Fri07252014

Your Health

Books help patients navigate stroke effects


It is sudden, unpredictable, life altering – and all too common. Every 40 seconds, someone in the United States has a stroke. A stroke can happen to anyone at any time.

A stroke is a medical emergency, yet many people do not know the warning signs. The American Stroke Association uses the acronym “FAST” to describe the signs of a stroke: Face drooping (F), Arm weakness (A), Speech difficulty (S) and Time to call 911 (T).

Time is of the essence when a stroke occurs. According to the American Heart Association, 150,000 Americans died from a stroke in 2010, and there are approximately 2 million stroke survivors in the U.S.

“Stroke” is a simple term to describe a complex problem. Sometimes referred to as a “cerebrovascular accident,” “cerebral infarction” or “brain attack,” a stroke is, in essence, a sudden brain injury caused by an abnormal blood supply to cells in a part of the brain. Strokes actually have many different causes and can vary widely in their impact. There are two main types of strokes: ischemic, caused by a loss of blood to the brain, and hemorrhagic, caused by bleeding in the head.

Because different parts of the brain control different functions, the impact of a stroke can vary in type and intensity. The common effects include speech and language problems, paralysis and weakness, pain, lack of coordination, loss of sensation, inability to swallow, bladder and bowel problems, mood disorders, cognitive deficits and inability to care for oneself.

Louis R. Caplan, M.D., renowned Harvard neurologist, recently wrote a book for stroke patients and their families. “Navigating the Complexities of Stroke” (American Academy of Neurology, 2013) can help patients work more effectively with their medical team to prevent and manage the effects of a stroke. As part of the American Academy of Neurology’s “Neurology Now” series, the book provides practical information for stroke patients and caregivers.

The second edition of “Navigating the Complexities of Stroke” centers on the case studies of four stroke patients, each with a different profile. Caplan begins by exploring brain anatomy and physiology, defining strokes and explaining why they happen. Later chapters describe types of strokes, the varied effects of strokes on the brain and the physical functioning of stroke victims. He outlines tests administered to individuals who may have had a stroke, available treatments and potential complications. Dysfunctions, disabilities and handicaps that may remain after a stroke have their own chapter, followed by one on recovery and rehabilitation.

Caplan closes with a practical section on planning for the future. Readers are taught how to maintain an emergency notebook as well as make formal and informal arrangements for care. He also addresses durable power of attorney, trusts, wills, guardianship and conservatorship.

Sara Palmer, Ph.D., a rehabilitation psychologist, and Jeffrey B. Palmer, M.D., a physiatrist specializing in stroke rehabilitation, focus on the unique way that caregiving for stroke patients affects spouses, in “When Your Spouse Has a Stroke: Caring for Your Partner, Yourself, and Your Relationship” (Johns Hopkins University Press, 2011).

The authors have more than 25 years of experience caring for stroke survivors and their families at Johns Hopkins School of Medicine. Rather than duplicate the information found in many places about stroke caregiving and rehabilitation, the Palmers focus on the impact of a stroke on marriage.

The book discusses the challenges and opportunities a couple will experience post-stroke. Problems addressed include emotional stress, feelings of loss, changing roles and changes in sexual relations. Caregivers may find it difficult to take care of their own health needs and balance work and family responsibilities, and they may feel burned out.

On the flip side, there can be meaning and value in being a caregiver. Spouses may become closer and find that they have a shared sense of purpose. A stroke can even present an opportunity to fix problems that existed in the marriage before. Caregiver spouses are partners in stroke recovery yet often feel taken for granted. “When Your Spouse Has a Stroke” fills an important gap for caregivers and patients alike.

Both books can be found on the shelves of Stanford Health Library. For more information, visit healthlibrary.stanford.edu/resources/bodysystems/cardio_stroke.html.

To learn more about surviving and coping with a stroke and to find answers to specific questions, stop by, call or email the library. Librarians and trained volunteers will do the research for you.

The main branch of Stanford Health Library is located in Hoover Pavilion, 211 Quarry Road, Suite 201. Hours are 9 a.m. to 5 p.m. weekdays. Library assistance is also available on the first floor of Stanford Hospital, near admitting, and on the main level of Stanford’s Cancer Center.

Nancy Dickenson is head librarian at Stanford Health Library. For more information, call 725-8400, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit healthlibrary.stanford.edu.

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