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This issue features the importance of increasing physical activity through recovery, from rehabilitation to the goal of independent exercise and options for that exercise. Check out our heart-healthy salad dressings using some oils you might enjoy experimenting with. Learn about the latest findings in the the immediate treatment of stroke.

Fall 2015Rehabilitation will Lead to Physical Activity that will Lead to Independent Physical Exercise

Physical exercise is great medicine for stroke survivors. The American Heart Association says physical exercise has positive “physiological, psychological, sensorimotor, strength, endurance, and functional effects” on recovery and beyond. It can reduce risk of re-stroke by managing blood pressure, blood sugars, weight and other risk factors.

After patients are diagnosed with stroke, rehabilitation begins in the hospital the first day and continues months beyond the time the patients are discharged. After the conclusion of therapy, stroke survivors will only continue to recover and improve if they are able to cross the gulf from rehabilitation—with the encouragement and direction of professional therapists—to independent physical activity and exercise.

Patients have a variety of options for bridging this gulf. Starting in September, the Stroke Center offered a Yoga-Tai Chi Mash Up, a balance class for stroke survivors. Volunteers Cindy Bonilla and Marianne Wick teach a stretching and balancing routine that students can continue at home. The class has been a great success and will be repeated starting mid-January 2016. Michelle, a recent stroke survivor, said “Taking the class gave me the confidence to sign up at the fitness center.”

Valley Medical’s Fitness Center also offers a therapeutic membership for people with medical conditions who would benefit from low- to moderate-intensity exercise under the supervision of an instructor. The Stress-Free Water Exercise offered several times a week in the Fitness Center pool is a great class for patients interested in low to moderate intensity activity.

This year, the Fitness Center has also partnered with Pinnacle Health to create a four-month wellness program that incorporates a total wellness profile. This includes diet, exercise and a medically-supervised weight loss regimen.

Find out more by downloading this flyer.

For those who like getting outside, South King County is also home to many smooth (and disability-friendly) walking and biking paths. The six-mile Soos Creek Trail which starts in neighboring Kent is a perfect example.

View the Soos Creek trail map.

NUTRITION AND PHYSICAL ACTIVITY

Improve your Cholesterol Levels by adding Omega Oils into your Diet—Here’s Two Salad Dressing Recipes to get You Going!

French Walnut Oil Vinaigrette

1 tablespoon roasted walnut oil

1 tablespoon balsamic vinegar

1 teaspoon Dijon mustard

Salt to taste (but not too much)

Flaxseed Oil Dressing

2 large cloves of garlic, crushed

1/4 cup flaxseed oil

1/4 cup fresh squeezed lemon juice

2 tablespoons white wine vinegar

RESEARCH NEWS / STROKE RESEARCH

New Stroke Prevention Efforts May Be Paying Off

Fewer people are being treated in U.S. emergency rooms for strokes caused by blood clots in the brain, which experts read as a sign that current stroke prevention methods are working.

The rate of ER visits for either a stroke or a mini-stroke (transient ischemic attack)—a temporary blockage of blood flow to the brain—decreased dramatically between 2001 and 2011, according to a new U.S. Centers for Disease Control and Prevention report.

Such ER visits declined 35 percent for adults 18 and older, and 51 percent for those 55 to 74, said the report from the CDC’s National Center for Health Statistics (NCHS).

The reduction in stroke is likely due to better control of risk factors. People are preventing strokes by taking cholesterol-lowering statin drugs and medications to control high blood pressure. In addition, fewer people are smoking, which is a leading risk factor for stroke, and indoor air laws are limiting nonsmokers’ exposure to secondhand smoke.

The CDC report, published in the March NCHS Data Brief, also contained evidence that doctors are providing more comprehensive care for stroke victims, experts said. For example, doctors more frequently used MRIs or CT scans to evaluate a patient who came to the emergency room with signs of a blood-clot stroke, the CDC report found.

The percentage of ER stroke visits that involved an MRI or CT scan increased 39 percent between 2001 and 2011. Scans are a critical piece of care for a stroke. Scans help determine whether the stroke is caused by a bleed in the brain or a clot. Both types of strokes require quite different, and in many cases, time-critical treatments.

Experts also found it encouraging that more patients are being admitted into a hospital for treatment after showing up in an ER for stroke. Less encouraging is that fewer people are arriving at the ER by ambulance after suffering stroke symptoms. The percentage of ambulance-transported stroke patients younger than 75 decreased 41 percent between 2004 and 2011, the report found.

Data and studies have shown that if you have a stroke and you get to the hospital early by ambulance, you have a higher chance of being treated with clot-busting drugs than if you arrive by any other mode of transportation. Clot-busting drugs are only effective when given soon after onset of stroke, and doctors may choose not to use them if hours have passed.

“Whenever anyone has symptoms suggestive of stroke, assume it’s a stroke and call 911 right away,” says Michael Previti, MD, Medical Director of Valley’s Stroke Center. “Get to the nearest emergency department as soon as possible.”

Valley Achieves Highest AHA Distinction for Stroke Care Valley Medical Center is nationally

recognized for achievement in stroke treatment, receiving the American Heart Association and American Stroke Association’s 2015 Get with the Guidelines Gold Plus Quality Achievement Award. The award recognizes VMC’s commitment and success in implementing excellent care for stroke patients, according to evidence-based

guidelines. In addition to the Get With The Guideline-Stroke award, VMC has also been recognized as a recipient of the association’s Target: Stroke Honor Roll Elite Plus, for improving stroke care. This Honor Roll designation is the AHA/ASA’s highest distinction awarded for Valley’s achievement in delivering tissue plasminogen activator, or tPA, within 60 minutes of arriving at the hospital (known as ‘door-to-needle’ time) to at least 75 percent of the hospital’s eligible ischemic stroke patients AND door-to-needle time to within 45 minutes in 50 percent of the hospital’s eligible ischemic stroke patients.

RESOURCES

Medical Science that Involves Stroke Survivors in Developing New TreatmentThrough our affiliation with UW Medicine, Valley is assisting the University of Washington Vascular Imaging Lab in enrolling volunteers in a study that will attempt to determine whether MRI can identify arterial plaques that are a high risk factor for stroke. You might be eligible to participate in this study if you:

• Have recently had an ischemic stroke

• Are willing to travel to UW Medicine South Lake Union in Seattle

• Are able to tolerate a MRI with contrast

• Are interested in participating in new treatments for stroke!

For more information, please contact the Research Coordinator Kristi Pimentel at kristidb@uw.edu.

Book CornerHigh profile celebrities, Kirk Douglas and Patricia Neal, both faced personal challenges following stroke and overcame them to continue to live in the public eye. Learn more about their interesting and fulfilling post-stroke lives.

My Stroke of Luck by Kirk Douglas

Prior to having a stroke during his 80th year, Mr. Douglas approached life as a positive, energetic and grateful person. If you add “honest” to that, then you have his approach to life after the stroke. His primary challenge after the stroke was the physical inability to talk, severe dysarthria. A huge problem for anyone, but especially devastating for an actor, Mr. Douglas had to relearn how to create sound so that others could understand his words. But true to his approach to life, he turned his energy toward a positive and grateful attitude. He recounts his recovery and ends the book with “My Operator’s Manual” sharing advice like “1. When things go bad, always remember it could be worse.”

Locate in the King County Library

Patricia Neal: An Unquiet Life by Stephen Michael Shearer

This biography is quite different from Mr. Douglas’s. It recounts Patricia Neal’s entire interesting life, with the story of her illness and recovery from three strokes nestled in the middle. A Hollywood actress who starred in dozens of films, she was also an Oscar winner. Married to Roald Dahl, the children’s writer, they had several children before she was struck with three hemorrhagic strokes during pregnancy. The strokes left her paralyzed on the right, and resulted in double vision and difficulty in speaking. She recovered completely and went on to establish The Patricia Neal Rehabilitation Center. She then went on to win a Golden Globe for her role as the mother in the original Waltons family movie, “The Homecoming.”

Locate in the King County Library

SEMINARS AND EVENTS

Stroke Club 2015

In 2016 the Valley Stroke Club (the stroke support group) will be available to you in the evening. This periodic event is for stroke survivors and their spouses and friends to come together for support and to learn from each other. The Stroke Club normally meets the last Tuesday of the month. For more information, call Rehabilitation Services at 425.228.3440, ext 5665 or visit valleymed.org/rehab.

Medical Arts Center (MAC), 4033 Talbot Road South, Renton, Conference Room C

NOVEMBER 24, 1:30 PM

Presentation: “You are what you eat”

DECEMBER 1, 6 PM

Help organize the agenda for the following year. It’s a potluck, so bring something to share.

Discussion will include changing monthly meeting time to Tuesday evening for 2016 and suggested topics of interest to support and learn from each other.

View 2015 Stroke Club schedule

Free Stroke Center Classes for the Community

CHAIR YOGA AND TAI CHI MASH-UP BALANCE & EXERCISE CLASS

January 14 to March 17, 2016Thursdays, 1 PM – 1:45 PM Medical Arts Center, Room C

Physical activity is key to living well—not just to survive, but to thrive!

Join us for the Chair Yoga and Tai Chi Mash-up Balance & Exercise class for post-stroke stretching; balance improvement and general physical activity for stroke survivors and their partners.

This class is limited to 16 people. The class is FREE, but registration is required on a first come, first served basis.

Register for each class session you would like to attend

you would like to attend.STROKE CENTER HOME PAGE

Stroke Center

StrokeSURVIVOR Living and thriving in a post-stroke world

The Newsletter of Valley Medical Center’s Neuroscience Institute’s Stroke Center