Ep 087 -- Keep Trying

As stroke survivors, we have to find the #StrokePerks where we can.

My GF recently hurt her ankle on the way to work. Fortunately, I have an assortment of canes that she can choose from to get around the apartment safely while she recovers.

Keep Trying

Getting from the car to the apartment, though, meant she had to use the can I had brought with me. Fortunately, I was able to walk a bit without it.

As I walked down the hall, I reflected on my early days of recovery. I spent time going up and down that same hall with Elissa, my PT from Rehab Without Walls. It took a lot longer to cover that distance back then. And trying it without the can worked for only a few feet.

Even a year ago, it took longer.

Today, I need the cane to walk longer, faster, safer, with a better gait, and with less fatigue.

The point is that I continue to get better. It's just a little bit at a time. And sometimes it's hard to notice. But it's happening. 28 months later.

Anyone who tells you recovery stops at 6 months or 12 months is WRONG. That's utter nonsense. Recovery may be fastest early on, but recovery continues for years.

But you cannot get better if you don't do the work or if you don't believe you can. The right, action-oriented attitude is essential to long term continued recovery.

Focus on getting just a little bit better every day.

Walking Predicts Return to Work

A study recently published in the AHA Journal reports that post-stroke walking speed is an accurate indicator of whether a survivor will return to work:

This study is the first to capture walking performance parameters of young adults who have had a stroke and identifies slower and less efficient walking. Walking speed emerged as the strongest predictor for return to employment. It is recommended that walking speed be used as a simple but sensitive clinical indicator of functional performance to guide rehabilitation and inform readiness for return to work post-stroke.

You can read the full details here https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.119.025614

It's an interesting article, and the story has been popping up in various news feeds that I follow. I'm not sure how actionable this is, though.

First, it doesn't appear to draw a distinction between knowledge work and physical work. It also doesn't appear to address the concerns of stroke survivors living with aphasia or other cognitive challenges who have no trouble walking.

Really what they seem to be looking at is the cognitive load involved in walking and extrapolating from there.

So this may be slightly useful early indicator in the early post stroke days, but when reading articles like this, there are a few things to keep in mind:

  1. Correlation does not equal causation.
  2. Headlines do not tell the whole story.

Look at this stuff critically. Nuance does not fit nicely into bullet points.

Eat More Bananas!

A new study says eating more bananas will prevent stroke!

Actually, it doesn't say that. But that's a headline you are likely to see.

A study from the University of Alabama at Birmingham demonstrated that a lack of dietary potassium in mice led to hardening and calcification of arteries. Such damage to the arteries in humans can lead to stroke and heart disease. Here's what the article says:

University of Alabama at Birmingham researchers have shown, for the first time, that reduced dietary potassium promotes elevated aortic stiffness in a mouse model, as compared with normal-potassium-fed mice. Such arterial stiffness in humans is predictive of heart disease and death from heart disease, and it represents an important health problem for the nation as a whole.

The UAB researchers also found that increased dietary potassium levels lessened vascular calcification and aortic stiffness. Furthermore, they unraveled the molecular mechanism underlying the effects of low or high dietary potassium.

So how do we get to the conclusion?

  • We assume the mice model applies to humans.
  • We assume we can get more dietary potassium by eating more bananas.
  • We assume that more dietary potassium in humans results in less hardening of the arteries.
  • We assume that less hardening of the arteries will lead to reduced risk of stroke in humans.
  • Therefore eating more bananas leads to fewer strokes.

Those facts may all be independently true. But at any point, that chain could break down and the results would not follow.

So what do you do with this information? As a researcher, you might try more direct research to get to fewer links in the chain.

As a consumer, look at what you can learn from. What is the benefit and risk of adopting this behavior?

In this case:

  • Bananas are tasty.
  • Bananas are cheap.
  • Bananas have minimal to no health risks for most people.
  • Bananas may increase dietary potassium and that may reduce the risk of stroke.
  • And have I mentioned that bananas are tasty?

So eat more bananas.

And have I mentioned you can eel them with one hand?


For World Stroke Day, Joe Borges (@JoseSoRocks) and Nefre (@StrokeLifeAlive) are doing a campaign to raise awareness. And you can participate


View this post on Instagram


My friends @joesorocks and @strokelifealive are working on an Awareness Campaign for Young Stroke Survivors for World Stroke Day in October.⁣⁣ ⁣⁣ Are you a #youngstrokesurvivor? ⁣⁣ You can take part in the campaign? ⁣⁣ ⁣⁣ Here are a few simple things you will need to do: ☑️Take a Black & White photo of you wearing a black or white shirt 👕;⁣⁣ ☑️Take it with a 😐 or 🙂 face;⁣⁣ ☑️Send them to Joe (joesorocks@gmail.com) or Nefre (strokelifealive@gmail.com);⁣⁣ ☑️The photos news to be sent by September 30th!⁣⁣ We want pictures from people around the world! 🌍⁣⁣ . . . Join us! Please comment or if you know of a stroke survivor, tag them below!🧠 . . . #wespeakupagainststroke #youngstrokesurvivor

A post shared by sᴛʀᴏᴋᴇ ʀᴇᴄᴏᴠᴇʀʏ 🎆 ᴘᴏsɪᴛɪᴠɪᴛʏ (@vince.856) on Sep 26, 2019 at 3:20pm PDT


You may be seeing this after the 30th, but You should still be good to submit photos by the 5th of October or so.

And if we're pas that, go ahead and share them online, anyway. Show the world you are part of the community and help even more folks learn the signs of stroke, how to reduce their chances of stroke, and that stroke can strike at any age.

Joe was on the Strokecast a few months back. You can listen to that conversation here. You can also hear from Joe every week on the Neuro Nerds Podcast.


Robyn Weiss of Rehab Without Walls on Strokecast


Return to Employment After Stroke in Young Adults


A need for bananas? Dietary potassium regulates calcification of arteries


World Stroke Day




Joe Borges on Strokecast


Joe on Instagram


Peel a banana with one hand


Where do we go from here?

Here is the latest episode of The Strokecast

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