Your Questions Answered
"I had 2 stents in my LAD 5 days ago and have intermittent pain in different areas of my chest. I then get anxious and afraid which causes my chest to tighten up. My Dr said to be prepared for twinges of pain in my chest but I just wanted to ask how long this last and if thinking I am having a heart attack is normal after having stents put in. Thank you"lmiller33, Support Network Member
"Post-procedure chest pain can occur following stent placement. For some it lasts a few days, for other it continues on for much longer. If your cardiologist warned you of the possibility, he knows what is going on with your anatomy and why you’re experiencing it. If the pain lasts longer than a few minutes, becomes severe in nature, or is accompanied by other symptoms such as shortness of breath, arm or jaw pain, or dizziness, you should seek immediate medical attention. Otherwise stay on your medical regimen and follow up with your cardiologist. If your pain is related to small vessels there may be medication to give you long term relief. If you feel that your pain may be made worse by your feelings of anxiety, speak with a healthcare professional about counseling or medication to ease your worry.Tessa Messinger, Critical Care and Clinical Research
Be well, Tessa"
"I had an MI 6 weeks ago with 2 stents. I am 54 years old. Havee DM and high Cholesterol. Initially, I felt great now have terrible and anxiety and insomnia. Take Xanax and Cymbalta. Is this normal to feel so anxious and depressed post MI"kathy11, Support Network Member
"Unfortunately, it is not unusual. About 15-20% of people who’ve had an MI or heart surgery will suffer from depression and/or anxiety afterwards. The good news is that we have effective treatments for both. Medications, such as selective serotonin reuptake inhibitors, can help with the physical symptoms of depression/anxiety, including insomnia and low energy. Psychotherapy can help with the fears of dying and post-traumatic stress symptoms that often occur following an MI. Please talk with your primary care providers about evaluating you for both types of treatments. I feel sure that you will be feeling better soon.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"They found a hole in my heart after I had a stroke. They want to repair it by going through my groin. Is this dangerous?"donna1929, Support Network Member
"ASD is Atrial Septal Defect (ASD) which is also known as a hole between the chambers of your heart. The treatment for this defect and after multiple testing is inserting a fine tube into a vein in your groin. This catheter is then passed to your heart. Inside the catheter there is a tiny balloon that the team will use to measure the exact size of the hole so that they can choose the best device to close. With all procedures, there are risks and each risk will depend on the person and their medical history. You would definitely want to follow up with your provider regarding any concerns and discuss risks factors that could be narrowed down to you and your medical history. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"Hello, I would like to seek help on my mothers condition. In 2011 she had a quadruple bypass surgery. Surgery was successful. Despite serious blockages, she able to recover soon and get back to daily lifestyle. Fast forward to 2017, she was complaining on chest tightness and uneasiness. After multiple trips to cardiologist, they finally agreed to perform an angiogram. Angiogram revealed 2 bypasses (from 2011 surgery) that we’re not working anymore. They placed 2 stents in one of the bypasses and since the other bypass was about 40-50% they didn’t do anything to that one. They also didn’t want to spend too much time invasively. Now more than a year later, she has been complaining for months about her nose being blocked making it hard for her to breathe. We have made visits to ENT doctors, lung specialists, cardiologists. They have found nothing wrong with her nose. Pulmonologist says she has a bit of asthma, so now she using an inhaler for about a month or so. Her nose is still constantly and severely blocked, neck and shoulder ache from the constant congestion. She has trouble breathing because of the blocked nose. Nasal sprays, teas etc nothing work. Would appreciate any advice! I hate to see her in pain like this :("Keepingfaith, Support Network Member
"Hello, it is recommended that you follow up with your concerns with your providers and specialists for your mother. The best treatment would be given when your providers have the medical records, labs, diagnostic testing readily available especially since there are multiple concerns from Cardiac to ENT.Dr. Latonya Law, Family Nurse Practitioner
Thank you, Dr. Latonya Law"
"My heart condition has introduced a PTSD type experience in my life. I’m constantly worried, anxiety and panic to do certain activities or be to far away from a hospital. What can I do?"Heart15, Support Network Member
"Anxiety and panic are not uncommon symptoms for people who’ve had life-threatening experiences such as a heart attack. To live better, those symptoms need to be diagnosed, treated and managed in an ongoing way, just like your cardiac condition. If you haven’t done so already, then please see your primary care provider to be evaluated for an anxiety disorder. If you receive a diagnosis of Generalized Anxiety Disorder, Panic Disorder and/or Post-Traumatic Stress Disorder, then you will likely be prescribed medication to lower your degree of reactivity to memories and anxiety-producing stimuli and will be given a referral to a psychotherapist to teach you relaxation and cognitive therapy skills. Most people who undergo treatment for anxiety get real relief. You can, too. Thank you, Dr. Barry Jacobs"Barry J. Jacobs, Psy.D., Clinical Psychology
"Hi, I am care giver to a loved one who suffered ischemic stroke on 14th dec 2018. It’s been one month now. He is still not seeing things clearly and it’s frustrating him. He always lived a very healthy lifestyle. He had his own gym as well. I want to seek advice from this group. Doctor is saying he will be all fine in 3 months but is it true?? He is having problem with vision majorly."Godbless123, Support Network Member
"Unfortunately, the details of your loved one’s case are not available to generate expert opinion. However, you should be encouraged that the treating physician believe that all will be well in several months. Recovery from stroke is best with a structured rehabilitation program and supportive social environment. Please continue to encourage your loved one to persevere. Remain positive as this attitude is contagious. Should you remain in doubt, seek a second opinion from a stroke expert in your region. Thank you, Dr. Hanna"Dr. Joseph Hanna, Neurology
"I had a mini stroke on January 9th 2018 i got nerve pain on my left leg more and less on my right leg but it was affected on the right side and they said it not from the stroke and l am doing alot of test why this is happening, Can you explain this and I am abit confused about it. Roula"Pink12, Support Network Member
"It's great that you have been able to lose weight and control your hypertension. Kudo’s to you. Obstructive sleep apnea is relative but carries a general risk ratio of two compared to those without it. Your recent weight loss likely reduced the severity of your nocturnal apnea. The addition of equipment to reduce your apnea at night will further reduce your risk of stroke and make your sleep more restorative. Keep up the excellent work of risk factor modification, follow your physician’s directives and your stroke risk will remain minimal. Thank you, Dr. Joseph Hanna"Dr. Joseph Hanna, Neurology
"How much recovery can be expected from a posterior cerebral stroke. Will the double vision resolve over time? Balance is greatly affected on the right resulting in scissoring with a step. Stroke was Nov. 25 with very little improvement in inpatient rehab. Complete exhaustion is huge issue and also had to have a pacemaker inserted Dec.17 and also needs a CEA. Thanks for any input"Nuttyrn, Support Network Member
"Your stroke sounds complex as many posterior circulation strokes often are. An individual’s recovery is often difficult to gauge. However, you are still early in your recovery phase. Most double vision resolves. Balance improves and even sometimes returns to normal. Fatigue can be a problem, but will improve in time with exercise, sleep hygiene, and attention to a nutritious diet. If your sleepiness remains a problem, medications exist that increase alertness. Please work with your caregiver to see if such a medication would be appropriate for you. Finally, always be hopeful as attitude is key to stroke recovery . Thank you Dr. Hanna"
"My left body became paralytic due to stroke 2 years ago. I have regained my functions except extension of fingers and grasping by left hand. I am having daily physiotherapy. How long it takes to get extension of fingers. I can flex them but can't extend. Pls. give your answer/opinion or recommend me how can I use my fingers"ashishjain37, Support Network Member
"Unfortunately, complete motor recovery occurs within two years after a stroke. The arm recovers usually from the shoulder to the hand with the muscles causing flexion becoming stronger than those that cause extension. Thankfully, researchers have been working for the last thirty years on a variety of means to augment human motion with machines. Automated gloves and implantable electrode arrays are just two of the many artificial ways to augment motion. Please contact your local stroke center and see if they have any trials being offered for motor recovery augmentation. If no one in your area has this expertise, you should search the National Institute of Neurologic Disease and Stroke website for information on where applicable trials are being performed. Good luck."
"Can you explain why fatigue is such a problem with stroke. I am having a horrible time with it. People and unwilling to understand and are very nasty about it. I have been called lazy among other things. I need help to deal with it and to prove it is real."Kitthann40, Support Network Member
"Approximately two-thirds of stroke survivors experience fatigue. Fatigue can take the form of either physical or mental exhaustion. It most likely starts within the first several weeks after a stroke, but occasionally can onset months later. The cause of fatigue is unclear. Factors such as disrupted sleep, pain and depression may play a role.
You should not need to prove its authenticity as more stroke survivors suffer similarly than don’t. Researchers have found that modifications to lifestyle can help alleviate fatigue after stroke. Routine exercise approved by your caregiver helps. Diet rich in fresh nutritious ingredients replenishes strength. Good sleep habits with adequate rest and adjustment to waking for early morning sunshine also alleviates symptoms. Lastly, if these things are not enough, medications can be added to heathen alertness. Feel free to talk to your caregiver to assist you in recovering your stamina. Thank you, Dr. Hanna"
"Age 66 female in good health, diagnosed with afib and svts after wearing a holter monitor several months ago. At first, just infrequent episodes, lately heart racing and feeling faint frequently while sitting, only last under a minute but very scary. I can't find any triggers except they only happen while I am sitting, never standing, walking or laying down. I can stop it by breathing exercises. It seems to be happening more and more. Is there a difference between atrial fib and atrial flutter? Could I be experiencing flutter since it lasts such a short time? My cardiologist has me on Metoprolol 12.5 mg 2x a day, Eliquis, and I was already taking HCTZ for high blood pressure. He said I shouldn't consider an ablation because I don't need it at this point and there is a risk and it doesn't always work. But this is scary and I feel worried about going anywhere in case I have one of these episodes."deejay4638, Support Network Member
"Here is a great summary of the difference in Atrial Fibrillation and Atrial Flutter https://www.health.harvard.edu/heart-health/ask-the-doctor-atrial-fibrillation-vs-atrial-flutter-Tessa Messinger, Critical Care and Clinical Research
In short they are very similar, but have slightly different approaches in treatment. As the above article states, an ablation isn’t effective from Afib which is what your holter monitor showed. The short bursts of palpitations that you are feeling could be Afib, Aflutter, SVT or a combination, it’s impossible to tell without a monitor. If you feel the frequency is increasing and the episodes are bothersome (lightheadedness), I would make an appointment with your cardiologist, or ask for an appointment with an Electrophysiologist, a heart rhythm specialist. Metoprolol does a great job controlling heart rate and rhythm, and you are on a lower dose so they may consider increasing your dose. Keep in mind it also lowers your blood pressure so they may then adjust your HCTZ dose. Eliquis is the most important if you are experiencing these arrhythmias. Keeping your blood thin will help prevent any complications such as stroke from the irregular rhythms. Hopefully a medication change can decrease your symptoms and make you feel more at ease.
Be well, Tessa"
"I have permanent Afib.66 yr old female.Canged my lifestle + lost 40lb.My Dr,. keeps pushing for a cardioversion+ablation. I am on 120mg sotalol 2x a day.Eliquis 5mg 2x a day.Digoxin 0.125mg 1x a day. Diltiazem 120mg x 1 a day.I also have small silicone breast implants.I chose rate control. Irregular h.b. 24/7.Should I consider the other route?"lezned, Support Network Member
"Cardioversion is a low risk standard treatment option for patients with persistent atrial fibrillation and Catheter ablation is an invasive treatment which has been reported to result in up to 60%-70% of patients in stable sinus rhythm. Due to not having more information about your diagnosis it is recommended that you follow up with your provider for more discussion and treatment as they will have your medical records available which could determine why this procedure is being pushed. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"I have a mildly lvh amd offen experience chest discomfort. Is that normal ? I’m not on any med because my blood pressure is back to normal and I do light walking for exercise to aid with regressing it back ."Sweetautumna, Support Network Member
"LVH is a term for a heart’s left pumping chamber that has thickened and may not be pumping efficiently. The thickened wall can cause the left chamber to weaken, stiffen and lose elasticity, which may prevent healthy blood flow. Without treatment you may experience symptoms of chest discomfort in which you should consult with your provider for further testing. Thank you, Dr. Latonya Law"Dr. Latonya Law, Family Nurse Practitioner
"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."
"on the fence about advice from heart surgeon and cardioligist for future valve repair/replacement. have been monitored for the past 4 years but now the status has changed to moderate/ severe. i have anorexia since 18yrs. am now 52 years. they are concerned because of this. i am trying to gain more weight to help the odds. what do you think. should i wait or risk the odds of it getting really bad. i have more tired days. i do run everyday for 45 min."MaryanneVio, Support Network Member
"Cardiac procedures should be taken seriously … It is recommended that you follow all of your cardiologist orders in regard to your heart health. Thank you, Dr. Latyona Law"Dr. Latonya Law, Family Nurse Practitioner
"Hello, I'm a father of new born boy, today he has 2 months and 13 days old, he is 58 cm and 5.5 kg. We made an Echocardiogram one month ago and it shows as main results Aortic Area was 0.19 cm2 ; speed of blood flow 5 m/s and average gradiant of 65 mm hg. Yesterday we made a 2nd Echo and we found that Aortic area is 0.3-0.4 cm2 (means increased) ; speed of blood flow is about 5,3 m/s and average gradiant of 53 mm hg. Is the increase of the Aortic Area a sign that it's better to not do any surgey now and wait to see the evolution os status by time better? Is the Aortic Surface by itself a reliable input to say that status isn't severe aortic stenosis ? How much the normal Aortic Area should be for a normal baby similar to my boy (Body Surface of 0,309 m2) ?? Please your help and advice for a worried father. Thank you in advance."Othmania, Support Network Member
"The gradient across the valve is what will drive the decision-making. With that gradient, there will likely be interest in intervention. The choices are a transcatheter balloon valvuloplasty or surgery. Which is the better option will depend on what the valve looks like (3 leaflets vs 2, etc). The aortic area will probably not be the primary determinant in when an intervention takes place. Thank you Dr. Breinholt"Dr. John Breinholt, Pediatric Cardiology
"My 6 month old son was diagnosed (echo done after a week) with a 3.4mm * 4mm perimembranous vsd at the time of birth (premature baby - 32 weeks). We did an Echo when he was 2 months old, and was told that the size of the hole had reduced to 2 mm and were asked to repeat the echo after his first birthday. During regular pediatric consultations, his pediatrician mentioned the murmur has become soft and asked us to do an echo as he felt that the VSD must have closed by itself or was about to close. So, we did an echo last week with a senior pedeatric cardiologist and were shocked to hear that the VSD has been partially closed by RCC prolapse and there is a mild Aortic valve (grade 1) leak now. He also told us that there is a mild AR and would need a surgery if the aortic valve leak increases. He prescribed digoxin and asked us to come for a follow up next month. We are struggling to recover from the shock and want to know whether surgery is the only option? Are there any symptoms that would indicate the increase in aortic valve leak? Will this be fixed by a one time surgery or will require life long medication?"TSDK1, Support Network Member
"It can happen that perimembranous VSDs can reduce in size, and rarely can close spontaneously. It is usually from tricuspid valve tissue that obstructs the defect, although in my experience, it usually only partially closes the defect. When they are small, many cardiologists choose to watch them. The one risk taken with that approach is the development of aortic valve regurgitation. In that setting, many would recommend closure before the regurgitation worsens.Dr. John Breinholt, Pediatric Cardiology
The VSD will be close with a single surgery. The outcome of the aortic valve is variable. It may not require further intervention, but that is not certain. Your child will require a lifelong relationship with a cardiologist if only to watch for any changes.
At this stage, surgery is the only option to address this problem.
Thank you, Dr. Breinholt"
"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
"Why when speaking with my physicians (prime, cardio, nehp), QOL discussions rarely include anxiety, depression and isolation, why? This has got to be as important as the count of steps or grams of sodium."OneOmega, Support Network Member
"You make an excellent point. Exercise and diet are very important for managing heart disease and for ensuring a high quality of life. But social isolation, anxiety and depression are also associated with decreased quality of life and must be addressed as assiduously as lifestyle modifications. I suggest you raise these emotional concerns directly with your physicians. I don’t think they will dismiss your questions, though they may feel more comfortable referring you to a mental health professional to best address them. Be your own best advocate and bring up what most matters to you, rather than only what your physicians ask about.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"Is it common for a stoke survivor to be unable to eat , not due to swallowing but due to getting the food passed her nose. She will,only take one little bite and no more. She has lost 50 lbs in 3.5 months. Also vomits at least 3 times a day, mostly just liquid"namaryvar, Support Network Member
"Most individuals after a stroke eat well. Difficulties with swallowing can be alleviated with feeding tubes positioned through the nose, mouth or directly into the stomach or intestine. This woman weight loss and vomiting are concerning for other conditions. I would take her to her primary physician as soon as possible to find the cause for her gastrointestinal plight. Thank you, Dr. Hanna"
"Hello: I have two grand daughters (twins) who were born 9 weeks early. They both have heart murmurs. One of the twins Angelina had surgery at CHOP. She was just released on Nov 18, 2018. She has a feeding tube and receives 1/8 of oxygen. Both twins suffer from acid reflux and feeding must be done very care fully. How long does it take to recover from surgery for a heart murmur?"angelinaA728, Support Network Member
"Heart murmurs are sounds, not heart disease. Sometimes a murmur is innocent, with no heart disease associated with it. It would be important to know the heart disease that was treated with surgery at CHOP to answer the question. Thank you, Dr. Breinholt"Dr. John Breinholt, Pediatric Cardiology
"My husband had a stroke 4 yr ago that affected use of his left arm and leg. He can't use his arm and can walk short distances with a leg brace and cane. He his terrible "tone" (spasticity) in his left side and leg that comes and goes. He describes it as burning and tightness. Everyone we've talked to (PT, primary, neurologist) says there's nothing that can be done for that. Is that true? It keeps him in bed and wheelchair for up to a week when its bad. Affects his ability to sleep and makes him miserable. Is there anything to help this???"OtterAnnie, Support Network Member
"Your husband’s stroke recovery seems to have been incomplete leaving him with both tone alteration and sensory disturbance on his left side. The tone problem can be addressed through therapy, pharmacology and surgery. The optimization of motor recovery should be individualized using all three modalities to allow him to perform daily tasks. The “burning” and tightness may be part of a post-stroke pain syndrome. This can be managed through therapy and pharmacologic approaches. Sometimes a refresher course guided by a stroke rehabilitation specialist helps improve the quality of life even years removed from the initial stroke. Thank you, Dr. Hanna"
"How common is it to see stroke patients go backwards in their recovery process instead of getting better?"IvetteRam, Support Network Member
"The grand thing about stroke survival is that nearly all get better in some degree as time passes. A period of deterioration within the first several days surrounding a stroke can be from extension of the incident stroke. Clots extend into additional vessels stealing blood from viable brain. Hemorrhage into the brain extends disturbing the surrounding environment even further. Later deterioration may be from a variety of medical conditions including infection, poor oxygenation and perfusion, additional brain swelling, blockage of the ventricular drainage system in the brain and depression to name a few. Thankfully, each of these causes for neurologic decline has a treatment and your clinicians have been trained to be watchful and to intervene early and optimize recovery. Thank you, Dr. Joseph Hanna"
"How to deal with stress and not feel discourage"Wifey4ever, Support Network Member
"Feeling discouraged is certainly stressful. So what’s the best way of dealing with discouragement? There are only two paths forward—changing your situation or changing your attitude about your situation. If it’s possible to change your situation through medical means to improve your heart’s functioning, then I recommend exploring them. However, if that’s not possible and you have to live with the residual effects of heart disease or heart damage, then it is vitally important to adopt a more positive attitude. Cautious and realistic optimism is associated with less depression and better overall outcomes; pessimism tends to have the opposite effect. How can you be more positive? For many people, waking up each morning and listing the things for which they are grateful—not the least of which is the gift of life—re-frames their medical predicaments as an obstacle to get over rather than an insurmountable barrier to happiness. In other words, focus your attention on what you have and still enjoy rather than what you’ve lost. For more on positive thinking, I suggest books such as Flourish and Authentic Happiness by psychologist Martin Seligman, Ph.D.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"I am studying pre-nursing now. I plan to apply for a job as a CNA in a couple of months. My current concern is my husband. He knew he had high blood pressure 2 years ago. He is 45 years old and he is a drinker. On average, he has 4 - 6 beers per day. He has gained a lot of weight due to his drinking habit and no physical activity. Now, he is going for Keto diet for the hope of losing weight, and he does not let me to cook for him. He complains that my cooking is to plain to eat. His Keto has full of of fat and meats. I am really concerned about his condition. He is very stubborn. I do not know what to do to help him."KimBach1234, Support Network Member
"Your husband is very fortunate that you cook for him and care so much about him. I understand your concern for his health; he does drink too much and is looking for short-cuts for losing weight. Unfortunately, though, I feel sure that the more you pressure him, the more he is likely to dig in his heels and defy you. The best way for you to wield influence, therefore, may be to praise him for any step he takes toward greater health—including the Keto diet—and not fuss with him too much about other things he should be doing. Recommend—but don’t push him—to see his primary care provider. Let that trained professional (not you) work with him on making better lifestyle choices—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"My Mom had a massive stroke today while she was in rehab recovering from what the Dr.'s believed was a mini stroke. The entire left side of her brain was affected and part of her right. The Dr explained in detail her grim diagnosis. The only thing the hospital staff can do is try to keep her as comfortable as possible. My Mom has been living with me for the past 15 years. She's not only my Mom she's my best friend. I informed the Dr. if there is no chance of recovery then I wanted a DNR added to her chart. They also removed the feeding tube they put in her and most of the other tubes as well upon my request. I told the Dr. I wanted Mom to come home with me and to have her placed on hospice care. This has occurred in less than 24 hours. My main question is how do I give her some food when she is completely unresponsive? Should I give her Gerber custard pudding or the like? A little bit added to her tongue for her to taste? I am completely out of my depth here and need any advice you can give. She made it clear to me years ago she would rather be dead than to be put in a nursing home to waste away. Please help me."Walker2019, Support Network Member
"Feeding someone who does seek food or indicate hunger is difficult. Thankfully, the body converts from sugar to ketones for energy and hunger subsides. If your mother had favorite tastes, introducing a small amount to the tip or side of her tongue may be pleasurable. Wetting a mouth applicator with a favorite taste may also suffice. Hospice care will help you provide your mother with excellent care and fulfill her wishes to die at home. Thank you, Dr. Joseph Hanna"Dr. Joseph Hanna, Neurology
"Our son was born with congenital heart disease but wasn't diagnosed till age 20. He had four open heart surgeries within 8 years. The last one was to put in a mechanical valve and repair an aneurysm on his heart. The night of the surgery he suffered a bilateral stroke. He has come along way since then. (14 months ago). He was always apprehensive about getting a mechanical valve because of the ticking sound. Now he is obsessed with this and worries about it stopping. As his mother/caregiver I want to help him to cope with this. How can I help him? If there is any info to help us, I would sooo greatly appreciate it. Thanking all in advance for any help. Donna"dandersen57, Support Network Member
"Your son’s stroke may have predisposed him to some psychologic difficulties. Even without a stroke people with artificial body parts can become obsessed with their function. Heart valve disease and surgery are common. An author and prosthetic heart valve recipient, Adam Pick, has written extensively on the concerns of individuals in The Patient’s Guide to Heart Valve Surgery. He also created an award-winning website HeartValveSurgery.com that may help your son. Lastly, please consider seeking out local assistance for your son with a psychologist specializing in medical phobias. Thank you for this question. Dr. Hanna"Dr. Joseph Hanna, Neurology
"Hello my name isDora my husband had a mini stroke just needed to talk with wives that been or going through with spouse. Need support I’m sad all the time about his recovery"DoraWilliams, Support Network Member
"Dora, your instincts are very good. Reaching out to others who have had similar experiences is an excellent way to better cope with your feelings of sadness and fear. The Support Network is an excellent place to find those others. I trust that you have already had some comforting and informative conversations with wives who are online here.Barry J. Jacobs, Psy.D., Clinical Psychology
A few of my own thoughts about your situation: Even though mini-strokes often leave little permanent damage, they shake people up terribly. Suddenly all sense of safety is stripped away. The aftermath is certainly a time for sadness. But, strangely, it is also a time for gratitude. As I’m sure your doctors have told you, mini-strokes are warning signs to heed to prevent a bigger stroke from occurring. You and your husband are lucky in a way; you have the opportunity now to change your lifestyles, live healthier, and reduce the likelihood of further misfortune. I feel sure the two of you will use this chance well.
Thank you, Dr. Barry Jacobs"
"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
"Is it normal to feel tired and depressed after a heart attack?"KimiT, Support Network Member
"Unfortunately, yes on both counts. Feeling fatigued after a heart attack may be due to decreased blood flow throughout your body, a side-effect of one of the medications you are now taking or a sign that your body is still recovering from the physical trauma of a heart attack. A fourth possibility is that the fatigue is due to the depression you may be experiencing. I suggest meeting with your primary care provider for an evaluation to help identify what cause or causes are responsible for your fatigue and depression and to consider appropriate treatments—changing your heart medication regimen, adding an antidepressant or referring you for counseling.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"My boyfriend of over 5 years had a heart attack at the age of 27. He isn’t on any drugs just a young man with a poor diet who was chain smoker. He had his heart attack on march 9th and had 2 arties clogged. Thankfully we made in into the ER in time where he then had to get a stent placed in. I understand he is struggling with this new life style now that he has to adjust his entire life. He’s quit cigarettes cold turkey since then. But I feel that his diet and his alcohol intake could be better. I tell myself every single day that it will get better. But emotionally it’s been getting harder. I can’t stress it enough on how he should’ve be grateful that he’s able to wake up and see another day. But it kills me inside that he isn’t concern about his diet and alcohol intake. The doctor gave us specific details tht he should only have 1 beer. But. I find him drinking 4 occasionally. I can’t sleep because I am always worried about his health. I just wish that this happened to me because when it comes to health he’s very ignorant nor cares to making any adjustments with diet and finding a new job that fits his health. I can’t stress enough and I can’t stop thinking about me not being able to live with myself if another episode to recurrent."Sangpanh, Support Network Member
"Your boyfriend is very fortunate to have you in his corner. This sounds like it has been a time of crisis and change for both of you. He has changed significantly—quitting chain-smoking is a tall order—but not enough to give you the assurance he is doing all he can to safeguard his health. Rather than remind him constantly about his eating and drinking and probably make him feel like you are nagging him, I suggest two strategies:Barry J. Jacobs, Psy.D., Clinical Psychology
--Write him a hand-written letter in which you express how much you care for him and how much his health and happiness mean to you. Ask him to take better of himself for his sake and yours.
--If you don’t think that direct approach would work, then I suggest you send a letter or leave a voicemail for your boyfriend’s cardiologist to inform him about your concerns for your boyfriend’s diet and alcohol intake. Let the doctor then do the dirty work of confronting your boyfriend about his health habits.
As the Serenity Prayer says, though, you will have to ultimately accept what you cannot change. If your boyfriend is ready to do more to help himself, then he will. If he isn’t and has more health problems, it will be extremely regrettable but not your fault. Really.
Thank you, Dr. Barry Jacobs"
"I experience bipolar 2, ptsd, depression and anxiety. But what works best for depression? Because I am taking prozac for bipolar 2, but it doesn't help depression even with a higher dose"Allie117, Support Network Member
"The treatment guidelines for Bipolar II Disorder call for an antidepressant (such as Prozac) and a mood stabilizer (such as Depakote or Abilify). Using the antidepressant without the mood stabilizer won’t work nearly as well for reducing depressive symptoms. I suggest you ask your prescribing provider to review your medication regimen. You may also want to consider psychotherapy as an adjunctive therapy. I hope you feel better soon!—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"Barry J. Jacobs, Psy.D., Clinical Psychology
"My husband is hearing impaired and sometimes it really stresses me out. What's the best way to handle it without getting frustrated with him. Thank you."Myheart66, Support Network Member
"Patience is more than a virtue. It is a skill learned with increased awareness and practice. So long as your husband is willing to wear hearing aids and do all he can to make it easier for you to communicate with him then his remaining hearing impairment is just going to be part of your relationship with him. You will have to adapt by choosing only quiet places in which to talk and regularly increase the volume of your voice.Barry J. Jacobs, Psy.D., Clinical Psychology
On the other hand, If he won’t get aids or wear the ones he has, then I suggest having a frank but calm talk with him in which you state plainly that he is making you unhappy. I hope he will then accept making changes for your sake and your marriage.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers"
"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"