If you are like many people who have experienced a catastrophic injury or illness, your stay in the acute care hospital or trauma center was punctuated by the thought "Thank God, I survived!" But now the long road of rehabilitation has begun, and it is totally new territory for you. To help you through the next few steps on your journey, it might be helpful to visit with someone who has had a stroke and been through rehabilitation.
Madonna Rehabilitation Hospital's Peer Volunteer Program matches individuals who have completed rehabilitation with people who are just starting the process of rehabilitation for the purpose of sharing meaningful life experiences and providing hope for the future. Adolescents who completed rehab are also available as a peer volunteer.
Peer Volunteers contribute in a number of ways, including:
Sharing information regarding the Madonna rehabilitation experience with individuals who are considering admission to Madonna, and/or their family members. They can answer questions about their day to day experiences from the perspective of the patient and/or family member.
Visiting individually with a patient and/or family member while they are an inpatient or outpatient at Madonna. Specially trained Peer Volunteers listen to your concerns, share their experiences, and provide encouragement and support.
Madonna Stroke Support Group
4th Thursday of every month (1-2 p.m.)
Madonna Rehabilitation Hospital-Flanagan Room
Contact person: Carol Olson 402-413-3886
Stroke Support Group at Brentwood Estates-Lincoln
3rd Tuesday of every month at 7:00 p.m.
Contact for more info: Kathy Schildt at Nebraska State Stroke Association
Stroke is a medical emergency. Every minute counts when someone is having a stroke. Go to the emergency room immediately when any of the signs of stroke are noticed or suspected. Immediate treatment can save someone’s life and prevent or reduce disability.
Know the warning signs of a stroke - think "FAST"
Face: Ask the person to smile. Does one side of the face droop?
Arm: Ask the person to raise both arms. Does one arm drift downward?
Speech: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
Time: If you observe any of these signs, it's time to call 9-1-1 or get to the nearest stroke center or hospital.
Stroke is the fourth leading cause of death in the United States and in Nebraska. It is also one of the leading causes of adult disability. A stroke occurs when a blood vessel to the brain is either blocked by a clot or bursts. As a result, part of the brain does not get the blood it needs and begins to die. The longer the blood flow is cut off to the brain, the greater the damage.
Reducing Stroke Risk
Everyone has some stroke risk. A few stroke risk factors are beyond your control, such as being over age 55, being a male, being an African-American, having diabetes, and having a family history of stroke. If you have one of these risk factors, it is even more important that you learn about the lifestyle and medical changes you can make to prevent a stroke.
Medical stroke risk factors include:
Previous stroke, previous episode of transient ischemic attack (TIA) or mini stroke, high cholesterol, high blood pressure, heart disease, atrial fibrillation and carotid artery disease. These medical risk factors can be controlled. Talk with your doctor about what will work best for you.
Lifestyle stroke risk factors include:
Smoking, being overweight and drinking too much alcohol. You can control these lifestyle risk factors by quitting smoking, exercising regularly, watching what and how much you eat and limiting alcohol consumption.
National Stroke Association's Stroke Prevention Guidelines
1. Know your blood pressure. If it is elevated, work with your doctor to keep it under control. High blood pressure is a leading cause of stroke. Have your blood pressure checked at least once each year – more often if you have a history of high blood pressure.
2. Find out if you have atrial fibrillation (AF). If you have AF, work with your doctor to manage it. Atrial fibrillation can cause blood to collect in the chambers of your heart. This blood can form clots and cause a stroke. Your doctor can detect AF by carefully checking your pulse.
3. If you smoke, stop. Smoking doubles the risk for stroke. If you stop smoking today, your risk for stroke will begin to decrease.
4. If you drink alcohol, do so in moderation. Having one drink each day may lower your risk for stroke (provided that there is no other medical reason you should avoid alcohol). Remember that alcohol is a drug - it can interact with other drugs you are taking, and alcohol is harmful if taken in large doses. If you don't drink, don't start.
5. Know your cholesterol number. If it is high, work with your doctor to control it. Lowering your cholesterol may reduce your risk for stroke. High cholesterol can also indirectly increase stroke risk by putting you at greater risk of heart disease - an important stroke risk factor. Often times, high cholesterol can be controlled with diet and exercise; some individuals may require medication.
6. Control your diabetes. If you are diabetic, follow your doctor's recommendations carefully. Having diabetes puts you at an increased risk for stroke. Your doctor can prescribe a nutrition program, lifestyle changes and medicine that can help control your diabetes.
7. Include exercise in the activities you enjoy in your daily routine. A brisk walk, swim or other exercise activity for as little as 30 minutes a day can improve your health in many ways, and may reduce your risk for stroke.
8. Enjoy a lower sodium (salt), lower fat diet. By cutting down on sodium and fat in your diet, you may be able to lower your blood pressure and, most importantly, lower your risk for stroke.
9. Ask your doctor if you have circulation problems. If so, work with your doctor to control them. Fatty deposits can block the arteries which carry blood from your heart to your brain. Sickle cell disease, severe anemia, or other diseases can cause stroke if left untreated.
10. If you have any stroke symptoms, seek immediate medical attention. For more information on stroke please visit:
National Stroke Association www.stroke.org 1-800-STROKES (1-800-787-6537)
American Stroke Association www.strokeassociation.org 1-888-4STROKE (1-888-478-7653)
American Heart Association www.americanheart.org 1-800-242-8721
Nebraska State Stroke Association www.nebraskastroke.org 1-888-808-5678
League of Human Dignity www.leagueofhumandignity.com (402) 441-7871 (Lincoln)
Vocational Rehab www.vocrehab.state.ne.us
Answers for Families www.answers4families.org
Ankle Foot Orthosis (AFO)- brace used to prevent/control foot drop during swing phase of gait in patients with hemiparesis following stroke, spinal cord injury or brain injury
Aphasia- a language disorder that results in impairment in the comprehension and/or formulation of language and can affect both the spoken and written modalities. Aphasia is usually acquired as a result of stroke, brain injury or brain tumor. It can be classified into several types commonly referred to as expressive, receptive, and global aphasia.
Apraxia- the inability to plan or execute a movement to function or participate in an activity
Apraxia of speech- a motor speech disorder caused by disturbance in motor planning or programming of sequential movement for volitional speech production
Aspiration- penetration of food or liquids into the airway below the level of the vocal folds before, during or after swallowing
Cognition- the thought process combining sensory function, learning, and the ability to choose an effective response; knowing, thinking, learning and judging
Contraversive pushing (pusher syndrome)- characterized by active pushing of the non-affected limb towards the affected limb, resulting in loss of postural control/balance and inability to maintain midline or upright posture.
Dysarthria- weakness or altered neuronal control of the muscles responsible for speech production or defective sensory feedback regarding their movement
Dysphagia- impairment in the ability to swallow
Fiberoptic Endoscopic Evaluation of Swallow (FEES)- a functional, diagnostic test of deglutition in which a contrast dye, a flexible endoscopic catheter (inserted nasogastrically), a light source, and an air source (which is used to test sensation of the cricopharyngeal region) connected to a video camera to test and document the oropharyngeal phase of swallow reflex.
Functional Electrical Stimulation (FES)- involves the use of electrical stimulation to elicit a muscle contraction that translates into a functional activity (eg. walking or performing upper extremity task)
Hemianopsia (visual field cut)- vision loss (blindness) in one half of the visual field; may involve a portion of the visual field of each eye
Hemiparesis- weakness on one half of the body
Hypertonia- abnormally increased muscle tone
Hypotonia- abnormally decreased muscle tone
Insight- the ability to foresee and comprehend implications of actions on circumstances; the extent to which an individual accurately judges his/her strengths and weaknesses
Kinesio Taping- The Kinesio Taping Method is used for patients with neurologic conditions (CVA, SCI, TBI) to improve muscle contraction of weakened muscles, reduce muscle spasm and hypertonicity, increase ROM, and provide proprioeptive feedback and muscle re-education to involved muscle groups.
Motor Control- control of movement and posture
Neuro-Developmental Treatment- A "problem solving" approach which involves the treatment of movement dysfunction in patients with CNS disorders such as stroke. Therapists identify each patient’s impairments causing ineffective movement patterns and use direct handling and facilitation to improve movement strategies used during functional tasks. Active participation by the patient is key to this approach.
NPO- "nothing by mouth"
Orthotic Device- an external appliance that supports a paralyzed muscle, promotes a certain motion, or corrects a deformity
Postural control- the ability to control the body's position in space for stability and orientation
Proprioception- refers to the unconscious awareness of one's position of joints or limbs in space
Sensation- the ability to identify the sensory stimuli, where it is located, and how intense the stimuli is
Spasticity- a type of hypertonicity that is velocity dependent; attributed to hyperactive stretch reflexes mediated through muscles spindle stretch receptors
Unilateral Spatial Neglect- unawareness of an entire area of space (usually the hemiparetic side) due to deficits in visual awareness and perception
Visual Attention- the ability to attend visually to elements in the environment including the ability to select objects that demand attention and to focus on them appropriately
Visual Perception- the ability to extract and organize visual information from the environment and integrate it with the information from other sensory modalities and higher cognitive functions