Image thanks to washingtoninjuryattorneyblog.com

Atrial fibrillation (AF) is the most common form of arrhythmia – a problem with the rate, or rhythm, of the heartbeat. It is believed to affect more than six million people worldwide.

According to the London Atrial Fibrillation Centre, part of London Bridge Hospital, many people notice that when they are “in AF” they cannot do as much as they could when their heart is in normal rhythm. And because AF is a chronic condition, “It is not uncommon for patients to be surprised at what they can do when restored to normal rhythm and feel worse if they return to AF because they have been reminded what it is like to be in normal rhythm.”

AF carries some significant health risks including stroke. It is generally accepted that this risk is greatly reduced by the drug warfarin in high risk patients and aspirin in low risk patients.

About 30 per cent of people with AF have no symptoms and it is discovered by chance however, according to the London AF Centre website www.londonafcentre.co.uk, most people will experience a combination of the following symptoms:

1.    Palpitation (a feeling that your heart is racing, going faster than normal or beating in an irregular way)
2.    Shortness of breath
3.    Lethargy
4.    Dizzy spells or fainting
5.    Chest pain
6.    Symptoms of stroke (transient or permanent weakness to one side of the body, speech or visual impairment).

These are the features of AF discovered when a health professional examines you. A rapid and irregular pulse is the commonest sign of AF and is usually the way in which it is discovered in people without any symptoms.

While there are not many options available now to treat AF there are some drug and surgical therapies that are being researched all over the world. In fact, AF treatment as a research activity has gained a lot of traction in medical research even in the last 10 years.

We talk a lot about the importance of diet as one of the ways to prevent having a stroke.  On our facebook fan page we have been asking our community to give us easy to make recipes that taste great, are healthy and store well. Cinzia from Nutrition Darling! supplied us with this one. So bon appetit

•    Ingredients (serves 4):
•    2 tablespoons plain flour
•    8 chicken drumsticks
•    1/4 cup olive oil
•    300g can chickpeas, rinsed, drained
•    1 garlic clove, crushed
•    1 brown onion, finely chopped
•    2 x 400g cans diced tomatoes
•    2 x medium carrots, peeled and chopped
•    1/2 cup chicken stock
•    75g feta cheese, crumbled
•    1/3 cup flat-leaf parsley leaves, chopped cooked couscous, to serve

Method:
1.    Preheat oven to 180°C. Combine flour and salt and pepper on a plate. Lightly coat drumsticks in seasoned flour.
2.    Heat 2 tablespoons oil in a large frying pan over medium-high heat. Cook chicken, turning occasionally, for 5 to 6 minutes or until golden. Transfer to a shallow 8-cup capacity baking dish. Add chickpeas.
3.    Heat remaining oil in frying pan over medium-high heat. Add garlic and onion. Cook for 5 minutes. Add tomatoes,carrots, stock and salt and pepper. Reduce heat to medium. Simmer, stirring occasionally, for 10 minutes until thickened slightly.
4.    Pour sauce over chicken, stirring to coat. Cover with foil and bake for 30 minutes. Remove foil and sprinkle with feta. Bake, uncovered, for 10 minutes or until feta has melted and chicken is cooked through. Sprinkle with parsley. Serve with couscous.

To meet Cinzia on Facebook click here.

Image thanks to handworkhandcraft.com

Sometimes we let our creative side lie dormant or even think we don’t have one. But art and creativity live in all of us - it is usually a matter of finding the medium of expression that is best suited to us or recognising the artist within and the art without. It doesn’t always mean we are a budding Van Gogh but as Wendy Lyons from the Croydon Stroke Support Group will attest, there is at least a smidgen of talent in every being and, sad as it may be, sometimes it takes hardship or disability to draw it out.

Wendy, who has always had a knack for arts and crafts, started a weekly art session with her stroke support group peers for the simple reason that she believes everyone benefits from artistic self-expression. Wendy has shown how creativity is not just a left or right-side brain phenomenon - and it doesn’t always take two hands. With her group she has learned to adapt certain artistic techniques to make them possible for stroke survivors to perform. Most of this adaptation, Wendy told us, involves adjusting the method to allow for one functioning hand.

One of the group’s best little fundraisers is hand-dyed silk scarves. Wendy sources the light-weight neutral-coloured scarves from a wholesaler in bulk and then buys also wholesale, beautiful French watercolours. She brings them to the group where they mix colours and apply them to the scarves with an eye dropper. It is a small twist but a most effective one: as Wendy explains, you only need one hand to draw up liquid and apply it with a dropper. The scarves are then spread with course rock salt to soak up the excess liquid and then rinsed and left to dry. The results are many-coloured, reflecting the different personalities of the people who have coloured them and are a sure-fire seller at stalls and other fundraisers.

Contact Croydon Support Group http://www.strokefoundation.com.au/friends_of_nsf_vic

Diet

Healthy eating can reduce your risk of stroke or having another stroke by reducing risk factors such as high cholesterol, high blood pressure, being overweight and diabetes.

The following information should be used as a guide only and may not be appropriate if you are underweight or have swallowing problems. Ask a Dietitian for an eating plan to suit you.

Have plenty of:

Fruit and vegetables
You should aim to eat about five serves of vegetables and two serves of fruit every day. Fruit and vegetables reduce your risk of stroke as they contain antioxidants which can help reduce damage to blood vessels potassium which can help control blood pressure fibre which can lower cholesterol folate (eg in green leafy f olate vegetables) which may reduce the risk of stroke.

Wholegrain breads and cereals

These include wholemeal or wholegrain breads, brown rice, wholemeal pasta, and breakfast cereals such as porridge. Wholegrain breads and cereals contain fibre, folate and other vitamins and may reduce the risk of stroke.

Fluid

Aim to drink 8 -10 cups of fl uid per day unless you are on a fl uid restriction. Water is the best choice. Getting the right amount of fluid is particularly important if you have a swallowing problem and are only drinking thickened fluids.

Eat in moderation:

Meat, chicken, fish

Red meat and chicken can be included as part of a healthy diet. Be sure to choose lean cuts of meat, watch your portion size, trim off any visible fat and take the skin off chicken. Fish has been associated with lowering the risk of certain types of stroke. Try to include some fish at least two to three times a week.

Low fat dairy

The calcium and potassium in low fat varieties of dairy foods can help control blood pressure and may contribute to lowering the risk of stroke. Choose low fat dairy foods including milk, yoghurt, cheese and custard.

Eat in small amounts:

Healthy fats

Polyunsaturated and monounsaturated fats are found in nuts, seeds, avocadoes and vegetable oils such as canola, olive and sunfl ower oils as well as spreads containing these.

Limit Unhealthy fats
These include saturated and trans fats. These can be found in butter, lard, fatty meats, fullcream dairy products, pastries, chips and some other snack foods (including fatty takeaway food). Saturated and trans fats can raise cholesterol and increase the risk of stroke.

Salt intake

Too much salt in your diet may raise your blood pressure and increase your risk of stroke. Choose no added salt or reduced salt products. Limit foods like salty snacks, foods in brine, processed meats and convenience meals and sauces which are high in salt. Limit salt added to your meals.

Alcohol

The NHMRC Dietary Guidelines for Australian Adults 2003 recommend limiting alcohol consumption to a daily level of two standard drinks for men and one standard drink for women.

Everyone should have at least one or two alcohol free days every week. A standard drink is a pot or middie of beer, a schooner/stubby/can of mid strength beer, 100mls of wine or a nip of spirits. It is a good idea to discuss your alcohol intake with your doctor as alcohol may interact with some of your medications or make it harder to control blood pressure.

More information

For expert nutrition and dietary advice contact an Accredited Practising Dietitian (APD) by visiting www.daa.asn.au or call 1800 812 942

Note: This fact sheet is number 7 in a series. For a complete list of fact sheets, click here.

www.strokefoundation.com.au

The National Stroke Foundation is holding a stroke education forum in May this year.
This is a wonderful opportunity for you, your family or your social or professional group to come along and learn more about stroke, its risk factors and how to prevent them.
Topics that will be covered include facts about stroke, the causes of stroke, stroke prevention and, importantly, what to do in the event of a stroke.
The forum is planned for May 2011 in the North Sydney area. The date and location is to be confirmed. Light refreshments will provided and admission is free.
To register your interest or for any questions about this or future events please phone Natalie Fairchild on 02 8404 4190 or email nfairchild@strokefoundation.com.au.

Self Evaluation Checklist In Preparation For Returning To Work

Meet Barb Wolfenden she is a young stroke survivor, you may have met her through our NSF Facebook community.  Barb has produced this self evaluation checklist in response to issues being raised by young stroke survivors regarding return to work (RTW). She will be completing her Bachelor of Social Work Honours this year (2011), and is specialising in research exploring experiences of younger stroke survivors in re-establishing identity and returning to work.

Barb kindly gave us this checklist in the hope that it may assist people getting back to work after having a stroke.

This Self Evaluation information is intended purely as a guide - it is best supported by individual consultation with allied health professionals to address the residuals of stroke relevant to your experience. Some of these residuals may be subtle and emerge following your return to work (RTW).
Make your points/comments as comprehensive as possible – they will help you to understand yourself & help you in planning your RTW. (They may similarly help in planning a return to study).

STRENGTHS & ABILITIES
You can promote these strengths and abilities in relation to RTW – list as many as you can.

PERSONAL STROKE RELATED CHALLENGES
Reflect on what you are finding difficult post- stroke – this may be individual or may involve interactions and relationships (however try and be employment focused for the purpose of RTW).

STRATEGIES FOR OVERCOMING EACH CHALLENGE
Consider what resources you can access – material aids, information or supportive people.
You may consult with eg. Occupational Therapist, Neuropsych or Social Worker to help in developing strategies, although you will probably develop many your self. Eg re memory issues: make notes/lists of tasks/priorities to work through, use a diary, use alerts in Outlook; Eg re fatigue:  build in rest periods/breaks at work as required and sit in a silent space with a cup of tea for a bit, negotiate reduced hours on RTW and gradually increase these as you develop stamina.

BARRIERS – Physical/Psychological, Material, Environmental, Social, Cultural, Structural.
Identify barriers. These tend to seem impassable when you encounter them – they may or may not become a problem for you. Eg. a workplace with stairs for entry when you need a ramp;  or a Manager who refuses to allow you any accommodations, or flexibility, to support your RTW.

BROADER SUPPORTS TO ASSIST WITH OVERCOMING BARRIERS
Consult with professionals such as RTW Officer or OH&S Officer within workplace,  your GP/Dr, Neuropsych, Occupational Therapist, Social Worker or others who support you - any of whom can advocate with you and on your behalf re your needs in RTW. It is best to develop a RTW Plan with professional support.
If needed, you can engage a relevant professional specifically to assist with RTW. Seek these supports either through outpatient rehab, or referral through your GP.

Neuropsych Assessments can help identify your strengths and also the development of strategies to overcome challenges. Neuropsych Assessments may be available at discounted prices through the Psychology Dept of universities if you have not had the opportunity of assessment privately or in rehab. (Neuropsych Assessments can also be beneficial in identifying where you may need support and/or the development of strategies with a view to enrolling in uni or TAFE. If you do enrol in uni or TAFE be sure to explore the possibility of registering with their Disability Support Service as this service will help ensure your needs are met within the uni/TAFE environment).

Refer to Policy – RTW policy within your workplace, Disability Act, Disability Discrimination Act, Disability as addressed by Australian Human Rights Commission which can be googled.

APPROACHES TO NEGOTIATING RETURN TO WORK
You may request a meeting to discuss your needs and adaptive approaches/strategies, prior to RTW, or even after you have commenced back at work. It can be helpful to include your supportive team, eg. OT, Neuropsych, Social Worker, Physio, Team leader at work/Supervisor/Manager, Key support or friend at work/natural mentor.

If you are linked with a rehabilitative employment service they may assist you to negotiate your RTW.

Another option: If you are a member of a work sector/industry Union, you may also contact your Union and request the assistance of a Union organiser or official in setting up a RTW meeting with your employer (be sure to include any of the health care professionals you would like involved - they may attend or provide written advice/reports regarding your RTW ). The Union organiser/official can attend a RTW meeting with you and advise on your rights and entitlements within the workplace, along with what responsibilities your employer has towards you in relation to your RTW following stroke, ie. in accordance with legislation and workplace policy. They can assist you in negotiating a RTW Plan that accommodates your stroke residuals. This process will likely include the RTW Officer within your workplace.
Furthermore, you can request support from your Union not only in the RTW process; but also if challenges or barriers arise over time within the work setting that you feel you need support in addressing.

DISCLOSURE OF STROKE
This is something I have grappled with beyond my RTW and I don’t know that I have the right answer yet, as it is very individual, can be complex and seems to vary depending on circumstance. It may help to consult with a trusted support or professional in making your decision re disclosure.

Obviously when you return to your pre-stroke workplace your supervisor and Manager may be aware of the fact you have experienced stroke, and possibly some of your colleagues also; however disclosure becomes an issue when you start in new employment. Whether to disclose, and even when to disclose, is by rights your choice.
You may have to fill out pre-employment forms that ask if you have a pre-existing condition, or respond to selection criteria within applications. It is at this time that you need to decide what your approach will be regarding disclosure. Then there is the interview. Some of us have visible signs of stroke, others may carry invisible stroke related challenges. Visible signs of stroke prompt questions regarding disability, invisible signs do not always. Some people may choose to disclose once they have been offered a position. However, whether to disclose stroke or not remains your choice; but please be aware that you may need to disclose in order to be covered by Workcover.

To meet Barb on Facebook click here.

This check list was developed 22 Jan 2011 by Barbara Wolfenden informed by personal experience and research through her Bachelor of Social Work. The content in this blog is the view of the author, and not necessarily the views of the National Stroke Foundation.

When Wendy Lyons heard a fellow stroke survivor sing a few lines of the song “Danny Boy” she was amazed.

Since joining the Croydon Stroke Support Group in Melbourne he had never uttered more than a couple of words. “It’s something I came to notice from then – those people who had lost speech after their stroke could still sing,” Wendy says. “It was then I wanted to start a choir for people with aphasia.”

A stroke can affect parts of the brain that lead to problems in communication. Aphasia, as it is known, can cause difficulty in comprehension, in thought and body language but it can also manifest in difficulties talking or speaking clearly. As stroke sometimes only affects one part of the brain people who can’t talk after a stroke can often sing.

“The left hemisphere of the brain affects speech,” Wendy says. “People who have a stroke on that side of the brain are often paralysed on their right side as a result.
“But music is processed by both sides of the brain.”

Stroke a Chord held its first rehearsal in May 2010 after Wendy’s first idea in 2008. The group, open only to people with aphasia and their carers, meets weekly, rehearses with a conductor, and holds performances.

“It really boosts everyone’s confidence,” Wendy says.

“And we have found that people’s speech is actually improving by this regular and structured singing.”
She tells of one group member who had had his stroke before the birth of his grandchildren.

“Until they heard him sing they had never heard his voice,” Wendy says.

Enquiries about the Stroke a Chord choir can be made to Wendy Lyons: gelyons@optushome.com.au

Here their story on ABC  lifematters