Category: news

05 Apr, 2025

Caffeine and Brain Injury: How Do They Mix?

I used to look forward when I got to my office for that initial cup of coffee. I only two cups a day unless I had a meeting, then 3 cups, 2 meetings, then 4 cups. Coffee is a stimulant so I’d stay awake and concentrate. I  did the same process for 25 years, and then I had my stroke.

So I wondered, what effect does coffee, or any other energy-boosting stimulant, have on my brain injury. I “wondered” well and these findings are the results.

Caffeine affects the brain in both plusses and minuses after a stroke or traumatic brain injury (TBI). Whether it helps you or is detrimental depends on your symptoms, recovery stage, and how your body feels after ingesting caffeine.

The plusses of having caffeine and brain injury:

  • Caffeine stimulates the release of dopamine, which can help with post-stroke depression and motivation.

  • Some research links caffeine to a lower risk of Parkinson’s disease and dementia, both of which can develop after brain injuries.

  • Some studies suggest that moderate caffeine intake (1 to 2 cups of coffee per day) may slightly lower stroke risk by improving blood circulation and reducing inflammation.

The minuses of having caffeine and brain injury:

  • Raises blood pressure (stroke risk, again or for the first time)

    • High caffeine intake can temporarily increase blood pressure, which may be dangerous if you’ve had a stroke or have hypertension.

  • Worsens anxiety 

    • Many TBI survivors struggle with anxiety, and caffeine can make it worse by overstimulating the brain.

  • Can disrupt sleep 

    • The brain heals during deep sleep. If caffeine affects your sleep, it may slow recovery and worsen brain fog, fatigue, and memory issues.

  • May trigger headaches or migraines

    • Some people develop caffeine withdrawal headaches or migraines, which are common after a brain injury.

  • Can increase dizziness and lightheadedness

    • If you have low blood pressure or dizziness after a stroke, caffeine might make it worse by causing dehydration or circulation issues.

With that said, should you drink caffeine after a stroke or TBI?

It may be acceptable if you don’t have any of the following:

  • High blood pressure

  • Sensitive to caffeine’s effects

  • Heart issues

  • Anxiety or sleep problems

  • Dizzy or lightheaded issues

Brain-boosting drinks for stroke and TBI

If you want to stay alert and focused WITHOUT caffeine, take advantage of these tips! Without caffeine, the following give you energy, support brain mending and neuroplasticity, and improve memory, without the side effects of caffeine.

  • Herbal teas for brain wellness
    • Turmeric Tea (Golden Milk) – Fights inflammation & supports memory
    • Ginseng Tea – Natural energy booster & brain enhancer
    • Peppermint Tea – Boosts focus & relieves headaches
    • Ginger Tea – Improves circulation & reduces brain fog
  • Try these TBI-friendly ingredients:
    • Coconut Water–Keeps you hydrated for better foc
    • Blueberries  Spinach–High in antioxidants for brain repair
    • Avocado and Flaxseeds–Healthy fats for brain function
    • Greek Yogurt–Protein for mental clarity

Tip! Blend: ½ banana + ½ cup blueberries + 1 tbsp flaxseeds + 1 cup almond milk

  • Hydrating brain drinks
    • Water with lemon and chia seeds to maintan the brain hydration and boost energy
    • Coconut water for electrolytes to prevent further brain fatigue
    • Beet juice increasing the brain’s blood flow 
    • Aloe Vera juice assists with digestion and inflammation
  • Warm, Comforting Drinks
    • Warm almond milk with cinnamon to support memory and reduces stress
    • Chamomile tea with honey to assist with relaxation and brain repair
    • Bone broth with amino acids that rebuild brain cells

Even mild dehydration can make brain fog, dizziness, and fatigue worse. Try to drink at least 8 cups of water daily and add these drinks for extra brain benefits. If you struggle with mental fatigue after brain injury, it’s a good idea to avoid non-natural stimulants altogether and find out about natural alternatives instead. Not only will you have longer energy, but you also will not have to worry about your recovery.

Although caffeine in modest amounts is not dangerous after brain injury, patients should still do their best to avoid caffeinated drinks as much as possible. The brain easily builds up a tolerance to caffeine, which means the more you devour, the fewer benefits you will see. Therefore, doctors will typically recommend using natural and organic alternatives as much as possible.

The following are a few healthy alternatives to caffeine that can help improve your energy after TBI:

  • Fast intermittently

Fasting intermittently has many health benefits, including boosting brain function and reducing mental fatigue. It also advises for several neuroprotective benefits to brain injury survivors.

Kristen Kizer, RD, LD, a registered clinical dietitian at Houston Methodist Hospital, says, “Most studies of intermittent fasting have focused on a 5:2 schedule, meaning subjects eat normally for five days a week, but restrict intake to 600 calories for two days.

“Personally, I wouldn’t want to be around me on my day I’m not eating,” Kizer jokes. “I have clients complain that the day they’re doing 00 calories they’re getting nauseous, they’re getting headaches, they can’t concentrate at work.” 

That’s why intermittent fasters are adopting another method, a 16:8 regimen, in which they consume all their calories within an eight-hour window.

Houston Methodist pharmacist Chase Janak, Pharm.D., has followed the plan for a year-and-a-half for weight loss. While he says it hasn’t been a cure-all, combining the 16:8 regimen with healthy eating has helped him lose fat and maintain his weight. He adds that with the increased concentration at work that comes with skipping breakfast, he craves sugary snacks less often.

When you fast, your body converts fat into ketones and burns those for energy rather than sugar, as it normally does. This process is especially helpful for brain injury patients because, after a TBI, the brain can no longer efficiently convert glucose into energy. However, the brain can still use ketones.

So fasting offers the brain another energy source to draw from. This process is the principle behind the ketogenic diet for brain injury patients.The ideal fasting length is around sixteen hours without eating. For most people, this just means skipping breakfast in the morning and stopping food after 8 p.m.

However, not everyone can fast safely. If you are diabetic or recovering from surgery, do not attempt to fast without permission from your doctor.

  • Eat energy-boosting foods

Fasting will not have much effect if you only eat junk food. That’s why you must consume healthy, energy-rich foods such as foods that heal the brain after a concussion.

These foods include:

  • Blueberries
  • Broccoli
  • Fatty fish
  • Bananas
  • Nuts

Also, make sure to stay hydrated. The more hydrated you are, the more your body can flush out the harmful contaminations that have accumulated in your brain since your injury, improve your mental clarity as well.

  • Exercise

Exercise not only encourages endorphins, which can make you feel more energized, it also increases oxygen levels in your blood and increases blood flow to your brain. All of this helps your brain heal faster and provides more energy throughout the day, making it a healthy alternative to caffeine after brain injury.

In the years past, many doctors discouraged exercise after a TBI, for fear that it might further damage the brain. But while it is important to rest in the immediate weeks after a brain injury, there is no evidence that light exercise after that point will cause damage. In fact, it may even promote a fuller recovery.

The best type of exercise for healing exhaustion is any kind of aerobic activity – such as swimming, biking, or yoga. If you find it too strenuous to exercise at first, do not worry. It will take time to rebuild your tolerance.

Instead, start with a light and short workout, maybe ten minutes or less. Then, gradually increase the fervor and frequency of your exercise routine. In the course of time, you should start getting enough energy and endurance to exercise systematically.

  • Get enough sleep

If you find yourself regularly fatigued, it could be because you have developed a sleep disorder that is stopping your brain from getting the rest you need to restore.

One of the most common sleep disorders after a brain injury is sleep apnea which occurs when a person’s breathing is disrupted while sleeping. This phenomenon tends to lead to an excess amount of CO2 in the bloodstream, which can cause extreme fatigue during wakened hours. A sleep specialist can offer treatments that will give you a stimulating night of sleep again.

  • Scale down stress

Too much stress on the brain can cause many conditions like cognitive decline and mental fogginess. That’s why it is important to find ways to reduce stress after brain injury.

Relaxing activities such as yoga and mindfulness are great stress-reducing methods. In addition, art therapy or music therapy can help you find a creative channel for your stress. These suggestions also will keep you from experiencing sensory overload.

As my mother used to say, everything in moderation and you’ll be fine. Listening to my mother, aside from my stroke, I was fine.

The post Caffeine and Brain Injury: How Do They Mix? appeared first on The Tales of A Stroke Survivor.

03 Apr, 2025

The Repeating Mistakes of the Past: A Looming NCD Pandemic

Advocacy Article

Ahead of the 4th UN High-Level Meeting on NCDs and Mental Health in September, 2025

April 3, 2025

The 19th and 20th centuries saw significant advancements in medicine and public health. However, despite these gains, governments and global health leaders failed to address the growing burden of non-communicable diseases (NCDs). The consequences of this inaction are now being felt in the 21st century.

The Mistakes of the Past

In the 19th and 20th centuries, governments prioritized addressing infectious diseases over NCDs. This oversight led to a lack of investment in NCD research, prevention, and treatment. The consequences were devastating as follows:

  1. Inadequate healthcare infrastructure- Many countries failed to develop healthcare systems capable of addressing the complex needs of NCD patients.
  2. Lack of awareness and education- Limited public awareness and education campaigns meant that many people were unaware of the risks and consequences of NCDs.
  3. Insufficient funding-NCD research and prevention efforts received inadequate funding, hindering the development of effective treatments and prevention strategies.

The 21st Century: A Repeat of Past Mistakes

Unfortunately, the 21st century has seen a repeat of these mistakes. Despite the growing burden of NCDs, governments and global health leaders have failed to take decisive action. Governments and global leaders current slow to lead and take action attitude on NCDs are felt strongly as highlighted below:

  1. Failed commitments– The 2011 UN High-Level Meeting on NCDs and the 2015 Sustainable Development Goals (SDGs) included commitments to address NCDs. However, many of these commitments remain unfulfilled.
  2. Inadequate funding– NCD research and prevention efforts continue to receive insufficient funding, hindering progress in addressing these diseases.
  3. Lack of progress– The global response to NCDs has been slow, and the disease burden continues to grow.

The Consequences: A Looming Pandemic

The consequences of these failures are dire. If left unchecked and unattended to, NCDs will become a pandemic, affecting millions of people worldwide which could have a catastrophic   consequences.

The following would be the results if governments and global leaders fails take a bold decision to lead and take action on NCDs during the 4th UN High-Level Meeting on NCDs and Mental Health in September, 2025.

  1. INCREASED MORTALITY AND DISABILITY– NCDs will become a leading cause of death globally, surpassing infectious diseases and a leading cause of disability.
  2. ECONOMIC BURDEN-The economic impact of NCDs will be devastating, with estimates suggesting that NCDs will cost the global economy trillions of dollars.
  3. HUMAN SUFFERING– Millions of people will suffer from the debilitating effects of NCDs, impacting their quality of life and ability to contribute to their communities.

Living with a Half-Life

Persons living with NCDs (PLWNCDs), the reality is stark. Many are forced to live with a half-life, unable to fully participate in their day-to-day activities in their communities or reach their potential. Persons living with NCDs are usually saddled with myriad of challenges. Key dominating challenges which cuts across especially for people from low-and middle –income countries are;

  1. LIMITED ACCESS TO CARE– Many people lack access to affordable, quality healthcare, exacerbating their condition.
  2. SOCIAL ISOLATION– NCDs can lead to social isolation, further impacting mental and physical health.
  3. ECONOMIC HARDSHIP-The financial burden of NCDs can be crushing, pushing persons living with NCDs families into poverty and worsening of their condition.

A Call to Action for Governments and Global Leaders

As we approach the 4th UN High-Level Meeting on NCDs and Mental Health in September 2025, we (advocates, persons living NCDs, caregivers, health professionals, CSOs, etc.) urge your Excellencies, to uphold to your oath, to protect and serve your citizens. Your constitutions mandate that you prioritize their well-being and health.

The duty as leaders has a moral Imperative from the living word of God in Proverbs 3:27, advises, “Do not withhold good from those to whom it is due, when it is in your power to do it.”

This wisdom underscores your responsibility to urgently act with kindness and compassion, particularly in matters of life and death (with respect to non-communicable disease, a looming Pandemic). The health and well-being of your citizens are not merely moral obligations but fundamental human rights.

The Urgency of Action

Non-Communicable Diseases (NCDs) pose a significant threat to global health, claiming millions of lives each year. In 2021, 18 million people died from an NCD before age 70 years. 82% of these premature deaths occurs in low-and middle –income countries. Cardiovascular diseases account for most NCD deaths, or at least 19 million deaths in 2021, followed by cancers (10 million), chronic respiratory diseases (4 million), and diabetes (over 2 million including kidney disease deaths caused by diabetes) (WHO, 2024).

As leaders, you have the power to implement policies and programs that prevent NCDs, improve healthcare systems, and save lives. Delaying action or withholding support is not an option.

A Call to Responsibility

We (advocates, persons living with NCDs, caregivers, health professionals, CSOs, etc.) urge your Excellencies to take immediate action to:

  1. Commit to Save Lives- Adopt and Implement a preventive care model to prevent 80% of NCD-related deaths through early intervention and treatment.
  2. Strengthen healthcare systems- Invest in healthcare infrastructure, personnel, and services to ensure equitable access to quality care.
  3. Earmark Revenue from Sin Tax- Allocate revenue from sin taxes (e.g., tobacco, sugary drinks, and alcohol) to fund NCD prevention and control programs.
  4. Monitor Progress and Accountability- Establish robust monitoring and evaluation systems to track progress and ensure accountability.
  5. Implement NCD prevention policies- Enact policies that promote healthy lifestyles, reduce risk factors, and support early detection and treatment.
  6. Ensure access to essential medicines- Guarantee the availability and affordability of essential medicines for NCDs.
  7. Enhance Research and Development- Encourage research and development of affordable, innovative treatments and technologies for NCDs.

 Recognition of Global Health Organizations’ Efforts in NCD Prevention and Control

Global health organizations, including the World Health Organization (WHO), United Nations (UN), and international non-governmental organizations (NGOs) such as the NCD Alliance, World Heart Federation (WHF), International Diabetes Federation (IDF), and NCD-specific focus organizations like the World Stroke Organization (WSO), World Obesity Federation(WOF),  International Union for Cancer Control (IUCC), Global Heart Hub (GHH), World Hypertension League,  International Society of Hypertension ,etc. are making significant investments in the prevention, control, treatment, and capacity building for health care  professionals  and advocates to better address non-communicable diseases (NCDs) at the national and regional levels.

These organizations are working tirelessly to enhancing healthcare systems and services for people living with NCDs, advocating for policies that support NCD prevention and control, training healthcare professionals and empowering people living with NCDs and Educating communities about NCD risks and prevention strategies with the support of their members and partners.

We (advocates, persons living with NCDs, caregivers, health professionals, CSOs, etc.) highly commend the contributions of these global health organizations and NGOs for their tireless efforts in controlling, preventing, and treating NCDs globally. Their work has made a significant impact on the lives of millions of people worldwide.

We urge donors and partners to provide uninterrupted funding to support the critical work of these organizations. Donors and partners continued support is essential to;

  1. Sustain progress: Maintaining momentum in NCD prevention and control efforts.
  2. Address emerging challenges: Responding to new and evolving NCD challenges.
  3. Ensure equitable access: Providing healthcare services and support to people, regardless of their geographical location or socio-economic status, thus to abolishing “Cash-and-Carry” system of care.

Together, we can make a meaningful difference in the lives of people living with NCDs and ensure the long-term success of NCD prevention and control efforts.

Conclusion

 Your Excellencies, as leaders, you have the capacity to make a meaningful difference in the lives of your citizens by reaffirming your committing to lead and take action on NCDs at the 4th UN High-Level Meeting on NCDs and Mental Health in September, 2025. We urge you to seize this opportunity, uphold your oath, and prioritize the health and well-being of your people. The time for action is now. Do not withhold kindness or help when it is within your power to LEAD and to TAKE ACTION on NCDs.

It’s time for governments and global health leaders avoid the repetition of the mistake of the past with its devastating consequences and  lead by taking action to address the growing burden of NCDs.

“Repeating the mistakes of the past will unleash an NCD pandemic. Health is a right, not a privilege. Inaction denies this right, leaving millions living a half-life.” – Sir Ad Adams Ebenezer

 

Advocacy Article by:

Sir Ad Adams Ebenezer, CDfJC

Global Health, Policy and Patient Advocate

Community Based Rehabilitation Robotics and AT Expert

Consultant

03 Apr, 2025

Vaccines and Brain Injury: There’s No In-Between

If you really want their honest opinions, the next time you’re with a group of people, begin talking about vaccines. The opinions go from white to black. There’s no in-between. You’re either for vaccines or against them. Hardly nobody cared until the pandemic, and then almost everybody cared.

“Did you get the COVID shot yet?” or “How come you didn’t get it? Do you want to sicken other people?” 

For me, it was exhausting. 

CHECK WITH YOUR DOCTOR BEFORE YOU TAKE ANY VACCINE

And for someone with a traumatic brain injury (TBI) or stroke, most vaccines are safe and favorable. However, certain jabs may require extra vigilance due to potential side effects on brain health, blood pressure, and immune system, especially with a brain injury. Here’s what’s up:

Live vaccines (MMR, Varicella, Yellow Fever, Flu nasal spray)

  • If you are on immunosuppressants for post-stroke inflammation or other conditions, live vaccines may not be safe.

  • Live vaccines could cause a strong immune system, leading to fatigue, inflammation, or mild fever.

Flu and COVID-19 vaccines may cause inflammation and even lower blood pressure

  • If you had a stroke and the cause was blood clots, some COVID-19 vaccines had rare blood clot risks.

  • Some people with brain damage have reported temporary worsening of brain fog, dizziness, or fatigue after flu or COVID-19 shots.

  • mRNA COVID-19 vaccines have a rare risk of myocarditis/pericarditis (inflammatory conditions that affect the heart), which could affect blood pressure—very important if you already have low blood pressure.

Shingles vaccine (Shingrix)

  • The Shingles vaccine could cause a strong inflammatory response that may temporarily worsen brain fog or fatigue in people with brain damage.

Tdap for Tetanus, Diphtheria, and Pertussis (Tetanus enters the body through cuts or wounds. Diphtheria and Pertussis–whooping cough–spread from person to person.) 

  • If you have a history of Guillain-Barré Syndrome (GBS is which the body’s immune system attacks the nerves), talk to your doctor before getting Tdap.

  • Some people with TBI or other neurological conditions report worsening muscle tightness or nerve pain after the injection.

Even though some vaccines need caution, many are highly recommended to prevent complications:

  • Pneumococcal (PPSV23, PCV15/20) to reduce the risk of pneumonia, which can lead to stroke complications
  • Tdap/Td (if needed) to avoid Tetanus and Pertussis which can cause breathing or nervous system issues

Before getting a vaccine, a checklist is in order:

  • Blood pressure to make sure it’s stable before the vaccination
  • Low fatigue to delay scheduling a vaccine when you’re extremely tired
  • Current symptoms to delay the shot if experiencing brain fog, dizziness, or inflammation
  • Medications to be certain there are no interactions with immunosuppressants or blood thinners
  • Hydration to drink extra water and rest for a good night’s sleep before the vaccine

Me? I got all the childhood vaccines but only one COVID 19 shot. No, I don’t “want to sicken other people,” but the people in my group were persuasive. There’s no in-between, remember?

The post Vaccines and Brain Injury: There’s No In-Between appeared first on The Tales of A Stroke Survivor.

21 Sep, 2023

GHANA’S CVD SCORECARD 2022-2023

WHF-SCORECARD-2022-GHANA(Dev3)

Summary of Ghana’s CVD Scorecard

The world over, Non-Communicable diseases (NCDs) have become a major public health concern with attendant negative implications on the lives and development of the individuals, the family, community, the nation and beyond. NCDs undermine the attainment of development targets at various levels through social, economic, and biological pathways in a vicious cycle of ill-health, poverty, strained family cohesion, poor mental health, productivity loss among others. The burden of mortality attributed to these NCDs, such as cancer, hypertension, cardiovascular disease, diabetes, stroke, etc. were expected to exceed that of communicable diseases by 2030. However, it is fast becoming obvious that NCDs may be contributing more to indices of morbidity and mortality than communicable diseases.

There is an established double disease burden of Communicable and Non-Communicable Diseases in Ghana, with Non-Communicable Diseases fast gaining prominence as the leading causes of hospital attendance and deaths. NCDs include diabetes, obesity, stroke, hypertension, cancer and others. Some of the afore-mentioned diseases (Hypertension, Diabetes, Obesity, etc.) are known predisposing risk factors for cardiovascular diseases. Indeed, an analysis of the trend of morbidity and mortality for Ghana has shown a rise in the prevalence of CVD related conditions. It is also known that the socio-demographics characteristics of those with CVD and related diseases are rapidly shifting from older age groups to younger ones and currently, individuals at high risk of CVDs are usually at the peak of their productive years.

The objectives of the Ghana NCD Policy include reducing the incidence of chronic NCDs; reducing the unhealthy lifestyles that contribute to NCDs; reducing morbidity associated with NCDs and improving the overall quality of life in persons with NCDs.

As part of efforts aimed at achieving objective of the country’s National Health Policy and NCD Policy is the establishment of systems for the prevention, early detection, prompt management and accurate reporting of CVDs at all Operational Levels.

The results of the CVD Scorecard Project have revealed unsettling trends in the economic burden of CVDs. For instance, the Estimated direct (e.g. health care-related) cost of tobacco use in Ghana’s population stood at 123 million USD every year, i.e. an average per capita of over Fifty – Two Thousand (52,000) persons (i.e. USD 2,363.3). The Proportion of premature CVD mortality attributable to tobacco (%) is estimated at 66.39%. Given the seemingly “low” prevalence of tobacco use, a proposed hypothesis for this could be explained by secondary smoking and the use of other forms of tobacco.

Recorded alcohol consumption per capita (15+ years) in liters of pure alcohol in a three-year period in Ghana averagely stood at 2.7 liters, meaning the entire Ghanaian population consumes 27,713,347.2 liters every year.

A quick look at the afore mentioned figures indicate that Ghana stands to make tremendous health and economic gains from combating CVDs and NCDs in general. The Project has also highlighted the strengths of the Ghanaian health system, such as a strong health workforce base and the availability of the appropriate clinical protocols and guidelines for health care delivery. Bolstering the weak structures of Ghana’s health care system, will afford tremendous gains in reducing morbidity and mortality due to CVDs and improving the quality of lives of Ghanaians.

Contact Ministry of Health Ghana  and the project coordinator Ad Adams Ebenezer for the full report via email ad.adams@sasnetghana.org or strokeghana@yahoo.com

SASNET GHANA Secretariat +233(0)594989495

Find Ghana’s CVD Score Card infographic link below

WHF-SCORECARD-2022-GHANA(Dev3)

28 Jan, 2023

Are You “Confabulating” with a TBI?

Confabulation is when people, a significant portion of Traumatic Injury Injury (TBI) survivors, have gaps in their memory and were asked to recount the details of past events. Rather than saying that they don’t know, people minds furnish missing details with confabulated memories of the incidents.

People who are confabulating can’t help it. They are not making an intentional attempt to lie. Rather, they are confident in the honesty of their memories even when somebody else challenges them. People who are confabulated are not conscious that their memory is incorrect, and they are not lying to deceive or manipulate others. 

Confabulation is often associated with memory disorders, brain injury (TBI), and psychiatric conditions like schizophrenia.

Signs and symptoms of confabulation are the following:

  • A lack of awareness that a memory is false.
  • No attempt to deceive or manipulate. 
  • The story is usually related t the person’s memory on past or current experiences.
  • The story can be either probable or improbable, coherent or unrealistic.

While confabulated stories involve presenting false information, the person believes that what they are remembering is true.

In other cases, a person’s memories can be quite ordinary. For instance, a person might not be able to remember exactly how they got a small bruise on their arm but may fabricate a story to explain how the injury occurred.

Family and friends may also be able to offer information that comes in contrast with the confabulator’s “truth.” Confabulation is often the result of brain disease or damage such as TBI.

There is not one specific area of the brain that is responsible for confabulation, but damage to the frontal lobe which is vital to helping us form memories and the corpus callosum which has a key role in visual and auditory memory are identified.

Different theories are used to determine why people confabulate. Some research suggests that two main factors play a role in this type of memory disruption. Being confabulated can sometimes stem from a false memory. This can be a case of “honest lying,” since people are relating to a confabulated memory that seems entirely truthful from their own point of view. 

A 2017 study verifies neuropsychological treatment for confabulation in individuals who experienced a TBI. Researchers asked participants to complete a memory task, then showed them their incorrect answers. Also, they were given specific instructions to pay close attention to their responses. 

Having social contact is important in owning up to confabulated memories. Don’t rely on memory alone for important information, especially involving those that are life-changing. 

People who are confabulated as well as family members and friends need to be educated on this word. Gaps in identifiable memory can be terrifying for people who undergo them and learn otherwise, and disastrous for those that hear them. 

As I have often said, having a brain injury is easier than the situations, like confabulation, that come after.

The post Are You “Confabulating” with a TBI? appeared first on The Tales of A Stroke Survivor.

20 Jul, 2022

Rehearsal Saves Me Again

My moving company will keep my belongings in storage containers for 2 to 3 weeks until there is a truck heading to west to Michigan.  The facility I am moving into will put a few pieces of furniture in my apartment so I will have a place to stay while I am waiting.  However, my car must be filled to the max because I need supplies to take a shower, do laundry, and make breakfast until the moving truck arrives.  I turned to rehearsal to make sure I can pack what I need in my car.  

The purpose of rehearsal is to make me feel awesome when I tackle a new task.  My 1st attempt shows me what I have to change.  My 2nd attempt lets me test new ideas to fix problems I discovered in step 1.  My 3rd attempt gives me an opportunity to combine and test the steps from attempts 1 and 2.  My 4th attempt gives me an opportunity to get faster.  Here are two examples of learning how to pack stuff in my car so I can stay calm on the day I leave for Michigan.

I need a rolling cart to take my clothes to the laundry room.  I need to know: 1) if I can lift the rolling cart into my car with one hand and 2) if it will fit in my back seat. I could not lift it straight upwards to put it in the car because it is too heavy.  However, when I leaned down and moved my hand close to the wheels, the weight of the long handle swung the cart horizonal. That made it easy to place the wheels on the floor of the car and then tilt the cart upright.  I was surprised to learn the small front wheels nested nicely under the driver’s seat.

I also need to know if 2 clothes baskets packed with bed linens and nested waste baskets will fit on my back seat.  I slid the 2 empty clothes baskets down my front steps and transported them to my cart using a small cart I keep on my patio.  I put them on my back seat and learned I could close the car door with room to spare.  The height of the basket raised the handle of the cart, but not enough to obstruct my vision in the rear view mirror.

There were so many constraints to take into consideration!                I would be a nervous wreck if I had not rehearsed these tasks. homeafterstroke.blogspot.com

02 Jul, 2022

Warfarin: A Blood Thinner and Rat Poison

I got a brain bleed 13 years ago and I wasn’t supposed to live. I had Protein S Deficiency that gave me blood clots and didn’t know it for over half my lifetime until I was diagnosed with a hemorrhagic stroke. The neurosurgeon didn’t operate because the chance that I would have survived the operation was zero, having thick and plentiful clots in every extremity. Instead, I was put on Warfarin, another name for Coumadin, and here I am, a decade later.

A little background first. The only restrictions with Warfarin are too much Vitamin K intake, like lots of cranberries, broccoli, or leafy green vegetables. The most important thing with Warfarin is to stay consistent. By staying consistent, the doctor knows how much Warfarin to give me through a prothrombin time (PT), a test used to detect a bleeding or clotting disorder and the international normalized ratio (INR) used to monitor how well the blood-thinning medication called anticoagulant is working. I take blood tests frequently and I am stable.

So how could Warfarin, the wonder drug, and Warfarin, the rodent poison, be related? 

A long time ago, in the late 1920s, the cattle and sheep in North America and Canada were dying from fatal bleeding, blamed on mouldy silage, (a method used to maintain the pasture for cows and sheep to eat later and stored in the silos when natural pasture isn’t beneficial, like in the dry season).

The cattle and sheep had grazed on sweet clover, a kind of hay. Hemorrhaging occurred usually when the climate was damp and the hay had become moldy. Tough times in the 1920s meant that farmers could not afford a replacement, so the hemorrhagic disease became known as “sweet clover disease.”

There were only 2 solutions, according to veterinary surgeons: destroying the moldy hay and having a replacement or transfusing fresh blood into the bleeding animals which was called “plasma prothrombin defect.”

But everything comes down to money, and even though the farmers were told not to feed the moldy hay, they did not follow the recommendation, and sweet clover disease remained, even a decade later.

By 1940, Karl Link, a biochemist, and his colleagues came upon a natural substance called coumarin, better known as dicoumarol from the sweet clover and was used as an anticoagulant, albeit an iffy one. The work was fully financed by the Wisconsin Alumni Research Foundation (WARF), who were given the patent for dicoumarol in 1941.

But in 1945, knowing that dicoumarol was a lengthy process in thinning the blood, Link considered using the coumarin derivative Warfarin as a rodenticide which had the reverse effect–slow bleeding until the little suckers bit the dust. Bleeding in who-cares-about-rodents fit the bill, and the compound was named Warfarin after the funding agency. It was marketed in 1948 as a rodenticide, and warfarin still exists today as both a rodent killer and a blood thinner.

 

In 1954, Warfarin became known as the go-to anticoagulant under the trade name Coumadin, and was approved for use in humans and, of course, rodents. But in humans, when there was still too much bleeding, Vitamin K foods reversed the effect. And too much Vitamin K led to clots. That is why I have to stay in the INR range of 2 to 3 when I get tested–above 3 could lead to bleeding and I have to take more Vitamin K; under 2 could lead to blood clots so I have to decrease my Vitamin  K. Thus, I get tested every other week.

The mechanism of Warfarin was not discovered until 1978, when John W. Suttie and colleagues, in an “Aha moment,” proved that Warfarin alters Vitamin K by slowing down the enzyme epoxide reductase, known as VKOR, which is highly sensitive to Warfarin, the most commonly prescribed anticoagulant. 
There it is, folks, as easily as I could say it. My trademark is, Know a little bit about a lot of stuff and you’ll get by fine.

The post Warfarin: A Blood Thinner and Rat Poison appeared first on The Tales of A Stroke Survivor.

27 Jun, 2022

Getting Hand Use Earlier than Stroke Survivors Think is Possible

Hand tests begin by asking clients to pick up objects from a table.  Stroke survivors would discover their affected hand can be useful earlier than they think is possible if hand-to-hand transfers were added to adult hand tests.  A small amount of finger movement done close to the body can make an affected hand functional.  If you pick up an object with your sound hand and open your affected hand 2 inches to receive the object from your sound hand, you may be able to do the tasks shown below.   A hand-to-hand transfer allows me to do 21 bimanual ADL tasks.
Example #1- Using a shower hose to spray water at the crotch does not take care of the nooks and crannies.  After a hand-to-hand transfer, my affected hand holds the shower hose close to my body which frees my sound hand to do its job.  This little bit of hand function means my mother, a nurse’s aide in the hospital, and I are the only people who have washed my crotch.  If my husband were still alive I would be mortified to have him do this intimate task.    
Example # 2 – When my affected hand was flaccid, I used to squeeze a deodorant bottle between my thighs so my sound hand could remove the cap.  Now my affected hand opens to receive a deodorant bottle from my sound hand and then holds the bottle still while it is resting on my thigh.  The two black lines show how little shoulder movement is needed when ADLs are done close to the body.
Example # 3 –  There used to be teeth marks on the cap of my toothpaste tube.  Now my affected hand can open to receive a tube of toothpaste from my sound hand which then removes the cap.  The end of the tube is propped against my stomach because this new tube is heavy.  I do not want to drop the tube and splatter sticky toothpaste on the floor.  I live alone so I would have to clean up the mess.
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25 May, 2022

Trauma Doesn’t Make a Person Strong, Recovery Does.

When I tell people that I am in the process of recovering from physical and mental trauma that I got while in a domestic violence situation, they usually have some variation of the same response: “I’m so sorry. You are so much stronger for having gone through that.” While I appreciate the sentiment, the trauma I experienced did not give me strength.

My trauma made me isolated. I stopped talking to people in my support system. When they would call I would either ignore them, or exchange pleasantries quickly, to prevent them from feeling the need to call me again. I would lash out at people who suggested that something was wrong, and ultimately pushed everyone away.

My trauma made me feel like I had to lie. I hid the truth of what was happening from everyone who loved me. Even when they asked what was wrong, or how I was getting so many injuries, I said I was clumsy and laughed it off. I lied to myself, convincing myself that I was the problem, and that it wasn’t a big deal. I compulsively started lying about every little thing: where I was, who I was with, what I was doing.

My trauma made me scared. I still jump at the littlest noises and any sign of conflict makes me shake. I have panic attacks with no apparent cause. I’m scared of people, of noises, of big objects. I have a hypervigilance that never seems to turn off.

My trauma made my self-esteem and confidence plummet. I don’t trust myself to make decisions, and everything I do I instantly judge myself for. I apologize for existing to my friends, and I don’t believe I belong anywhere. I can’t look people in the eye.

My trauma left me with long-term mental and physical issues. I’m still having neurological complications that doctors are having trouble figuring out. I still struggle with depression and anxiety. I became numb to everything around me, and was filled with dark thoughts that never seemed to end. I would struggle to get out of bed to even shower, and I would sleep for days on end. I didn’t find enjoyment in anything, and felt hopeless. While that has luckily ended, I still can’t make eye contact with people that make me even the slightest bit nervous. I have intense nightmares, and I still shake if there are loud noises.

Strength is defined as “the capacity to withstand great force or pressure,” with “withstand” meaning “remaining undamaged or unaffected by.” So you see, I was not strong for simply surviving my trauma. And when I am told some variation of “you are so strong,” when I feel anything but, it serves as a reminder that I was not able to “withstand” my trauma.

Strength comes in recovery. From withstanding the pressure to not heal yourself. From learning how to break bad behavior patterns that developed so that you could survive. From sticking up for yourself when you normally would have stayed silent. From choosing to prioritize yourself over other people. Recovery is where that ability to withstand force or pressure is tested.

I will heal, and I will find my strength again. But for now, I am shaken and sensitive, and that is OK. Strength does not come from surviving trauma, it comes from rebuilding one’s self. From withstanding all of the things that make it difficult to get back up again. From getting out of learned behavior patterns that were needed to simply survive. I am not “so strong” right now. But I will be.

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Lewis Moulton
lewismoulton@yahoo.com