With technology booming, there are so many options out there to help and assist with our SLP role post stroke.
Here is a short list of some iphone/itouch/ipad apps that may be of interest:
1. Speak it
3. Yes/No
4. Proloquo2Go
Are there any others that you have found helpful or that you’ve used?
There’s also an app to help with stroke prevention by monitoring your sodium intake!
Honestly there’s an app for everything:)
So I was thinking about possible blog topics and I got thinking about primary prevention (which is always a pretty hot topic in health care). “Would that be an interesting blog topic?” I asked myself.
You always hear about how the best cure is to prevent the disease in the first place. What is involved with stroke prevention? Eat right and exercise – that about covers it right? And I don’t really have to worry about strokes anyway; I’m only 28, right? Then I started thinking about the average age of people having strokes these days. We are starting to see younger and younger individuals affected by stroke as well as a myriad of other nasty diseases and conditions. I also thought of all my relatives who have diabetes, cancer, heart disease, etc. I most definitely have some unhealthy family members!
All of these factors made me realize that maybe (just maybe) it may never be too early to start thinking about primary prevention.
So, I made a resolution, I am going to spend the next 6 months making an evidence based attempt at making primary prevention a major life goal. I’m going to focus on primary prevention of stroke as well as diabetes, heart disease and anything else I come across. I will record my progress and investigations on this blog so that others may benefit from my experiences.
So, where to start….let’s look at some Canadian statistics. I want to know if there truly is a trend toward disease or if the media just wants me to think that “the sky is falling”. Let’s head over to Statistics Canada and maybe the Health and Stroke Foundation website while I’m at it.
http://www.statcan.gc.ca/start-debut-eng.html I found this great PDF entitled “The Changing Face of Heart Disease and Stroke” http://www.statcan.gc.ca/pub/82f0076x/82f0076x1997001-eng.pdf
which states:
Cardiovascular disease (heart disease and stroke) is the leading cause of death of over one-third of Canadians. It not only affects the elderly but is also the third leading cause of premature death under age 75. Mortality rates for ischemic heart disease and acute myocardial infarction continue to decrease, but mortality rates for stroke have not changed significantly during the past ten years.
Also:
The Canada Heart Health surveys from 1985-90 found that 41% of men and 33% of women aged 18 to 74 had two or more of the major risk factors (smoking, high blood pressure, elevated cholesterol, physical inactivity, or obesity). The risk of heart disease and stroke increases with an increased number of risk factors.
Age 18 – 74! That’s quite a range! Ok, so now I know that you DO NOT need to be “old” to be at risk for stroke. Nor should you wait until you’re older to think about prevention. That being said, what are the risk factors?
Here are a few:
Age
Sex
Family history
Tobacco smoking
Physical inactivity
High blood pressure
Dyslipidemia
Overweight
Diabetes
Excessive alcohol use
High cholesterol levels
Oxidant diet/Antioxidant use
Mental Stress
Exertion in the cold/Snow shoveling
Infections and inflammatory agents
Atrial fibrillation
Ethnicity
Take a look at this list. The majority of the risk factors on there are completely preventable.
“Ok” I say to myself “Great, this disease is totally preventable and I managed to find all this out in about half an hour with Google”. I feel that if I can get all this via Google in a short time period then the average Canadian should be able to do it too.
Now I think the next step should be to figure out how many (and which) risk factors I have. To do this, I found a really cool risk assessment tool on the Heart and Stroke Foundation website. Go check it out here:
http://ww1.heartandstroke.ca/hs_Risk.asp?media=risk_ntl
Ok, risk assessment complete! It turns out that I have more than 3 risk factors for stroke (yikes). Then I stumbled across this little tidbit:
Ask your doctor about having your cholesterol tested if you:
Are a male over 40
Are a female over 50 and/or post-menopausal
Have heart disease or stroke, diabetes or high blood pressure
Have a waist measurement of more than 1-2 cm (40 inches) for men or over 88 cm (35 inches) for women
Have a family history of heart disease or stroke
So….stay tuned for my next blogpost:
Visiting my physician: Blood Work and Blood Pressure (coming soon)
Thought this might be a great song to get you through Friday!!
A list of cookbooks e-mailed to me by some of my patients with dysphagia and the family members who assist with food preparation.
The Dysphagia Cookbook: Great Tasting and Nutritious Recipes for People with Swallowing Difficulties
by Elayne Achilles $21.95
The I-Can’T-Chew Cookbook: Delicious Soft Diet Recipes for People With Chewing, Swallowing, and Dry Mouth Disorders
by J. Randy Wilson $19.76
Soft Foods for Easier Eating Cookbook: Recipes for People Who Have Chewing and Swallowing Problems
by Sandra Woodruff, Leah Gilbert-Henderson $20.95
Good Looking, Easy Swallowing: Creative Catering for Modified Texture Diets
by Janet Martin, Jane Backhouse $55.00
If some of you have not already read this article, it may be of interest.
Patients who have a mini-stroke accompanied by speech problems, are more likely to suffer from a treatable heart condition called atrial fibrillation, according to Ottawa research presented today at the International Stroke Conference.
Dr. Mukul Sharma, deputy director of the Canadian Stroke Network and an author of the study, said that speech problems “provide a clinical clue for physicians, alerting them to the need to look early and suspiciously at the heart” as the origin of a mini-stroke, or transient ischemic attack (TIA).
TIA patients have a 10-per-cent risk of a major stroke within 90 days, with half of strokes occurring in the first week. That’s why identifying the cause of TIA quickly and effectively is critical.
Atrial fibrillation (AF), or irregular heartbeat, is a common and treatable risk factor for stroke but it frequently goes undetected. Patients with AF can be closely monitored and prescribed medication to prevent blood clots.
Dr. Sharma and his team studied 1,369 patients with TIA treated in The Ottawa Hospital’s emergency department. Of these patients, 48 were identified as having speech difficulties. The study found that patients with speech difficulties were twice as likely to have had a blood clot that originated in the heart than other TIA patients (20.8% vs. 10%).
In addition to his role at the Canadian Stroke Network, Dr. Sharma is also the director of The Ottawa Hospital Stroke Clinic and an assistant professor of neurology at the University of Ottawa.
TIA patients with speech difficulties more likely to suffer from irregular heartbeat
Check out this recently published article about dysphagia and stroke outcome.
Here is the summary and full article is below:
Influence of Dysphagia on Short-Term Outcome in Patients with Acute Stroke
American Journal of Physical Medicine & Rehabilitation. 90(4):316-320, April 2011.
Abstract Objective: The aim of this study was to determine whether dysphagia present at initial swallowing evaluation is associated with the type of diet eaten at the time of discharge and the location to which the patient is transferred after discharge.
Design: A total of 409 newly diagnosed acute stroke patients were studied.
Results: After hospital discharge, 140 patients returned home, 250 were transferred to another hospital for rehabilitation, and 7 were admitted to a nursing home. Twelve patients died. A total of 205 patients were on a regular diet, 96 were receiving a dysphagia diet, and 96 were on enteral feeding at discharge. A total of 90.7% (127/140) of patients who were discharged home were on a regular diet. Most of the patients on a dysphagia diet or enteral feeding could not return home. The scores of the functional independence measure were higher in the patients who returned to their homes than in other groups.
Conclusions: Although it is necessary to indicate other factors, such as the physical status to establish better rehabilitation networks, clinical assessment of swallowing in acute stroke is very important to determine whether the patients can go home directly.
Influence of Dysphagia on Short-Term Outcome in Patients with Acute Stroke
SpeakEasy 