2023-04-24

How do you measure blood pressure at home?


Lots of stroke survivors joined the stroke club due to high blood pressure. I'm one of them.

The biggest challenge with high blood pressure is that it doesn't hurt. Most people will feel no symptoms unless something goes terribly wrong. Or they might learn they have the condition if they get an annual physical.

Because of the danger of high blood pressure directly, and because of the danger of other conditions that manifest as high blood pressure, it's important to check it regularly, and that doesn't mean you have to go to the doctor every week.

You can find home blood pressure meters all over the place -- from Amazon to Costco to the corner grocery store. But which one is best? And what do you need to know if you've already had a stroke?

This week, I'm joined by Carol Lucarelli of Omron Healthcare. Omron is a leading manufacturer of home blood pressure meters. In fact, one of their devices is sitting on the table next to me as I type this. It was that very device that gave me the 210 over 160 reading that kicked off my stroke story several years ago. More recently it read 134 over 77 -- not perfect, but still much better than the condition that collapsed my right middle cerebral artery.

One reason I wanted to talk with Carol was that I heard about Omron's Going for Zero mission. The other reason is that I like tech and gadgets, especially when they can save lives.

IMAGINE A HEALTHIER WORLD

We believe the next generation won’t be defined by age, but by a world without heart attacks or strokes. This is a world-changing mind-set we call Going for Zero™. We do our part through technology supporting personal fitness, heart health, healthy lungs and freedom from pain. You bring this commitment to life by understanding and sharing heart health with every step.

https://omronhealthcare.com/generation-zero/

Carol joins us to talk about how these devices work, how they compare to the doctor's office, and why we should trust devices from Omron from wrist devices to upper arm cuffs to smart watches.

If you don't see the audio player below, click here to listen to the conversation on the original site.

 

Click here for an AI-generated transcript

Who is Carol Lucarelli?

Carol Lucarelliu's professional headshot. She wears a light blue blazer against a gray background.

Carol Lucarelli is the Executive Director of Marketing and Ecommerce at OMRON Healthcare, the global leader in personal heart health and wellness technology.

Lucarelli is a seasoned marketing professional with over 25 years of experience in the consumer packaged goods space. During her time at OMRON, Lucarelli has led the marketing initiatives for numerous product innovations, including the launches of HeartGuide Complete as well as VitalSight, OMRON’s first remote patient monitoring service.

Wrist vs Arm

Home blood pressure monitors typically come in two types -- wrist or upper arm.

The wrist mounted devices are typically smaller. You simply put it on your wrist, secure it, press a button, and raise your hand to get it at the appropriate level.

A woman sits in a chair and wears an upper arm blood pressure cuff

The upper arm models will typically wrap around your bicep or upper arm. Some will have the guts of the device on the cuff; others will have a hose that goes to a device on your desk, table, or lap.

In the past, I assumed the upper arm would be the more reliable device because that's what many medical facilities use. Over the past few years, though, I've seen more medical teams using the wrist versions for convenience.

Carol also explained that whether it's wrist mounted or upper arm mounted, the devices are held to the exact same standard of accuracy. As long as a device is on the Validated Device List, you can assume the model is accurate.

Ask your doctor if they have a recommendation. There are all sorts of health reasons why one style might work better for someone than another style. Different deficits after stroke may impact the choice. While cognitive, language, sensory, and pain challenges can all have an impact, hemiparesis - or limb paralysis - is probably the bigger factor.

A person wears a wrist mounted blood pressure monitor on their wrist.

Once you choose your device, it's also a good idea to bring it with you the next time you go to the doctor. This way your doctor can double-check its accuracy against their own blood pressure equipment. While the Validated Device list ensures your model is generally accurate, this process ensures your particular meter is accurate.

Hemiparesis recommendations

Typically, we take blood pressure measurements on the left arm. It's closer to the heart and will provide a more accurate reading for non-stroke folks.

After stroke, a stroke affected limb, however, doesn't have the same muscle activity of a non-affected limb. And that muscle activity affects blood pressure readings. That limb may also experience more edema or swelling due to less effective circulation, lymphatic draining, and other things. That can also impact the blood pressure readings.

So, to correctly read blood pressure, you should take a reading on the unaffected side. A difference of 10 points between the sides is not uncommon.

The other issue that impacts readings is arm position. The cuff where the reading takes place should be level with the heart. With an upper arm cuff, that's easy. With a wrist mounted device, it's more challenging. You have to be able to lift the wrist to the same height as the heart.

Your arm is also supposed to be relaxed when you take the reading so it should be on a bed, table, shelf, or some other item to hold it at heart level. To get an accurate reading, the arm should not be held up under its own power.

If you have a care partner who can fasten the device, great. Then an upper arm device can be easy to use. You don't need to worry about arm height because it's naturally at heart level. If the main unit connects via hose to the cuff, you can even use the unaffected hand to push the ON button.

If you're by yourself, the problem is fastening the cuff in the first place. It took me several years after stroke until my left arm had enough strength and dexterity to tighten the cuff on my upper arm. Sometimes I still don't get it right and have to try again.

Fighting with that costs energy and aggravation, which raises my blood pressure so now I have to take extra time to make sure I relax adequately to get an accurate reading.

Once the cuff is set and I chill out a bit, I can get a good reading.

A wrist cuff is easier to put on. It still requires a certain amount of dexterity and strength in my affected hand, but it's much less. And it's easier to reach the strap with my teeth, so I can use my bite to help tighten the straps.

Then the trick is to get it at heart level. Sitting up can be tough because I have to use my affected side to lift my unaffected arm so I'm not messing with the reading by using the strength in the arm with the monitor.

One solution to that which works with both types is to take readings in my recliner our lounge chair. I can get strapped in and then lay back with my arms in neutral positions and the device naturally at heart level, relative to the ground.

So, putting the device on is likely easier with a wrist device. Getting an accurate reading is likely easier with an upper arm device.

A picture of the Omron HeartGuide wrist blood pressure monitor/smart watch. It reads 118/88

Of course, that all assumes I'm doing this by myself. If someone is able to consistently help, it changes that calculation a bit.

Consider your goals, your deficits, and your doctors' recommendations. Try some different devices to find the one that you will use most consistently to generate the most accurate readings.

Though the Omron Heart Guide wrist monitor / smart watch does activate my technolust…

Getting Good Data

Carol gave four recommendations for getting an accurate reading.

First, sit upright in a hard-back chair. No slouching. This will give you a good base to start from, assuming your deficits allow you to do this.

Second, be seated for 5-10 minutes before taking your reading. If you've been moving around from place to place or doing your sit-to-stand exercises for the day, your blood pressure will likely be elevated from that activity.

Third, keep the cuff at heart level.  If it's an upper arm cuff, that's easy. If it's a wrist cuff, you may need to support the arm that's wearing the device.

Fourth, keep your feet flat on the ground, assuming tone and spasticity allow that. Crossing your legs or ankles will restrict the flow of blood and reduce the accuracy of your readings.

These tips will help you get readings, but more important than your exact posture is taking your readings in the same (or similar) posture each time to ensure consistency. Often the trends over time are more important than any particular reading.

Chart from heart.org showing levels of hypertension

Validated Device List

Whichever style of meter you choose, you want it to be accurate. And a good place to start is the Validated Device List.

The Validated Device list is maintained by the American Medical Association. The devices on it have been evaluated by a third party to ensure they meet the standards for accuracy that doctors can trust. While Omron has a bunch of devices on this list, it includes plenty of other manufacturers, too. All of these devices will meet the minimum standards for accuracy.

Consistency

We end up talking about consistency a lot on this show.

Carol talks about the importance of taking blood pressure readings consistently. The actual result often matters less than the trends over time. And the only way to spot trends over time is to consistently collect that data, like brushing your teeth.

Consistency isn't just about blood pressure. Consistently executing a PT, OT, or SLP home exercise program is one of the keys to recovery. We talk about the thousands of reps needed for neuroplasticity over time, but it's the consistency that will make that happen. Doing 100 reps a day, every day will yield better results than doing 1,000 reps once a week.

The core call to action for every episode of the show is, "Don't get best…get better." You don't have to become the best at anything to be successful; it's likely to be a fool's errand. Instead, just try to get a little better every day. Consistent work to improve just a tiny bit can add up to huge gains over time.

What consistency lacks in flash and drama, it makes up for in long-term results.

Hack of the Week

Carol shared a couple tips and I have one of my own this week.

First, use electronic reminders around the house. That could include smart phone alarms. Or it could be devices like the Amazon Alexa or the Google Home devices. Set those devices to remind you to check your blood pressure, take your medication, do your exercises, or whatever.

Your brain is doing enough in recovery. If you can outsource some routine stuff to robots, go for it.

When there are things about your devices that you don't like, let the manufacturer know. When enough people make suggestions or point out problems, then they may realize changes need to be made. If they don't hear from customers, or customers whose business they lost, it's a lot harder to make the most appropriate changes to the products.

And, while I could be wrong (and hope I am) I don't think most medical device companies have folks with hemiparesis working in their engineering departments.

Finally, my biggest struggle with an upper arm blood pressure cuff is tightening it adequately with my affected hand. My strength and dexterity are improving, but I still have a long way to go.

One trick I have is to tighten it around my elbow and lower arm. I still can't tighten it all the way; it will be loose there. Once I have that secure though, I can slide it up to my upper arm (with effort). While it was loose on my lower arm, because my upper arm is bigger, it is now tight enough to get a reading without the machine throwing an error message.

Links

Where do we go from here?

More thoughts from Carol Lucarelli

  • A red field with Carol Lucarelli's professional headshot on the left. The text reads: How do you read blood pressure at home? New episode on your favorite podcast app With Carol Lucarelli http://Strokecast.com/Omron
  • A woman sits at a table and reads her blood pressure with an uppewr arm cuff pm yjr Omron BP7900 The text over the image read: Your blood pressure changes every moment of every day. - Carol Lucarelli
  • A woman uses a wrist mounted blood pressure meter while seated across a desk from her doctor The text over the image read: When you take that one reading with your clinician on an annual basis, you are not in the know. Your doctor is not in the know. - Carol Lucarelli
  • A person uses a wrist mounted blood pressure meter at sa table The text over the image read: You need to monitor your ups, your downs, the ebbs and the flows [of your blood pressure] and all of that with consistency. - Carol Lucarelli
  • A picture of the Omron Connect app running on two smart phones The text over the image read: The monitoring is so important because not only do you become more aware of what your own numbers are, you recognize when there's a change. - Carol Lucarelli
  • A picture of a clinician reading blood pressure in a medical facility with traditional equipment The text over the image read: Doctors, nurses, medical assistants -- if they've learned how to take a blood pressure reading correctly, it still will differ from person to person. - Carol Lucarelli
  • A picture of the Omron HeartGuide wrist blood pressure monitor/smart watch The text over the image read: All manufacturers of blood pressure monitors need to meet a minimum standard. - Carol Lucarelli
  • A picture of the Omron BP 7000 upper arm blood pressure cuff/meter The text over the image read: [At Omron] We actually hold ourselves to a higher standard than the FDA requires of us so we try to tighten up that accuracy measure of 3 to 5 millimeters of mercury plus or minus. - Carol Lucarelli
  • A picture of the Omron BP 7900 bloopd pressure meter with the cuff sitting behind it The text over the image read: And so we actually recommend to everyone who's purchased an Omron device get a new cuff annually. - Carol Lucarelli
  • A picture of a wrist mount Omron blood pressure monitor sitting on a surface reading 118/78 The text over the image read: If you're holding [the cuff] above heart level, you're going to get a lower reading than reality. If it's below heart level, you will artificially increase the reading. - Carol Lucarelli
  • A picture of the Omron HeartGuide wrist blood pressure monitor/smart watch straight on showing step count The text over the image read: The only way that I can help build more accessibility into our devices is to hear from the people who need it. - Carol Lucarelli

 

 


Here is the latest episode of The Strokecast

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2023-04-17

What is chronic pain?


Pain sucks. Chronic pain sucks even more. And for many stroke survivors, this is now their life. Actress, artist, documentarian, and stroke survivor Maggie Whittum explored the world of chronic pain with us in episode 38 and with Barbie dolls filled with nails or covered in suffocating clay. Other survivors have talked about living with pain, even when there is nothing "wrong" with the limb. 
 
 
 
 
 
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A post shared by Maggie Whittum (@maggiewhittum)

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And once you've lived with pain for several months you don't become accustomed to it. In fact, the nervous system increases  your response to pain.

So what's going on here?

The brain damage from stroke drives chronic pain in many survivors through a perfect storm of symptoms:

  1. Decrease in sensory filtering

  3. Increase in sensitivity

  4. Homuncular changes in the mind-body connection

In this conversation, Physiotherapist and pain specialist Brendon Haslam joins us to talk about the nature of post stroke pain, how clinicians may treat it, why some medication work while others don't, and how, after stroke, we may no longer know just how big or small our hand is.

If you don't see the audio player below, visit the original article page here.

 

Click here for an AI-generated transcript

Who is Brendon Haslam?

Brandon Haslam looks at the camera while wearing a navy blue sweater

Brendon is a physiotherapist and current PhD candidate with the University of Melbourne. Brendon has a particular interest in pain following stroke, and his PhD is focusing on identifying contributions to upper limb pain in stroke, and understanding possible neural networks involved in the pain experience.  The aim of this research is to increase understanding of pain following stroke, and subsequently develop effective interventions to manage the significant problem of chronic pain in stroke.

What is chronic pain?

Once someone experiences a pain for 3 months, it's considered chronic pain.

The nature of chronic pain after stroke goes deeper, though. For one thing, we normally think of pain as resulting from tissue damage or injury. While sometimes joint injury, shoulder subluxation, tendonitis, and other conditions may be a factor, they don't tell the whole story.

For example, lightly touching an affected limb may be extremely painful. Applying the exact same stimulus to and unaffected limb and an affected limb may feel like nothing on one side and extremely painful on the other, even if there is no physical difference in the stimuli.

A stroke affected limb may just hurt for no obvious reason. And that can be what the survivor just has to live with.

Over the last 20-25 years, as Brendon explains, our understanding of pain has evolved quite a bit. We no longer think of it as coming from specific pain receptors. Rather, it a broader sense of safety or danger to the body. And the more someone lives with chronic pain, the more sensitive the nerves at the spine will become to those sensations. Rather than learning to ignore the pain, we can become even more sensitive to it.

One of the biggest challenges with stroke recovery is how the brain sometimes loses the ability to inhibit or disregard signals and data. In the case of chronic pain, the brain fails to disregard those signals as the spinal cord in effect raises the volume.

In the case of tone and spasticity, as we learned from Dr. Wayne Feng, the brain loses the ability to inhibit signals from the spine to the affected limbs that drive tone.

For some survivors, like artist Seth Ian Shearer and NeuroNerd Joe Borges, the stroke reduced the ability of their brains to filter out or inhibit external sensory input. The go out and about with sunglasses and earphones to navigate the world.

Stroke is as much about the brain no longer stopping things as it is about the brain no longer being able to do things. And chronic pain falls right into these challenges.

The Study

I wanted to speak with Brendon after reading a study published in the journal Brain Sciences called “My Hand Is Different”: Altered Body Perception in Stroke Survivors with Chronic Pain.

It's a fascinating look at how stroke survivors with chronic pain develop a false image of the affected hand.

Our results support the hypothesis that individuals with sub-acute and chronic stroke who experience chronic pain are more likely to report changes in body perception (as indicated by presence of alterations in perceived hand size) than those without pain. Further, the frequency of altered body perception of the hand, and strength of the association were greater when the region included the hand.

We've talked about the homunculus in previous episodes, and you can read more about the idea of the homunculus in this Strokecast article. Basically, the homunculus is a representation of the amount of neuronal real estate taken up by different body parts based on how much we use them and how we use them. For example, the thumb will occupy more space in the brain that the elbow.

After stroke, our homunculus can undergo changes based on the injury and our new use patterns for our body. And among those changes are how we feel pain.
 This study provides useful information in understanding that those changes take place. It reinforces the idea that pain is related to homuncular perceptions. And it further supports the perfect storm of chronic pain causes that we discussed in the episode.

Hack of the Week

Brendon's hack is to get into meaningful activities that bring you joy. Sort of like how Tawnie in the previous episode got into Mermaiding.

There are lots of reasons to focus on activities like this -- whether that's volunteering in a community, playing a sport, creating art, developing a podcast or something else. Doing something deliberate and planning it gives us something to look forward to. Having a reason to get out of bed is super important, not only for stroke recovery, but for life in general. Making progress, striving, or even just doing something to improve your life and mood -- to bring joy is a powerful motivator to keep going. And for some folks, that means to just get to the next day. For other folks it's a way to change the world.

Pursuing activities that bring genuine joy is a good thing in and of itself.

But as Brendon points out, it has biological implications, too. It opens the proverbial "drug cabinet" in our brains to drive increased dopamine. This drives learning, which is the essence of stroke recovery -- teaching the brain to do the functions the dead brain cells used to do. Dopamine also drives the production of Gaba. And Gaba works to turn down the body's sensitivity to irrelevant information.

Essentially, it helps the body inhibit some of the sensations that cause problems after stroke.

Pursuing activities that drive joy addresses the challenges of stroke on multiple levels.

Links

Where do we go from here?

More thoughts from Brendon

A redsquare with the Strokecast logo and Brian Haslam's headshot. The text reads "What is chronic pain? New episode on your favorite podcast app http://Strokecast.com/pain"

A redheaded woman paws at her face in agony. The text over the image read: Pain is actually an experience that our body, our brain, our whole nervous system sort of basically generates as a means of self-protection. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A collection of audio cables plugged into some sort of breaker box. The text over the image read: Pain as an input -- as a sensation -- is actually not correct anymore, but more pain as an output like an emotion. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A tiger lurks in an algea covered pond The text over the image read: We attribute an experience of pain to a body part that we view is currently under danger. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A black and white photo of lots of people walking down a city street The text over the image read: 20-25% of the general population in the world experiences ongoing pain. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of walnut that looks similar to a brain in its skull. The text over the image read: The ultimate decision of whether you experience pain is determined by your brain, but it is a as a result of a lot of different information coming in from different systems and how that is processed. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of a woman clutching the back of her neck in pain The text over the image read: People with stroke, unfortunately, are two to three times more likely to experience chronic pain than someone without a stroke. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of several people wearing HazMat suits The text over the image read: Pain is the is an ultimate way of protection because it makes me do things differently. It will make me stop interacting with that stimulus. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of a volume knob set to 10 The text over the image read: So when information gets into the central nervous system, basically the volume switch gets ramped up. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of 2 young stiudies reading large, thin books while standing in an ethereal forest. The text over the image read: Ongoing pain becomes a learnt process and a bit like a skill acquisition. The body becomes, or the self becomes, incredibly skilled at evoking a protective behavior such as pain in order for it to feel safe. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of a cloverleaf interchange The text over the image read: Pain should just be thought of as part of the whole situation, rather than something out on its own. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of two security cameras mounted on a wall. The text over the image read: Pain is a good thing for a lot of situations. It's designed to make us safe. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A pictrure of multicolored loops of light. The text over the image read: We need to be thinking of pain as a normal experience as part of our day-to-day sort of things and an important one in the right context. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of a person wearing a hoodie standing in front of a brick wall at night. The text over the image read: You will experience pain if there is more evidence of danger than there is of safety. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of three empty beds in a hospital ward. The text over the image read: Very few people who experience ongoing pain following their stroke experience pain in the early days in that acute setting. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of a padlock securig two aquamarine doors. The text over the image read: It's not actually the stroke itself that has caused the pain, but maybe the stroke has created an environment where it's perceived to need more protection. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A picture of a woman holding a finger in front of her mouth to shush the viewer. The text over the image read: A system post stroke can be overwhelmed because it loses the ability to quiet down information that isn't relevant to the task. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

An illustration of multicolored nerve cells. The text over the image read: And we're now sort of going into sensory retraining as a means of reducing pain and increasing function. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A black and white photo of a hand held up with the palm facing the camera and the fingers slightly curled. The text over the image read: How do people with stroke perceive the size or the shape of their body part?... Those that had chronic pain, were much more likely to report that their hands now felt two different sizes. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A person touches a lake with the back of their hand. The text over the image read: The hand is really crucial to how we perceive our environment, second probably only to vision. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.

A person holds up a stone with the word believe painted on it. The text over the image read: You can do all the best treatments in the world, but if it doesn't fit with what that person believes is actually going on, they will not work. - Brendon Haslam Of course chronic pain sucks after stroke. But it also changes how big you think your hand is. Pain researcher and PhysioTherapist Brendon Haslam talk about the nature of pain after stroke, what happens neurologically, and the latest research in this episode. Visit http://Strokecast.com/Pain to learn more.


Here is the latest episode of The Strokecast

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