2018-11-16

Episode 040 -- Meet Dr. Kimberly Brown


Dr. Kimberly Brown headshotAs stroke survivors, Emergency Room physicians play an important part in our survival and rapid treatment, but we often don't think about them. We build ongoing clinical relationships with our neurologists, physiatrists, OTs, PTs, Speech Therapists. Rehab nurses, CNAs, and more, but not the ER docs. When they see us, our brains are in full crisis/panic mode, our loved ones are terrified, and the doctors are busy making rapid assessments, decisions, and referrals. By the time we get a chance to calm down and assess our new landscape, they are long gone and have transitioned off our care team.

That's one reason I enjoyed talking with Dr. Kimberly Brown. It was a chance to get some insight into a field I knew little about. 

Among the things I found interesting was how she talk about the impact of technology in medical education -- listening to a heart murmur on the computer during school work and later tying that into the real world in listening on an actual patient.

We also talk about the role of ER Pharmacists, the role Methodist University Hospital has had in treating folks with the clot busting drug tPA, and some of the challenges around public health.

We do have some discussion of the politics of healthcare in this episode. Regardless of how you feel about the Affordable Care Act, the Americans with Disabilities Act, and the future of Medicare and Medicaid, the political decisions around these programs will directly affect the lives of millions of stroke survivors and potential survivors in the US, and it's important to be aware of what's going on and express your views to your elected officials.

We reference the FAST signs for stroke. If you're not familiar with them they are:

Stroke warning signs: Face, Arms, Speech, and Time

 

We also talk about sepsis or being septic. Sepsis can be the result of the body's attempt to fight an infection. Basically, the infection results in the body dumping an excess of chemicals into the blood stream to fight the infection, but it instead leads to inflammation in other organs. Symptoms of sepsis can sometimes mirror stroke. Sepsis is a life threatening condition.

Fortunately whether you come into the ER with Sepsis or Stroke, folks like Dr. Kimberly Brown are there to take care of you.

Dr, Kimberly Brown working on a laptop at a cafe

Dr. Kimberly Brown is an emergency physician in Memphis, Tennessee. She is a native of Milwaukee, Wisconsin and earned her undergraduate degree from Fisk University. Loving warmer weather, Dr. Brown earned her Master of Public Health degree from the University of Florida in Public Health Management and Policy. She attended Ross University School of Medicine and recently completed her emergency medicine residency as a member of the inaugural graduating class of the University of Tennessee Health Science Center in Memphis, Tennessee. Dr. Brown’s clinical interests include neurologic emergencies, critical care, sepsis, and education. In her free time, she enjoys traveling, volunteering, watching too much reality tv and trying new restaurants.

Improving Care in the Stroke Belt

Dr. Brown serves patients in the Stroke Belt of the US. This is the region of the country that since the early 60s has had a significantly higher about of stroke patients and higher mortality from stroke than the rest of the country. It includes:

  • Tennessee
  • Virginia
  • Kentucky
  • North Carolina
  • South Carolina
  • Georgia
  • Alabama
  • Mississippi
  • Louisiana
  • Arkansas
  1. Making sure all patients have access to coverage
  2. Decrease food desserts
  3. Programs to incentive physicians to go to under-served communities in Appalachia and urban centers to ensure access to care
  4. Make sure schools are good so kids can read and understand their health
  5. Medical professionals have to do a better job at educating patients about how their body works and what's going on with it.

 

Hack of the Week

When you arrive at the ER, especially as a previous stroke survivor or person with disabilities. It's important to provide the team with as much information as possible. The need to know about the medications (legal AND illegal) you are taking, any previous stroke or medical issues, what disabilities you already had, and more.

Any video or recent photos of you prior to this incident can also be extremely helpful to the staff so they can get a better sense of what's changed.

Every Branch and Leaf -- National Caregivers Month

November is National Caregivers Month. These people make a huge difference in our lives, and it's important to recognize and thank them for their support. One way to support caregivers is to read Dr. Kate Lorig's book "Building Better Caregivers." I talked with the author back in episode 19 at http://strokecast.com/kate.

Larry Benitez is one of my colleagues from a professional networking group. He's also a banjo player who volunteers at the Old Friends Club in the Seattle area. The Old Friends Club support folks with Alzheimer's and Dementia.

Larry recently recorded a song dedicated to care givers. You can learn more about it here. Or just watch the video below. Be sure to comment on and like the video over on YouTube, too.

 

Links

Dr. Kimberly Brown's Website

www.drkimberlybrownmd.com

Dr. Kimberly Brown's Email

info@drkimberlybrownmd.com

Dr. Kimberly Brown's Facebook

https://www.facebook.com/drkimberlyb/

Dr. Kimberly Brown's Instagram

https://www.instagram.com/drkimberlyb/

Dr. Kimberly Brown's Twitter

https://twitter.com/drkimberlyb_

Chronicles of Women in White Coats

http://womeninwhitecoats.com/

Methodist University Hospital Emergency Medicine

http://www.methodisthealth.org/healthcare-services/emergency-medicine/

Stroke belt on Wikipedia

https://en.wikipedia.org/wiki/Stroke_Belt

Sepsis on Wikipedia

https://en.wikipedia.org/wiki/Sepsis

FAST from the American Heart Association

https://www.strokeassociation.org/STROKEORG/WarningSigns/Stroke-Warning-Signs-and-Symptoms_UCM_308528_SubHomePage.jsp

Strokecast Episode 19: Meet Dr. Kate Lorig

http://strokecast.com/kate

Old Friends Club

https://www.oldfriendsclub.org/about-us-1

Larry's Song on YouTube

http://strokecast.com/larryssong

Larry's post on LinkedIn

http://strokecast.com/LarrysStory

 

Where do we go from here?


Here is the latest episode of The Strokecast

2018-11-13

Episode 087 -- Choose Your Headline and Meet Scott Charlston


2-Minute Tip: Choose Your Headline

 

As you frame your talk, make sure you choose the headline for it.  Flip through a newspaper or magazine and look at the headlines. Their job is to give you a little bit of information in a way that is compelling enough that you want to read more. They have to be short. They can be funny, But when you define the headlines for your talk, you also need it to get people to come see you and give you their time.

 

Think about your headline as the kind of thing that might be the subject line of an email or go on a poster advertising your talk. If you already know your goal for the talk and what you want people to take away from your talk, you should be able to develop the headline easily. If you can't, then maybe your talk isn't quite ready yet and you need to review your goals again.

 

Post Tip Discussion: Meet Scott Charlston

 

Scott Charlston HeadshotI first met Scott through a professional job hunting workshop where we are both looking for our next adventures. If you're looking for a great PR or media relations expert, reach out to Scott. If you're looking for a corporate trainer, product evangelist, or podcaster, just email bill@2minutetalktips.com.

 

In this episode, you'll hear about just what it is PR professionals do and the things they work on while doing media training. While there's an obvious surface level overlap between public speaking, ultimately it goes deeper. The core themes of defining and knowing your message, understanding your audience, and telling compelling stories that I talk about all the time on this show are also the core elements that Scott focuses on in his work with executives and media relations teams.

 

Scott spent 6 years as a reporter and anchor at Spokane's KREM TV before moving into PR for nearly 20 years with Weber Shandwick and Verizon Wireless. He's done media training, media relations, executive coaching and even more -- all with a focus on putting people at the center of the story, distilling complex ideas into clear benefits.

Links

 

 

Call To Action:

  • What are your thoughts on this chat and PR? Let us know in the comments below.
  • Share this episode with a friend, colleague, relative, reporter, or PR Specialist. Just give them this link: http://2minutetalktips.com/scott
  • Subscribe to 2-Minute Talk Tips for free in your favorite podcast app.
  • Don't get best...get better.

Check out this episode!

2018-11-09

Episode 039 -- The FLAME Study: How Anti-depressants (SSRI) help Stroke Recovery


This week, Dr. Nirav Shah and I talk about antidepressants -- SSRIs specifically -- in Stroke Recovery. The FLAME study demonstrated the benefits to motor recovery.

SSRI stands for Selective Serotonin Re-uptake Inhibitor. Basically, the way data gets sent from one nerve cell to another is through the use of chemicals, like serotonin. The body produce serotonin and the collects it when done, taking it out of the system. An SSRI slows down the collection process -- it inhibits the re-uptake. That leaves more serotonin floating around the brain.

Having more serotonin floating around the brain can help reduce, manage, or eliminate depression and other conditions. That's why SSRIs are some of the most common anti-depressants on the market.

The FLAME study looked at how Fluoxetine (AKA Prozac) behaves in folks who recently had a stroke. Fluoxetine is an old school antidepressant and SSRI. The study appeared to show that the extra serotonin in the brain may help promote neuroplasticity and recovery of motor skills after stroke, and that's why we're talking about it today.

My Experience

When I was inpatient, the doctor put me on an SSRI due to the FLAME study. She tried Prozac (AKA Fluoxetine) first. Unfortunately, it gave me an anxiety attack. On the other hand, I now know what an anxiety attack feels like. Not pleasant.

A Xanax took care of that.

We tried again the next day, this time with another SSRI called Lexapro (AKA Escitalopram). Someone explained to me that the molecule that makes up Lexapro is the mirror image of the Prozac molecule. I'd had Lexapro in the past, with no ill effects so it was worth a shot. Success! No anxiety attack this time. And that's how an SSRI earned a spot in my daily collection of medication.

But did it help my recovery? Maybe. There's no way to tell for sure. The data indicates that it should and there is no reason to think it didn't help. As a side effect, I did not go into the deep depression so common among other stroke survivors.

This is a new use for SSRIs, Fluoxetine, and Escitalopram. It's borderline off-label. Not all doctors are familiar with the idea that SSRIs promote the neuroplasticity that supports recovery of motor functions. And that's how I ended up explaining the research to my primary care physician as he reviewed my meds with me post-hospital.

The FLAME study covered 6 months. I'm still taking the Lexapro today. When I talked to my rehab doctor about whether I should continue we concluded that since I don't have any negative results from it, we may as well keep it up. If there's a chance it can help, and it's not hurting, then that sounds good to me.

Dr. Nirav H. Shah

Dr. Nirav H Shah Headshot

Dr. Nirav H. Shah is a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in t: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging.

He is a practicing neurohospitalist and served as the stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. He enjoys mentoring trainees and collaborating on publications and conference presentations.

Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit.

Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer.

So let's fan the FLAME of stroke recovery with Nirav.

Hack of the Week

Daily pill organizer with one door openMany stroke survivors use a day of the week pill organizer to keep track of meds. And, sometimes, the day of the week. The organizer can also make it easy to keep track of whether or not we've taken pills for the day.

After taking your pills, leave the door for that day open exposing the now empty chamber. That gives you and your caregiver an easy to see visual queue the deed is done.

 

Links

FLAME study Presentation

http://www.my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_427770.pdf

Efficacy of Fluoxetine - a Trial in Stroke (EFFECTS)

https://clinicaltrials.gov/ct2/show/NCT02683213

Predicting recovery in acute poststroke aphasia

https://www.ncbi.nlm.nih.gov/pubmed/29451321

Nirav’s previous appearance

http://strokecast.com/nirav

Nirav on Stem Cells and Stroke Recovery

http://strokecast.com/stemcells

Nirav  on LinkedIn

https://www.linkedin.com/in/nirav-h-shah/

Nirav at Swedish

https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893

Nirav on Twitter

http://twitter.com/NeuroNirav

The Neurohospitalist

http://journals.sagepub.com/home/nho

Nirav’s Photography

www.thoughtpotential.com

Sentinel Healthcare

http://www.sentinel.healthcare/

Where do we go from here?

  • Check out the links to the FLAME study and the other SSRI stroke studies above.
  • Subscribe to Strokecast for free in your favorite podcast app.
  • Use your pill box door as a reminder/calendar.
  • Don't get best…get better.

Here is the latest episode of The Strokecast

2018-11-06

Episode 086 -- Incorporate Excellence and Brevity


2-Minute Tip: Incorporate, Don't Emulate

 

A movie that's inspired by a true story takes elements of that story and creates its own thing from it to move the audience. It doesn't attempt to duplicate the original story itself because that would be a documentary and not a theatrical tale. Both the original story and the entertaining film can be excellent things, but they are different things.

 

When we try to be more effective speakers, one thing we do is watch excellent speakers. That's a good thing. Watch as many excellent speakers as you can. Just don't try to be them.

 

They got where they are with their own unique combination of practice, training, and life experience.

 

You got where you are with your own unique combination of practice, training, and life experience. 

 

Watch those excellent speakers and think about what they do well and why. What specific behaviors or techniques to they use to get their message across. Is that a technique you can use in your talks? Give it a try.

 

Here you are trying to incorporate specific behaviors. You are not trying to be someone else. Incorporate; don't emulate.

 

Post Tip Discussion: Brevity

 

The proper length for a talk is to be exactly as long as it needs to be and not a second longer.

 

Sometimes that takes work. It's easy to craft a long talk. The work comes in trimming away the unessential parts.

 

Make your point. Support your point. Get off the stage.

 

How often have you heard the audience say, "I wish that presentation was longer."

 

Call To Action

 

  • Subscribe to 2-Minute Talk Tips in your favorite Podcast app.
  • Share this episode with a friend, colleague, or relative by giving them the link http://2minutetalktips.com/brevity
  • Incorporate techniques from other excellent speakers
  • Don't get best...get better

 

Bonus

 

In the spirit of getting the heck off the stage, this week's episode includes "Opening Band" by the legendary musical comedy duo Paul and Storm (released under Creative Commons Attribution, Non-Commercial, Share-alike). You can check out more of their work here.


Check out this episode!

2018-11-02

Episode 038 -- Meet Maggie Whittum


I first met Maggie Whittum a couple months ago, thanks to the episode I did with the folks at The Slow Road to Better. We connected to record this episode and I enjoyed the chat.

Maggie has a nice deliberate way of speaking. You can hear the emotion in her voice as she talks.

Like Whitney last week, Maggie's story is a frightening reminder that even if you do everything right, stroke can happen to anyone at any age. That doesn't mean you should ignore risk factors. Just keep in mind that a healthy lifestyle only reduces risk of stroke. It doesn't eliminate it entirely, On the other hand, a healthy pre-stroke life helps make rehab easier.

Maggie Whittum headshotMaggie was 33 years old when a cavernous angioma failed and she had a hemorrhagic stroke in her brain stem.

At the time, stroke was the furthest thing from her mind. She was a healthy, athletic, driven non-smoking actor in the best physical condition of her life. After spending several years acting, producing, and directing [projects around the world she moved to the Washington, DC area to pursue a Master of Fine Arts program at George Washington University. That all changed when her stroke hit her at the end of her first semester.

Now, Maggie lives in Denver where she continues to work on her recovery, creates art projects to illustrate just what chronic pain is like, and acts on stage with the Phamaly Theater, a company focused on providing opportunities for actors with disabilities.

Now, Maggie is taking everything she's learned from her time as an actor, director, producer, writer, teacher, and stroke survivor to assemble a team and create The Great Now What, documentary exploring stroke, recovery, the healing power of art, and her journey to claim a powerful new identity.


 

Hack of the Week

The great thing about carrying a purse, messenger bag, backpack or other carrying device is that it's easier to carry stuff. You can just throw all your stuff in there and go. 

With a little thought, however, the process can be much more efficient. Arrange items in the bag specifically for single-handed use instead of just tossing stuff in. Consider flaps that allow easy access to a bus pass, a caribiner for keys, or a designated pocket for a disabled parking placard. A little planning can make the day a little less stressful.

Links

The Great Now What

https://www.thegreatnowwhat.com/

Crowd Funding

https://www.seedandspark.com/fund/the-great-now-what#story

The Great Now What on Facebook

https://www.facebook.com/TheGreatNowWhat/

Maggie Whittum on Instagram

https://www.instagram.com/maggiewhittum/

Maggie Whittum on Twitter

https://twitter.com/MargaretWhittum

Maggie Whittum on IMDB

https://www.imdb.com/name/nm4591025/

Maggie Whittum RAISE Award Nomination

http://www.stroke.org/stroke-resources/raise-awareness-stroke/raise-awards

Fates and Furies on Amazon

https://www.amazon.com/Fates-Furies-Novel-Lauren-Groff/dp/1594634483

The Crash Reel with Kevin Pearce

http://thecrashreel.com/store/

The Crash Reel on Amazon Video

https://www.amazon.com/Crash-Reel-Kevin-Pearce/dp/B00HWL2BS4

Phamaly Theater Company

https://www.phamaly.org/

Cavernous Angioma

http://www.angiomaalliance.org/pages.aspx?content=62

Slow Road to Better on Strokecast

http://strokecast.com/slowroad

Where do we go from here?


Here is the latest episode of The Strokecast