Wednesday, January 9, 2008

From the Files of Nurse Maureen Adduci

Maureen, our resident medical expert, kindly took some time to give us some background information on strokes and her perspective of Alex's condition.
Thanks Maureen!


Okay, a little medical discussion. (Keep in mind I spent most of my life in surgery but have spent time with CVA's (cerebral vascular accidents).)

The biggest thing to realize is that the range of injury is incredibly wide. My take on Alex is [he suffers a ] pretty big first one with some recovery and then the catastrophic one. I think the loss of speech is the toughest. It's called aphasia and it has two forms. Patient can't understand what's being said to them or can't remember the words needed to express themselves (very common in a lot of different brain injuries); sometimes you see both. You can recover from this with a lot of therapy. Motor skills are very specific.....frequently paralyzed on one side and that can be limited recovery even with a lot of therapy.

One of the most distinctive things with stroke patients is their inability to control their upper airway so they tend to choke, drool and have great difficulty speaking. This is beyond the cognitive aspect of aphasia: it's motor skills. Think Dick Clark or Kurt Douglas.

As for "catatonic" (which is not a word I would use; I always associated that with psychiatric conditions), it's all different but I'm going to presume to be diagnosing Alex. If there is movement (and in his case there seems to be), it is involuntary nerve transmissions. The moaning.....well, that can be considered involuntary but can be a result of pain or something else. As the brain suffers these injuries it dies in spots. So you lose all different things. Certain areas hold certain capabilities, including the last/worst: ventilation (breath control).

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