Thursday, August 30, 2007
Sunday, August 26, 2007
Naamua - Life beyond Loss
Earlier this week we covered a topic which is close to my heart, and with the statistics being as they are, possibly close to yours too. Mark McEwan—the veteran broadcaster—came on to talk about his challenging recovery from a stroke. A terrible affliction, but one that affects 700,000 Americans a year making it the third largest cause of death behind heart disease and cancer.
Mark’s recovery is a true inspiration: he lost the ability to speak and walk, but now walks well and speaks with only mild impairment. He joins the 6 million or so stroke survivors living in the United States. But while more and more people—like Mark—escape death from stroke, the disease is still a leading cause of serious disability.
When my father suffered his fatal stroke—officially labeled a “massive cranial bleed”-- he already knew what it was like to live with disability. Ten years earlier, a blood clot on his spine had left him paralyzed from the waist down meaning he not only became a wheel chair user, but also suffered various health complications. He had to move into a long-term care facility years before he even reached retirement age, and he felt life was all but over.
But then came a ray of light in the form of a nurse named “Mary”. If you believe in these things, you might have called her an angel. A truly beautiful, selfless person who warms the world of everyone she comes into contact with. She had never seen my father walk, play tennis, cook, garden or many of his other favorite pursuits, yet she fell in love with him just the same. They spent 7 happy years together, despite my father’s deteriorating health, and then came the stroke.
The bleed took my father’s life so quickly, Mary had literally given him a cup of tea and the TV remote 2 hours before. I guess it was the very definition of going quietly in your sleep. Considering his health issues including constant infections and almost complete loss of sight, you might call his passing a painful blessing. He got a brief respite from suffering to experience true happiness, before being permanently relieved of pain.
It is devastating to lose someone you love, as I’m sure most of you know. But perhaps for the person themselves there are times when death is welcomeTuesday, August 21, 2007
Life Lessons: The great escape
Monday, August 20, 2007
Wednesday, August 1, 2007
Amantadine for Adynamic Speech: Possible Benefit for Aphasia?
American Journal of Physical Medicine & Rehabilitation. 86(8):605-612, August 2007.
Barrett, Anna M. MD; Eslinger, Paul J. PhD
Abstract:
Barrett AM, Eslinger PJ: Amantadine for adynamic speech: possible benefit for aphasia? Am J Phys Med Rehabil 2007;86:605-612.
Objective: Dopaminergic agents may stimulate behavior and verbal expression after frontal lobe dysfunction. Although amantadine is used in neurorehabilitation of motivational disorders and head injury, it is not commonly prescribed to improve aphasia. This pilot study examined verbal fluency on and off amantadine for nonfluent speech.
Design: Four participants undergoing inpatient rehabilitation, meeting criteria for transcortical motor aphasia had stroke (2), stroke postaneurysm surgery (1), or brain tumor resection (1). We administered 100 mg of amantadine twice a day in an open-label, on-off protocol, with multiple assessments per on-off period.
Results: Off medication, subjects generated a mean 12.62 of words (abnormally few) on the Controlled Oral Word Association test. On medication, word generation significantly improved to 17.71 words (P = 0.04), although scores remained psychometrically in the abnormal range.
Conclusions: Further research on amantadine, specifically for nonfluent speech and nonfluent aphasia, including effects on functional communication and control conditions, may be warranted.
(C) 2007 Lippincott Williams & Wilkins, Inc.