Your Questions Answered
"Any cardiologist in San Antonio that specialize in rare heart diseases? I have Apical Hypertrophic Cardiomyopathy."Sal2929, Support Network Member
"There are multiple groups in San Antonio. If the patient is a child, they should be seen by one of the pediatric cardiologists. If an adult, there will be many cardiology practices.Dr. John Breinholt, Pediatric Cardiology
Thank you, Dr. Breinholt"
"I am 22 years old and a female, while my parents have had heart problems their heart problems were due to lifestyle choices because they were both smokers, I do not smoke, I am pretty active, I eat healthy for the most part, I'm a healthy weight, no high blood pressure or cholesterol, so just last year I started getting these "heart hiccups" where I feel a jolt in my chest and it feels like my heart flutters or skips a beat but when it does it, its beating at a normal rate and sometimes they kind of hurt or its just a strong sensation, so my question is, is what is it??? It feels like only one thump idk if its my heart or something else??"Kearseym, Support Network Member
"She should be evaluated by a cardiologist. They will start with an ECG and maybe order a Holter monitor or Event Monitor. It is important to document what this is. It sounds very much like PVCs or premature ventricular complexes which are “extra beats.” They can often mean nothing serious, but it is good to be sure, and if they are causing a lot of patient distress, some cardiologist may opt to treat with medicine to reduce the symptoms.Dr. John Breinholt, Pediatric Cardiology
Thank you, Dr. John Breinholt"
"I have recently been diagnosed with cardiomyopathy and congestive heart failure. I need to lose weight. What is a safe diet for a female person with these conditions? Also can you recommend a good book for patient education?"szq113, Support Network Member
"Individuals with heart disease should start a diet which should be eating foods in moderations. A diet that lowers the blood pressure, lowers the blood sugar levels, helps with weight loss and curbs LDL which is the bad cholesterol. With any diet, you would want to get approved by your medical provider. In your diet, you would want to include more vegetables, grains, legumes, whole grains, and fruits. It is important to limit saturated fats, eat a variety of protein-rich foods, decrease salt intake and limit cholesterol. Here’s an example of certain foods to eat and how they help, Oranges reduces blood pressure and cholesterol, Kale prevents atherosclerosis, sardine’s lower triglycerides, lentils-reduces blood pressure, Almonds reduces LDL and fatal arrhythmia, and garlic reduces blood pressure and plaque.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"I'm needing help ASAP. I'm a 48 white Male who is unemployed, No Insurance and needing to see a Heart Specialist. Any Help on getting Free Imaging test done on my heart, In the Memphis TN, area, Or if anyone knows of an Organization that could help in this matter, My research has come up with no help at all. Both parents passed away having Heart attacks. I'm currently on Two Blood Pressure medications, And a Cholesterol / Plaque Blocker."helplessTn1, Support Network Member
"In Memphis, Tennessee there is an organization called Memphis Health Center in which they deliver many healthcare needs plus refer individuals to areas for different specialties. One unique information about this organizations is that they help many individuals without health insurance. You could reach this organization at 901-261-2000 in which they will be able to direct you.Dr. Latonya Law, Family Nurse Practitioner
Dr. Latonya Law"
"Where can heart failure patients find palliative care programs?"MarDav, Support Network Member
"There are many palliative care programs and I will list a few that I know provide exceptional serviceDr. Latonya Law, Family Nurse Practitioner
• VITAS Healthcare is a very good program with expert Palliative care in which service is provided 24 hours a day, check out website www.vitas.com/palliativecare.com for more information.
• Palliative Care & The Heart Failure patient, you can find more information on www.heart.org/idc/groups/heart-public@wcm/@fda/documents
• Hospice Care-American Heart Association, more information on www.heart.org/hospice_care_ucm_454473
Dr. Latonya Law"
"Is it normal to get dizzy spells and at time pass out for a second after a stroke? My husband had a stroke three years ago and has just started to have dizzy spells and has passed out on occasion. After his stroke he was diagnosed with AFIB and takes xarelto for this. Really concerned."rdesrosiers, Support Network Member
"Hello, thank you for this question. I would recommend that your husband follow up with his medical provider with the symptoms being described. The dizzy spells could be related to other medical problems that would have to be ruled out first with possible additional treatment. Due to your husband having a history of a Stroke and A-fib he should be monitored closely and follow all medical advice given by his medical provider. A-fib treatment plan is one that minimizes the risk of stroke.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"I had a TIA 5 days ago, I am still having numbness in my right leg, and also feeling very fatigued, Are these symptoms normal and if so how long does it take for these symptoms to subside. Also feeling very anxious about having an other TIA or a stroke. I was put on Plavix and Lipitor."susie59, Support Network Member
"your symptoms are known as residual or ongoing symptoms that could last a few weeks, and some people continue to experience some symptoms for a while afterward. The symptoms that you describe includes numbness in legs, very fatigued which are common. In most cases, these symptoms do improve over time. The best advice for you in preventing future TIA or Stroke is to control risk factors and treat other medical conditions that can lead to a stroke. Lifestyles changes and following up with primary care providers is strongly recommended. You can help prevent a TIA or Stroke by taking steps toward a heart-healthy lifestyle. Thank you for this great question. Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"My Dad is in the hospital with a hemorrhagic stroke. He has been sedated for two weeks and this week slowly coming around. He cannot speak, but he is awake now, and beginning to recognize us. he looks as if he is trying to communicate. He has a Trach in his throat and cannot speak. My family and I are wondering at what point we should try to explain to him what is happening. He looks as if he is confused and frustrated at his lack of ability to do anything. And we want to tell him at the right time that he had a stroke and is recovering. Do you have any information, contacts or suggestions on when or how to do this? Thank you"Bsweatt, Support Network Member
"It’s understandable that you want to be respectful of your father by keeping him informed about what’s happened to him. But it is doubtful that now is the right time to do that. The right time will be when he is cognitively capable of fully grasping what you are explaining and emotionally prepared to deal with that information’s implications for how his life has been changed. Most families wait for their loved one to raise questions when they are ready for answers. I suggest you do the same.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"My brother had both an ischemic and hemmoraghic strokes March 2017. He was in a coma for 4 weeks. We are now 6 months post and we are dealing with short term memory issues. He walks, talks and eats on his own. My question is how do we assist him in remembering the here and now and that he hasn't taken care of his two little boys for 6 months even though he believes he is taking care of them now."dlake56, Support Network Member
"In the assistance of helping your love one remember the here and now would first be to do many activities that will stimulate the brain. There are many games that require you to use your brain which can be a simple game of chess or checkers. These games will help regain your brother’s memory which will happen over a period of time. It is known that memory can take a while to come back but stimulation should be done. The stimulation could help bring certain memories that could lead or trigger the important lost memories especially of loved ones. Another idea would be to use post reminders about different activities that goes throughout the day. Repetition of certain activities including making mnemonics will help bring memories back but also keeping in mind that all memories might not return. The goal is to stay active."Dr. Latonya Law, Family Nurse Practitioner
"What is the best way to handle someone refusing all therapy?"Keiglf01, Support Network Member
"The short answer is to ask him or her why and then to listen carefully to the explanation without passing judgment. People sometimes refuse treatment because they’ve lost all hope. They may need an evaluation by a physician to determine whether they are, in fact, being realistic or overly pessimistic due to depression. If they are being realistic, then their wishes as self-determining individuals should be respected. If depression is making them gloomier than is warranted, then treatments to improve their mood and outlook should be considered. I’ve seen a number of people in my career who changed their minds and decided to accept whatever therapies were offered once they were no longer depressed.Barry J. Jacobs, Psy.D., Clinical Psychology
Sometimes people decline treatments because they fear their side-effects, such as nausea, fatigue or clouded thinking. Again, it would be best to confer with a physician about those concerns. Changes in medications may possibly alleviate these side-effects while still providing therapeutic benefit. —Barry J. Jacobs, Psy.D., co-author, AARP Meditations for Caregivers"
"Yes I'm wondering I had double bypass mitral valve ring repair and pacemaker how am I to strengthen my heart when I have bad siactic nerve and needing back surgery"Marli55, Support Network Member
"Wow! Sorry to hear that you needed to have all of those procedures, but I'm glad that they went well! Rehabilitation, as you know, is critical after these procedures to get your strength and endurance back as quickly as possible and to increase your functional status, particularly if more, non-heart related procedures are needed. In my patients who also have back, hip, or joint issues that make it more difficult to rehab, I always suggest load-reducing or load eliminating activities such as recumbent bicycles and water aerobics and/or swimming. I would also make sure that you talk to a cardiac rehabilitation specialist and your physical therapist at your local cardiac rehab to individualize your rehabilitation in light of your sciatica and back issues. Good luck on your recovery!John Osborne, Principal Cardiologist
Dr. John Osborne"
"How do I get these cardiologists to listen to me? There is a serious problem with my heart. It has gotten to the point to needing oxygen treatment. So bad that I have to use speech recognition to type. I can't talk very long or walk a few steps or shower or shop or sleep without getting extremely out of breath. It's so bad that I wake up out of my sleep out of breath. Please help me."Msjackson75, Support Network Member
"I'm so sorry to hear of your difficulties! Many cardiologists are more oriented to invasive cardiology and procedures and less oriented toward diagnostic difficulties. I might suggest looking for a cardiologist who specializes in preventive cardiology and/or imaging as they tend to be more diagnostically oriented as opposed to those that are procedurally or invasively oriented. Usually these issues can be diagnosed with tools such as echocardiography (a heart ultrasound) and blood tests, such as a BNP (B-type Natriuretic Peptide) test. Less commonly, tools such as Cardiac CT Angiography and/or cardiac catheterization (a "heart cath" or angiogram) might be used to determine if these symptoms are being caused by a heart-related condition. I would also suggest that you might seek out a Pulmonologist (a lung specialist) who can also work with the cardiologist to determine what the problem is and whether it may be due to a lung related issue or a heart-lung issue. Another idea would be to see an ENT (Ear, Nose, Throat or Otolaryngologist) to ensure the there is not a problem with the airway and vocal cords. Good luck on your journey and don't give up hope! There are cardiologists and other specialists out there who can help you!John Osborne, Principal Cardiologist
Dr. John Osborne"
"Have HBP, neuropathy in feet, polyps on Thyroid-recently diagnosed with CHF. I know the physical sci. of condition but, need help understanding how to care for myself."suewonder, Support Network Member
"Monitor BP daily and keep it under control. Do not gain weight. Check for fluid retention in feet and abdomen. Monitor how many pillows you put under your head at night to feel comfortable. I would be curious to know, what is is your heart ejection fraction? These are good topics to discuss with your health care team.
"ive been told i have hbp since the age of 17 so i stopped going to doctor ... a friend died in his sleep and i feel like its time to do something... i have no insurance ive lost my job bit i don'twant to die yet where do i turn for help?"Niegusashidd, Support Network Member
"Hello, Most cities have a county hospital where patients may not need to pay for their health care if they are below the poverty level. Churches may help too. I know of many doctors who volunteer there.
Though you for this question.
"I have been struggling to lower my bp for 18 years. I have changed my diet, quit smoking, and tried over 20 meds/med combinations. The meds make me horribly sick to the point I cannot complete ADL alone but don't actually lower my bp more than 5pts systolic. I feel just fine without the meds even though my pressure is thru the roof. I have been to several cardiologist, nephrologist, neurologist, over the years and none can find a combo or med that actually lowers my bp. Please help"asheehan34, Support Network Member
"Thank you for posting this question. Sorry I did not get your age with the email. Is your Potassium normal? How is your kidney function? You may have a secondary cause for your HTN which may need to be evaluated. Would be helpful to keep a chart of your BP 3-4 times a day for 2 weeks which may help to find the right meds. I suggest you talk to your doctor about next steps.
"My 14 yo daughter was diagnosed four yrs ago with svt and mild leaky tricuspid valve. She had successful ablation three yrs ago. Back then dr said leak would be to be fixed “one day”. But last year it started leaking more. Just had first mri. Says moderate stage. TR 26%. Question of small hole. And borderline rv overload with rv volume 1.5 times that of left. What do you think next set should be? Cardiac Cath? At this rate when would you guess it would need repair? Is it always done open heart? Thanks from a nerve racked Mom!"HollyAlfred, Support Network Member
"Hopefully, you have a pediatric cardiologist who can help guide you in thinking this through and decision making. A cardiac catheterization is probably not necessary at this point, but the valve may reach a point where repair is necessary. From the information provided, I’m not sure if your child has arrived at that point yet. At this point, the primary option for tricuspid valve repair is surgical. Please follow up with her cardiologist and keep asking questions. Thank you, Dr. Breinholt"Dr. John Breinholt, Pediatric Cardiology
"My daughter was diagnosed with VSD when she was 2 weeks old. We monitored it but then was told it had gone away. She is now 10 and complaining of chest pain and sob with activity. Went back in and echocardiagram now shows VSD and ASD. Could this cause her pain? Should I be looking for something else? All pulmonary test were normal."Djenn434, Support Network Member
"The pain is very unlikely to be related to the heart defects. It is very possible that applying pressure to the chest area where it hurts will cause pain, which is suggestive of it not being the heart, but the muscles and joints of the chest wall. The next steps are probably to decide what to do about the defects, depending on her age. Thank you, Dr. John Breinholt."Dr. John Breinholt, Pediatric Cardiology
"How to care for 4 year old with Ebstein's anomaly of heart (severely displaced tricuspid valve with free regurgitation) with WPW and small septum secundum defect, on 10 mg propranlol tds"MK1988, Support Network Member
"This is a complicated question and my first suggestion is for you to talk this through with the child's medical team. Based on the information you have provided, the WPW (and its attendant risk of SVT) is being treated with the propranolol. The ASD is helpful due to the problems with the tricuspid valve. If the valve disease is severe enough, it's possible to opt for a surgery to address it. There are multiple options depending on the condition of the valve and the different center’s approaches to surgical intervention. Some involve valve replacement, some involve valve repair.Dr. John Breinholt, Pediatric Cardiology
Again, I urge you to talk with the medical team for a complete explanation and treatment plan.
Thank you, Dr. John Breinholt"
"I was born with congenital heart defect and had open heart surgery at 10 to repair sub-aortic stenosis. Then in 2005 I had to have open heart surgery for aortic valve replacement. I chose a tissue valve. My tissue valve is starting to fail so I am now facing my third surgery. I have been told I have three choices....mechanical valve, tissue again or TAVR. I am hoping to do the TAVR but have a lot of questions. Does anyone have any experience with my situation?"Kayceemartin, Support Network Member
"Thank you for this question. TAVRs are most commonly performed by adult cardiologists. It is possible to have a TAVR since it would be a “valve in valve” implant. The patient’s age might be factor, but in any case adult cardiologists do this most often. Given the patient’s history of congenital heart surgery, I would recommend a collaborative approach with an adult and pediatric cardiologist.Dr. John Breinholt, Pediatric Cardiology
Dr. John Breinholt"
"My 15 year old daughter was just diagnosed with ventricular tachycardia on Friday, after years of her having fainting spells, shortness of breath, and other symptoms. The pediatric cardiologist was very helpful, but I feel I did not understand the amount of physical activities she can do. He said no sports, gym activities until he sees her in 3 months after being on a beta blocker, getting an mri and seeing a dr, that deals with the electricity of the heart. I feel like I want to keep her in bed all day, but she won't have it. she has some emotional problems from this because no one would believe her that something was wrong. they would say she needed to drink more water, or it's in her head. She has told me she wants to die, because of the dizziness and headaches. She also has a concussion because of these episodes, and no her eyes do not converge and we are seeing a vision specialist. I just want to know how far should i let her walk, do stairs, and stuff like that. Thank you. Danna"demurod, Support Network Member
"This is a challenging situation. If she indeed has VT, it is very important that she see an electrophysiologist. I agree that competitive sports and gym activities should be limited until she is seen, but she shouldn’t shut her life down in the meantime. Regular activities should be okay in the meantime. Doing nothing won’t prevent any problems. A risk from the “fainting spells” would be injuring herself, so if she feels dizzy, she should sit down.Dr. John Breinholt, Pediatric Cardiology
See the electrophysiologist and go from there.
Thank you for bringing this question to us.
Dr. John Breinholt"
"When will I begin rehab after open heart surgery for HOCM?"Teacher1970, Support Network Member
"Hello, After heart or vascular procedure you’ll need help getting back on your feet. Rehabilitation is an important part of your recovery. Rehabilitation begins in the hospital. After the staff consultation and the assessment from the cardiologist, the rehab staff is notified to assess your physical condition and discuss next steps for rehabilitation. Once rehabilitation starts; two to eight weeks later, your medical provider will determine the next stage of your rehabilitation. Normally you will begin a 12-week exercise program, specifically designed and individualized for people who have had heart or vascular surgery. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"I had a fall in October and I hit my head. I had the Fall in the afternoon after moving the trash can I lost my footing and fell hitting my head on trash container. I got up quickly looked at my clothing to make sure I wasn't dirty. I have always tried to look my best even when moving the trash container. I survey my self and was pleased I had gotten dirty, but my head was hurting at the site where the trash can hit me. I went in side and told my wife I had fell down. She asked me if I was okay and I put her hand on the spot where I hurt my head. She said " thats stange I can feel this spot traveling. We should probably go to the ER to have you checked out". Quite naturally I refused. We had things to do that day and I was waiting on the mail man to bring me my workers comp check. You see I fell at work and injured my knee and my back which led to me losing my balance. My wife and I ran our errands and went out to eat and returned home later that night. We entertained ourselves with the TV till around 12 midnight. That is when I noticed I still had a nagging headache but now my face is tingling. I was so foolish. Again, my wife insisted he go to the ER now. We took my blood pressure at its 236/ over 120 something. Some far out number, and still I refuse. I said "wait until in the morning" Ill be better then. I got up that morning and I don't know something told me I should go to the ER. It may have been that I couldn/t control my right side,or that my head was still hurting or the fact that I could not even Dress my self. My right arm was trying to slap my face off. It was out of control. It was then I stopped protesting as went to the ER. THe medical doctor on call knew what he was dealing with right away. Within Three days I was on my way to a rehab facility and was up walking in a week and working on my speech. Once out of the hopspital I quickly went back to my old eating habits. Well, did I mention that I am also Diabetic. I was feeling so good back to my old self. I was as frisky as a rabbit. My wife didn't know what to think of me or why. Well a week into being home other signs of the stroke started to show up. We where heartbroken and baffeled. How could this be happeining to us. I speech became a little more labored and now my arm hurts I can feel tingling up my arm like a hundred ants a crawling on my arm. So back to the ER I go this time I know better than to put up a fight. That is when we found out that there had been a delay in the stroke and that this happens. I begun therapy and now I am on my way to recovery. It has not been easy. Seems like for every step I make forward something takes me two steps back. It is so frustrating. YOu work hard to get your life back and it just dangles is front of you like a carrot and yo wonder if you will ever get your life back. Then like a bad joke the very medicine that seemed to help is contributing to memory loss. Gabapentin that I am taking is now contributing to memory loss. Do this nightmare ever end?"BobbyRay, Support Network Member
"While taking Gabapentin, acute/short term memory loss is commonDr. Latonya Law, Family Nurse Practitioner
especially depending on the dosage. Although it seems that you
are making small steps and not much improvements it is wise to
speak to your provider to determine if other options available
instead of Gabapentin. During this process, you must remain
positive. Remember that every medication could possibly have
a side effect but you have to weigh the benefits with the risks.
Dr. Latonya Law"
"My 48yr old husband had a stroke Mar 2017. Thankfully with 6 months of rehab, he has almost fully recovered. The issue he is having is Central Post Stroke Pain. He is currently on Nortriptyline but it only takes the edge off. Does anyone have an experience with effective treatments? We are desperate! Thank you!"kellymast, Support Network Member
"There was a wonderful article in Stroke Connection that appeared in Spring 2017 issue on central post-stroke pain, which is often related to damage to an area of the brain that carries lots of sensory pathways. The symptoms are treated with medications and early mobilization post-stroke. There is correlation between chronic pain and stroke so I encourage family/caregivers to be on watch for signs of depression and to alert MD/healthcare practitioner re: such. The article also mentions the use of motor cortex stimulation which is an experimental treatment that is currently being tested. See also this website: https://centralpainsyndromefoundation.com/.Stephanie Vaughn PhD RN CRRN FAHA,
Thank you, Dr. Vaughn"
"My father is 48 years old and suffered a stroke in December that has left his right side numb. We have just began to see a neurologist, but we are not completely sure about what goes on with his thought process. He is unable to work or drive but his desire to go to rehab or to even go somewhere as simple as Walmart is non-existent. If left alone, he doesn't move from his chair and may even forget to eat all day long. Is there a way to fuel the desire in him to want to work harder for his recovery? We do not want to force him and make him miserable, but something needs to be done. Thank you."asudaughter2, Support Network Member
"Often, motivation and desire to participate may be affected by the location of the stroke, as well as the psychosocial implications (depression, anxiety) of such a change in status and abilities. Depending on the location of the stroke, he might benefit from speech-language services and/or occupational therapy to assess his ability, desire, and opportunities to participate more in therapy and the community. He may also benefit from seeing a counselor to work through the life changes experienced due to the stroke. You’re very right that forcing him will not be as helpful. Continuing to support him as best as you can and trying to encourage activities and hobbies that he used to enjoy are good ideas for improving his buy-in to community and therapy activities.Joseph S. Kass, MD, JD, FAAN, Neurology
Alicia Danto, PT, DPT, NCS
Harris Health Stroke Team under the Stroke Medical Director Dr. Kass"
"I had a stroke 3 months ago with weakness on left side. Is it normal to get tired to almost exhausted after trying to do things?"cherrywalk, Support Network Member
"Thank you for the question. Fatigue is very common after stroke. In fact, it affects up to 40% of stroke survivors to varying degrees. There are several different factors that can worsen fatigue in stroke survivors including undiagnosed obstructive or central sleep apnea, medications, thyroid problems, and vitamin deficiencies. Your doctor can assess you for these factors.
Dr. Anjail Sharrrief, M.D."
"My husband is a 6 year stroke survivor and he is struggling with frustration, high anxiety, unable to sleep, etc. Some of his actions are: throwing objects across the room, opening the passenger car door when I'm driving down the road, saying hurtful words, ending friendships with family members. I've tried taking him to a psychologist but he says I'm the one who needs the therapy and he doesn't want any part of it. I've learned how to minimize these event from reoccurring, but still think he / we could use some professional help."nerak1958, Support Network Member
"Dear Caregiver nerak1958: I will tell you what you already know: Your husband sounds depressed. Males often express depression through anger. It is also true that stroke survivors—especially those with left hemispheric strokes—have high rates of depression. In addition, your husband may have decreased control over his behavior because of frontal lobe damage due to his stroke. I agree that he needs help. I suggest you call or write a letter to your husband’s primary care physician about your concerns. Primary care physicians routinely evaluate patients for depression and could diagnose and then treat your husband with medication. His physician may also be able to persuade him to meet with a mental health professional, especially one who is familiar with the after-effects of stroke. In the meantime, try to be as patient with him as you can. He is suffering. Unfortunately, he is making those around him suffer, too. It seems that misery does love company.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"Trying to understand heart attack from a mental health perspective. My husband is 62 and had a heart attack -- actually cardiac arrest -- they said sudden cardiac death. He was revived through CPR. He is now back at work but I feel he is pushing himself. He is recovering from broken ribs from CPR and says he is tired but he keeps doing thing. I fear he is overdoing it. He is closed to talking about his experience. How can I help him?"Linda1957, Support Network Member
"We men have big egos. We try to prove to ourselves that everything is okay after our heart attacks by pushing ourselves to resume our normal activities. His cardiologist should specify to your husband and you just what he is allowed to do within safe limits at this time. If he pushes beyond those limits, then I would call your husband on it and point out that he is being reckless. You might also remind him that he wasn’t the only one who went through cardiac arrest—you did, too—and that his choices now have ramifications for the both of you. Caution is wisdom here.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"Hello my brother suffered a stroke 4 months ago and its still a challenge for him to remember his kids name or his wife name. He also has difficulties saying his name. He has speech therapy twice a week still his progress is slow. My question is, can we as a family do things at home to help the process and how ling does this condition last"Winbern007, Support Network Member
"One option would be to make a memory book for your brother. You can place pictures of each family member in the book. Then, beside each picture write names, birthdates or any other important information. Ask him to read the information daily. Often times, patients that have difficulty speaking find it easier with reading.Joseph S. Kass, MD, JD, FAAN, Neurology
To help the patient say his name, reading in unison (together) can be very helpful. Also, practice saying his name while using tapping. (While saying his name out loud, tap your hand in rhythm on the table)
After a stroke, we know patients do not plateau as previously believed. Patients can continue to improve for years.
Thank you for this thought provoking question.
Reyna Bohmann M.A., CCC-SLP
Traci Kurkowski, D.H. Sc., M.S., CCC-SLP
Harris Health Stroke Team under the Stroke Medical Director Dr Kass"
"I am seeking a residential option for my husband, who is hemiplegic with spasticity from hemorrhagic stroke in 09. He is only 63. Are there facilities that are better suited for him as a patient than the standard nursing homes , which cater mostly to elderly, memory impaired patients?"bobbiet, Support Network Member
"Depending on where you and your family are located, a post-acute brain injury facility may be able to properly assist you in finding a good place for your husband that will help provide the best environment possible. I would google post-acute brain injury facilities and find the closest one near you and see if they can guide you.Joseph S. Kass, MD, JD, FAAN, Neurology
Thank you for asking this.
Stephanie M. Hessel, PT, DPT-answering on behalf of the Harris Health Stroke Team under the Stroke Medical Director Dr. Kass."
"My mother recently had a stroke a severe stroke the stroke she's not hungry she won't eat and she has no desire to eat anything at all . What was the left side of her that she's having the most problems with his she can't use her left side but like I said with the eating or lack of it introduces entirely new problem. Have you heard of this before and do you have any suggestions.?"Crzy5150, Support Network Member
"Thank you so much for this question. Some survivors experience a decreased sense of taste and smell. A few things that may help are choosing healthy options with strong flavors, choosing visually appealing foods, consider nutritional beverages/supplements and continuing to try new foods. I often hear comments from patients regarding the differences of what foods they “liked” and “disliked” before and after strokes. It sometimes changes significantly.Joseph S. Kass, MD, JD, FAAN, Neurology
Depression is common following a stroke and may cause a decreased appetite.
Please make sure that her physician is aware if she is exhibiting signs and symptoms of persistent sadness, anxiety, empty moods, loss of interest in activities, and feelings of hopelessness. If diagnosed and treated, one may begin to see a change in appetite and nutrition.
Best, Naylon Bird BSN, RN-BC, SCRN-answering on behalf of the Harris Health Stroke team led by Dr. Kass."
"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 family history of heart disease & after some chest discomfort while exercising, I was diagnosed with angina pectoris. 3 weeks ago had heart cath & 5 stents inserted. At the time the doctor said my arteries were “wide open” and I had suffered no heart damage. Was already taking BP, cholesterol & triglyceride medication for years with no side effects. New meds include Metoprolol & Brilinta. Very fatigued, upset stomach and loss of appetite have ensued. Also having what I would call minor chest discomfort as my current cardiologist says arteries and stents are healing themselves as I’ve been through a lot. Not normally an anxious person, I have been obsessed and can’t stop thinking about every discomfort is really bad. I’m only 49 and have lost 15 lbs in the last 3 weeks (205 lbs now). Can any of my side effects be part of new medications on just my over anxiety? Maybe I was too positive in thinking this would be a “quick” recovery? Really working on lifestyle changes, also starting cardiac rehab next week and have new cardiologist at Cleveland Clinic but won’t see him for 6 more weeks. Any thoughts on what is “normal” recovery. I don’t want to be a cardiac cripple but so many questions without many answers at this point."Tastreet0714, Support Network Member
"You sound like you are trying very hard to regain a sense of health and safety. I recommend strongly that you work closely with your cardiologist to guide you through what will probably be a lengthier recovery process than you may have originally expected. From my perspective, your symptoms sound like they are probably caused by multiple factors, including side-effects of your new medications and increased anxiety. It is normal and expectable to have an increased sense of vulnerability after major heart surgery. It becomes very difficult for cardiac patients to distinguish what are the normal pangs of an aging or recovering body from the alarming signals of mounting heart problems. Again, please let your cardiologist and cardiac rehab personnel help you distinguish one from the other. It will take months to trust your body again and to not over-interpret relatively benign pains.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"How do i manage really bad anxiety after a heart attack?"ELLEN69, Support Network Member
"It is normal to worry about your health after having a heart attack. But when you worry uncontrollably—perhaps finding yourself unable to think about anything else other than your health—we call that anxiety. Anxiety detracts from your quality of life and, in its most severe forms, can be utterly debilitating. Fortunately, there are behavioral and medical treatments for it that are generally effective.Barry J. Jacobs, Psy.D., Clinical Psychology
Behavioral strategies include physical exercise (within limits set by your physician), relaxation exercises such as deep breathing, and facing your fears. To give you an example of this last strategy, heart attack survivors will ultimately feel less anxiety and regain a sense of safety if they can push themselves to engage in physical activities they’ve been avoiding out of fear of causing another heart attack. That’s easier said than done, of course. Cardiac rehab programs—with their graduated exercise programs under professional supervision-- often can give patients renewed confidence in their physical abilities and thereby reduce their fears.
In cases of moderate to severe anxiety, medications can also be helpful as adjunctive treatments to the behavioral strategies. Your primary care doctor or cardiologist can evaluate you and prescribe one of many possible medications to provide you with relief from the tension of constant worries.—Barry J. Jacobs, Psy.D., co-author, AARP Meditations for Caregivers"
"Next week my husband is having surgery to replace his aortic valve. I am getting more and more nervous each day. What advice can anyone give me to get through this and advice for his care after the surgery. I thank you for your help in advance."MarilynU72, Support Network Member
"Heart surgery raises uncertainty and entails risks which cause stress to all family members. No strategy will completely relieve that stress until the surgery and recovery period are over but there are means of coping better: Educate yourself about his condition and the surgery so that you know what to expect both on the day of the operation and afterward. Ask a family member or friend to keep you company at the hospital during the surgery. Line up other friends to drop off meals or help you with errands after surgery so that you can be mostly available to your husband. Ask the surgeon, cardiologist or primary care physician for ways to best communicate with them if you should have any questions or concerns. Give your husband sufficient time to heal. Give yourself sufficient space from him to take care of yourself over the weeks of his recovery.—Barry J. Jacobs, Psy.D., co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"How do you get over your fear of another Cardiac arrest enough to participate in life again?"Slateire, Support Network Member
"Fear is most effectively conquered when it is faced squarely. With your cardiologist’s guidance, gradually resume cherished physical activities which you have been afraid may cause harm. By doing this, you will prove to yourself that you are still capable and will regain some sense of safety. Along these lines, an excellent means of regaining your confidence is to enroll in a cardiac rehab program in which you will be encouraged to take on greater physical challenges with the support of the knowledgeable staff members and other cardiac arrest survivors.Barry J. Jacobs, Psy.D., Clinical Psychology
Thank you, —Barry J. Jacobs, Psy.D., coauthor of AARP Meditations for Caregivers"
"I'm a caregiver of an adult Schizophrenic son . I am also a person who had 1 heart attack and now has what they call 'broken heart syndrome '."Krossin303, Support Network Member
"The fact that you have “broken heart syndrome”—a temporary condition in which stress hormones cause one area of the heart to stop pumping normally—suggests that you are under great duress. Is it the heart attack or your caregiving for your son (or both) that is affecting you so? Physiological symptoms of stress are the body’s signals that you need to reduce the stress you are under. I’m sure that’s easier said than done. But is it possible to change your caregiving plan, at least in the short term, by getting increased help for your son? Are there ways you can focus on increasing your self-care activities (e.g., proper sleep, diet and exercise)? You have survived your heart attack and have been given another chance at life. Your well-being and your son’s depend on your ability to make necessary changes.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology