Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label TIRR Memorial Hermann. Show all posts
Showing posts with label TIRR Memorial Hermann. Show all posts

Thursday, August 11, 2022

After 6 Brain Surgeries and a Stroke, Resident Aims to Inspire Others

 She was lucky with her PM&R doctor. In my opinion my PMR doctor knew nothing and did nothing for my stroke rehab.  He wrote 3 E.T.(Evaluate and Treat) prescriptions; OT, PT, ST, which proved he knew absolutely nothing about stroke rehab and washed his hands of the failed outcomes. 

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

After 6 Brain Surgeries and a Stroke, Resident Aims to Inspire Others

Claudia Martinez, MD, always knew she wanted to become a doctor, she just took a different path

A photo of Claudia Martinez, MD

Claudia Martinez, MD, a third-year resident at TIRR Memorial Hermann in Houston, always knew she wanted to become a physician.

Growing up, she envisioned being able to give back to small towns like the ones her parents were from. "I would see the disparity there not having access to medical care," she told MedPage Today.

However, about 10 years ago, during Martinez's senior year of college, her plans took a harrowing detour.

Martinez began having headaches as well as weakness in her arms and legs. An MRI of her brain led to a diagnosis of Chiari malformation, a condition in which brain tissue extends into the spinal canal.

The condition was pretty severe, Martinez explained. A neurosurgeon told her that if she didn't undergo immediate brain surgery, she could become paralyzed from the neck down.

On her first day of her senior year in college, Martinez underwent her first brain surgery.

She would need five more in the next few years to address ongoing health issues and complications. And during the sixth procedure, in 2017, she suffered a stroke.

Though Martinez had been able to complete much of the education she needed to become a physician from her hospital bed, having a stroke and needing rehabilitation care changed her career trajectory.

Martinez had initially planned to go into a surgical field, she said. But the stroke diminished function in her hands.

"That was a little hard to accept," Martinez said.

She suffered other deficits, too, and ended up at TIRR Memorial Hermann for a year of intensive follow-up care.

Martinez now credits the institution for inspiring a new passion.

"When I was here, I got to see what PM&R [physical medicine and rehabilitation] was all about," she said. "Once I was exposed to that, I really liked the attitude they had in seeing what patients could do instead of what they couldn't."

The physicians, therapists, and nurses take "all the broken pieces" after a patient has sustained a stroke, spinal cord injury, or car accident, "really putting them back together," she said.

"The big hospital saved their life, then they come to us and we restore their lives," she said.

Since then, she has gained back 90% of the function she lost.

Though Martinez said she doesn't always share her personal journey with patients, occasions arise that are well suited for that kind of support.

There may be a patient who is not motivated to do therapy, who has lost hope, she said.

"I remember sitting in that hospital bed not knowing what my future would look like," Martinez said.

Patients can feel alone, like there is no one else going through the same thing, and it can take a long time to get better, she said, noting that her stroke was 5 years ago and that she is still recovering function.

"When I have shared my story, I really do feel like that will make a difference," Martinez said.

Additionally, it's not only patients that Martinez is seeking to help.

Her residency program at TIRR Memorial Hermann has been incredibly supportive, she said, providing the necessary accommodations for her to succeed.

Residents with disabilities can be very successful, she said. They can still be a physician, and a good one at that.

She said she's all but settled on pursuing further training and a fellowship to become a specialist in spinal cord injuries.

Looking back on her journey, Martinez said she remembers asking her neurosurgeon whether she could put off her initial brain surgery, and the surgeon responded that, "'You can't take care of anyone else until you take care of yourself.'"

"We shouldn't necessarily change our goals," Martinez said, "sometimes it just takes a little different trajectory."

Monday, September 12, 2016

TBI Action: A new Web-basedTools Aid in Choosing Treatment Options for TBI Patients

At least TBI patients have something, Stroke survivors have nothing but doctors flailing in the dark, knowing nothing about how to get their patients to 100% recovery. You are once again fucking screwed. 
http://tirr.memorialhermann.org/journal/2016-summer/tbi-action/
The work of a research team led by principal investigator Mark Sherer, Ph.D., ABPP, FACRM, has resulted in the development of a web-based resource created to help clinicians working with persons with traumatic brain injury (TBI) develop case conceptualizations and consider treatment options. Practitioners can access TBI ACTION (Traumatic Brain Injury Assessment Conceptualization Therapeutic Intervention Options Narrative) at http://tbiaction.tbindsc.org.
“The typical TBI ACTION user is a psychologist or neuropsychologist who conducts cognitive testing in a rehabilitation setting,” says Dr. Sherer, senior scientist and associate vice president for research at TIRR Memorial Hermann and a clinical professor of physical medicine and rehabilitation at Baylor College of Medicine and at McGovern Medical School at UTHealth. “Once clinicians have the results of a client’s cognitive processing, memory and verbal fluency tests, they can enter the scores on the website. There are 12 questionnaires on the site, which can be completed by the client in 30 to 40 minutes. An algorithm combines the test and questionnaire scores to describe the dimensions that represent key indicators of recovery from TBI, including cognitive processing speed, verbal fluency, self-reported cognitive symptoms, independence and self-esteem, resilience, emotional distress, post-concussive symptoms, physical symptoms, physical functioning and economic and family support.”1
The website grew out of a research project funded by the 2010 Rehabilitation Research and Training Center grant on Developing Strategies to Foster Community Integration and Participation for Individuals with Traumatic Brain Injury. The $4.2 million grant awarded to researchers at TIRR Memorial Hermann by the National Institute on Disability and Rehabilitation Research funded three research projects and five training projects. Among them was Dr. Sherer’s study, “Development and Validation of a Classification System of Symptoms and Characteristics to Guide Treatment Assignments for Persons with TBI Living in the Community.” The ultimate aim of the study was the creation of a web-based classification system that can be used to recommend the type of treatment most likely to provide the greatest benefit to persons with TBI. Participants for the study were recruited from three centers following discharge from neurosurgery and inpatient rehabilitation programs: TIRR Memorial Hermann, Rehabilitation Institute of Michigan at Wayne State University, and Spain Rehabilitation Center at the University of Alabama at Birmingham.
After identifying the dimensions, the researchers conducted a cluster analysis to determine the number of groups they could derive from a large cohort of 504 people with TBI. Five groups emerged.2 In May 2014, they assembled a consensus group of 17 experts from around the country and Australia at the Galveston Brain Injury Conference to review draft descriptions of the five groups and develop lists of therapeutic options. The experts’insights form the basis of the website, which allows practitioners to apply data gained from research directly to their clinical practice.
Dr. Sherer views the website as an assist to clinical judgment. “Clinicians can use the website to get a description of their client, treatment options, the average profile of group members and an individual profile of their client, allowing them to compare the characteristics of their client to people assigned to the group,” he says. “Each client is an individual who won’t necessarily fit precisely into any of the five groups. In the end, clinicians have to use their judgment in applying the information available on the website.”
Use of the website is free, secure and HIPAA compliant. “Clinicians have a good idea of what’s going on with their clients,” he says. “The site allows them to compare their own measures with those of a team of expert researchers. We hope the information we’ve provided will spur some new ways of thinking that ultimately will improve outcomes for people with TBI.”
1Sherer M, Sander AM, Nick TG, Melguizo MS, Tulsky DS, Kisala P, Hanks R, Novack TA. Key Dimensions of Impairment, Self-Report, and Environmental Supports in Persons with Traumatic Brain Injury. Rehabilitation Psychology 2015 May;60(2):138-46.
2Sherer M, Nick TG, Sander AM, Melguizo M, Hanks R, Novack TA, Tulsky D, Kisala P, Luo C, Tang X. Groupings of Persons with Traumatic Brain Injury: A New Approach to Classifying Traumatic Brain Injury in the Post-Acute Period. Journal of Head Trauma Rehabilitation. 2015 Dec 24. [Epub ahead of print]

Saturday, February 6, 2016

New NeuroRecovery Research Center Opens At TIRR Memorial Hermann

For those close by you can ask what strategy they are following to choose the research to be done.
http://www.prnewswire.com/news-releases/new-neurorecovery-research-center-opens-at-tirr-memorial-hermann-300216030.html
A new research facility has opened on the campus of TIRR Memorial Hermann in Houston. The NeuroRecovery Research Center is part of a more than 42,000 square-foot building devoted to finding new, innovative ways to treat and rehabilitate patients.
In addition to providing the very highest level of rehabilitation services to patients, TIRR Memorial Hermann has long been a leader in cutting-edge research to treat people with a range of disabilities and complex conditions such as brain and spinal cord injury, stroke, multiple trauma, amputation and neurodegenerative diseases.
"The NeuroRecovery Research Center will house a number of labs conducting different studies and trials at the same time. The amount of collaboration that will go on among our teams is something that just can't be beat," says Dr. Gerard E. Francisco, chief medical officer at TIRR Memorial Hermann, director of NeuroRecovery Research Center and Professor and Chairman of Physical Medicine and Rehabilitation Department (PM&R) at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth).
The NeuroRecovery Research Center is a collaborative project among clinicians, scientists and engineers. Currently TIRR Memorial Hermann is one of just 3 sites in the United States taking part in a clinical trial aimed at assessing Vagus Nerve Stimulation (VNS) during rehabilitation for improved upper limb motor function following a stroke.
TIRR Memorial Hermann is one of just a dozen sites in the United States participating in a unique stroke trial aimed at improving the quality of life for stroke survivors. Researchers use a non-invasive device capable of mapping the brain in order to deliver targeted magnetic stimulation that can suppress or enhance specific brain activity. Researchers are then able to determine the therapeutic effects of the navigated magnetic pulses for stroke rehabilitation.
"It was important that our research building be connected to TIRR Memorial Hermann and the bridge is symbolic of how we want to do research," says Dr. Francisco. "We do research to answer real world clinical questions so we can do better in our clinical care."   
Carl Josehart, Sr. Vice President and CEO, TIRR Memorial Hermann concurred.
"This is an exciting time at TIRR as we take the research component of our rehabilitation services to the next level," said Josehart. "This state-of-the-art facility will provide researchers with the tools to pioneer new advances in rehabilitative medicine and get our patients back to the life they love."
To learn more about the NeuroRecovery Research Center and the clinical trials and studies currently underway visit tirr.memorialhermann.org or call 713-799-5000.
Media Contact:
Glenn Willey
713.242.2581 – (Office) 
919.622.0623 – (Mobile)
Glenn.Willey@memorialhermann.org