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October 29, 2008 > The Story Doesn't End With a Stroke

The Story Doesn't End With a Stroke

Free Stroke Seminar Focuses on Critical Gains Made During Rehabilitation Process

One of the first things Washington Hospital Stroke Program Coordinator Doug Van Houten, R.N. points out during his educational talks to the community is that stroke, also known as a "brain attack," is the third leading cause of death in the United States. That's between 160,000 and 170,000 deaths a year attributed to strokes. Or one death every three minutes.

"But the story doesn't end there; this is just the beginning," Van Houten says. "There are 5.7 million stroke survivors living in America. Probably 18 percent to 20 percent of survivors are institutionalized in long-term care facilities in the first two months."

This is a major reason why so many people remain unaware of the enormous impact stroke has on the lives of community members - both stroke survivors and their caregivers.

For a person who has survived a stroke, their journey has just begun, Van Houten

On Wednesday, Nov. 5, Van Houten and Dr. Ash Jain, medical director of Washington Hospital's Stroke Program, will talk about Acute Management of Stroke and Chronic Care and Stroke Rehab during a free community seminar from 6 to 8 p.m. in the Conrad E. Anderson, M.D. Auditorium at 2500 Mowry Avenue in Fremont.

"When a person first has a stroke, it's an emergency and whirlwind," Van Houten says of the acute care process that Dr. Jain will discuss. "Then, once the patient has had all the acute care measures taken care of, and they've reached a chronic stage, this is when we really focus on rehabilitation."

From one individual to the next, stroke survivors might experience vastly different challenges and stages of improvement, according to Van Houten.

"For people that are really seriously disabled after a stroke, they will most likely go to nursing care facilities until they get better," he explains. "People with light symptoms after a stroke may receive outpatient care. For those in the middle, they will go to acute rehab centers, which are facilities that really focus, focus, focus on getting the person back to normal."

For patients recovering in an acute rehab center, they might spend a full day, from 8 a.m. to 4 p.m. in appointments with rehab specialists, including occupational therapists, speech therapists and physical therapists, all of whom focus on helping the patient try to recover as much function as they can during an initial two to three-week period.

"We always think of patients getting most of their function back within two to three months after having a stroke," Van Houten says. "But really the progress never stops. One woman had a stroke a year ago and just recently gave up her cane. It sometimes takes even years for people to get better.

"A positive attitude, access to good rehab and creativity - these are all really important aspects of the rehab process and a measure of how well somebody is going to do. The person who says, 'I'm going to beat this somehow' is going to be the person who gets better."

During the seminar on Nov. 5, Van Houten will discuss in depth the eight major challenges that face many stroke survivors, including ways rehab can help overcome these obstacles.

Challenges he will discuss include:
* Emotional problems/social deprivation: Between 40 percent and 50 percent of stroke survivors still struggle with depression years after having a stroke.
* Inadequate lung ventilation: Van Houten will discuss how speech therapy can help prevent patients from aspirating food and water when they swallow.
* Disorders of sensation: Patients that have numbness on one side after a stroke may tend to neglect that side, which can lead to safety issues, such as placing a hand on something sharp or hot resulting in injury.
* Incontinence of bowel and bladder: An estimated 50 percent of stroke patients will have some incontinence issues during hospital admission. This can make the difference between going to a skilled nursing facility and going home, Van Houten says.
* Oral/facial dysfunction: This includes problems speaking and eating caused by weakness or numbness of the facial muscles, which can contribute to aspiration and malnutrition.
* Abnormal tone in the muscles: If a limb becomes paralyzed after a stroke, it can become flaccid or spastic, which can lead to fractures and inability to walk well. Treatments include Botox(r) injections and other implanted medications.
* Movement problems: The inability to move independently can lead to social isolation, dependence on others and altered body images issues, as well as other physical problems associated with not being able to get up, including pneumonia, blood clots and pressure sores.
* Attitude of others towards the patient: Often when interacting with stroke survivors, other people, including caregivers, become frustrated with survivors trying to do things for themselves. Van Houten will discuss ways for patients and caregivers to help one another.

"After addressing these challenges, I focus on the benefits of rehab, including how the process can help stroke survivors regain function and independence," Van Houten says.

But stroke isn't something that only affects survivors, he points out. Caregivers for those who have had a stroke also face an uphill battle, and they need support, too. That's why Van Houten spends a portion of his talk addressing the caregivers, who are most often spouses.

"The caregiver is intimately involved in a patient's recovery, and traditionally they are new to the rehab process," he says. "This is why I talk a little to them and tell them how what they're doing is so important and so valuable. Their effort and energy is such a benefit to the patient."

Get the facts about stroke

To learn more about advancements in acute stroke management and the chronic care and rehabilitation process, join Doug Van Houten, R.N., and Ash Jain, M.D. on Wednesday, Nov. 5, from 6 to 8 p.m. at the Conrad E. Anderson, M.D. Auditorium, located at 2500 Mowry Avenue in Fremont.

For more information about Washington Hospital's Stroke Program, visit, click on "Services & Programs," select "Taylor McAdam Bell Neuroscience Institute" and choose "Stroke Program" from the drop-down menu.

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