1. NEWS: RESEARCH on Stroke Recovery & Rehabilitation: Stent v. Medical Care for Brain Artery Blockage

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1 Paul Berger & Stephanie Mensh s Stroke Survivor NEWS & ATTITUDE FOR YOU - SEPTEMBER 2011 ~~~<<~~ IN THIS ISSUE ~~>>~~~ 1. NEWS: RESEARCH on Stroke Recovery & Rehabilitation: Stent v. Medical Care for Brain Artery Blockage 2. PAUL S SURVIVORS TIPS: Are You Legal? *** CELEBRATE National Rehabilitation Awareness Week *** September STEPHANIE'S CAREGIVERS TIPS: Community Resources Rated By New National Study 4. PAUL'S FAVORITES: Teach Yourself 5. EATING FOR STROKE HEALTH Lower Your Blood Pressure 6. WHAT'S NEW on: *** BOOK NEWS: View the Amazon Kindle Book Trailer at: "How to Conquer the World With One Hand...And an Attitude" Paul's internationally acclaimed adventures and inspiration with stroke and aphasia! 7. Stroke Reading Problems? Free Read-aloud Software ~~~ Intensive Aphasia Therapy News ~~~ 8. Subscribe **** Now on FACEBOOK **** Please click "LIKE" on the StrokeSurvivor.com Facebook Page...ask your friends to "like" us too: Please FORWARD this newsletter to your friends and colleagues who would benefit from these tips. Click it forward to people in your stroke club, volunteer groups, place of worship, community services and neighbors, too! 1. NEWS: RESEARCH on Stroke Recovery & Rehabilitation: Stent v. Medical Care for Brain Artery Blockage Preventing a second stroke in high risk patients by opening blood flow through a major artery to the brain was tested comparing two approaches: (1) inserting an expandable stent device, and providing intensive medical therapy; v. (2) providing intensive medical therapy only. The medical therapy included aspirin, drugs to prevent blood clots, high blood pressure and LDL cholesterol, and lifestyle modification programs to quit smoking, increase exercise, and control diabetes and cholesterol. Page 1

2 Enrolling new patients in the study, funded by the National Institute of Neurological Disorders and Stroke (NIDDS), was stopped a few months ago, when results showed that those patients who received a stent suffered a significantly higher number of strokes and deaths within the first 30 days, than those receiving intensive medical therapy only. The so-called study, Stenting v. Aggressive Medical Management for Preventing Recurrent Strokes in Intracranial Stenosis (SAMMPRIS) had enrolled 451 high risk patients (having blockage of 70 to 90%), among 50 different locations in the U.S. In the stent group, 14.7% suffered a stroke or died within 30 days, and 20.5% within the first year of the study had another stroke or died, compared to 5.8% and 11.5% for the same periods among the medicaltherapy-only group. To read a press release on the research, visit: To read the article published in the New England Journal of Medicine online September 7, 2011: For additional resources to help you find information on medical, health, rehabilitation, recovery, selfempowerment, and more, we have collected our favorite links at: 2. PAUL S TIPS FOR SURVIVORS: Are You Legal? A stroke changes your life, your health, your work, your finances, and your relationships. You need legal documents that recognize these changes. If you had a Will before your stroke, you should review it. Recently, my wife Stephanie and I visited an attorney to update our Wills and to create other important legal documents. * First, we agreed to a family member to help if either of us needed assistance with our legal responsibilities. We asked if they would help, and they said, "yes." I have aphasia--speech problems from my stroke--so I may need help making phone calls, completing forms, etc. * Wills. We each have a Will to say how we want our valuables distributed after our death. We listed the family member to serve as executor, if the Page 2

3 spouse was dead or incapacitated. We thought about how to make the process easier for the executor and the beneficiaries. * Durable Power of Attorney. This gives the spouse the power to conduct financial, business, and legal activities for you. We also listed the family member, so they could help. * Advanced Medical Directive. This gives the spouse the power to receive information and make health care decisions for you, if you cannot. Hospitals, physicians, and other healthcare providers are required to follow federal privacy laws that restrict who can receive information about your health and treatment, so this legal document is important. Again, we listed the family member, so they could help. * Living Will. This helps you think in advance about what you want to do, and guide your family and doctors on treatment in case of terminal illness or permanent vegetative state, for example, if you do not want the dying process artificially prolonged. * Insurance & IRA Beneficiaries. We updated the primary and secondary beneficiaries listed on our health insurance and IRA accounts to match our Wills. Our attorney gave us a helpful section-by-section summary of each document. The sentences were a little simpler than the actual legal documents. With my aphasia, this process was challenging and we needed extra time to review everything before we signed. Now, my legal responsibilities are in order, and I feel good. If I can do it, you can do it, too! The American Bar Association provides referrals to attorneys in your area. For information, visit: Other insights and tips for coping with life and taking control of your recovery after stroke are available on my website at Do you have a tip to share? Send it to me at Paul@strokesurvivor.com for a free gift if we use it. Page 3

4 I'm a stroke survivor working hard to give you tips, solutions & motivation for a better life. If you like what you see, buy me a cup of coffee (or 2 or 3) and I'll send you a special thank you! * 1 cup: * 2 cups: * 3 cups: *** CELEBRATE National Rehabilitation Awareness Week *** September Celebrate the benefits of speech, occupational, and physical therapy this week by showing your family and friends what you have accomplished with rehabilitation. Make a phone call, send an , go out in the neighborhood. For inspiration, visit my Articles and Tips page: Learn more about Rehabilitation Awareness Week at the official website: 3. STEPHANIE S TIPS FOR CAREGIVERS: Community Resources Rated By New National Study We probably don't need a new report to tell us this: middle class people cannot afford the cost of nursing home services or long term home health care services. The AARP, Commonwealth Fund, and SCAN Foundation joined forces to examine state-by-state affordability, accessibility, choice, quality, and--interestingly--support for family caregivers, in their first-ever "State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers." Caregiver supports are defined by the Scorecard to include: * Percent of caregivers getting needed support * Legal and system supports for caregivers * Health tasks able to be delegated to aides. The Scorecard showed that 77% of family caregivers who were surveyed a few years ago reported that they get emotional and social support when they need it. Legal and system supports scores were much lower, averaging a "3" on a 12-point scale. These supports Page 4

5 were defined as: state family medical leave laws; mandatory paid family and sick leave; protection of caregivers from employment discrimination; the extent of financial protection for the spouses of Medicaid beneficiaries who receive nursing home or long term community support services; and assessments of the caregiver's health, quality of life, etc. The researchers also proposed that family caregivers would benefit if state nursing license laws permitted aides to perform a list of key "health maintenance" activities, such as administering medications, and diabetes testing and injections. You can view your state's score on the Scorecard's interactive website at: We live in Virginia, so I looked up my state's ranking among the 50 states and D.C. * Overall, Virginia somehow ranked a 12 out of 51. Minnesota was #1, the best in the country. Mississippi was #51, the worst. * I think Virginia's high overall rank was skewed by the high ranking for "affordability," which in itself is a little misleading. Nursing home annual costs were "only" 196% or about 2 times annual median income in the state, and annual home health costs "only" 70% or about 3/4ths of annual median income. * Virginia ranked 16th for our State Medicaid program giving choice of setting and provider; and 25th for quality of life and quality of care. * Virginia did not do so well in its "Support for Family Caregivers," ranking 44th in legal and system supports--a dreadful 1.6 on a scale of I guess we're a friendly state (our motto is "Virginia is for Lovers"), because 81% of caregivers said they usually get needed emotional support. AARP and the other Scorecard developers hope that consumers will use this data to push their state governments to do more to provide long term services and supports in the community, mostly funded by the federal-state Medicaid program. Meanwhile, Medicaid program funds have been targeted as a potential source of cut-backs by the House-Senate special Page 5

6 deficit reduction super-panel. AARP and 70 other volunteer groups supporting people with disabilities will be holding a rally, "My Medicaid Matters" at noon on Capitol Hill in Washington, DC, on Wednesday, September 21. Details at: I plan to send the link to this report to my elected officials and ask them to help improve community services. For more tips for caregivers, please visit: and *** Stroke Survivors & Professionals: WHY should YOU read Paul's books?? BECAUSE... ***...My books are different! Most books on stroke cover a year or so after the stroke. While it is inspiring to see how others have reacted to their own big life changes and the difficult therapy in the first few months, my books cover 20 years of adventures that will motivate you to get up and go! I show you how to take control of your life...how to go back to work...find jobs, lose jobs...try old things like skiing...and new things like computer drafting...overcome the greatest fear of all-- speaking to a group, despite severe aphasia. Real life. Did you know on one of my vacations, I got lost in a coal mine in Wales? PLUS, my books are easy to read, and filled with everyday adventures. No other stroke survivor has as many publications as me! For details on "How to Conquer the World With One Hand...And an Attitude" and my other famous books & CDs: For the NEW e-book Amazon Kindle edition, visit: 4. PAUL'S FAVORITES: Page 6

7 Teach Yourself After my stroke, I lost my ability to read. With speech therapy, and help from my Franklin Electronic dictionary, I was able to regain my reading ability. The "Dummies" series is easy to read and fun and covers almost every interest, including: "Stroke for Dummies" and "U.S. Presidents for Dummies." I am interested in learning all about Twitter. So now I'm reading "Twitter for Dummies." You don't have to give up reading after a stroke, I am proof! To see some of the "Dummies" books I've read, visit: Here's a list of more than 2,000 "Dummies" books: For details on other Paul-tested helpful books and products, visit: and 5. EATING FOR STROKE HEALTH Lower Your Blood Pressure Eating foods with a lot of salt (sodium) can raise your blood pressure. To help you control your blood pressure and your salt, experts recommend less than 2,300 milligrams of sodium a day (about 1 teaspoon of salt). Adults age 51 and older, African Americans of any age, and individuals with high blood pressure, diabetes, or chronic kidney disease should further reduce their sodium intake to 1,500 mg a day. The USDA gives 10 tips to cut back on salt: 1. Think fresh. 2. Enjoy home-prepared foods 3. Fill up on veggies and fruits 4. Choose dairy and proteins that are lower in salt 5. Adjust your taste buds 6. Skip salt 7. Read food labels 8. Ask for low-sodium foods when you eat out 9. Pay attention to condiments 10.Eat more potassium Page 7

8 For details: The NIH has an interactive website on blood pressure and sodium at: For details on other Paul-tested helpful kitchen, shopping, and eating tips, visit: 6. WHAT'S NEW on the Stroke Survivor.com web site. We're adding helpful new things to our web site all the time. Coming soon are links to: * The Association of Rehabilitation Nurses We have many useful links for survivors, families and professionals on rehabilitation, motivation, and to regain fulfillment posted to our Resource Links pages. Visit: *** Intensive Aphasia Therapy News *** News Release Introducing the Interval Intensive Aphasia Treatment program from The Aphasia Center at Steps Forward and This new program combines the benefits of on-site intensive aphasia treatment with ongoing online intensive aphasia treatment. Some unique features of the program include: * Intensive--two weeks of treatment * Convenient--on-site treatment near your area (VA; DC; MD; PA; NY; NJ; DE, NC, OH and WV), online treatment in your home * Flexible--10 hour and 20 hour weekly schedules * Continued practice--homework is given daily, with online follow-up sessions * Recurring sessions--follow up with online treatment, then complete more onsite sessions * Cost-effective--minimizes expenses for travel and housing making expert intensive treatment affordable For more information about this program, contact Bill Connors at bill@aphasiatoolbox.com or Page 8

9 *** ADVERTISE YOUR PRODUCT OR SERVICE IN OUR NEWSLETTER *** Contact us at or Special rates for newsletter & web: Would you like to view a previous month's newsletter? Visit our newsletter archive at: 7. Stroke/Aphasia Reading problems? After a stroke, many people have reading and other language problems, known as "aphasia." Hearing a sentence read aloud helps to understand it. You can hear this newsletter read aloud while each word is highlighted on the computer screen with the FREE text reader software described at: SPECIAL!! THREE E-BOOKS ON STROKE RECOVERY *** Excerpts, details, ORDER your copies: *** Make every day better for stroke survivors and caregivers with these great practical solutions & motivational tips available NOW to download ANYTIME, ANYWHERE! 1) "Paul Berger s Conquering Aphasia & Stroke TODAY!" 2) "Stephanie Mensh s Conquering Aphasia & Stroke for Caregivers" 3) "StrokeSurvivor.com Articles to Take With You" *-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-* WHAT PEOPLE THINK: "I loved it! Paul's E-book is practical, informative, and easy to read. An uplifting, mustread for all stroke survivors with aphasia. It 's just terrific and I think it fills an important void in the post-stroke literature." --Susan Ryerson, Neurological Physical Therapist, PT, DSc, Alexandria, VA "I have been asking people for 30 years what helps and what doesn't work. I have recommended Paul's Page 9

10 materials to my clients for years. This E-book adds new ideas and suggestions that are so very practical and useful." --Bill Connors, Founder and Director of the Pittsburgh Aphasia Treatment, Research and Education Center "The parts on getting out in the community were some of the best parts. It is important that stroke survivors try to live as normal a life as possible. This book lets stroke survivors recognize that they can have a quality life which is full and fulfilled." --Samuel Aylesworth, Stroke Survivor, Manassas, VA "Stephanie's E-book is well written, logically organized, easy to understand, and full of practical suggestions that should be helpful and encouraging to caregivers of stroke survivors. I particularly liked the examples of Stephanie s real-life experiences." - Janet M. Gritz, MA, CCC-SLP, founding member & consultant to Montgomery County Stroke Association "This E-book gives useful, practical advice from someone who's lived it. We're all overwhelmed at times, and Stephanie shows you, one step at a time, how to get through the day and make the next day better." - Gwen Flanders, partner of a stroke survivor *-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-* THREE GREAT HOW-TO BOOKS! (1) "Paul Berger s Conquering Aphasia & Stroke TODAY!" 50 real-life, Paul-tested ideas, solutions and motivation for stroke survivors to return to everyday activities. Organized for easy-reading, with resource links. (44 pages in PDF) ONLY $9.95 * Hospital and coming home * Solutions for all stroke survivors * Conquering aphasia * Enjoying recreation * Returning to work * Finding motivation * Resources Page 10

11 (2) "Stephanie Mensh s Conquering Aphasia & Stroke for Caregivers" Get an intimate perspective on 7 key caregivers issues and solutions, tested in Stephanie's relationship & observed in others, with unique resources. (31 pages in PDF) ONLY $9.95 * Coping with Change * How to Be Supportive While Building Independence * Building the Caregiver Team * Time Management Tricks * Money Issues & Caregiver s Employment * Living with Stress...Stress...STRESS! * Care for the Caregiver * How the Survivor Can Help the Caregiver (3) "StrokeSurvivor.com Articles to Take With You" Take this collection of 11 articles from our website with you, put in your notebook, & add your own notes & pages. (33 pages in PDF) ONLY $5.95 READ OUR E-BOOKS ON ANY COMPUTER. Easy PDF format accessible on all computers with Adobe Reader. Why wait for UPS or the postman to deliver? Order, download and read in minutes! ***Excerpts, details, ORDER your copies: *** Many thanks to our e-book sponsor: * Aphasia Solutions Network 8. SUBSCRIBE Welcome to our online newsletter. If you would like to receive a copy each month, please sign up at: or by ing us at: info@strokesurvivor.com. Please see info below if you wish to change addresses or unsubscribe. DISCLAIMER: The information in this newsletter is not Page 11

12 intended to be medical advice. For medical advice on your stroke recovery, consult a physician or other health care practitioner. Paul Berger and Stephanie Mensh Authors of "How to Conquer the World With One Hand... And an Attitude" Positive Power Publishing P.O. Box 2644, Merrifield, VA Paul@strokesurvivor.com or Stephanie@strokesurvivor.com /\/\/\/\/\/\/\ Page 12