Jun 1, 2019

Oxygen Getting to Brain Cells Is the Problem During Stroke, But Wait! There's Possible Relief Heading Your Way!

You don't do it for you, stroke survivors. You already had a stroke. You're thrilled for them, the loved ones who come after. But don't get too excited. Researchers have been only experimenting on mice and dogs so far. But if these results translate to humans, FDA approval is likely. Imagine reducing the side effects of stroke by restoring oxygen to the brain with an intravenous injection that has an oxygen carrying drug molecule so small it passes through the clot like water passes through sand.  It would be administered as soon as side effects appear and should have no downside effects if it’s deemed safe. Many possibilities for the drug exist like stroke. Tissue oxygenation is possibly coming your way and quite soon. 

Mike Sheikh, with a pedigreed degree, a Pharma consultant, and a load of smarts, shared this with me. Here is the fascinating discovery authored by Mike Sheikh himself.
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Extending the Golden Hour for Stroke Victims 


Researchers refer to the first hour from the onset of stroke symptoms as “the golden hour” because “time lost is brain lost.” The sooner the patient gets in the que to get a diagnosis for the type of stroke, the better the outcome.  Diagnosing a stroke is as simple as FAST which stands for Face, Arms, Speech, and Time.  The time it takes to identify the patient is suffering from a stroke is only 1 minute, but the paradox is that treatment cannot begin until imaging is complete and the doctors have ruled out a hemorrhagic stroke.  
According to a UCLA research study the average time from onset to treatment is 2.5 hours.  Ischemic strokes which account for 87% of all strokes can be treated with a powerful clot busting drug called Tissue Plasminogen activator (tPA).  Ethics dictate that doctors can do no harm.  This means that even though there is an 87% chance that tPA will bust the clot and stop the brain from dying, medical professionals have to sit on the sidelines while the brain deteriorates until the diagnosis is complete.  If any hemorrhagic patients were given tPA, they would surely die.


Average Stroke Patient Experiences Almost a Decade of Brain Aging Before Treatment

The focus to reduce the time to diagnosis is critical with respect to brain aging.  Patients receiving treatment sooner than 2.5 hours had a better ability to walk, live independently, and had reduced mortality.  The clinical benefit of tPA was best used before 4.5 hours of onset.  Studies have shown that an ischemic stroke consumes almost 2 million neurons ever minute until blood flow is restored.  This translates into 14 billion synapses lost and 7.5 miles of myelinated fibers lost every minute and accelerated aging of the brain by 3.1 weeks.  

In a typical stroke scenario 30 minutes is spent getting to the hospital which results in a brain aging of 1.8 years and then the additional 2 hours to get imaging results in another 7.2 years of aging.  This brings the total aging of the brain to 9 years in the average stroke case.  The indirect cost of stroke care in terms of lost productivity and care taking is estimated at $22.0 billion annually.     


Fast Treatment Has Medical Benefit
Researchers also found that faster treatment results in better outcomes. They have quantified that to mean that for every 15 minutes knocked off the time to treatment results in a 4% greater chance of walking, 4% less likely to have a brain hemorrhage, and 4% are less likely to die. Putting this into perspective, if brain tissue oxygenation could be restored in 15 minutes, there is a 40% great chance of walking.  

Blood Clots are Actually Porous and Not Impermeable Barriers
The crux of the problem during a stroke is getting oxygen to the effected brain tissue.  The only transport mechanism to the effected brain tissue are through the arteries blocked by a blood clot.  Blood clots, however, are not solid impermeable barriers and are more like fish nets full of fish (blood cells) that will allow smaller molecules and fluid to pass.  So when the road is closed to large oxygen transporting vehicles like the red blood cells, they are still open to the much smaller co-polymers in the blood plasma that pass without consequence.  When these arteries start to form clots, they are exacerbated by fibrins that eventually form a net that ends up trapping more red blood cells.  Fibrinogen is normally dissolved in blood plasma and through a cascade of interactions generates thrombin which converts the fibrinogen in the blood plasma into long strands of fibrin that radiate from the clumped cells designed to trap more blood cells.  [Bottom line:] Instead of breaking up the clot, the simpler solution is to try to get an oxygen delivery vehicle that is small enough to pass through the clot.     

The Oxygen Bridge


The key to overcoming the blood clot in the brain is to think small.  This is where BXT-25, a developmental drug that is 1/5000th the size of a red blood cell, might have the right idea.  BXT-25 is a combination of Heme (from hemoglobin) and a co-polymer designed to stabilize it in the bloodstream.  BXT-25 can stay active in the blood for up to 9 hours.  Heme is the chemical structure that carries oxygen and is the fundamental building block of the human body’s oxygen transport system.  It is injected intravenously and then circulates within 3 minutes through the blood stream and picks up oxygen in the lungs and transports it to various tissues and organs including the brain.  

The concept behind this drug is to allow a first responder to give a stroke patient an oxygen bridge until imaging can identify the type of stroke and apply the treatment. [No matter what kind of stroke!] Providing this oxygenation has no downside risk regardless of the type of stroke, unlike the tPA, which could kill a hemorrhagic stroke victim. Getting this vital oxygen to the brain could dramatically improve patient outcomes and greatly reduce the amount of recuperation time from a stroke.  


BXT-25 could break the paradigm of the golden hour and put this lifestyle-saving drug in the hands of first responders much like the AED improved outcomes for patients undergoing cardiac arrest.
     
BXT-25 [BXT stands for the name of the company, Bioxytran] could be a game changer in the treatment of stroke patients.  The drug is currently under development and is NOT FDA approved.

For more information on how it works visit the website or play this video of how it works.
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Remember to click on the links to the website and video. Again, it's only being tested on mice and dogs, but that discovery is huge if the results translate to humans. Mike thinks that FDA approval could occur within 2 years. 

And keep this in mind. Prof. Avraham Mayevsky, on the Advisory Board of Bioxytran, is a worldwide authority in the field of minimal invasive monitoring of tissue and organ physiology, a professor in Israel at the Faculty of Life Sciences, Bar-Ilan University. 

Final point: Again, many of my readers already had a stroke. But stroke can be hereditary. So think of them

May 25, 2019

The 10 Most Read Posts Since My Blog First Appeared 10 Years Ago

I love to blog. (And I won two awards--one from Medical News and the other from Feedspot). It's a catharsis in a way, defined by Merriam Webster as the purging of emotional tensions, relieving oneself of the feelings that through catharsis, arise to the surface. In the 10 years my blog, The Tales of a Stroke Patient and More, has been alive (as opposed to "live" which in my mind doesn't have the same impact), I have always liked to bring you, my dear readers, thought-provoking and inspirational tales to keep your mind working.

There is a counter when you write for Google's Blogger which shows, among many other things, the 10 most read posts to date. I hope you gain something from them if reading for the first time, or re-read them for reinforcement, published around the world in every continent except Antarctica. (I'm starting to wonder if anybody even lives there!) Here they are in order:

A Place for EVERYTHING Stroke and Other TBIs--strokefocus.net 

(10,095 readers)

This is the story of amazing Daniel Gu and how he founded Strokefocus.net, the completed website coming in June. It's a touching, almost tear-producing process of his recovery. 

Alcohol and Stroke: You May Be Just Asking For It 

(8681 readers)

This post created some brouhaha because people took offense that it was directed at them instead of thanking me for the information. Oh, well. No good deed goes unpunished. 


The Words I've Been Longing To Hear: An Energizing Visit from the Cable Guy 

(8,360 readers)

Don't get any ideas of an intimate nature! We were just having a conversation. That was the first time the cable guy and I spoke without asking me to repeat myself. The post has near-comical elements.


Fatigue and Stroke, aka I'm Hittin' the Wall 

(7,838 readers)

The world is filled with acronyms, and this post follows suit.  It's called PSF, Post Stroke Fatigue, and explains possible reasons for PSF and the foods that combat it. 


How Two Legal Drugs Caused My Hemorrhagic Stroke 


(6,717 readers)
The thinking was I was allergic to Heparin which isn't an allergy at all. As a result, the doctor finally took away every blood thinner. The right thing to do? Not really, I learned much later on. 


Caregivers Are Suffering; Stroke Survivors Are Suffering: Who Has It Worse?


(5,964 readers)
When it comes to caregivers, they are passionate about the position whether they are burned out or lovingly embrace it. But GFYS? That came from one of the burned out ones. 


Can't Do's and Can Do's: A Stroke Survivor's Thoughts


(5,389 readers)
I open up on my limits. Ten for each. If I think about my 10 "can't do" set , I try not to dwell on it. After all, I have 10 "can do" activities that follow.


Thoughtless Person: You Didn't Finish the Book YET? Stroke Survivor: No, Dumbass. Remember? I've Had a Stroke!


(5,339 readers)
Dyslexia and aphasia are only two of the subjects discussed. I read slower now, but I read, and other disorders are included. That title, by the way, happened to me.


Ten Things NOT to Say or Do to a Stroke Patient


(5,274 readers)
Insensitivity is at the heart of this post. After I wrote this post, some other bloggers copied the title. I didn't mind because that's stroke awareness, front and center. 


Sex and the Stroke Survivor: A Case of Futility?


(5,046 readers)
Sex is very important to some people, but after they had a  stroke, not so much anymore. Tips on how to do more are included with illustrations even. Hoo-hah.


May 19, 2019

Life and Death, the Great Equalizers

Michael R. Strain, the well-known economist, once said, "That we all start life helpless and completely dependent means we have much more in common than I appreciated a year ago" [when his son was born]. I had the same newly-found thoughts like Strain when my boys were born, and for the one I lost in between, too, as birth being an equalizer. 

The other side of the discussion at hand? We all die. Thus, the title of this post. But of the two--birth and death--death is recognized as the greatest-of-all, the king-of-the-hill equalizer. "You can't take the money with you when you die," my father would always say about wealth amassed during any person's funeral. He died, too, and he followed the everlasting rule. #6, says the angel.



Once in a while, more often now, I think about death. The thoughts are random. I think to myself, in less than 10 years, I'm going to be 80. I feel 50, even now that I had a devastating, close-to-death stroke and wearing the leg brace. Go figure.

People always commented on my youthfulness, that I seemed 10 years younger than my current age.

"45?" they would say. "You look 35!"

"Come on. 55? You look 45," they argued. 

Those contradictions, that I looked younger than I currently was, all evaporated when I turned 65. Nobody says anything remotely like that anymore. Sometimes, I prompt them. They roll their eyes.

The baby boomers, some of them, maybe even most of them, and I believed in perpetual youth up to around 60 years old. Many of them are fixated on not only being alive but looking younger as well. There are under-the eye creams for bags, wrinkle products to get rid of those very fine lines, sometimes only apparent to you, and Jennifer Aniston and the like extolling the merits of items that give you a youthful glow. I tried them all. Hogwash. Growing old is not for sissies, Joyce #2's father would say. It sucks. 



It's better that the alternative--death, I mean--unless you're willing to die, even welcome death, and not discover how stories turn out while you're alive. For example, I don't want to die: 
Before I know if I will ever be a grandmother 
Before I'll finish the 5th book (I'm working on #3 currently) 
Before I improve enough to do a 5-mile walk without stopping

The country artist, Randy Travis, said it best in the song, Three Wooden Crosses:
I guess it's not what you take when you leave this world behind you.
It's what you leave behind you when you go.


https://www.youtube.com/watch?v=cP8lCapcqwM

The final thing I'm going to blurt out in this stream-of- consciousness rant: if you're feeling anxious right about now, if I put thoughts in your head that you wish weren't there, watch  this video to feel better.  


https://youtu.be/PpJoM1Yvm-Y

Um, feel better now?