Can Brain-Injured People Ever Achieve Prolonged Happiness, aka MY List Doesn't Have to Be YOUR List

People who tell you that they experience complete happiness every hour of every day are delusional. For example: If you sent someone a virus warning by forwarding the email so they could see what it looked like and forgot to remove the infected attachment, or if some barista screwed up the order and you got espresso--which you drank--instead of decaffeinated, or if you put on mismatched socks because it was early in the morning and still dark outside, and you had to endure working like that in the office all day, there's a "shit" or "wtf" or something like it in there somewhere, even if you don't say it out loud.

Come on. That's life, and it gets tough sometimes. It's not supposed to be perfect. But what about the brain injured, including stroke, who have more good reasons for having a sub-par day. What about them? 

Without further ado, here is my list for achieving happiness  as a stroke survivor, in no particular order because they each make me smile--and yes, for a prolonged while. 

1. Listening to or playing music  

Debbie Hampton, the creator of the site The Best Brain Possible (https://www.thebestbrainpossible.com), wrote, "Research shows that listening to music can reduce anxiety, depression, blood pressure, and pain as well as improve sleep quality, mood, memory, increase some cognitive functions, enhance learning and ward off the effects of brain aging." She continued to say that music stimulates your whole brain because music is structural, mathematical, and architectural based on connections between one note and the next. 

[Just a sidenote: I am now in a band now and I feel one of the happiest moments ever while I am playing the keyboard, (even with only the left hand).]

2. Having a good hair day

If you can remember, though it was long, long ago, there weren't any blow dryers or Moroccan oil to tame one's hair. As a result of that time, I sometimes was known as frizzy headed. But now, with blow dryer and oil in hand, I can even stand in the drizzle and my hair, though it would change into gentle curls, wouldn't get frizzy. So...good hair day ranks in the top 10.

3. Getting "Shares" on Facebook

To think that I've said something that matters to other people gives me joy. I haven't counted, but the posts on my blog, The Tales of a Stroke Patient and More, occasionally get shared which means the posts are shared with their friends, which means those people who shared my posts thought it important enough for all of their friends to observe.  

4. Trying a new meal 

I like try new to try new recipes at home and that makes me happy if it meets the requirements. I can't use a knife with only one hand so the recipe has to contain bite-sized pieces that I could munch on or sandwiches that I can hold. For example, my assistant bakes chicken (I don't like the deli stuff) and, when it's finished, slices it up with a teaspoon of barbecue sauce drizzled over the chicken, and puts it on low carb wheat bread. The remainder she freezes, wrapping them individually in tin foil. Ask me in the Comments section for other recipes if you can't use a knife.

5. Walking faster with my quad cane

It's a difficult line to draw. I do not want to jeopardize safety by walking too fast, yet I walk too slow for fear of going too fast. So how fast is too fast? 

In the study Determinants of Walking Function After Stroke: Differences by Deficit Severity," Dr. Shawnna L. Patterson et al found that "balance, cardiovascular fitness, and paretic [having paralysis] leg strength are all important factors involved in determining a person’s long and short-distance walking function after stroke. Balance is more important in those with more severe gait deficits, whereas cardiovascular fitness plays a greater role in those with milder deficits." 

I want both--balance and cardiovascular. So trial and error will not be looked by me as a drudge but rather as an adventure in walking.

6. Watching human-like animal behavior 

I'm healthily addicted--and happy--when I see ordinary animals doing extraordinary things. In the image above, Tori, the Indonesian Orangutan, goes to her zoo keepers when she has a tantrum if she doesn’t get her daily fix! 

And then there's Abe, my son's cat, who eats corn on the cob if my son holds the cob on both ends. Munch, munch, goes Abe without pausing. Hilarious!

7. Finishing sentences using the right words

It brings me great happiness when I can finish a sentence on my own! I have aphasia, a communication disorder that in my case is finding the right word, usually the last word. "It's so, er, um," I would say in the beginning of the disorder post-stroke, struggling to finish the sentence. It's improving, but I'm working tediously to fix it by looking up every word obsessively that's new to me or getting a different slant on a word already known. It's a mental workout. I tell people who want to finish my sentence in a nice way to fuck off. And to think that I used to speak for a living!

8. Taking a long shower

I love a warm shower to the point of smiling. Dr. David Greuner, surgical director of NYC Surgical Associates, says, "Generally speaking, the ideal shower is a warm, five to ten minute shower. Hot showers are great when you’re sick to help moisturize the nasal passages and help decongest you." And most people know that a hot shower can also ease aching in sore muscles (which I always have). 

9. Making peace of mind my priority

When my sons are happy and healthy simultaneously, when I'm not falling, when I have money left at the end of the month, when my frozen-to-microwave chicken sandwiches didn't run out before a marketing trip, when all my plants are bug free, I have peace of mind. And that make me happy.

10. Joining hands around the globe for world peace

Not gonna happen tomorrow, or next week either. But when it does, you'll see me smiling broadly. 

Write about your list in the Comments section and I'll feature it in the blog!

Or maybe you don't have any list. In that case, please get on it. In my opinion, things that make you happy are to be known and celebrated.

Stroke Survivors: R U OK? and More--Conversations About Suicide

Hang with me here. It's time. I want talk about something which is taboo in most social circles. It's kind of more like a one-to-one conversation. The topic? Suicide. I know many--a husband who had a loving wife and children, three friend's nephews, a distraught colleague, and so many more who committed the end-of-life drama prematurely. 

R U OK? has an organization that addresses just that. I wrote to them and here is their reply:  

"At the moment, R U OK? operates only in Australia out of a single national office in Sydney. We are currently developing a formal international health promotion partner framework, which will follow on from an international trademarking process. This process is taking some time and isn’t finalised as yet.

"Ideally R U OK? is seeking to expand this initiative internationally with suitable organisations interested and capable of being the central point of contact and health promotion partner for the R U OK? campaign within their countries. Until this happens - anyone interested in promoting the R U OK? message, you may download and use the existing resources from the R U OK? website (www.ruok.org.au) to promote R U OK? within your internal environment only.

"Similarly, you may share existing R U OK? social media, video and other content through your own channels. The R U OK? logo is trademarked, so no changes may be made to the logo. No changes or alterations may be made to the content, unless you change language to be culturally relevant or appropriate. We also recommend that you provide links or information of localised help/health services within your region. [Sorry, Australia. Not too much here in America].

"It’s critical that any organisations or individuals understand and respect R U OK?’s positioning and role as an early intervention campaign, within the suicide prevention health promotion space."

R U OK?’s mission is a world where we’re all connected and are protected from suicide and to inspire and empower everyone to meaningfully connect with people around them and support anyone struggling with life.

R U OK offers a 4-steps plan to a conversation: 
Ask ‘R U OK?’
Listen
Encourage Action
Check-in/Follow-up

'How to Ask’ page is located at http://www.ruok.org.au/how-to-ask.

At home in America, Representative Susan Wild, a Congresswoman, gave this impassioned speech to her colleagues that cried out for more measures regarding mental health. She, and her family and friends, too, were a victim of her husband's unsuspecting suicide. 

https://www.cnn.com/videos/politics/2019/06/27/susan-wild-partner-suicide-kerry-acker-speech-sot-vpx.cnn

“Routine screening of suicidal ideation after stroke, especially targeting subjects with specific characteristics, is needed to plan pharmacological and psychosocial interventions aimed at reducing suicide risk,” Dr. Francesco Bartoli, MD, PhD, University of Milano Bicocca (Monza, Italy), and colleagues said.

But here is the twist in suicide: Stroke survivors are more than twice as likely (learned opinions say even higher) to attempt suicide within a decade of their stroke than non-stroke patients, according to a nationwide study of more than two million Taiwanese adults.

The Neurology Times write that though the illness is an immense global presence and the most common cause of disability worldwide, cultures handle stroke diagnoses in different ways, Tomor Harnod, MD, PhD, and colleagues wrote in the Journal of the American Heart Association. In developed Western countries like the U.S., stroke patients are usually highly intolerant of their disability, which has led to increased rates of suicidal ideations and attempts in those populations.

“In different countries, cultural heritage and socioeconomic status would usually influence a patient with disability thinking about a suicide attempt,” the authors wrote. “Ethnic and cultural differences from Western countries may make Asian people more tolerant of their impairment, dependence or disability in daily life than their European or American counterparts.”

The National Institutes of Health in conjunction with American Academy of Neurology completed a study that will amaze you.

Headed by Swedish researchers in the remarkably morose study entitled "Poststroke suicide attempts and completed suicides: A socioeconomic and nationwide perspective," the researchers found the following:

This nationwide cohort study included stroke patients from Riksstroke (the Swedish Stroke Register) from 2001 to 2012. We used personal identification numbers to link the Riksstroke data with other national registers. Suicide attempts were identified by a record of hospital admission for intentional self-harm (ICD-10: X60-X84), and completed suicides were identified in the national Cause of Death Register. We used multiple Cox regression [explanation: method for investigating the effect of several variables upon the time a specified event takes to happen] to analyze time from stroke onset to first suicide attempt.

RESULTS:

We observed 220,336 stroke patients with a total follow-up time of 860,713 person-years. During follow-up, there were 1,217 suicide attempts, of which 260 were fatal. This was approximately double the rate of the general Swedish population. Patients with lower education or income (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.11-1.68) for primary vs university and patients living alone (HR 1.73, 95% CI 1.52-1.97) had an increased risk of attempted suicide, and patients born outside of Europe had a lower risk compared to patients of European origin. Male sex, young age, severe stroke, and poststroke depression were other factors associated with an increased risk of attempted suicide after stroke. The risk was highest during the first 2 years after stroke.
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Here's a little-known fact: I contemplated suicide in the first 2 years after my stroke, but I couldn't move around too much to finalize and, the thing that made me ultimately NOT do it, was my boys would take it so hard. I couldn't do that to them. After the 2 years passed, I wanted to do it less and less. And now almost 10 years later? No suicide thoughts at all.

That's the thing with a stroke. You get better over time, but the waiting is abhorrent, so much so that you might think about ending it all at the beginning. But just thinking about it, if you think about suicide at all, is enough for most of us.