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

(This post is not only for stroke survivors. It is for caregivers, family, friends, health professionals, and others who want to understand fatigue and stroke).

I always pushed myself to the limit. I was like my father, who was shot in his auto parts store by some robbing druggies in 1971 and died on the spot, putting an end to his boundless energy. He worked twelve hours a day, seven days a week, and yet, when he returned home, he ate dinner at 8pm, and sometimes went out again, and always on the weekends, with my mother, who was a stay-at-home mom and had to deal with my boundless energy.

But now that I've had a stroke, my energy has boundaries. All my friends will tell you. I get an entire list of the things I want to do in a day, but I'm always changing the schedule because when it comes to the list, I'm just too damned tired to finish all of it. Why is that? I wanted to know, and I found out a whole lot.

Everybody feels tired at some point. It's the body's way of saying, "Slow down and rest awhile." But the National Stroke Association (NSA) says that post-stroke fatigue (PSF) affects as much as 70 percent of stroke survivors. PSF happens without warning and happens as much as years after the stroke. PSF is not just feeling tired and wanting to take a nap. With PSF, you have to take a nap.





The NSA identified 3 types of fatigue for stroke survivors:

Cognitive (ex: mental fatigue, difficulty focusing, delirium)
 

Physical (ex: function limitations, spasms, pain, muscular weakness, interrupted sleep)

Emotional (ex: motivational deficits, depression, crying and laughing at odd intervals)

I encountered all of them. On the cognitive side, I still have mental fatigue and usually rest once a day; just resting, not necessarily napping. I seldom have difficulty focusing, and deliriums only the first year. I have all of the physical ones randomly, except for function limitations all the time. I have right-sided weakness—a paralyzed arm and I walk with the aid of a quad cane. As for emotional fatigue, I am still, somehow, motivated, but I had depression the first year and off and on since then, and less now. I cried and laughed at the wrong times and places, but that confusion went away after two years.

Aside from different types of fatigue, some medications may point to or worsen fatigue. The medication dosage, the time of day of the medication, or the actual medication itself may need to be adjusted.

Be aware of time and place. Loud stimulation such as music and crowds can be overwhelming for a stroke survivor and bring on fatigue. Some survivors keep a diary of the times a places where fatigue occurred--hand-written or recorded--and if that's so, don't take this diary lightly. Remember, a stroke survivor doesn't want to take a nap; they have to take a nap.

Look for which activities have the greatest impact on stamina, or energy level. (The ones in parentheses are my reactions). Is it watching a sports events? (If the team is winning, go team!) Going shopping? (Absolutely nothing gets in the ways of shopping, especially for clothes). Having a meal? (I didn't fall asleep during a meal. Ever).

The top 10 foods, according to the NSA, that can help ward off fatigue include:

1.   Walnuts
2.   Pumpkin seeds
3.   Quinoa
4.   Yogurt
5.   Whole grains
6.   Wheat bran cereal
7.   Red bell peppers
8.   Tea
9.   Watermelon
10. Dark chocolate

But listen up! Every stroke, just like snowflakes, as the yarn goes, is different. As for me, once I found this list a while ago, I eat them all except pumpkin seeds. They make me cough. And I don't take as many naps every day since.

According to strokeassociation.org, survivors expend more-than-normal energy to do everything.

“You may have less energy than before because of sleeping poorly, not getting enough exercise, poor nutrition or the side effects of medicine. You have as much energy as before, but you’re using it differently because of the effects of your stroke. Things like dressing, talking, or walking take a lot more effort. Changes in thinking and memory take more concentration. You have to stay 'on alert' all the time--and this takes energy,” says the association.

In an article entitled “Post-stroke Rehabilitation: Fatigue After Stroke,” Ed Koeneman says, “The medical conditions of a survivor, such as diabetes, heart disease, anemia, respiratory disease, migraines, or pre-stroke fatigue can contribute to a [stroke] survivor's post stroke fatigue. This is because the stroke itself or the side effects of stroke medication may worsen the survivor's fatigue.

"Sleep apnea is also relatively common among stroke survivors and is reported in high rates among individuals who report fatigue after stroke. However, no solid relationship has been proven," says Koeneman.
 

 And there it is--"no solid relationship has been proven." My belief is that stroke fatigue falls to the back burner, but use the suggestions in this post. They may help. One reader, a stroke survivor, wrote, “Every time I turn the television on and water the plants with one hand simultaneously, I get re-energized.” Good for you, C.L. Whatever works.
------------

In collaboration with http://www.just-health.com.au

The Yin and the Yang of Vaccinations and Strokes

Vaccines have been hurrah-ed as one of medicine's top success stories which have eliminated a host of dastardly diseases in the US. And stroke in childhood is very rare, affecting about 6 in 100,000 per year, according to the National Stroke Association. So what's the connection between vaccinations and strokes? It all comes down to the ying and the yang.

The Yin

In an article entitled “Vaccine-induced strokes on the rise among young people,” published by Natural News, Heidi Stevenson writes that vaccinations are “the elephant in the room” when it comes to a factor for so many younger people getting strokes.

In October 2007, the American Academy of Neurology published a report and found that “between the years of 1993 and 2005, the stroke rate among individuals under the age of 55 increased by more than 44 percent.” Many health professionals said lack of exercise and poor dietary habits might play a factor as well. But vaccines might contribute, too, says Stevenson, with causing seizures and strokes in the young as well.

"A range of neurological disorders [is] associated with vaccines, including macrophagic myofasciitis, encephalopathy, epilepsy, convulsions, Guillain-Barre syndrome, nerve deafness, blindness, paralysis, sudden infant death syndrome, and of course, autism," writes Stevenson. "Now that the earliest recipients of mass vaccination programs are entering middle age, why should we be surprised to find that they're more likely to suffer from another indication of brain damage, stroke?"

A Canadian doctor, Andrew Moulden, who has been in practice for close to 30 years, uncovered the truth before Stevenson. Dr. Moulden discovered that in 2001, vaccines can promote microvascular strokes in some people. Though the news never came to light and was never published in any medical journals, vaccines cause the body's immune system to reject vaccines which prompts a huge release of white blood cells.

And this influx of white blood cells, says Dr Moulden, “are too large to enter the bloodstream, surround capillaries, and actually clog and/or collapse them, leading to what are essentially micro-strokes. As a result, these blockages prevent smaller red blood cells from effectively delivering oxygen to the organs [ie, the brain, for example] near these capillaries.”

Says Stevenson, “What should be clear by now is that vaccines are taking a severe toll on people's brains. The cost both to the individuals, whose lives are affected by strokes, and to society as a whole, which loses productiveness and is burdened with their care, is massive."

The Yang

In an article entitled Vaccines reduce risk of strokes in children, children who received some, few or no vaccines were nearly “seven times more likely to have a stroke than kids who had all or most of their recommended shots,” according to Dr. Heather Fullerton, a professor of neurology and pediatrics at the University of California, San Francisco, and presented the findings of the study at the American Stroke Association's International Stroke Conference in San Diego.

“Pediatric strokes are rare,” says Dr. Fullerton. And to bolster her argument, Fullerton says research has shown that infections greatly increase a child's risk of stroke, partly by causing a temporary increase in the blood clotting. "The exciting thing about this [Fullerton] study is that with vaccination, it might prevent these strokes from happening," neurologist M. Shazam Hussain says, director of the stroke center at the Cleveland Clinic.

Robert Brown, the Mayo Clinic College's chair of neurology, called the study's findings "remarkable. To lower the risk of stroke is noteworthy. And while strokes in children are rare, these are precious young children who are having these strokes, which affect them throughout their long, long lives."

Leaders of the international study, Vascular effects of Infection in Pediatric Stroke, or VIPS, interviewed the parents or guardians of 310 children who had a stroke with 289 children who hadn't. The children, who were around 7 or 8 years old, were from 40 centers on five continents, and is the most renowned study on pediatric stroke funded by the National Institutes of Health. The study concludes that children who received some, few or no routine vaccinations were almost seven times as likely to have a stroke than those receiving all or most vaccines. 

So what do you do as parents? Vaccinate or not? If the National Institutes of Health and other studies are valid, and my guess is they are, with children who received "some, few or no routine vaccinations were almost seven times as likely to have a stroke," how could you  not?

As with everything, there are laws. According to the Yale Journal of Health Policy, Law, and Ethics, the federal government recommends that all children between birth and age eighteen years receive seventy doses of sixteen vaccines.  Of these recommended vaccines, the majority of states require between thirty and forty-five vaccine doses for children to be able to attend school. Forty-seven states require preschool-age children to receive three doses of the hepatitis B vaccine to attend public school. The federal government recommends that infants receive their first dose of the hepatitis B vaccine shortly after birth, while they are in the hospital. 

Every state and its requirements for immunizations are listed at http://www.immunize.org/states.

A nonpartisan, nonprofit website, http://vaccines.procon.org, presents facts, studies, and pro and con statements on questions related to whether or not vaccines should be required for children. In its Did You Know segment, it offers these statements:
 

Did You Know?

All 50 states require vaccinations for children entering public schools even though no mandatory federal vaccination laws exist. All 50 states issue medical exemptions, 48 states (excluding Mississippi and West Virginia) permit religious exemptions, and 20 states allow an exemption for philosophical reasons. Over 5,500 cases alleging a causal relationship between vaccinations and autism have been filed under the National Vaccine Injury Compensation Program in the US Court of Federal Claims between 2001 and 2009. The US Court of Federal Claims Office of Special Masters, between 1988 and 2009, has awarded compensation to 1,322 families whose children suffered brain damage from vaccines. About 30,000 cases of adverse reactions to vaccines have been reported annually to the federal government since 1990, with 13% classified as serious, meaning associated with permanent disability, hospitalization, life-threatening illness, or death. According to a 2003 report by researchers at the Pediatric Academic Society, childhood vaccinations in the US prevent about 10.5 million cases of infectious illness and 33,000 deaths per year.

There's really no choice. How can you not?