visit http://strokecast.com/Bionik Click here for a machine-generated transcript Who is Rich Russo? From the Bionik website: Mr. Russo Jr. has over 15 years of finance and accounting leadership experience and is a Certified Public Accountant. From March 2017 through November 2020, Mr. Russo was the Vice President of Finance and United States Chief Financial Officer, of IcarbonX, a privately held digital health management company specialized in artificial intelligence and health data, and a predecessor PatientsLikeMe. While there, he was responsible for, among other things, the merger of three companies, fundraising, and the ultimate dissolution of certain affiliated companies. From 2007-2016, Mr. Russo held various key leadership roles for Nasdaq-listed companies in life sciences, pharmaceutical and medical device industries. From September 2015 to October 2016, he served as Corporate Controller for Pieris Pharmaceuticals, Inc., a clinical stage biotechnology company, and prior to that, he had roles at Juniper Pharmaceuticals, a woman’s health company focused on developing therapeutics, and Cynosure, a medical device company focused on aesthetic treatment systems. In each of these roles, Mr. Russo was responsible for all finance activities and SEC reporting, including partnering closely with management to ensure effective and efficient financial procedures throughout the organizations. Mr. Russo started his career in 2005, where he served as an auditor at Pricewaterhouse Coopers in the assurance group. Mr. Russo is a graduate of Bridgewater State University in Bridgewater, MA, where he graduated from a dual degree program, receiving his Bachelor of Science in Accounting and his Masters in Management and Accounting. Other Inpatient Solutions The Bionik system is one for hospitals and rehab units. The rapid reps help in partnership with the rehab professional. In that respect, it's similar to devices from Restorative Therapies. I talked with the team at Restorative Therapies in episode 92. You can find that episode here.  The key difference is that Restorative Therapies uses Functional Electric Stimulation (or FES) to activate a patients muscles. The Bionik solutions provide physical assistance to help the patient complete motions. They are different ways to stimulate the brain, increase repetitions, and drive the neuroplasticity that is so key to recovery. They are also both intended for use in a hospital or rehab facility with the help of a trained therapist. The other devices I talk about often, like those from sponsor Motus Nova and previous guests with Neofect and Racoon Recovery are for at home use, as a supplement to therapy provided at a medical facility, or as an alternative when those services are not available, for whatever reason. You can learn more about those devices by clicking the links on their names above or from the link table at the bottom of this post. The point of all these solutions is the same -- drive patient recovery through increased movement and repetitions to neureoplastically teach to brain how to access that limb once again.

If you have a hole in the middle of your heart and it's not supposed to be there, is that a problem? Should it be fixed? The answer is a resounding, "Maybe." Dr. David Thaler and his colleagues looked at the impact of PFO closure on stroke patients and found that often, the best solution is to leave it alone. They developed a scoring system to help neurologists and cardiologist make the best decision on a patient-by-patient basis. Dr. Thaler joins me in this conversation to talk about the research and recommendations. (If you don't see the audio player below, visit http://Strokecast.com/PFO) Click here for a machine generated transcript. About Dr. Thaler Dr. David Thaler, MD, PhD, FAHA, is the Neurologist in Chief at Tufts University Medical school. He is the Chairman and an active professor in the Department of Neurology. Additionally, he continues to treat patients and is a clinician focused on stroke care. He  continues to work to advance the field with a research focus on acute management of cerebrovascular disease, secondary stroke prevention, cryptogenic stroke and patent foramen ovale (PFO). Dr. Thaler's training involves work at: Oxford University John Radcliffe Hospital, UK Brigham and Women's Hospital St. Elizabeth's Medical Center He is a Board Certified specialist in Neurology and Vascular Neurology. Stroke Basics with Dr. David Thaler Dr. Thaler works on projects ranging from advance neurological  research to the fundamentals of stroke education. This video is an excellent, short introduction to stroke  that is also sharable: https://youtu.be/i_gtxYQlECc One of the things that is especially interesting about this video is that in describing the symptoms of stroke the first one he mentions is tingling on one side of the body. This usually isn't mentioned as a stroke symptom by most warnings. In episode 156, coming up in a few weeks, I talk with a survivor who had this exact symptom and was told by first responders that she definitely wasn't having a stroke and by emergency room personnel that she probably wasn't having a stroke. It turns out she was having a stroke. BEFAST and AHORA are excellent starting points for recognizing the signs of a stroke, but they are not comprehensive. They do not cover every sign of stroke. They are just a useful short hand. What is a PFO? A PFO is a hole in the heart. Roughly 25% of the population has one. I have one. Guests Misha Montana and Christine Lee both had PFOs that led to their strokes. After we are born, our blood follows a path through the heart. It comes in the right side. When the heart beats, the blood on the right side heads out of the heart to the lungs. There, it drops of CO2, picks up oxygen, filters out clots, and heads to the left side of the heart. It will pour into the left side and when the heart beats, it sends that oxygen-rich blood on to the brain and other parts of the body. Then that blood drops off its oxygen, picks up CO2, and heads back to the right side of the heart to start the whole cycle over. Before we are born, though, the process is different. While we are developing in our mothers' uteruses, we don't breath air. All the oxygen and nutrients we need to build fingers and toes and kidneys and hearts and brains comes from the umbilical cord. Since we're not breathing air, there's no point in sending blood to the lungs. Instead, in utero it goes straight from the right side of the heart to the left side of the heart through a hole in the middle. That hole is called a Patent Foramen Ovale, or a PFO. It normally closes on its own shortly after we are born. A quarter of the time it doesn't close after birth, and that allows unoxygenated, unfiltered blood to sneak across the heart, skip the lungs and drag a blood clot to the brain. So, if you've had a stroke, and you have a PFO, should you have surgery to close that hole? Maybe

A stroke is, of course, a traumatic event. It kicks off a deep dive into the medical system of whatever country you're in. For some, the first stroke is just a preview. Or even an intermission in other ongoing medical issues. That was the experience of Kawan Glover. He's come back from multiple strokes and brain surgeries to be an author, coach, and speaker. And he did all that before he was 25. Today, I talk with Kawan about his journey. (If you don't see the audio player below, visit http://Strokecast.com/KawanGlover)   Click here for a machine-generated transcript About Kawan From KawanGlover.Com In the summer of 2014, Kawan noticed a lack of coordination and muscle control, specifically on his right side. One morning, while working at his internship, it became clear he had difficulty speaking and writing. He was instructed to go to the Doctor's off where they ran neurological tests. After seeing the results, the Doctor strongly advised Kawan to go to the Hospital. Kawan was not alarmed and felt the issue was being overblown. Despite what he felt, Kawan heeded the Doctor's instructions and went to the Hospital of Southern Maryland. There he waited six hours to get a CT scan. After some time, the Doctor came out to shed light on what, if anything, was wrong. The Doctor told him he had a lesion (area of tissue that has been damaged through injury or disease) on his brain, but he would need an MRI to get more in-depth details. To get the MRI done, Kawan went to George Washington Hospital. The imaging came back and the doctors told Kawan he had a Cavernous Malformation. Kawan didn't know what that meant, so he thought nothing of it when he was told to go home and monitor. Within a few days, Kawan was back in the Hospital when his coordination worsened, and his vision became blurry. He returned to GW Hospital and had his first brain surgery on August 15th, 2014. That may have been a moment of pause and reflection for most, but at 20 years old, there was no stopping Kawan. Only a week later, he returned to school and everything that came with it. Drinking, partying, and staying up late. As a result, he had a stroke a month later, on September 18th, 2014. After spending a month in rehab, he returned to school with a new mindset, but yet again, life had other plans. The benign brain tumor would grow back twice, resulting in two more brain surgeries on October 1st, 2015, and October 12th, 2017. In between those surgeries, Kawan struggled with suicidal ideations, depression, and opioid addiction. After everything was over, Kawan had a whopping medical bill of $1.2 million. Despite all his hardships, Kawan still graduated and started a coaching business called Overcome Adversity LLC. He is also a Podcaster with a podcast called Favor: The Podcast. All fitting for someone with his background. Kawan wrote a book called "Favor: How Stroke Struggle and Surgery Helped Me Find My Life's Purpose"* He is an author, a coach, but most notably a survivor. He now uses his story to inspires others, and transform them from a victim to a Victor! Favor ain't fair. It's Just Favor. Kawan quoted his grandmother as saying, "Favor ain't fair. It's Just Favor." Good things and bad things will happen to good people and bad people. We can complain all we want that it isn't fair. It isn't just. And maybe it's not. Maybe we lived a good life. We were nice to everyone. We took care of the less fortunate. We respected our partners, friends, and family when appropriate. And stroke still happened. Maybe we did all the health stuff right: No smoking No illicit drugs No excessive alcohol consumption Healthy diet and exercise Appropriate blood pressure and blood sugar Etc. And we still had a stroke. Maybe no one even knows why. It's not fair. Now that we know that, what are we going to do about it? We can mourn the loss of our previ

I was saddened to learn of the passing of Peter G. Levine. Deb Battistella, OT and Cohost of the Noggins and Neurons podcast with Pete announced in the January 17 episode that Pete passed away following a brief illness. You can hear Deb share the news and her thoughts here. Pete is known in stroke survivor circles as the author of the book, "Stronger After Stroke" where he talks about therapeutic approaches and why the work. His focus has been to help folks with varying levels of paralysis after stroke to recover function and live their best lives. I share more of my thoughts in this episode: (If you don't see the audio player below, visit http://Strokecast.com/RememberingPeteLevine) Click here for a machine generated transcript I interviewed Pete in 2020 and found him to be down to Earth and passionate about supporting patients and survivors. He was fun and easy to talk with and I could feel the fire of caring he had for our community. Pete's approach was scientific. He was a strong supporter of Constraint Induced Therapy and at a more basic level, of the need to get in more repetitions -- thousands of repetitions -- to drive the neuroplastic changes in the brain that represent recovery. That also means he wasn't afraid to speak out about "treatments" that have not been scientifically demonstrated to be safe and effective. There are a lot of people out there making claims about miracle cures without the data to back up those claims, and Pete was a vocal opponent of those snake oil sales people. When Pete and I spoke, he summed up his approach to stroke recovery with these four lessons: Recovery takes a lot of repetitive practice. Recovery takes a lot of visualization. Don’t expect miracles. Don’t let the perfect be the enemy of the good. It's a simple approach that makes a lot of sense. It's not sexy or flashy or miraculous. It relies on hard, consistent work and stringing together a lot of minor improvements. There is no shortcut. His comments about visualization were especially interesting to me. Pete explained how the research has shown that watching someone walking or running activates the same parts of the brain as actually walking or running. It's why athletes and musicians visualize their performances before hand to improve their performance. And it's why I found value in visualizing my fingers moving as I tried to move them under the blankets while I drifted off to sleep at night. You can find my interview with Pete here at  Ep 115 — Stronger After Stroke with Peter G. Levine. We talk about his work and the science of recovery in much greater detail. If you've followed Pete's blog (Stronger After Stroke), read his book Stronger After Stroke, heard him talk or otherwise been inspired by or have memories of Peter that you would like to share, you can record or email them to Deb, his cohost, at this link. I'm sure she and Pete's family, friends and colleagues will definitely appreciate it. Hack of the Week This week, I'm sharing a hack I've discussed before, but it feels in line with Pete's approach to recovery. Try something with your affected limb three times, every time. For example, if you are left side affected, try turning a door knob with your left hand when it's time to open or close a door. Maybe you can't do it yet. That's okay. Just try. Use your unaffected hand to put your affected hand on the knob. Or do it with a light switch. Or picking up a cane. Or whatever. Try it three times each time the opportunity presents itself. After three times, if you haven't accomplished the task, that's fine. Then you can use your unaffected side to do it. The advantages of this approach are that it keeps your brain trying to use the affected side. It's getting in more attempts at repetitions and making the exercise part of everyday life, instead of restricting it to exercise time. And

Jasmine Loh was enjoying a pleasant lunch at work when the aneurysms hidden in her brain suddenly burst. Her world went blank briefly while the stroke settled into this thirty-something's head. A few minutes later, she reconnected with reality and went back to work to continue validating the performance of semiconductor fabrication equipment. That was in 2014. She left her job in semiconductor manufacturing due to her stroke, wrote a book, taught herself email marketing, and now does digital services for friends and clients In 2021 I met Jaz  through Clubhouse.  She co-hosts an online support group there from her home in Singapore. I enjoyed hearing Jaz's perspective on her stroke story, her dreams in the early days, and her experience of nearly "crossing over." You can experience all that, too, in this conversation with Jasmine Loh. (If you don't see the audio player below, visit http://Strokecast.com/Jaz)   Click here for a machine-generated transcript About Jasmine Loh Want to know about me? I am... - a brain aneurysm stroke survivor and a cancer survivor from Singapore 🇸🇬💪 - Founder of 2nd Chance in LIFE Club 🥰 - a mother of 2 dogs and 2 cats 🐶😻 - left my 19 years MNC corporate career (Systems and Automation Engineer, 2015) 🥳 - Co-founder of Always Awake LLP (yep, turned my side hustle to my main biz) ✌️ I give hope and help self-employed, solopreneurs, entrepreneurs and small business owners to position their brick and mortar businesses online, to get qualified leads and enquiries via building websites, landing pages, funnels, managing their social media marketing and ads campaign.  Surface my clients’ business that is optimized for online presence, so that they can claim their stake effectively in the digital space by: 1. Increasing their exposure online 2. Generate more qualified leads and enquiries 3. That can convert to sales Clients who have worked with me over the years, grow with me together as I help them transform their business in stages to where they want. My goal for them, is that they are no longer that burnt out individuals that’s being bogged down by digital transformation strategies that they are not familiar with, as I am here to help them. They can reclaim their health and time back, do things that they like and spend time with the people that they love. ——————————————— “Life has no limitations, except the ones you make.” ~ Les Brown “Today is history in the making.” ~ Jasmine Loh ✌️P.S...  I’m also looking to connect with folks who are blessed with a 2nd Chance in LIFE after a health crisis.  Let’s inspire, help, support and uplift each other in ways we can.  There’s so much more to life than just biz.  🥰 Stroke in Women vs Men Stroke can present differently in women and men. BEFAST is a good starting point for recognizing stroke in all genders. A stroke will usually manifest as a sudden loss of or change in : B- Balance E - Eyesight or vision F - Facial Symetry A - Ability to hold both arms up S - Speech, slurring, or language T - It's time to call an ambulance This list is not comprehensive, especially for women and AFAB folks. It will reflect most strokes, but not all. In the case of Jaz's stroke, it's not as much help. The American Heart Association also identifies these as symptoms of stroke, especially in women: General weakness Disorientation and confusion or memory problems Fatigue Nausea or vomiting Whether it's BEFAST or these additional symptoms, the most important detail remains -- with stroke, time lost is brain lost. The most important thing to do for someone who may be experiencing a stroke is to call an ambulance. You can read more abou