Ep 084 -- Small things Matter

This is what my stroke looks like on the MRI. Or rather, this is what it looked like while it was happening. See that white curved, bulge-y line on the just to the left of the black thing in the middle? That's it. At one end of the line is a blood clot that's not letting blood through. Since blood flow and other thick tissue blocks the signal, the white line indicates that there is nothing there.

An MRI showing a right MCA thrombolic CVA

The image is essentially looking up my brain from the bottom. If the monitor you're looking at was 3D, my feet would be coming out the back of your head and the top of my head would be behind the screen. My face is at the very top of the image, and the back of my head at the bottom.

That mean the clot is in the middle of the right side of my brain -- specifically my right middle cerebral artery (MCA).

The MCA is pipe that is about an 1/8 of an inch wide (3.25-3.5 mm for the non-Americans). That's about the thickness of 3 and a half dimes (about 35¢). It takes very little material to block such a small space for a few hours, and yet that's all it took to change the course of my life. To result in the 84 episodes of this show that now exist. To cost an insurance company $200,000. To put me in the hospital for a month.

All the good and bad that has come from my stroke is due to that incredibly small thing.

Because small things make a big difference.

An update

Back in Episode 77 (http://Strokecast.com/StarbucksAndJelly) I talked about my experience with the jelly containers at breakfast and how they were incompatible with one-handed use. I shared this story with the hospital.

After that, they made changes. I talked about it on Instagram:



I recently spoke at another support group and found out the person running it listened to that episode, raised it with the team there, and they've now made changes to jelly distribution.

Will new stroke survivors know the difference this makes? No. But I do. It's a small thing. And by sharing my story I now know that hundreds of survivors a year will be able to start their days with one less failure or challenge.

And those little things matter.

Little Robots in the Future

This story has been making the rounds on Twitter:

MIT engineers have developed a magnetically steerable, thread-like robot that can actively glide through narrow, winding pathways, such as the labrynthine vasculature of the brain.

In the future, this robotic thread may be paired with existing endovascular technologies, enabling doctors to remotely guide the robot through a patient’s brain vessels to quickly treat blockages and lesions, such as those that occur in aneurysms and stroke.

-- http://news.mit.edu/2019/robot-brain-blood-vessels-0828

This tiny, slippery, flexible robot has the potential to revolutionize mechanical thrombectomy (the surgery where doctors use a groin or wrist based catheter to drag a clot out of the brain). It can do less damage to the arteries and expose doctors to less radiation over the course of their careers.

Plus, you could have a robot with a laser on its head running around your brain! How cool and terrifying is that?


Where do we go from here?

Here is the latest episode of The Strokecast

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