Staff and Consultants:
Ellen Magnis, Vice President, American Stroke Association
Wendy Segrest, Director, American Stroke Association Operations
Debi McGill, Editor-in-Chief
Jon Caswell, Lead Editor
Mike Mills, Writer
Sam Gaines, Writer
Pierce Goetz, Art Director
Michelle Neighbors, Advertising Sales
Copyright 2005 American Heart Association ISSN 1047-014X
Stroke Connection Magazine is published six times a year by the American Stroke Association, a division of the American Heart Association. Material may be reproduced only with appropriate acknowledgment of the source and written permission from the American Heart Association. Please address inquiries to the Editor-in-Chief. The information contained in this publication is provided by the American Stroke Association as a resource. The services or products listed are not owned or provided by the American Stroke Association. Additionally, the products or services have not been evaluated and their listing should not be construed as a recommendation or endorsement of these products or services.1-888-4STROKE (1-888-478-7653) StrokeAssociation.org
contents July/August 2005
23 26Stroke Connection Magazine is underwritten
in part by Bristol-Myers Squibb/Sano Pharmaceuticals Partnership, makers of Plavix.
Feature StoryHealing through Music 14
I think I should have no other mortal wants, if I could always have plenty of music. It seems to infuse strength into my limbs and ideas into my brain. George Eliot
ArticlesDetermined Kathy 11
Kathy Morelli was an avid bicyclist before her stroke. With a little help from
her friends, shes on the road again.
Advances in Rehab 13Two new, up-and-coming post-stroke therapies.
Stroke. Youre the Cure. 21Find out what ASA is doing and what
you can do to make a difference.
Examining Medicare Reform 23Plain-English explanations of recent changes.
Cholesterol New Information for High-Risk Patients 26
When it comes to bad cholesterol, new guidelines for high-risk patients say the lower the better.
DepartmentsLetters to the Editor 1
Stroke Notes 2 Readers Room 6
Life at the Curb 28Introducing a new column from
comedian (and survivor) John Kawie.
Everyday Survival 30a division of
Produced and distributed in cooperation with Vitality Communications
July/August 2005 1
mail: c/o Editor-in-Chief Stroke Connection Magazine 7272 Greenville Ave. Dallas, TX 75231
fax: 214-706-5231 e-mail: firstname.lastname@example.org
We Want To Hear From You
Letters may be edited for length and scientic integrity. The opinions presented are those of the individual and do not reect those of the American Stroke Association.
editor Connecting You to UsL E T T E R S
I am a hemorrhagic stroke survivor since December 1999, and at present I am suffering thalamic pain syndrome. Endurance is my lifestyle since then. According to my neurologist, my hypothalamus was pushed by a blood clot during my stroke, and it is not easily addressed. Through your magazine Ive got encouragement that life must go on though tough! Living in pain (left side from ear, eyes to toes), spasms, excruciating pain and lots of it is my daily experience, yet Ive survived already more than ve years. Your magazine really inspires me.
Leobardo Felipe, SurvivorGeneral Santos City, Philippines
Editors Note: We investigated thalamic pain in our September/October 2003 issue. That article is now available on our Web site, www.strokeassociation.org.
My wife had a stroke seven years ago and has suffered with lack of interest and terric headaches all day, every day, since then. Our family doctor says she may gain some interest back, but its been seven years. She is very frustrated.
As for the terrible headaches, shes been trying pain management. If she takes pain pills, they provide some relief but when they wear off, the pain becomes 10 times worse.
If anyone has experienced anything similar, did you nd something that helped?
Weldon Power, CaregiverSteweache, NS, Canada
What a great magazine! I am inspired all over again. A year after my stroke, I volunteered to visit some recent survivors. I was discouraged that most only wanted sympathy, rather than working to recover some of what they had lost. I wish I had known about Stroke Connection so I could have added them to the subscriber list.
Rick Davis, SurvivorSalt Lake City, Utah
My husband had a stroke at age 59 in May 2002. He experienced short-term memory loss and has shown improvement. He was unemployed at the time. We had to use what little savings we had for prescriptions and to help with living expenses. He is an only child, both parents deceased, and last February we had to cash an IRA. He wasnt thinking, I guess, and the bank didnt remind him that this would be income and now we owe a few thousand dollars in taxes!
He cannot receive disability due to not working at the time of the stroke. We are fearful of the future will we have money for prescriptions, etc.? He has also been diagnosed with sleep apnea but is unable to wear the device that helps prevent sleep apnea. He takes one or two naps daily and believes his medications make him sleepy. However, his doctor is not too quick to try anything else.
Thus the reason for this letter: Do your readers have any suggestions on relieving the sleepiness so he might feel like doing everyday house errands and help with our nancial difculties? I am 55 and could retire but nancially I am unable to. Many of the things in Mary Morgans story in March/April issue reminded me of my husband. She is correct, the medical profession does not give the patient or family much information. I believe more should be communicated.
Linda Jennings, CaregiverPennsboro, West Virginia
notes Connecting You to the WorldS T R O K E
Playing interactive virtual reality games signicantly improved motor function in a small study of stroke survivors. The technology appears to help reorganize brain functions, allowing survivors to regain some walking ability.
Stroke often impairs one side of the body and walking ability. In many cases survivors compensate for the impaired leg by using the intact leg, which can cause further problems in the weakened limb.
There have been a number of approaches used in stroke rehabilitation to help patients recover gait function, but outcomes have been variable, said lead author Sung H. You, P.T., Ph.D., assistant professor of physical therapy at Hampton University in Hampton, Va. The problem is that we dont fully understand how recovery after stroke affects the brain. So we investigated how virtual reality intervention affects stroke patients brains, and, ultimately, their ability to walk.
Dr. You studied 10 survivors (average age 57) who had experienced strokes at least a year earlier. All had weakness on one side. They were randomly assigned to a control group, which received no intervention, or a virtual reality (VR) group, which received the computer-assisted training an hour a day, ve days a week, for a month.
Three games were used Stepping Up/Down, Sharkbait and Snowboarding to build range of motion, balance, mobility, stepping and ambulation skills.
Stepping Up/Down simulates going up and down stairs and helps hip exion and extension, weight-shifting and balance.
Sharkbait simulates deep-sea diving with sharks, electric eels and other sea creatures, and requires weight-shifting, stepping, protective reexes and squatting.
Snowboarding simulates snowboarding down a narrow slope, and requires trunk exing and extending, lateral bending and weight-shifting.
In each game, the patient is positioned in front of an interactive screen which projects a virtual reality scenario.
Researchers measured patients ability to walk before and after therapy, and did imaging studies of the brains of the ve patients who had VR training.
Before therapy, brain imaging showed that movement in the affected leg stimulated activity on both sides of the brain, which is abnormal. After therapy, movement in the affected leg stimulated activity in the opposite hemisphere.
These are the rst ndings that suggest that VR training results in a reorganization of brain activation, which is associated with improved gait function, Dr. You said. The brain reorganization was associated with notable gain in locomotor function.
Most of the VR-trained subjects reported spontaneous uses and condence in the affected limb during daily activities such as transferring in and out of the bathtub, putting on trousers and stepping onto a step or curb, Dr. You said. These functions were not possible before VR.
To view a video news release of this story, visit www.strokeassociation.org.
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