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September 30, 2009 > There is Hope After Stroke

There is Hope After Stroke

Stroke Treatments Keep Evolving, But Prevention is Priceless

Washington Hospital's Stroke Program offers cutting edge tools for the diagnosis and treatment of stroke, thus greatly improving patients' outcomes. But all the technology and medical expertise in the world don't mean a thing unless patients understand the gravity of stroke and seek help immediately.

On Tuesday, Oct. 6, from 6 to 8 p.m., Washington Hospital's Stroke Program Medical Director Ash Jain, M.D., and Stroke Program Coordinator Doug Van Houten, R.N., will share information about the future in diagnosis and management of stroke, as well as common issues of life after stroke.

Stroke treatment continues to evolve

"I will begin by summarizing risk factors and why stroke happens, and I will go on to management of stroke and what advances have taken place," Dr. Jain says. "I will address medical management of stroke - including the use of medications that thin the blood and prevent clots. Then I will inform audience members about the new drugs that are being released on the market and those that will be coming in the next few years."

Commonly recognized blood thinners, such as warfarin, will soon replaced by new drugs, and Dr. Jain will discuss their upcoming replacements.

"As far as dissolving blood clots, we have Tissue Plasminogen Activator (tPA), and now the issue is giving the tPA in the emergency room via IV; directly into the carotid artery; or using devices to pull the clot out, including the Merci catheter and Penumbra, which are used to take the clot out of brain arteries to reopen the channels," he explains.

But in order to make use of these revolutionary technologies, community members and medical personnel must be well-informed so that stroke patients reach the emergency room as fast as possible and receive expeditious care.

"It is vital that patients, EMTs and the ER physicians are all in sync so we can rush a patient through the treatment process and not lose any time, because the faster we treat patients, the better the outcomes," he says.

Dr. Jain will also talk about the extension of stroke care from hospital to home by way of specialized stroke centers and stroke units where patients can receive continuing care after acute treatment.

"I will discuss the importance of setting up rehabilitation centers which specialize in the care of stroke patients and outpatient rehabilitation services that take care of patients once they have returned home," according to Dr. Jain.
At the beginning and end of each seminar he gives, Dr. Jain says he always emphasizes the importance of stroke prevention, because avoiding a stroke altogether is the best possible outcome.

Life after stroke comes with challenges and hope

Stroke statistics are grim, and Doug Van Houten, R.N., is one of the last people to sugar coat the truth. But he still sees a great deal of hope for stroke survivors who are willing to work hard, seek support and maintain a positive outlook despite challenges.

"Though almost 25 percent of stroke patients die within a year, most stroke survivors actually improve," he says. "Stroke causes brain damage, and these cells don't regenerate. But then how do patients improve? They seem to be able to rewire in some way, and most do get better - whether a little bit or a lot depends on each person's particular situation."

Still, life after stroke is fraught with challenges that need to be addressed head on.

"Prevention is a really big issue because 25 percent to 30 percent of stroke survivors will have another stroke," Van Houten says. "You've already got the whole disease process in place, and if you've got high blood pressure, diabetes and high cholesterol, then these things need to be managed."

"Secondly, the factors associated with stroke are also closely associated with other vascular conditions such as heart attacks, diabetes, kidney failure and peripheral vascular disease (PVD), and you need to manage these conditions to prevent other conditions as well."

Also, there are major implications for the person serving as the main caregiver for a stroke survivor, who is most often the person's spouse, Van Houten points out.

"Thirdly, just as the person with stroke is catapulted into this realm of disability, this other person is catapulted into the role of caregiver," he says. "For the most part, caregivers are not trained, and though there are a fair amount of resources for stroke survivors and caregivers, they tend not to take advantage of them. It puts a tremendous amount of stress on the caregiver. The average stroke survivor is over 50, and the caregiver will often have their own health issues."

Van Houten encourages stroke survivors and caregivers to make use of the resources that are available to them in the local community. Washington Hospital offers a free Stroke Support Group on the fourth Tuesday of each month from 1 to 2:30 p.m. in the Neuroscience Conference Room, located at 2500 Mowry Avenue in Fremont.

The support group allows newly diagnosed stroke survivors and those that have been living with stroke for many years to share advice and support in a comfortable environment. Van Houten facilitates the group, which also offers features guest speakers and regular attendance by a licensed social worker who answers questions and connects participants with community services like paratransit.

"The fourth aspect about life after stroke that I will cover is mindset and willingness to work hard in rehab," Van Houten says. "Attitude has a lot to do with how well stroke survivors do in the long term."

To learn more about the future of stroke diagnosis and management, as well as issues revolving around life after stroke, join Dr. Ash Jain and Doug Van Houten for the next free Stroke Education Series on Tuesday, Oct. 6, from 6 to 8 p.m. in the Conrad E. Anderson, M.D. Auditorium located at 2500 Mowry Avenue in Fremont.
To register, call (800) 963-7070.

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