Go from Cope ...to Hope

NeuroAID™ Newsletter

May 30, 2008

Dear Readers

Welcome to NeuroAid’s May newsletter. The idea of this monthly release, is to share vital information for stroke patients and their family, and helping them deal successfully with the common challenges life presents after a stroke.

We want this to be more than a one-way communication, and would be most happy to hear back from you. What you have experienced and learned will be very valuable to others and we will make sure it reaches as many people in our community as possible. Do also let us know what topics you wish to read in future issues of your Neuroaid s newsletter.

We would like to assist you in your return to daily life while recovering from stroke. As you are probably already aware, making the best use of time is of vital importance in your stroke recovery. Therefore, please allow us to call you at a number, day and time of your convenience, to hear your questions and explain our answers. If you agree, kindly fill the table bellow:

Number:
Date:
Location/ time zone:
Person to ask for:

If you choose to contact us yourself instead, call us on our US toll free number: 1-800-882-4046/ +65-6478-9430 or email us at: info@neuroaid.com.

The Neuroaid team at Moleac

Returning Home

What follows is a short list of critical tips, to start your rehabilitation on the right foot.

1- MAKE ARRANGEMENTS BEFORE YOU LEAVE THE HOSPITAL.
Don’t forget to ask your doctor before leaving, to arrange a home visit by an occupational therapist (OT), who is trained to help you manage daily activities and regain your independence. This person will check your home and may suggest simple changes to make everyday living easier, and they also will arrange for changes to be finished before you return home.

2- ACCOMMODATE YOUR HOUSE TO YOUR RECOVERY.
Forty percent of stroke survivors suffer serious falls within a year after their strokes. That’s why the OT will suggest you to move extra furniture out of the way either to corners or another room, to move electrical cords out of pathway, to remove loose carpets and runners in hallways and stairwells or to fasten them with non-skid tape to improve traction. Low pile carpeting is better than a thick one because it makes wheelchair or walker movement easier. Try stair glides, stair lifts and platform lifts if you need to use the stairs many times during the day.

3- ACCOMMODATE YOUR BATHROOM.
The bathroom usually poses challenges. To make bathing both simple and safe, use sturdy hand rails, grab bars in the tub or shower, non-slip flooring strips installed inside and outside. Don’t hesitate to use them to stabilize and balance yourself. The bathing supplies should be easy to reach and use.

4- ACCOMMODATE YOUR BEDROOM.
The bedroom is a place where you should feel safe and comfortable. To make your private world safer, make sure that all the utilities are easy to be reached, like the telephone, the light switch and other personal items. Use a nightlight and clear a path for easy access to the toilet at night. At last, since some accidents are unavoidable, consider placing disposable “blue pads” underneath your sheets, which prevent bed staining, with cloth on one side and waterproof material on the other.

5- GET 100% INVOLVED IN YOUR RECOVERY.
After a stroke, home treatment will be an important part of your rehabilitation. You may need assistive devices to help you to eat, to get dressed, to walk, or you may feel like letting a caregiver take charge; however, for a successful recovery, you have to be as involved as possible. The more you can participate, the better. After a stroke, a combination of physical, speech, and occupational therapies can help you manage the basics of daily living.

6- SLOW DOWN AND PLAN YOUR RECOVERY.
It is important that you slow down, take time, plan a task and break down tasks into a series of simple steps. Day after day, you will find these little steps add up to a large progress. Furthermore, a regular exercise program for stroke survivors is recommended, including 20 to 60 minutes of aerobic exercise three to seven days a week, a strength training with resistance or light weights two to three times per week and other stretching and flexibility exercises, as well as trainings in balance and coordination.

7- TRY TO ADD FUN TO YOUR RECOVERY.
Not only can regular physical exercise improve the quality of life for stroke survivors by increasing their strength and mobility, it can also reduce their risk for a repeat stroke and a heart attack. If you want to have some fun while practicing, try this video game especially designed for home stroke therapy. More information is on http://www.youtube.com/watch?v=WEtth_vDimg.

8- DO NOT BE AFRAID TO FACE YOUR RECOVERY.
A stroke is always stressful for the family therefore; the caregiver needs as much support as possible from others. It would be better if the family members and the caregiver work together in order to ease the stress on everyone. When everything is being prepared, you are still asking yourself thousands of questions, you may be afraid of facing your disabilities. No worry, considering new resources, equipment and therapies which are available each year, just take advantage of them to improve your quality of life. Continue to set new goals for your stroke recovery, and tomorrow will always be a better day!

Source:
National Stroke Association NSA
Stroke Recovery Association NSW
WebMD – Stroke guide
American Heart Association
Youtube

Depression after a stroke

Depression after a stroke is not uncommon and is perfectly understandable, but it is a clinical condition that is more serious than feeling sad or very upset with a loss of independence. Up to one out of three stroke survivors experiences some symptoms of depression sometimes after their stroke, a fraction of them will even experience severe depression.

These symptoms can occur right after the stroke, during rehabilitation or once you get home. The size and location of the stroke, previous or family history of depression and pre-stroke social functioning all seem to affect the likelihood and severity of post-stroke depression. Identifying the signs of depression early and dealing with it appropriately is important to maximize the post stroke recovery.

What follows is a list of useful advices to keep an eye on depression and address it promptly.

1- DEPRESSION MUST BE IDENTIFIED AND ADDRESSED THE SOONER THE BETTER.
Depression can cause behavioral and personality changes in stroke survivors and, unfortunately, stroke recovery can also be negatively affected, especially by major depression, as it can cause them to loose motivation and to become less compliant with their rehabilitation program. In fact, several medical studies have concluded that depression can delay or damage the prospects of stroke recovery. It is thus very important to identify and address depression. Yet there is no need to worry: there are ways to recover!

2- START BY KNOWING ITS SYMPTOMS.
A stroke may cause dramatic changes in your behavior or diminish your ability to function or communicate, and thus make it hard for people around you to distinguish disability from depression. Depression is thus commonly viewed as a natural or inevitable response to the effects of the stroke and often left undiagnosed and untreated. However, depression is a separate illness that can be treated successfully with the help of friends, family, support groups and professional care.

The National Institute of Mental Health recommends that anyone experiencing five or more of the following symptoms for more than two weeks should seek a medical evaluation for depression:

Persistent sad or "empty" mood
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in ordinary activities, including sex
Decreased energy, fatigue, being "slowed down"
Sudden trouble sleeping or oversleeping
Sudden loss of appetite and weight, or weight gain
Difficult concentrating, remembering, making decisions
Irritability
Excessive crying
Chronic aches and pains that don't respond to treatment
Thoughts of death or suicide, suicide planning or attempts

If you feel suicidal contact your doctor or a mental health professional immediately and contact friends or family for company - anyone who feels suicidal should not be alone.

3- CHOOSE THE RIGHT TREATMENT AND GO AHEAD.
The treatment of post-stroke depression depends on its severity. Normally we separate between reactive depression and major depression. Reactive depression describes a depressed state that occurs after an event or change. The common theme is a state of transition and hence it is common after a stroke. Reactive depressions are less severe than major depression. Its treatment may involve talking therapies, which can be obtained from rehabilitation counselors, psychologists, psychiatrists and general practitioners. Major depression describes a state of low mood or a loss of enjoyment of daily activities. Its management will involve the use of medication, normally in combination with talking therapy. Major depression may occur in combination with reactive depression.

4- KEEP YOUR DOCTOR INFORMED OF ALL MEDICATIONS YOU ARE TAKING.
If on medications it is important that all doctors are aware of all of the medications that have been prescribed to avoid unfavorable interactions. This is very important as some medicines commonly used to treat depression are dangerous for stroke survivors and other common post-stroke medicines can deepen depression. Always using the same pharmacy, allowing for the pharmacist to alert your doctor of potential problems, could thus be a good idea.

Here are some activities that may help stroke survivors avoid or fight against depression:

Make the most of your rehab: the more you recover, the better you will feel and the better you feel the more motivated you will be for you rehab exercises (in this way you are creating a virtuous cycle) – however it is essential to look at the progress over longer periods (month) as it is not visible on a day-to-day basis. At the same time it is important to realize that adequate therapy for depression can trigger rehab activities.
Get involved in daily activities with friends or family. Many stroke survivors feel isolated and alone, even if they aren't physically incapacitated from the stroke.
Ask your family to stimulate your interest in people and social activities.
Set goals and measure accomplishment.
Plan daily activities to provide structure and sense of purpose.
Join a stroke support group. Other survivors will understand your issues, and offer support and ideas to help you manage your emotions.
Speak openly and honestly to your caregivers about your emotional changes. They’ll be glad you did, and together you can work out a solution.
Maintain your quality of life by staying active and doing things you enjoy
If you're capable of volunteering, even if it's just an hour or two a week, it will not only help others, but could also help you feel better about yourself.
Ask your doctor how to relieve any physical discomforts like pain, muscle spasms, and constipation that can all add to depression.

In any case, it is important to acknowledge that recovery from depression takes time, even some anti-depressants take several weeks before they begin to help. It takes much of your own effort and decisiveness, and it is perfectly possible and expected that you will get over it and move on in your stroke recovery.

Sources
http://www.stroke.org/site/DocServer/NSAFactSheet_Emotions.doc?docID=989
http://www.strokensw.org.au/depression.html
http://www.ahealthyme.com/topic/depstroke
http://stroke.about.com/od/lifeafterastroke/p/depression.htm

Moleac introduces Neuroaid's latest advances in stroke recovery at the European Stroke Conference.

Moleac was present with its own stand at the 17th European Stroke Conference in Nice, France from 13th to 16th of May. Moleac believes that this is an important initiative and unique opportunity to meet with international stroke specialists from throughout the world to get updated on recent development and advances in the stroke community. While most of the industry and clinicians continue to focus on prevention and secondary prevention, the novelty and data of Neuroaid triggered a huge interest in a route to effective recovery. Moleac also hopes that its participation will contribute to increased awareness of Neuroaid's achievements and ongoing clinical trials (CHIMES); all which is aimed at better informing practitioners in order to help stroke patients worldwide.