The toolkit was uniquely co-designed by an interprofessional group of researchers, allied health professionals, stroke organizations and people with lived stroke experience, to create a person-centred, inclusive experience for users to learn about and access aquatic therapy.

“STARRT is the first aquatic therapy toolkit developed at Sunnybrook,” explains Dr. Marinho Buzelli, STARRT project lead. “This unique toolkit will help deliver a more specialized aquatic therapy experience to persons with stroke experience across Canada.”

The need for a stroke toolkit for aquatic rehabilitation

Stroke is a medical emergency resulting in a sudden loss of brain function and is often caused by an interference with blood flow to the brain. In Canada, stroke is the leading cause of adult disability as it can result in restricted movement, paralysis and impaired speech even after medical intervention. For many persons with stroke experience, the road to recovery is long and filled with many challenges. Aquatic therapy, which involves exercise in water, has been shown to have several benefits for people recovering from a stroke.

“I’ve had the chance to observe how aquatic therapy has changed the lives of so many with stroke experience,” says Shaylene Leibl-Smith, a recreation therapist at Saskatchewan Health Authority and a member of the STARRT advisory team. “From stress and pain management, freedom of movement, confidence building and connecting with others, it’s rewarding to see the progress individuals can make participating in aquatic therapy.”

Sharing lived experience to empower survivors

Danny Foran is the patient partner that is sharing his own stroke journey to help and empower other survivors. As a member of the STARRT co-design team, Danny’s experience using aquatic therapy informed some of the benefits, exercises and caregiver supports identified in the toolkit.

Dr. Marinho Buzelli, STARRT project lead, and Danny Foran, transferring his experience with stroke to help design the toolkit.

In 2012, Danny suffered a serious stroke that left him paralyzed on the left side of his body. In addition to different on-land rehabilitation exercises like physiotherapy, Danny joined an aquatic therapy club for stroke survivors. Since pursuing aquatic therapy, Danny has felt an improvement in his balance, strength and endurance, and has even learned how to swim using his right arm.

“Not only has swimming helped me physically, but it’s also supported my mental health since suffering my stroke,” explains Danny. “Swim clubs like the Oakville Strokers allow survivors to meet with each other in and outside the pool, which is a very empowering and motivating experience.”

Rehabilitation can be a frustrating experience for persons with stroke experience, who struggle with movements and activities that they could do before having a stroke. Danny hopes that sharing his experience to design resources like STARRT, will help survivors on their rehabilitation journey, and provide them with both physical and mental benefits and comfort.

“It’s been rewarding to participate in the design process of STARRT,” adds Danny, “I’ve been able to transfer my knowledge of aquatic therapy into an accessible tool for others.”

Danny participating in aquatic rehabilitation after suffering a stroke that left him paralyzed in one side of his body.

Optimizing recovery through aquatic therapy

STARRT is designed to teach persons with stroke experience, caregivers and health care professionals about the benefits of aquatic therapy, answer questions about what to expect from an aquatic therapy class and showcase aquatic therapy pool locations across Canada via an interactive map.

There are currently over 700 pools in Canada that patients and caregivers can explore in the STARRT toolkit. From swimsuits to medications to snacks, STARRT also provides a list of what you might need at an aquatic therapy session, as well as different strengthening, balance, aerobic exercises and games you can try in the pool.

“When designing STARRT we wanted persons with stroke experience to inform the foundation of the toolkit,” adds Dr. Marinho Buzelli. “The goal of this project is to help persons with stroke experience reap the physical benefits from aquatic therapy, and feel more confident and independent in their functional ability by providing them with all the information they might need in one location.”

If you or someone you care for is interested in learning about the rehabilitation benefits of aquatic therapy post-stroke, or would like to learn about aquatic therapy facilities near you, visit STARRT.ca.

The post Let’s get STARRT-ed: Empowering stroke survivors with access to aquatic therapy appeared first on Your Health Matters.

Stroke is a medical emergency resulting in a sudden loss of brain function. Most strokes, also known as ischemic strokes, are caused by an interference with blood flow to the brain, due to a clot, narrowing of a blood vessel or bleeding. In Ontario, there is one new stroke victim every 30 minutes. Dr. Bradley MacIntosh, senior scientist in the Hurvitz Brain Sciences Research Program and member of the Dr. Sandra Black Centre for Brain Resilience & Recovery at Sunnybrook Research Institute (SRI), and his lab are using deep-learning AI tools to support acute stroke imaging and aid in the treatment of patients suffering the deadliest types of stroke.

Although ischemic stroke makes up the majority of cases, an intracerebral hemorrhage (ICH), or brain bleed, is another form of stroke and occurs by a spontaneous artery rupture. Traumatic brain injury can also result in a brain bleed. ICH is the deadliest types of stroke, accounting for one in six acute strokes.

Timely diagnosis and treatment play a critical role in stroke patient outcomes and in order to provide care for patients suffering from a brain bleed, clinicians need to know the size of the bleed and where it is located. The MacIntosh lab has built an AI tool called VIOLA to analyze, detect, and outline locations of hemorrhages visible on computed tomography (CT) scans of patients who have had a stroke. The VIOLA tool searches CT scans and automates these measurements, saving time and potentially improving patient outcomes.

The VIOLA tool can scan CT images and highlight potential brain bleeds in a matter of seconds, assisting clinicians in determining timelier diagnoses and treatments.

“The VIOLA tool can provide clinicians with an accurate analysis and measurement of a brain bleed, enabling faster care and ultimately increasing the likelihood of recovery for stroke patients,” explains Dr. MacIntosh. “The tool also has the potential to create automated and standardized reports, which can assist clinicians in delivering stroke care.”

The VIOLA tool was developed by a collaborative team led by Dr. MacIntosh and researchers at the Computational Radiology and Artificial Intelligence unit at Oslo University Hospital in Norway. The tool is currently undergoing clinical evaluation at Oslo University Hospital, with international collaborators in Sweden and the United States serving as stroke centres for external validation. For the next phase of his research, Dr. MacIntosh hopes to implement the updated version of the VIOLA tool at Sunnybrook. While VIOLA continues to undergo validation, Dr. MacIntosh is using Sunnybrook stroke images to pursue and study new and complimentary AI radiology tools.

“ICH is the deadliest type of stroke and can have devastating, lasting impacts on a survivor’s brain function and physical ability,” adds Dr. MacIntosh. “Stroke researchers are making big progress. There were two landmark clinical trials for ICH in the last year. We created VIOLA with the hope of jumpstarting more ICH research to advance future care for stroke patients.”

The post AI in Action: Locating brain bleeds faster appeared first on Your Health Matters.

The stroke was a surprise for the 25-year-old.

How did it happen? Should other young people be worried?

This is an age group is not typically associated with stroke, but doctors say it’s important to be aware that stroke affects people of all ages.

Dr. Mark Boulos, a Sunnybrook neurologist and stroke expert, answered our questions about TIAs, Hailey’s unexpected health event, and tips for stroke prevention.

Note: Dr. Boulos is not Hailey Bieber’s doctor. His responses are based on the comments she shared in her YouTube video about her TIA.

What is a stroke and how does it compare to a mini-stroke or TIA?

A stroke is when blood flow to the brain gets interrupted, leading to damage to the brain. This can be caused by blocked blood vessels or hemorrhaging.

A “mini-stroke” or a TIA happens when you have transient deficits due to lack of blood flow to a specific part of the brain, but when you do scans, you don’t see any damage. And while they may not leave a mark on the brain, TIAs are still important to pay attention to as they can be warning signs for future stroke.

We don’t typically associate TIAs or strokes with young people. How did this happen in Hailey Bieber’s case?

In her YouTube video, Hailey mentioned that she did have some risk factors, which wouldn’t typically be problematic on their own. But together, it looks like they created the perfect storm.

She mentioned that she was on birth control, and some forms of birth control in young women increases the risk of stroke a little bit. Not very much, but that would have been a risk factor for her. She also noted that she suffers from migraines, and the combination of using some forms of birth control and having migraines can further increase the risk of stroke.

She also recently had COVID, which can also increase your chance of blood clots.

She mentioned she had been on a plane, too. If you’re on a plane and you’re sitting in the same spot for a long time, clots can develop in your legs then travel through your body, including to your brain via something in the heart called a Patent Foramen Ovale, or PFO, which she mentioned she had in her YouTube video. That would have been a trigger as well.

To elaborate on PFOs, there is this connection between the two sides of the heart, which is supposed to naturally close when you are a fetus. In 25 per cent of the population it doesn’t close, leaving a hole in the heart, or a PFO. This isn’t typically a problem, but it can become a problem.

Clots are usually kept on the right side of the heart, which controls the circulation to the lungs. If the clot stays in there, it’s actually OK. The trouble is that a PFO could facilitate a clot going from the right side of the heart to the left. The left side of the heart pumps blood to the rest of the body, including to the brain. If a clot gets into the left side of the heart and goes up to the brain, that could lead to a stroke.

The combination of all these factors could have led to Hailey’s TIA.

These risk factors are all so common. Should young people who have these risk factors be worried about TIAs or strokes?

Statistically, TIAs and strokes are not common in young people. They do happen, but if you’re young and healthy, the risk is minimized. It is important, however, to be aware that stroke can strike at any age.

In general, while the factors mentioned are common, more context is needed around the risk of stroke.

If you’re on some forms of birth control, this can increase your risk of having a stroke, but the risk is minimal. About eight in 100,000 women who are on birth control will have a complication like a stroke. The risk of stroke in women who use some forms of oral birth control is further increased in those with migraines. If you’re worried, have a discussion with your doctor.

If you’re going to be in a plane for a long time, stroke risk prevention is very simple. Walk around, stay hydrated, move your legs to help prevent clots from developing. Just don’t sit in the same spot for a long time.

PFOs are present in about 25 per cent of people, but that doesn’t mean 25 per cent of people will have a stroke. In fact, many people with PFOs never even realize they have them.

It’s important to speak with a health-care professional if there are concerns about risk factors for stroke.

How can people reduce their risk of stroke?

There are things that always help prevent overall vascular risk factors: exercise, healthy eating, not smoking, keeping your cholesterol in check, monitoring your blood pressure, getting enough sleep every night and checking for sleep apnea. To avoid stroke, these things are important for everyone, including young people. 

And of course, knowing the warning signs of stroke to get help right away is important. The earlier a person is treated, the greater their chances of recovery. Knowing the warning signs can help you act fast to get the help needed, if you or someone you know is experiencing a stroke.

The post Hailey Bieber’s mini-stroke shines a light on stroke and young people appeared first on Your Health Matters.

Co-led by researchers at Sunnybrook Health Sciences Centre and the University of Calgary at the Foothills Medical Centre, the study’s findings that Tenecteplase (TNK), a heart attack drug, is an effective treatment for acute ischemic stroke, could lead to a change in clinical practice.

The pivotal study has recently been published in The Lancet.

Researchers also presented the ground-breaking results at the Canadian Neurological Science Federation Conference in Montreal, and the 2022 European Stroke Organization Conference in France. The results have also been published in The Lancet.

Dr. Rick Swartz, study co-principal investigator and stroke neurologist at Sunnybrook, shares insight on how this latest breakthrough could become the standard treatment for acute ischemic stroke and what it means for patients.

What is the current treatment for acute ischemic strokes?

Dr. Swartz: Currently, Alteplase, or tPA, is the standard for treatment of acute ischemic stroke. It is a clot-busting drug that has been used to treat stroke for decades. tPA is extremely effective in treating stroke.

How can a heart attack drug also treat stroke?

Dr. Swartz: Tenecteplase, or TNK, is a common medication used to treat heart attacks and works to dissolve clots to help restore blood flow. TNK is a modified version of tPA. It binds to fibrin, which is part of a blood clot, and helps to dissolve the clot, restoring blood flow to the brain. It is important to note the brain is more complicated and vulnerable to bleeding than the heart, so the dosage in this study for stroke was half the dose that is typically given for treatment of heart attacks.

Why is Tenecteplase effective in the treatment of stroke? 

Dr. Swartz: One of the reasons Tenecteplase, or TNK, is so effective is that in can be administered as a single dose directly to the patient. In contrast tPA requires an infusion over the course of an hour. The ability to give it as a one-time dose saves critical time and complication as TNK could potentially be administered wherever the patient is seen first, at a medical centre or small hospital.

What does this mean for patients?

Dr. Swartz: There are extensive implications for our study findings. This is the first time since 1995 that a new approach to emergency stroke medical treatment has been studied and found to be at least as effective and safe as the current treatment, tPA. In real-world use, it may lead to faster treatment, and could be especially helpful for people with large clots being treated and sent to centres like Sunnybrook for further interventions.

In stroke, every minute counts – the faster the treatment, the greater chance of brain recovery. Current stroke guidelines will need to be reviewed, but our findings could change the way stroke is treated in Canada and around the world.

The post Behind the Research: How the latest in stroke research at Sunnybrook could change emergency stroke treatment appeared first on Your Health Matters.

“When a Code Stroke is activated, I liaise with paramedics in real time as they are enroute to hospital with the patient,” says Anna. “I also work with our stroke team and emergency department to prepare for patient arrival and next steps.”

A stroke occurs when blood suddenly stops flowing to the brain. The longer a stroke is left untreated, the greater chance of injury to the brain. When a patient is treated quickly, with medication, surgery, or both, there is a greater chance of recovery.

“When it comes to stroke, time is of the essence,” she says. “If you suspect that you or a loved one are having a stroke, don’t wait. Seek medical attention and get help.”

Code Stroke Nurses are part of a stroke patient’s care pathway. Anna sees first-hand how stroke can be life-changing for patients.

“Some are frustrated and frightened because they can’t speak their mind or can’t move one side of their body because of a stroke. Sometimes a patient is unresponsive and requires life-saving measures,” explains Anna. “When I see patients 24 hours after receiving treatment, some are speaking and smiling again, or participating in physiotherapy. Occasionally one of them will remember me from the chaos and point me out to their family to say, ‘She was there helping me when I couldn’t walk or talk or move,’ and it makes me happy to no end to see their progress. It is extremely rewarding to see when patients recover from stroke.

Code Stroke Nurses work with multiple systems and departments on a daily basis.

“I have an extraordinary appreciation for how many systems are constantly at work to deliver quality care,” adds Anna. “The stroke team at Sunnybrook is an exceptional group of individuals who truly and sincerely provide patient care to the best of their abilities.”

June is #StrokeAwarenessMonth. To recognize the signs of stroke, think FAST – F: Is the Face drooping? A: Can you raise both Arms? S: Is the Speech slurred or jumbled? T: Time to call 9-1-1.

Learn more: sunnybrook.ca/strokecare

The post Supporting stroke patients through their journey: Meet Code Stroke Nurse Anna Liu appeared first on Your Health Matters.

It was November 2021, and Jenny Shin was on the way to a work assignment when it happened. Her sister was driving, and Jenny was in the passenger seat on a phone call.

“My vision became blurry. I started seeing rainbow-coloured balls in my left eye and remember thinking, ‘something’s not right’,” she recalls.

She tried to rub the blurriness away. She had a busy day ahead — a photo shoot with a client, some meetings — there was a lot to do. As a public relations professional in Toronto and a self-proclaimed workaholic, she needed to get on with her day.

Instead, the blurriness worsened and she started feeling dizzy. The 47-year-old tried to tell the person on the phone that something was wrong, and she had to end the call.

“That’s when I heard screaming on the line and the person was saying, ‘Jenny, are you okay?’’’

She soon realized that her speech was affected — instead of words, garbled sounds were coming out.

Jenny also noticed her right hand wasn’t working when she had difficulty putting her sunglasses away.

“I was sort of bracing myself for something,” she remembers.

Another unexpected injury

Jenny’s sister reacted quickly by taking her to get help. Jenny felt her symptoms escalating — she was feeling disoriented and even more dizzy.

They ended up at a near by hospital and while trying to get out of the car, she had a devastating fall and hit the pavement. The impact broke Jenny’s neck.

“My sister let out a scream, and emergency personnel came out immediately,” she remembers.

Jenny was then rushed by ambulance to Sunnybrook, which is one of nine regional stroke centres in Ontario.

“When I arrived at Sunnybrook, it was a huge relief,” says Jenny, “I saw the doctors, nurses, everyone in scrubs — it was like a well-oiled machine.”

Stroke care

“Jenny’s stroke and neck fracture both required immediate attention,” says Dr. Houman Khosravani, medical director of the inpatient stroke unit at Sunnybrook. “Her neck and spine needed to be kept immobilized, and our teams then worked very quickly to treat her stroke as the priority. We took special care to rescue the brain while maintaining mechanical and medical stability with the neck injury.”

An ischemic stroke is a medical emergency that happens when blood suddenly stops flowing to the brain. Oxygen and nutrients can no longer reach the brain and its cells begin to die.

The saying “time is brain” is a key message from stroke teams. It means when an individual starts showing symptoms of a stroke, every minute counts. The longer a stroke is left untreated, the greater chance of injury to the brain. There’s a crucial 4.5-hour window from onset of symptoms, where stroke patients can receive clot-busting medication or surgery, which can help remove blood clots that lead to stroke. Both can potentially restore blood flow and limit disability after a stroke.

Jenny arrived in time and was prepped for surgery.

“We successfully removed a clot from one of the brain blood vessels using a procedure called a mechanical thrombectomy,” explains Dr. Leo da Costa, neurosurgeon and medical director of Sunnybrook’s Centre for Neurovascular Intervention. “With any stroke case, it is important for patients and families to seek medical attention quickly.”

Facing a new reality

The stroke left Jenny paralyzed on her right side. Due to her neck injury, she had to wear a neck brace to keep her safe.

A fiercely independent person, Jenny soon realized she had to adjust to the situation.

“At one point I could not lift a finger, or move my foot or anything.”

Although her new reality was frustrating, Jenny says “I had made peace with myself and the prospect of being permanently paralyzed.”

Still, Jenny kept trying to move her muscles. After being admitted to Sunnybrook’s inpatient stroke unit, she didn’t give up. Eventually, she was able to move her fingers and toes.

“I was relieved, and cautiously optimistic.” Jenny also says the support she received from the health-care team helped make a huge difference in her recovery.

“I remember a day when I was trying to brush my hair and I was having a very hard time with it. One of the nurses noticed, but knowing my independent spirit, she stood by and kept an eye on me,” Jenny recalls. “She just helped to lift my elbow a bit to help make it easier. She didn’t take the brush away and start doing it for me. This nurse offered the most beautiful and dignified way of lending support so I could continue to do it myself. I don’t know if she’ll ever know how much I appreciated that.”

Stroke at any age

Experts say that there is a general misconception that stroke only affects the elderly but in reality, stroke can happen to anyone no matter the age.

Typical risk factors for stroke include high blood pressure, high cholesterol, history of smoking, diabetes, and/or sleep apnea.

“In general, to reduce the risk of stroke, it’s important for individuals to be active, exercise, and have healthy lifestyle habits” says Dr. Khosravani.

At 47 years old, Jenny says she’s always been aware that stroke can strike anyone, but like most people, wasn’t expecting it to happen to her.

Dr. da Costa says Jenny’s stroke appears to have been caused by an issue in a carotid artery, one of the major blood vessels in the neck that transports blood to the brain.

“There’s a tear in the wall of the blood vessel and that forms a clot,” explains Dr. da Costa. “In general, this could happen for various reasons, some patients have underlying or undetected issues with the vessels and sometimes it is related to injuries.”

Rebuilding strength and function after stroke

In the weeks and months following her stroke, Jenny worked with physical and occupational therapists in the Stroke & Neurological Rehabilitation program at St. John’s Rehab to regain use of her right hand and build strength in her right leg.

“When clients come in, we work together to help them set their goals. It’s very much a team approach,” says Vidya Umaibalan, an occupational therapist at St. John’s.

“With Jenny, we’ve been working on high level balance, her mobility and flexibility – getting the range back and coordination,” says Hina Khatri, a physical therapist.

“I’m also working on fine motor skills – typing and doing finger exercises to help the tiny muscles in my fingers remember how to do physical tasks again,” says Jenny.

In addition to rebuilding day-to-day skills, the team also helped Jenny get back on her feet. When she was strong enough, she tried walking in high heeled shoes again, which she’d worn every day for work prior to her stroke. Jenny and the team took it one step at a time. Her team also provided recommendations for alternative footwear for non-work-related situations.

“It took some getting used to again and they were so encouraging,” Jenny smiles.

“I feel truly blessed to be able to be part of someone’s life and help them get them to where they want to be,” says Hina.

“Being part of that journey with patients means so much — helping them understand that they can adjust to a new normal, and that the stroke doesn’t define them,” adds Vidya.

That’s certainly the case for Jenny, whose positivity and hard work has continued throughout her journey.

“It’s been challenging but I’m working with an incredible team. The saintly support and care I received at Sunnybrook leaves me in awe and humbled,” Jenny smiles.

“What could have turned out to be one of the most traumatic experiences of my life has instead become one of the most positive. Through the compassion and education I received at Sunnybrook, I feel empowered to flourish (versus just surviving) as I move forward with confidence in the second chapter of my life.”

The post Jenny’s story: rebuilding strength after stroke appeared first on Your Health Matters.

With atrial fibrillation, the heart may not be able to pump blood normally. This can cause blood to pool in a small pouch that sits off the left side of the heart, known as the left atrial appendage (LAA), and form a clot. If left untreated, the clot can enter the bloodstream, travel to the brain and cause a stroke.

To reduce the risk of stroke, physicians often prescribe a blood-thinning medication, or anticoagulant. These medications slow down or prevent blood cells from clumping together to form a clot. But they may not be appropriate for everyone.

“Despite their effectiveness, taking blood thinners may be difficult for some patients,” says Dr. Sheldon Singh, a cardiac electrophysiologist at Sunnybrook’s Schulich Heart Centre. “These medications are not always well-tolerated and they present a risk for bleeding complications.”

How a unique heart device can help prevent stroke

A treatment called the Watchman implant is an alternative to blood thinners. It is designed to permanently seal off the appendage in the heart where blood clots can form.

“This procedure can protect those who are at a high risk of stroke from atrial fibrillation but who either cannot take blood thinners, or cannot take them consistently for a long period of time,” says Dr. Singh. “Studies have shown that, on average, people who got the implant lived longer than those on some blood thinners, likely caused by life-threatening bleeding.”

In the minimally-invasive procedure, a specialized device is guided by a catheter through a vein in the upper leg and into the left side of the heart. Once in position, the implant is released and seals off the left atrial appendage. Over time, heart tissue grows over the device to create a permanent barrier. The procedure typically takes an hour, with only a 24-hour recovery time.

More procedures, more lives

In the five years since Sunnybrook first introduced the minimally invasive treatment, approximately 40 patients have received the device, with the help of donor support.

During that time, a new iteration of the device first used in Ontario by Sunnybrook has made it easier to implant, says Dr. Singh, “which makes the procedure quicker and safer.”

In March 2020, the Ministry of Health announced its decision to fund 20 Watchman cases annually at Sunnybrook, along with five other centres in Ontario, making the life-saving procedure more accessible for patients who need it. After completing all 20 cases within just five months, the Schulich Heart Centre will be resuming the treatment in April 2021.

“With provincial funding and growing capacity, the procedure is gradually becoming a valuable and more commonly accepted alternative,” says Dr. Singh. “This means we have more opportunities to reduce the risk of stroke in people with atrial fibrillation who previously had very few options.”

Global studies are underway

The Schulich Heart Program was recently selected as one of three Canadian centres, and the only Ontario program, to participate in a clinical trial evaluating the Watchman technology. It is also one of only two Canadian centres chosen to participate in a pivotal global trial evaluating the Watchman against blood thinners in the general population with atrial fibrillation. Set to launch in 2021, the U.S.-run trial will involve patients who have received ablation to treat atrial fibrillation. Researchers will compare the outcomes of those who take blood thinners to those who receive the Watchman device.

“If you have atrial fibrillation and you’re looking for an alternative to blood thinners, speak to your cardiologist about your options,” says Dr. Singh.

The post An alternative to blood thinners appeared first on Your Health Matters.

Julian was talking to his wife on their family room couch before taking on an afternoon of housework. When he stood up, he felt a strange sensation in his left eye and sat back down. Then, all his strength drained from his body. Thinking little of it, he dragged himself to the bedroom to sleep it off. It wasn’t until hours later that he called 911 and was rushed to the emergency room at Sunnybrook Health Sciences Centre.

“Life suddenly changed. Everything changed,” says Julian.

Julian suffered a stroke that weakened the entire left side of his body so much so that he was virtually bedridden for more than a month. He couldn’t sit up or even raise his arm. Doctors said his stroke was likely caused by high blood pressure and his 30-year history of heavy smoking.

“I didn’t pay much attention to my blood pressure. Sometimes I didn’t take my medicine. I didn’t eat right. I smoked one-and-a-half packs every day,” he admits. “Now, all of my mind is on exercise, getting back my health and my capability of daily life.”

Julian rebuilds his strength and balance with physiotherapist Chaya Plonka at Sunnybrook’s St. John’s Rehab.

Since April, Julian has been working with a multidisciplinary team at St. John’s Rehab, including nurses, physicians, physiotherapists and occupational therapists, to regain his strength, balance and mobility.

“After a month, something in me changed. I tried to adjust my psychology to think in a positive way,” he says. Soon after, he made the decision to quit smoking and became determined to get moving.

“Every day I exercised,” he says proudly. “Eventually, I was able to stand up by the side of my bed. Then, I took a couple of steps. Gradually, a couple more. Then I pushed the wheelchair outside the room and walked down the corridor.”

Julian was still dependent on a wheelchair when he was discharged as an inpatient but continued his rehabilitation through the hospital’s outpatient program.

“About a week after discharge, I got rid of my wheelchair,” he says. “Now I barely use a cane. I’m almost back to normal.”

Back at home, Julian insists on going for walks in his neighbourhood every day and is determined to prevent a second stroke.

“The stroke was very bad for me and in a way it’s good for me,” he says. “After the stroke, I quit smoking and a lot of bad habits. On the whole, my body and health is much better.”

The post Julian says his stroke was a ‘wake-up call’ appeared first on Your Health Matters.

The acronym FAST is a simple way to identify signs and symptoms of a stroke.  

Face: Is the face is drooping?
Arms:  Can you raise both arms?
Speech: Is the speech slurred, or jumbled?
Time to call 9-1-1

[mks_toggle title=”Click to view plain text version of infographic” state=”close “]Face: Is the face is drooping?
Arms:  Can you raise both arms?
Speech: Is the speech slurred, or jumbled?
Time to call 9-1-1[/mks_toggle]

A stroke can happen to anyone: children, young people and the elderly. It occurs when blood flow to the brain suddenly slows or stops and when this happens it only takes a few minutes for damage to brain cells to begin.

There are also some atypical symptoms that may be signs of a transient ischemic attach (TIA) or “mini-stroke.” They are signs of stroke that are not as obvious as FAST and they can include such as dizziness or feeling confused.

Experts say, “time is brain.” To help save more brain from being damaged, act FAST and quickly. Call 9-1-1 to get help if you think you’re seeing signs of someone having a stroke. 

The post Get help FAST when you see signs of stroke appeared first on Your Health Matters.

It was June 26, 2017, and Louis woke up at 6:00 AM feeling tired. After having some breakfast, Louis texted his partner to let him know he would be staying at home that day to rest. On the way back to the bedroom, he suddenly lost his balance.

“I was paralysed. I could barely move my legs and body,” says Louis. “It happened really fast. I had no idea what was happening. My priorities were about to change.”

Louis found he was no longer able to text. The only thing he could do was call his partner with one press of a button using an app on his smartphone.

“When I got through to him, I was only able to say ‘dizzy’ and ‘home’,” explains Louis. 

At this point, it was 6:15 AM. 

His partner recognised that Louis was slurring his words, which is one of the signs of stroke. Acting quickly, arrangements were made for another friend to tend to Louis while his partner drove over to pick them up. 

They arrived at Sunnybrook a short time later where Louis was rushed to the emergency department and treated right away, receiving stroke medication by 8:30am.

“In the case of a significant stroke, emergency blood clot-breaking medication can only be administered within 4.5 hours of the time of onset of the stroke,” says Dr. Mark Boulos, stroke neurologist at Sunnybrook.

“I am grateful I received the drug in time,” says Louis. “The stroke took me by surprise. I was 39 years old and I never thought I’d have a stroke.”

Why young people can have strokes

A stroke is a medical emergency that occurs when blood suddenly stops flowing to any part of the brain. When this happens, the brain is not receiving oxygen and nutrients and brain cells begin to die.

“It is uncommon for younger people to be diagnosed with stroke, however, not completely unheard of,” says Dr. Boulos. “People of any age can experience a stroke; a child, youth, those in their 20s and 30s, and older. Stroke knows no age.”

The possibility of a stroke had never crossed Louis’ mind. 

“My health was excellent and I was in top shape,” he says. 

Louis’ doctors found a pre-existing heart condition that had never been diagnosed, called patent foramen ovale (or PFO), which is a congenital heart defect that can increase the risk of stroke. 

“I learned I had a hole in my heart,” explains Louis. “I had that hole for 39 years and didn’t know.”

Dr. Boulos says other factors may contribute to an increased risk of stroke in young patients such as genetic conditions that may predispose an individual to blood clotting or inflammation or abnormal blood vessels in the brain.

“The reasons why someone may have a stroke at a younger age are often quite different compared to strokes that occur in people at an older age,” says Dr. Boulos. 

“For example, young patients may have stroke from a tear in a blood vessel (known as a “dissection”), whereas other mechanisms, such as an irregular heart rhythm like atrial fibrillation or plaque build-up in an artery, will be more likely in an older patient,” he explains. 

General risk factors for stroke include: 

• High blood pressure
• High cholesterol
• History of smoking
• Diabetes
• Sleep apnea

“It is important to maintain an active and healthy lifestyle to help reduce the risk of stroke,” says Dr. Boulos.

The importance of acting FAST when you see signs of stroke

It is also important to act quickly at the first signs of a stroke. More time means more brain is saved.

There are 100 billion neurons in the brain. They are crucial to helping us think, learn, move and talk. Each of these specialized cells is responsible for delivering messages to areas from the brain and spine to other cells in the body. 

When a stroke occurs, time is ticking. 1.9 million brain cells die each minute that a stroke goes untreated.  This is why experts say, “time is brain.” If you think you’re seeing the signs of stroke. There’s no time to lose. A stroke is a medical emergency.

“Strokes detected and treated earlier result in better outcomes compared to patients who get diagnosed/treated later in the course of the stroke,” says Dr. Boulos.

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Face: Is the face is drooping?
Arms:  Can you raise both arms?
Speech: Is the speech slurred, or jumbled?
Time to call 9-1-1.

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Life after stroke

It took many months, but Louis was able to make a full recovery.  

“I’m feeling strong,” says Louis. “I still exercise, eat healthy and continue the same good habits that I had before.”

Louis adds that having experienced a stroke has changed his perspective on life. “I am not stressed anymore by work, relationships or small things.”

For other stroke patients, Louis has this advice. “Take all the support you can get. Patience, resilience and discipline are important factors that have helped me get through it.”

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