Your Questions Answered
"My son is 18. He has bicuspid aortic valve and we just found out he has stenosis at 33% - which jumped a lot over previous year. His velocity is also a bit over normal. Is he likely to be recommended for surgery? We are doing stress test. he has no symptoms."YoungMansDad, Support Network Member
"The decision to intervene on a bicuspid aortic valve has to do with the degree of stenosis. We are typically trained to look at the pressure gradient across the valve, which isn’t related here. Usually, a mean gradient of 50-60mmHg would lead to an intervention, as that meets the criteria for “severe stenosis.” The type of intervention can vary. Some patients are a good candidate for balloon valvuloplasty which is a catheterization based procedure and not a surgery. Some are better fits for a surgical repair. A lot has to do with the nature of the valve.Dr. John Breinholt, Pediatric Cardiology
A stress test is reasonable, and it is not surprising not to have symptoms. Symptoms do not often drive the decision making to intervene. It is the findings of increasing stenosis or hypertrophy of the left ventricle.
Thank you Dr. John Breinholt"
"Hi! I had an open heart surgery 1.5 years ago, when I was 39, my aortic valve was replaced for artificial biological one. And I still have not recovered emotionally - the fear of pain.. and also no much gratitude.. many people write that they are grateful to be alive, that they feel more energy.. Since for me it was valve leak, and I did not feel symptoms (although my heart and aorta were about to explode), my better condition is more theoretical than what I really physically and emotionally felt. And I for sure feel physically and emotionally the consequences of the surgery - my healing chest bone still hurts, I am afraid of flues, etc.. And my question is how to start feeling grateful?.. feel the energy again?.."Ludmila1405, Support Network Member
"About 20% of people who’ve had heart surgery will develop clinical depression afterwards. Clinical depression robs us of the ability to enjoy living, including the capacity to feel grateful for the things and people we have. You may be clinically depressed. Please make an appointment to meet with your primary care provider for an evaluation. We have very good treatments—medicine and counseling—that may help you regain your zest and begin feeling grateful for your life as it is.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"I am a 70 year old female who recently (4weeks ago) had an ablation (freezing kind). It seems to be successful. I have identified some major triggers and am avoiding them, caffeine, icy drinks, lack of sleep and aerobic exercise. I have been doing water aerobics for the past 10 years to control my blood sugar. Is there a site or a profession that helps cardiac patients with resuming an exercise routine? What do you suggest for recovering A-fib patients?"justme9898, Support Network Member
"Good morning, It is recommended that you speak with your cardiologist about an exercise routine in which they will be the ones to clear you. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"Is there a list of food I can and CanNOT eat after a massive heart attack?"Vradac, Support Network Member
"It is important to have Healthy Eating Goals in which you should: *Eat vegetables, whole grains, fruits, nuts and seed every day, * Choose healthier fats and oils, Aim for three serves of fish and seafood per week, Limit fried or baked foods, especially chips, biscuits, cakes, and other baked cereal products, avoid adding salt to food and drink mainly water. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"Hi I had open heart surgery, because of having A-Fib also had a pace maker put in with an ablation. I had tried all the other heart medicines and was not able to use do too being very sick. So the only one I can use is Warfrin now my hair is coming out and wanted to take CQ10, but it said that do to Warfrin they advised against it. So now I am upset to know if I am going to loose all my hair and how can I stop the hair loss. Please give me any information on this subject i would appreciate it so much . Thank you Bernadine"bernie4me, Support Network Member
"Due to the nature of the medication Warfarin and your heart condition you speak with your cardiologist in regard to adding any supplements. Do not take any supplements without consulting with your doctor in which you should make an appointment to discuss in an office setting. Thank you"Dr. Latonya Law, Family Nurse Practitioner
"My Uncle has been suffering from Dilated Cardiomyopathy and we are having a really terrible time trying to manage his symptoms. The doctors said, heart transplant is the only option for a long term solution. My uncle is not open for a transplant since the survival rate is not very impressive and so, he refused to consider it. A week back, he had a bad stroke. About 60-70%. Now we are terrified that we will lose him. Any suggestions to help him get through the stroke recovery phase will be great. I am reading that very rarely people recover 100%. I am hoping at the least he will become independent enough to handle daily activities. My another main concern is the treatment for the base condition, Cardiomyopathy. Is there any simpler option instead of transplant? Is anybody out there who went through a different treatment instead of transplant and are leading a better lifestyle? Please let me know...."RamyaMurthy, Support Network Member
"Your uncle’s stroke is unfortunate given his current heart ailment. His stroke disability will at first improve quickly with about two-thirds of the eventual recovery by 90 days. Set expectations for recovery realistically and always show optimism as it is contagious. Recovery can be hastened with early therapy along with the addition of certain antidepressant medications. Your rehabilitative providers can assist you in selecting the correct one. Your encouragement will lend support and improve his quality of life both now and in the future.Joseph P. Hanna M.D., Neurology
Thank you, Dr. Hanna"
"I am a 63 year old female who has been in persistent AFib for several years. I was taking aspirin daily to prevent stroke until last September when I had a stroke. As a result of the stroke I have peripheral vision loss in both eyes but thankfully I am able to drive and read. I have been on Pradaxa since the stroke. I am a Kaiser Permanente patient and have asked Kaiser ablation specialists about having an ablation done but was advised by both of these specialists that the chance of success from an ablation isn't that good (both indicated about a 30% chance that an ablation would work), One of the specialists told me that he would do an ablation but it would most likely require more than one ablation and the long term prognosis of staying in normal sinus wasn't promising. Should I forgot about having this procedure or is this still worth trying given the low chance of success? I am religious about taking the Pradaxa but am quite concerned about having another stroke. Thank you for your help. Mary Taylor"MaryTaylor, Support Network Member
"Electrophysiologic ablation o atrial fibrillation has various success rates. Not knowing the particulars of your case, The cardiac electrophysiologists have estimated a one in three chance that your rhythm would remain regular after performing the procedure. Perhaps another question that could be answered would be how to minimize your risk for stroke without suffering from bleeding complications while taking oral anticoagulants. The risk for complications from the electrophysiology procedure should also be disclosed for that cardiologist so that you may have a fuller understanding. Thank you, Dr. Hanna"Joseph P. Hanna M.D., Neurology
"As a caregiver I feel totally depleted. I need professional help and support to go on another day. What can I do? Support group meets once a month for one hour - no help there! I need help soon!"jamiefrye2, Support Network Member
"Caregivers should never feel alone. Many sources exist in your community that can help. Local stroke support networks exist in most regions. If these are not helpful, your physician can refer you for counseling or to a social worker for assistance. Most insurance including governmental provides support for respite care for providers needing downtime. Lastly, reach out to community support in the form of non-profit secular and religious organizations. Hope that you find the help that you require to put you at ease. Thank you, Dr. Hanna"Joseph P. Hanna M.D., Neurology
"My husband had a MCA stroke and has been very impulsive in regards to spending money. I tried power of attorney- which he later revoked. He has numerous credit cards and loans that I know nothing about. How can I save myself from his behavior and debt he has incurred without my knowledge???"jamiefrye2, Support Network Member
"Some brain injuries including stroke cause individuals to become impulsive. This behavior can lead to unintended consequences like unfettered spending. Thankfully, neuropsychologists recognize behaviors like those exhibited by your husband and can assist in reducing their impact on your life. Seeking consultation with the neuropsychologist to first assess triggers and vulnerabilities in the psyche leading to impulsivity. A plan for behavior modification can then be outlined to build resilience to impulses. Skills can be built including mindfulness, regulation, and relaxation techniques that minimize exposure. Lastly, if needed, power-of-attorney for finance, healthcare can be sought with the support of both medical and legal experts. Debt that has already mounted will likely need both the help of financial and legal counsel. Thank you, Dr. Joseph Hanna"Joseph P. Hanna M.D., Neurology
"how long after initial stroke can nerve pain develop?"Dragonbrat79, Support Network Member
"Nerve pain can begin immediately after a stroke or any anytime in the future. Typically, pain does not begin in the first several days but becomes apparent as recovery occurs. Thank you, Dr. Hanna"Joseph P. Hanna M.D., Neurology
"My husband has Familial Hypercholesterolemia, and I have high cholesterol, but the doctor says it is not the same, why?"Support Network Member
"Cholesterol can be high for a lot of reasons. Lifestyle can play a large role, some medications increase cholesterol levels, some diseases can increase cholesterol levels (for example certain types of kidney disease and thyroid disease). Familial Hypercholesterolemia is different in that it is an inherited disease that leads to very high cholesterol levels starting very early in life. In most patients, FH is inherited as an “autosomal dominant” disease, i.e. a child of an affected parent has a 50/50 chance of inheriting Familial Hypercholesterolemia. You should discuss this further with your physician and you may find the website of the FH Foundation helpful as well. Thank you for this question."Vera Bittner,
"I have Familial Hypercholesterolemia and want to have a baby, does this mean my children could have it too?"Support Network Member
"Most cases of Familial Hypercholesterolemia are inherited as an “autosomal dominant condition”. This means that each of your children has a 50/50 chance of inheriting the gene for Familial Hypercholesterolemia. Your children should be checked for this disease when they are young and treated early. You should discuss this in more detail with your physician and you may find the website of the FH Foundation helpful as well."Vera Bittner,
"Now that I have the Familial Hypercholesterolemia diagnosis, what will my future be like?"Support Network Member
"The earlier Familial Hypercholesterolemia (FH) gets treated, the better the future outlook. There are studies from the Netherlands that suggest that treating FH from childhood improves the outlook so much that treated FH patients have the same outlook as individuals of a similar age in the general population who do not have FH. It is important that you look at your lifestyle and avoid anything that could worsen your risk of heart disease: don’t smoke, eat a heart-healthy diet, stay physically active. It is also important that your high cholesterol is treated with cholesterol-lowering medications. Some patients require more than one medication to control their cholesterol and may benefit from an injectable form of cholesterol lowering medication. Others with particularly high levels of cholesterol may require a procedure that is similar to kidney dialysis and removes the excess cholesterol from the blood stream. You may find the website of the FH Foundation helpful."Vera Bittner,
"I am a 37 yr old single mom who recently was diagnosed last year June, 17, 2017.....that I had a rare form of heart failure called PPCM. I just so happen to go to the ER that day because I was 7 months pregnant and I was having the most difficult issues such as not being able to breathe or.catch my breath and at that point I began to swell very badly in my legs ankles and feet, also my lips turned very blue so after 3 hrs of the nurses having issues with not being able to put an IV in my arm, they finally succeeded.. but right after I heard the nurse call someone else and said she was not getting a heartbeat at all on my baby so they rushed me back to have an emergency cesarean... well apparently they almost lost me, when I finally came to I was so confused.. they tell me they were able to save me and my baby but that I had a rare form of heart failure PPCM,which was an extremely rare case.. it was already in the advance stages of heart failure. My EF was only 10% and due to this condition, my kidneys were also failing... a year later , being now, my EF hasn’t gotten any better, my condition has gotten worse very very quickly. Now I’m being treated at shands hospital in Gainesville FL UF hospital.. amazing people there ... my family it seems and I’ve met life long friends there just in this short amount of time... I’m in process of having my name listed for heart transplant... now March last year my mom under went a brain surgery but didn’t survive.. I was hiding my pregnancy Bc I did not want to cause my mom to have a major stroke... so 3 months after she passed away I end up giving birth extremely early to my son ... no one was aware except I told my sister and she talked me in to giving my baby a great life by adopting himoit. His daddy was and is in prison for years to come. I have a 6 yr old son as well. I did not want to adopt my baby out but then I give birth and are told I’m basically dying and can’t support myself now l, well I was devastated, confused, I cannot explain it... I decided to keep my baby and move into my sons fathers parents home and raise my 2 boys for about 6 months... but I’m embarrassed to say that for some reason I was never able to bond with my baby! I felt/feel like the most worthless crappy mother out there.. and I couldn’t even hold him Bc I was sent home with a life vest from hospital then had a pacemaker/defibrillator implanted in me last September.. and if my machines were to go off and I’m just touching my baby boy that it could harm him possibly death.. so I moved my oldest son and myself in with my dad Bc he was married to mom 43 yrs and we all were still in process of grieving period... so the other grandparents are temporarily adopting him now and he’s getting the most love support everything u can imagine and we see him as much as possible:) question is .... I believe I am having severe emotional issues such as depression, anxiety, panic attacks . Is it possible to get PTSD after going through something so tragic last year? How would I be treated for that? Thanks so much, Tina 🙏"Cmonti29, Support Network Member
"You have been through an enormous amount, Tina, and have lost so much. Yes, it is possible that you are experiencing a variation of PTSD, as well as severe depression and anxiety. I don’t think I can do justice to your very complicated situation by offering advice in this forum. But I do recommend to you that you talk with your primary care doctor about getting a referral to a mental health therapist to undergo a thorough evaluation. Mental health treatment is obviously not going to take away all your problems but may help you better face them with your best energies and sharpest wits. I hope things go much better for you and your family in the future.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"how to overcome tiredness when on beta blockers"BarbaraEska, Support Network Member
"Fatigue is a common side effect but there are ways to manage the side effects which includes discussing with your doctor about splitting your dosage up or possibly a smaller dose, you might also like to speak with your doctor about taking this medication before you go to sleep as some individual might find having a better sleep while on beta blockers, also exercise may help to counteract side effects, brightens moods and increase alertness. Speak with your doctor about your symptoms and do not stop taking your medications without consulting your doctor. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"My son was recently diagnosed at 12 yrs old with PAPVR. He is scheduled to see a cardiac surgeon soon. Any help with information and connection with parents who have been faced with this would be greatly appreciated. I am scared and I am trying to learn all I can.. in what to expect... If anyone can share their experiences it would mean the world to me."Bsmall, Support Network Member
"I am unaware of any specific group for this. Most of these patients do very well. It is a relatively straightforward surgery that involves the closure of an atrial septal defect (sinus venosus) and rerouting of the pulmonary vein. The challenges typically involve where the pulmonary vein enters, and complications can involve residual narrowing of the pulmonary vein. Nevertheless, it usually goes well.Dr. John Breinholt, Pediatric Cardiology
Some centers have begun offering alternative approaches to this surgery that involve a less invasive approach that doesn’t involve a sternotomy (incision in the middle of the chest), but rather in the underarm area. One center is in Sacramento, and the other is the University of Texas HSC at Houston/Children’s Memorial Hermann Hospital where I work. This is a relatively new approach with a better cosmetic result. Thank you, Dr. Breinholt"
"What is exactly is congestive heart failure"Pfletcher490, Support Network Member
"Congestive heart failure is a broad term that describes the heart's inability to effectively or efficiently handle its function. It might be because the strength of the heart is weakened, or it might be because of a congenital defect that leads to over circulation of blood to the lungs. The definition of CHF is easier to explain depending on the heart being discussed. Thank you, Dr. Breinholt"Dr. John Breinholt, Pediatric Cardiology
"My daughter is born on 28 th may 2018. on 29 may 2018 she was diagnosed with hypoglycemia. On June 10, 2018 she aspirated twice and admitted in NICU with breathing difficulty. On June 12, 2018 she was diagnosed with two holes in her heart, one asd of 3 mm and PDA of 4 mm. Her pneumonia is still there today on 18 th June 2018 but improving."MJH1979, Support Network Member
"The hypoglycemia and aspiration are unlikely due to the heart. The ASD is small and may never need intervention. Unless it “grows” as she grows and becomes a size that we would consider closing, it would not be done until she is 3-4 years old at the soonest. The PDA could require intervention. Sometimes the measurements can overestimate, but if she has heart chamber enlargement (on the left side) in addition to the PDA, it may need to be closed. It is also possible that the pneumonia is related, but it would require examining her and having more information to know for sure. I hope she has a cardiologist. That would be the most important next step. Thank you for this question, Dr. John Breinholt"Dr. John Breinholt, Pediatric Cardiology
"My child has Ostium Secundum ASD of 7-8 mm and Large Perimembranous VSD during his first month of age. Now he is 5 months old and the ASD is 5 mm and Moderate VSD. Can you please suggest wheather any surgery will be needed or it will cure itself."parijat, Support Network Member
"Perimembranous VSDs do not frequently close on their own, particularly if they are moderate to large in size. ASDs can get smaller, and even close. If the ASD is only 5mm at 5 months of age, it is possible it will close, or at least not require surgery (or even catheter based closure). The VSD is more difficult to predict. If the child continues to do well clinically, doesn’t require any medical therapy, is growing and thriving, he can wait. We do watch the aortic valve closely because flow through the defect can influence that valve and cause problems. If it does, surgery will be necessary. Sometimes the defect can be partially closed by valve tissue from the tricuspid valve (from the right ventricle). If that happens (or has already happened), sometimes we can close those defects in the catheterization laboratory, without surgery.Dr. John Breinholt, Pediatric Cardiology
The short answer is the ASD may not need anything or could be closed with a device and without surgery. The VSD is more difficult to predict and hard for me to comment without more information. However, if he is doing well, there is time and surgery may not be necessary.
Thank you for this question.
Dr, John Breinholt"
"I had to list the above option, altho I am not sure it is what I have. What I have is a heart valve defect, since birth, but I only found out about it last year. My lower valve does not completely close, so there is regurgitation, i.e., back-flow in that section of my heart, with every beat. It sounds like a small heart murmur via a stethoscope, but only when I am stressed or troubled. My question is what will happen if I ever have a heart attack? I see physicians at my local university campus. I overheard once that my condition should not pose a problem unless I have a heart attack. What problems would present themselves if I ever do have a heart attack? I work on keeping lower cholesterol, but I inherited it from my Mother, and she always took a statin. I am on one but I know it will make no difference, as I have been on them before. What would happen if I did have a heart attack in relation to my valve deformity?"Annie6556, Support Network Member
"Annie 6556 due to the nature of your diagnosis and defect since birth is highly recommended that you discuss these questions with your cardiologist because they will have your health records available. Each case is different and I would want for you to receive the correct information and what pertains specifically for you.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"I just had an angioplasty procedure and would like to know what the recommended cholesterol levels should be now. Total cholesterol level LDL recommended level, HDL recommended level and the Triglycerides level. I can't find this information anywhere. thank You Jerry Stevenson, age 76"Irith, Support Network Member
"It is definitely recommended that you speak with your doctor regarding developing a strategy to help reduce your symptoms and risks.Dr. Latonya Law, Family Nurse Practitioner
• LDL 190 or more is considered very high, the lower your cholesterol number, the lower your risk.
• HDL cholesterol (good cholesterol) –a higher number means lower risk because it protects you against heart disease.
• Triglycerides- less than 150 is normal, A high triglyceride level has been linked to a higher risk of coronary artery disease.
Thank you for this question. Dr. Latonya Law"
"With rehab and recovery will I be able to cook again without burning or dropping everything?"Sherri55, Support Network Member
"I’m sorry you have suffered from an injury that has prevented you from cooking effectively. Recovery from a stroke depends on the type and size of the injury as well as your ability to work with the therapists and work on your deficits. Keep at it! Dr. Sunil Sheth"Dr. Sunil Sheth, Vascular Neurologist
"I had CABG 3-26-2018 and returned to work on 5-7-2018. How long will it take for my chest to completely be pain free? Also my cardiologist told me if I can point to the pain it's not heart related is that true? I'm currently on a low dose aspirin and 10mg Atorvastatin. I did not suffer a heart attack, my CABG was a single by-pass. What is the life expectance after CABG without a heart attack? I was told I could go for another 50 years with no problems."JDJ1965, Support Network Member
"The breastbone should be healed within four to six weeks following heart surgery. It is important to follow your doctor’s orders. The discomfort comes from the sternal which is why precautions to the heart sternal are important. In regards to life expectancy to this varies depending on other medical factors but the goal of the CABG is to improve the quality of life. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"How do you learn to reuse your right side with out physical therapy"Sherri55, Support Network Member
"In general, the more you can try to use the weakened side of your body, the better it will recover. Physical therapy offers a guided means of doing so, with exercises that focus on the types of movements that will help you recover the best. Thank you, Dr. Sunil Sheth"Dr. Sunil Sheth, Vascular Neurologist
"I always have had great blood pressure, I have also been on the Birth Control pill since the age of 18 took a break from it few times just to be put back on it for female health conditions. I'm 52 turning 53 been off the pill for about 3 months no periods since then. recently got diagnosed with high blood pressure. Doctor put me on Amlodipine Besylate 2.5mg I weigh 112 pounds, My question is do I have to be on this medication for the rest of my life also is there anyway that maybe the birth control might have caused my high blood pressure?"Sadie2, Support Network Member
"There are many causes for hypertension and each individual will vary. It is recommended that you discuss with your doctor more about hypertension in which they will be able to determine what is best for you. Thank you for this question. Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"My spouse is having issues with “Pumphead” syndrome. He had mitral valve replacement 9/17. Anyone out there have any advice for us?"Cwag528, Support Network Member
"Pumphead syndrome also known as Postperfusion syndrome is usually seen after the patient has been hooked up to a heart-lung machine for open heart and also valve replacement. Each individual symptom varies but they could include patchy recall, social difficulties and possibly personality changes. The main symptoms of Pumphead is decreased mental capacity in which the condition and symptoms varies for each person which is hard to determine. Studies have shown a high incidence of neurocognitive deficit soon after surgery, but the deficit are often not a permanent impairment Thankyou for this question."Dr. Latonya Law, Family Nurse Practitioner
"I need help finding the proper care or rehab for my adult son who is on Alaska Medicaid and Medicare. His stroke encompassed the entire right hemisphere, right eye blindness and left eye left field cut along with left side weakness of his left leg and paralysis of the left arm. His stroke happened 8/24/14 he is now 35. He steals and sells my property to buy pot and alcohol. He's not drinking and smoking everyday as far as I know but his behavior is that of a addict. I've found places that would be perfect, I think, but none of them take Medicaid/Medicare. What am I supposed to do? He's going to end up homeless if I can not find the proper help for him and support for me. Please, are there solutions that I'm not aware of?"dianalavona, Support Network Member
"Substance abuse and the anti-social behaviors that go along with it are a scourge for many American families nowadays. But it sounds like there are three issues here for your family:Barry J. Jacobs, Psy.D., Clinical Psychology
--The one that you present is that of insurance coverage for drug rehab services. I strongly recommend that you call your state’s Medicaid office directly to learn of exactly what treatment services your son might be able to receive and where. I doubt that Alaska has no facilities or intensive outpatient programs that accept “dual eligible” insurance—Medicare and Medicaid.
--That said, it will make no difference what resources you find unless your son is truly interested in changing his behaviors. I’ve talked with many parents who, with all best intentions, tried to rescue their children by strong-arming them into drug rehabs, then found that their children quickly dropped out of those services. The prevailing philosophy of substance abuse rehab in general is that addicts must decide to change for themselves and not at the behest of their parents or anyone else in their lives.
--But a third issue here is whether your son’s drug use is his primary problem or whether he is using pot and alcohol because he’s bored, depressed and/or anxious. People with significant disabilities of all types have high rates of substance use because of their lack of gainful employment and low self-esteem. Before you even try to find a substance abuse program for him, I would have him evaluated by his primary care physician who can sort out which of your son’s problems should be treated first.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"
"My husband suffered a lower left lobe brain bleed 5182018, he is improving, however, the Aphasia and confusion are acute. Will his communication and understanding ability improve?"zeigler56, Support Network Member
"Improvement will continue for several years after the stroke. His recovery will be hastened and ultimately better if encouraged to participate in his speech and language therapy. Thank you, Dr. Joseph Hanna"Joseph P. Hanna M.D., Neurology
"I wanna know why doctors be so careless sometimes?"79051, Support Network Member
"In the 24 years that I spent as a psychologist working in a primary care office to teach family physicians about behavioral health issues, I found the hundreds of physicians with whom I interacted to be mostly caring, largely competent, and frequently frustrated. The healthcare system in which they have to work—seeing patients in 15-minute intervals that often felt rushed to them—caused them to cut corners by shortening conversations and postponing explorations of certain patients’ complaints until the next medical appointment. I don’t know if that’s what you mean by “careless” or if you are referring to the mistakes they sometimes make. In those rushed sessions, medical mistakes are made—mostly small ones, such as forgetting to write out prescriptions or fill out forms. But in rare instances, larger mistakes occur with the potential to do harm. Of course we need a better, more flexible system in which physicians have the time they need to practice with greater care. Until that day, however, it is essential that patients and the family members who accompany them to medical appointments remain on guard for physicians’ mistakes. I suggest asking questions if you have doubts about the treatment plans, double-checking prescriptions before you leave the office, and calling back afterwards if you still have concerns. Decreasing carelessness is a goal we can all help achieve.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"after hemoric stroke and 9 days coma what are chances."Stefan, Support Network Member
"I’m very sorry you or your loved one is suffering from what appears to be a devastating stroke. The prognosis after this type of brain injury can be difficult to predict. I would recommend that you continue to work with your physicians and care team to understand what their impression is about how you or your loved one is doing and what the future may hold. Thank you Dr. Sunil Sheth"Dr. Sunil Sheth, Vascular Neurologist
"Are heart disease and stroke related to each other? If my child has heart disease, could she have a stroke?"AHA/ASA Katie Bahn, Support Network Member
"In adults, high blood pressure, irregular heartbeat, hardening of the arteries, and diabetes can play key roles in stroke. However, this is less common in children. Children can have cardiac issues like congenital heart defects or acquired heart disease that can increase the risk of strokes. It is important for families to discuss the underlying cardiac condition and the risk of stroke with their physician.Dr. Nivedita Thakur, Pediatric Neurologist
Dr. Nivedita Thakure"
"Do children have the same stroke symptoms as adults?"AHAASAKatie, Support Network Member
"Strokes in children, especially infants and newborns, can present differently than in adults. The symptoms could be misdiagnosed with more common conditions that mimic a stroke like viral illness, migraines, or epilepsy.Dr. Nivedita Thakur, Pediatric Neurologist
-Change in mental status--Example: extreme sleepiness
-Using one side of the body more than the other
-Focal signs like weakness
-Change in mental status
-Sudden difficulty with speaking or comprehension
-Sudden vision problems
Should your child experience these symptoms, call 9-1-1 immediately."
"My baby had a stroke in utero. What are the main developmental achievements that I should look for as he grows?"AHA/ASA Katie Bahn, Support Network Member
"Monitoring development will be important, especially milestones that a baby should achieve by a certain age.Dr. Nivedita Thakur, Pediatric Neurologist
Development can be impacted by areas damaged in the brain. Thus the location and extent of injury are important factors. Another important aspect is brain plasticity. Brain plasticity can be seen in babies because the brain is developing and so different parts of the brain or an undamaged area in the same location can take over function. Therefore it is difficult to predict exactly how much difficulty a child will have in the future.
It’s important to follow development closely and get them in therapy to help practice skills they may be struggling with. This will allow the brain to use the pattern of repetition to build pathways that may have been disturbed due to the injury.
Thank you, Dr. Nivedita Thakur"
"What Causes a Pediatric Strokes in children?"AHA/ASA Katie Bahn, Support Network Member
"Strokes in children can be caused by a variety of factors:Dr. Nivedita Thakur, Pediatric Neurologist
Cardiac: Examples--Congenital heart defects or Acquired heart disease
Hematologic: Examples--Sickle cell disease or Clotting disorders
Infection: Examples--Meningitis or Encephalitis
Vascular: Examples--AVM malformation or Moyamoya
Metabolic or Genetic: Examples--Marfan syndrome or MELAS (Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes)
Trauma: Example--head and neck trauma"
"Hi all. My son had a stroke in utero or at birth... he presented with seizures during the first 36 hours of life which were controlled with phenobarbital. He's 7 months now and is doing as great as we could all hope for. Meeting his milestones and more and has no deficits or signs of stroke as of yet. We know that prognosis for this is extremely variable, which is why I'd like to hear if anyone has a similar case/ experience and what the outcome was (in regards to the area of the brain that was affected). His stroke was in his left frontal lobe, I'd say maybe 1/8th of his left side and a small part of white matter in the back of his right side... the neurologist said he is almost borderzone if that helps... I've looked at studies and patients classified as borderzone seemed to have good prognosis... but the studies are all over the map and I don't really know what to conclude at this point other than expect the worst but hope for the best. Any information from patients or parents of children with similar diagnosis would help tremendously."Support Network Member
"Thank you so much for this question. You are correct in the information you have received so far. There are 2 key aspects that we consider. The first is the location and extent of injury. The second aspect is brain plasticity. Brain plasticity can be seen in babies because the brain is developing and so different parts of the brain or undamaged area in the same location can take over function. Thus it is difficult to predict exactly how much difficulty a child will have in the future. Key aspect is following development closely and getting them in therapy to help practice skills they may be struggling with, so that the brain can use the pattern of repetition to build pathways that may have been disturbed due to the injury. I hope this helps you with what to expect in the future."Dr. Nivedita Thakur, Pediatric Neurologist
"I have a friend that had a stroke and she is having a very hard time at home. She has the at home therapy etc but she is pivoting into the depressed, crying because she can't do what she use to. Her stroke left her left side unusable her eye, arm and leg which is getting a little better but her husband is in a wheelchair also and he is overwhelmed with doing all the housework, cleaning, washing clothes etc. It has been exhausting for both of them--they have tricare prime so putting her in a nursing home is out they don't cover it. They live in Warner Robins, GA and I am trying to find someone that can help them out. They have an adopted teen 14 years old --which has add, adhd--she just shuts it all out. They don't have a computer either that is why I am asking...if anybody can refer me to anybody that can help them..please let me know..quickly Thank you"PattiePitts, Support Network Member
"You are a good friend to be trying to help them. Their situation is obviously very difficult. They need several types of help:Barry J. Jacobs, Psy.D., Clinical Psychology
--A social worker from Veterans Affairs or the Georgia Department of Public Assistance may be able to help them get increased insurance coverage to pay for other in-home support services.
--A licensed clinical social worker, psychiatric nurse or clinical psychologist through the home care agency that’s providing therapy may be able to evaluate your friend for depression and then initiate effective treatments.
--A case worker from the Georgia Division of Children and Families may be able to provide support services to all the family members to keep this family intact.
--Most of all, though, they need a guide through our complicated social services and healthcare systems. Sometimes insurance company care managers can play that role.
Your friend’s problems are complex. She will need to be patient. She will need you to stick by her as she slowly tries to rebuild her life.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"
"I am newly diagnosed with AFib, I am having anxiety because it was a frightening experience. I find myself checking my pulse rate and breathing throughout the day, HELP! I want this to stop..."Sunshine12, Support Network Member
"It is not unusual for people with atrial fibrillation, as well as many other heart conditions, to develop uncontrollable worries about their health. We call this marked tendency towoard worry “anxiety.” Unfortunately, one of the symptoms of severe anxiety is to have a racing heart—something which only would only make your afib symptoms worse! What would be most helpful is to realize that afib isn’t likely to kill you every time you feel your heart skipping or racing. Your anxiety would then dissipate. This usually takes increased familiarity with this new reality of your heart condition—and that takes time. However, if you continue to respond with anxiety every time you feel your afib symptoms, then it would be advisable to meet with you physician to be assessed for an anxiety disorder. We have very good pharmacological and psychotherapeutic treatments for anxiety that will help you worry much less and live with your afib much better.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP"Barry J. Jacobs, Psy.D., Clinical Psychology
"I lost my Dad to a heart attack along time ago. I still think of it as yesterday. How do I get through this???"CliftonL, Support Network Member
"I’m sure your Dad meant a lot to you but grieving the death of a parent usually goes on for one to two years—certainly not forever. When a period of mourning never seems to end, we call it “complex bereavement.” It is often associated with intense feelings of guilt. The grieving survivor generally feels guilty for whatever he or she did or didn’t do for the person who died while still alive. Complex bereavement frequently leads to clinical depression. If this description seems to apply to you, then I suggest you ask your primary care physician for a referral to a mental health therapist or grief counselor who can help you decrease the guilt and finally experience some resolution of your prolonged grief.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"Please suggest a site about depression: causes and treatment. I first experienced depression about 20 years ago after surgery on my knee. The surgery went fine but for 6 months afterwards my calf muscles were in intense pain. I saw numerous doctors and physical therapists, but no one gave me a diagnosis. I was given a ton of pain killers. Finally I had a major depressive episode. I was given Paxil. Now after all that time, I am experiencing depression again, this time I believe because of numerous stressful events. My doctor is excellent, but I really want to understand depression. I have had another doctor tell me that people need to make good decisions, that you must simply accept that bad things happen, and then more bad things happen. I did not find this helpful and do not think this is something that someone that is depressed should be told."HappySue, Support Network Member
"In my opinion, major or clinical depression is often a chronic, recurring illness that can be triggered by stressful events, such as significant losses or changes. It is a good idea for you to learn as much as you can about your condition, especially the steps you can take to manage it over time and prevent frequent recurrences. There is lots of information online about depression but not all of it is reliably accurate. I usually refer clients to the Mayo Clinic’s depression section (https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007) and the WedMed Depression Center (https://www.webmd.com/depression/default.htm) for a good, basic overview. I would then meet with your doctor again to discuss any specific questions you have about what you’ve read and how they apply to your life.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"I'm a recovering addict with depression, anxiety and chronic pain and weight gain. How do I cope?"Lizzylee, Support Network Member
"It sounds like you are really suffering. Many recovering addicts suffer from depression and anxiety. So do those who have marked chronic pain. When people with depression and anxiety use food to comfort themselves, they then often gain weight. I suggest asking your primary care physician to evaluate you for depression and anxiety. He or she can direct you to appropriate treatments—for example, medication or psychotherapy or both—that are typically helpful and may make a significant difference for you. You will learn new ways of coping other than eating. Your weight may then become more manageable. Good luck!—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology