ON THIS EPISODE OF CYCLE OF HEALTH, POST-STROKE CARE.

IN THE US ALONE, STROKES ARE RESPONSIBLE FOR NEARLY 140,000 DEATHS EACH YEAR.

STROKE CAN LEAD TO SERIOUS, IN FACT, MY GRANDFATHER, FATHER AND TWO COUSINS EACH HAD A STROKE SO I'M A LITTLE WORRIED ABOUT HAVING ONE.

JOIN US AS WE EXPLORE THE CENTER FOR LIFE SKILLS AT ITHACA COLLEGE AND HEAR FROM FOUR EXPERTS DISCUSSING STROKE, TREATMENT AND REHAB COMING UP ON "CYCLE OF HEALTH."

2 HELLO!

WELCOME TO CYCLE OF HEALTH, I'M DR. RICH O'NEILL.

TONIGHT'S TOPIC, POST-STROKE CARE.

ACCORDING TO THE CDC, NEARLY 800 THOUSAND PEOPLE IN THE U.S.

SUFFER A STROKE EACH YEAR.

AND 1 IN 4 OF THOSE ARE IN PEOPLE WHO HAD A PRIOR STROKE.

WHOA!

THIS IS A BIG REASON WHY IMMEDIATE REHABILITATION AFTER A STROKE IS SO IMPORTANT.

REHAB EASES THE TRANSITION FROM HOSPITAL TO HOME AND HELPS PREVENT ANOTHER STROKE AND SOME LONG-TERM DISABILITIES.

BUT HOW LONG DOES RECOVERY TAKE?

IS IT DIFFERENT FOR EVERYONE?

DO SOME FOLKS NEVER FULLY RECOVER?

TONIGHT, FOUR EXPERTS WILL HELP US ANSWER THESE QUESTIONS AND MORE.

THEY ARE: MR. JAMESON CRUMB: CLINICAL PROGRAM DIRECTOR FOR CROUSE NEUROSCIENCES DR. DAVID PADALINO: NEUROSURGEON AT CROUSE DR. SAMI ABDUL-MALAK: CHIEF OF NEUROLOGY AT CROUSE AND MS. KELLY VAN AUKEN: CERTIFIED DOCTOR OF OCCUPATIONAL THERAPY AT CROUSE THANK YOU ALL FOR BEING HERE.

NOW, FOLKS, WHEN I WAS VERY YOUNG, ONE OF MY EARLIEST MEMORIES, FOUR OR FIVE, I MET MY GRANDFATHER FOR THE FIRST TIME.

AND I REMEMBER A BIG SMILE FROM HIM, AND THEN HE REACHED OUT TO ME TO SHAKE MY HAND LIKE THIS WITH HIS LEFT HAND.

AND I WAS LIKE, I REMEMBER, WHOA, THIS IS VERY WEIRD.

WHAT IS THIS GUY DOING?

THAT WAS MY INTRODUCTION TO STROKE.

AND IN THE MEANTIME, MY FATHER HAD A COUPLE OF STROKES.

MY TWO COUSINS HAVE HAD A STROKE.

SO WHAT ARE THE RISK FACTORS?

I'M A LITTLE WORRIED ABOUT HAVING A STROKE.

WHAT ARE THE RISK FACTORS FOR STROKE?

>> SO THE MORE DEFINABLE ONES ARE FIRST AND FOREMOST AGE.

THE OLDER WE GET, THE HIGHER THE RISK OF A STROKE AND THE HIGH INCIDENTS OF STROKES.

>> THIS IS NOT SOUNDING GOOD FOR ME SO FAR.

>> THE OTHER RISK FACTORS WOULD BE NORMAL-- WOULD BE FAMILY HISTORY.

IT'S NOT EXACTLY GENETIC BUT THERE IS A GENETIC COMPONENT IN RARE CASES OF STROKE.

THE MORE ONE HAS A FAMILY HISTORY OF BAD BLOOD VESSELS, WHETHER IN THE HEART OR PERIPHERY OR KIDNEYS OR AND OF COURSE THE BRAIN, THE BLOOD VESSELS THAT SUPPLY THE BRAIN MPLE THAT INCREASES THE RISK FACTOR FOR STROKE.

MORE IMPORTANT FOR US, AS PHYSICIANS AND CARETAKERS AND AS HUMANS IS THE 45 RISK FACTORS.

THE MAIN ONES ARE HIGH BLOOD PRESSURE, HYPERTENSION, SMOKING, DIABETES, HIGH CHOLESTEROL, WHAT YOU CALL HYPERLIPIDIMIA.

AND BLOOD ELEVATION.

THESE ARE THE ONES THAT OUR EFFORTS IN PREVENTION ARE GUIDED TOWARD SO THAT WE CAN DECREASE THE INCIDENTS OF STROKE AND PREVENT THEM AS MUCH AS POSSIBLE.

>> I'VE ONLY GOT TWO OUT OF SEVEN.

I'M DOING PRETTY GOOD.

I'M FEELING BETTER ALREADY.

THANK YOU.

WHAT ARE THE COMMON SYMPTOMS OF STROKE?

WHAT AM I LOOKING FOR?

>> SO WE USE AN ACRONYM WHEN WE GO OUT INTO THE COMMUNITY AND EDUCATE THE GENERAL POPULATION.

IT'S FAST.

AND THOSE LETTERS STAND FOR FACE, ARMS, SPEECH, TIME.

AND SO BASICALLY WHEN YOU ARE HAVING SYMPTOMS, YOU LOOK AT SOMEONE'S FACE AND THERE IS ASYMMETRY AND THEY SMILE AND THEIR FACE IS DROOPING, USUALLY USUALLY THE LOAR PORTION OF THE FACE THAT IS INVOLVED IN A STROKE.

>> DROOPY FACE.

>> SECOND IS ARM.

AND ARM REALLY MEANS THE ENTIRE SIDE.

SO IT CAN BE ARM WEAKNESS AND/OR LEG WEAKNESS BUT ONE OF YOUR SIDES LIKE IN YOUR GRANDFATHER'S SITUATION, ISN'T WORKING THE SAME.

>> HIS OTHER ARM WAS HANGING DOWN.

YOU CAN'T LIFT THAT ARM OR LIFT IT AS WELL AS YOU CAN THE OTHER SIDE.

SAME THING WITH THE LEG.

YOU ARE NOT ABLE TO BEAR WEIGHT ON IT, THE SAME WAY YOU WOULD THE OTHER SIDE.

THE S IS FOR SPEECH.

SOMETIMES YOU WILL NOTICE PEOPLE WILL START SLURRING THEIR SPEECH.

THEIR SPEECH WILL BE CONFUSED.

THEY WON'T BE UNDERSTANDING WHAT YOU ARE SAYING OR ABLE TO EXPRESS THEMSELVES APPROPRIATELY AND THE LAST IS T. AND T IS TIME.

AND TIME IS ONE FOR WE WANT TO GET PEOPLE EVALUATED AS FAST AS POSSIBLE.

SO IF YOU START NOTICING ALL THESE THINGS HAPPENING, IT'S VERY IMPORTANT THAT YOU GET TO A HOSPITAL, WHETHER THAT BE BY EMS OR GETTING YOURSELF THERE, WHICH EVER IS THE QUICKER WAY FOR YOU TO DO SO BECAUSE THAT GIVES US MORE TREATMENT OPTIONS ONCE YOU DO REACH THE HOSPITAL.

>> AND AN IMPORTANT SIDE BAR TO THAT IS THAT THE TIME OF LAST NOEL IS VERY IMPORTANT.

>> LAST KNOWN...?

>> LAST KNOWN WELL TO BE AT YOUR NORMAL BASELINE AND THIS IS A QUESTION VERY COMMONLY ASKED EVERY TIME WHICH CAN MEAN THE DIFFERENCE BETWEEN BEING ABLE TO RECEIVE OR NOT BEING ABLE TO RECEIVE CERTAIN KINDS OF TREATMENTS SO THAT'S GOING TO BE AN IMPORTANT TIME TO NOTE.

>> SO THERE IS A WINDOW THAT CERTAIN TREATMENTS CAN BE APPLIED THAT YOU WANT TO GET THERE BEFORE THAT WINDOW CLOSES.

>> ABSOLUTELY.

>> BECAUSE BASICALLY, WAS WE AIM AT WITH THE TREATMENT ARE AVAILABLE TO US, AND WE'LL GO INTO THEM LATER...

WHENEVER THERE IS A STROKE, THERE IS AN AREA OF THE BRAIN THAT ALREADY IS DAMAGED IRREVERSIBLY.

WE CANNOT SALVAGE.

WE CANNOT DO ANYTHING ABOUT IT.

AND AROUND IT, THERE IS AN AREA WHERE THE BLOOD SUPPLY IS COMPROMISED.

BUT IF WE RESTORE THE BLOOD SUPPLY IN A TIMELY FASHION, WE CAN SAVE THAT AREA.

THAT'S WHAT YOU CALL THE ULTIMATE STATE OF THE PATIENT DEPENDS ON HOW MUCH YOU HAVE BEEN ABLE TO SALVAGE OF BRAIN TISSUE.

>> WHAT ARE THE TREATMENTS YOU ARE REFERRING TO RIGHT NOW?

ARE YOU SAYING IF YOU GET THERE QUICK, YOU CAN DO CERTAIN THINGS.

WHAT ARE THOSE TREATMENTS?

>> WELL, SOME OF THE TREATMENTS INCLUDE INTRAVENOUS THROMBOLITTIC AGENTS.

CLOT BUSTING AGENTS AND I'M SURE HE WILL GO INTO THAT IN MORE DETAIL AND THEN INTERVENTIONS WHERE I AS A SURGEON CAN PULL OUT CLOTS OR PUT IN STENTS OR DO SOMETHING TO AUGMENT OR IMPROVE THE BLOOD FLOW TO GET THE BLOOD TO THE AREA OF THE BRAIN THAT IS IN NEED OF IT THAT CAN POTENTIALLY RECOVER.

>> YOU ARE REFERRING TO WHAT WE TALKED ABOUT A THROM THROMBECTOMY.

>> YOU GO IN ONE THROUGH OF THE ARTERIES?

>> WE ENTER THE ARTERY OF THE LEG, FEMORAL ARTERY OR THE ARM VESSEL CALLED THE RADIAL ARTERY, AND WE CAN NAVIGATE CATHETERS AND WIRES UP INTO THE BLOOD VESSELS OF THE BRAIN AND VERY CAREFULLY PULL OUT THE CLOT, INFLATE A BALLOON, PLACE A STENT OR SEVERAL OTHER DIFFERENT INTERVENTIONS THAT CAN HELP RESTORE BLOOD FLOW.

>> SO ONCE A PERSON IS MEDICALLY OPTIMIZED, ARE THEY ABLE TO START REHAB RIGHT AWAY?

OUR REHAB PERSON HERE?

>> ACTUALLY WE START RIGHT AWAY IN THE HOSPITAL AS LONG AS THEY'RE MEDICALLY STABLE.

OUR JOB AS OCCUPATIONAL AND PHYSICAL THERAPISTS, IN ADDITION TO SPEECH LANGUAGE PATHOLOGISTS WE HAVE AT THE HOSPITAL ARE TO GO IN AND ASSESS THE PATIENT'S STRENGTH, BALANCE, THEIR COGNITION, THEIR VISION, THEIR ABILITY TO TALK IN INFORMATION, AND ULTIMATELY WHAT THIS PERSON IS DOING IN THEIR LIFE BEFORE THE STROKE HAPPENED; YOU KNOW, WHAT WERE THEIR LIFE ROLES.

ARE THEY A MOTHER, A SON, A TEACHER?

WHERE DO THEY WORK, THOSE TYPES OF THINGS.

AND HOW DO THESE DEFICITS THAT HAPPEN BECAUSE OF THEIR STROKE, HOW DOES THAT AFFECT THEIR FUNCTION?

HOW CAN WE MAXIMIZE THEIR FUNCTION AND TRANSITION THEM EVENTUALLY TO HOME.

SOMETIMES WE DO HAVE TO RECOMMEND SOME TYPES OF REHABILITATION.

BUT ULTIMATELY, OUR GOAL IS FOR OPTIMIZING FUNCTION AND INDEPENDENCE.

>> YOU ARE HOPING TO GET THEM BACK TO WHERE THEY WERE BEFORE.

BUT YOU ARE OPTIMIZING GIVEN THAT THERE HAS BEEN SOME DAMAGE DONE.

WCNY TEAMED UP WITH JOURNALISM STUDENTS FROM ITHACA COLLEGE TO EXPLORE THE CENTER FOR LIFE SKILLS, A PROGRAM ASSISTING PATIENTS WHO HAVE A NEUROLOGICAL CONDITION WHERE TRAINEES GET HANDS-ON EXPERIENCE IN THEIR RESPECTIVE FIELDS.

LET'S TAKE A LOOK AT WHAT OUR BUDDING JOURNALISTS PUT TOGETHER: >> WHEN I STARTED AS AN O.T.

IN 1990, OUR LENDS OF STAY I THINK-- OUR LENGTH OF STAY WAS 38 DAYS AND NOW IT'S DOWN TO NINE NOW, IN-PATIENT STAY.

SO HOW IN NINE DAYS YOU DON'T EVEN RECOGNIZE-- YOU CAN'T EVEN WRAP YOUR HEAD AROUND THE FACT THAT YOU HAVE A NEW JERSEY LOGICAL-- A NEUROLOGICAL DEFICIT AND WE ARE SENDING YOU HOME.

THE CARE HAS SHIFTED FROM INPATIENT REHAB WITH NURSES TO FAMILIES.

FAMILIES NOW HAVE TO TAKE PEOPLE HOME WHEN THEY'RE A LOT SICKER AND A LOT MORE DEPENDENT.

IF THEY'RE HOME, THEY'RE MISSING OUT ON COMPREHENSIVE REHAB.

WE LIVE IN A RURAL COMMUNITY.

THERE IS VERY LITTLE NEUROLOGICAL REHAB IN THIS AREA.

LIKE LITTLE.

THERE IS SOME OUTPATIENT POCKETS BUT NO COMPREHENSIVE PROGRAM SO PART OF THE GRANT WAS TO BRING A COMPREHENSIVE NEUROLOGICAL REHAB PROGRAM TO A RURAL SETTING.

A LOT OF THESE FOLKS GRADUATED, IF YOU WILL, FROM AN INPATIENT PROGRAM.

THEY'VE ALREADY GRADUATED.

THEY'VE ALREADY DONE THE OUTPATIENT, BUT THEY'RE NOT QUITE WHERE THEY WANT TO BE.

SO THAT'S WHERE THIS PROGRAM COMES IN.

AND A LOT OF INSURANCES DON'T COVER THIS TYPE OF BRAM PROGRAM FOR AS LONG AS IT IS.

MOST PEOPLE ARE DONE WITH STROKE REHAB BY THE END OF THREE MONTHS.

THREE MONTHS.

THAT'S ALL INSURANCE WILL COVER.

WE HAVE PEOPLE THAT HAVE BEEN IN THIS PROGRAM FOR FOUR YEARS NOW.

THE BIGGEST DIAGNOSIS OF PEOPLE WHO HAVE HAD A STROKE.

THE NEXT ONE WOULD BE AN ACQUIRED BRAIN INJURY OR TRAUMATIC BRAIN INJURY.

WE HAVE HAD FOLKS COME FROM CAR ACCIDENTS OR MAYBE A HEART ATTACK AND THEY HAVE HAD LACK OF OXYGEN TO THE BRAIN.

WE HAVE HAD PEOPLE WITH PARKINSON'S DISEASE AND THAT'S BY FAR, I THINK, THE MARKET OF THE FOLKS WITH STROKE.

FOR THE STUDENTS, THEY GET TO SEE FIRSTHAND, IT'S ONE THING, I TEACH NEUROSCIENCE AND APPLIED NEUROSCIENCE.

IT'S ONE THING TO TALK ABOUT HIGH TONICISY AND BUT ANOTHER THING FOR SOMEONE TO COMMUNICATE WITH SOMEONE WITHY PHASIA OR STRETCH OUT SOMEBODY'S ARM WHO HAS CONTRACTIONS, TO FEEL IT AND SEE IT HANDS ON.

>> SO FOR TODAY'S LESSON PLAN, I HAVE TWO GOALS IN MIND FOR ALL THE PARTICIPANTS, WHICH WAS FUNCTIONAL COMMUNICATION AS WELL AS FUNCTIONAL MOTOR SKILLS.

SO THEY WOULD BRIGHT A WRITE A LITTLE BOOK AND THEY WOULD USE THEIR HANDS AND OTHER MATERIALS AND CREATE A BOOK AND THEN AT THE END, I WOULD HAVE THEM WRITE TWO SENTENCES AND THEY WOULD SHARE IT WITH THE CLASS OR SHARE IT WITH THE GROUP.

>> FOR US AS FACULTY AND CLINICIANS, WE CAN KEEP TRACK OF EVERYTHING PEOPLE ARE DOING IN EVERY SINGLE AREA, RIGHT?

SO IF WE HAVE A CLIENT WHO IS GETTING OUTPATIENT P.T.

AND OUTPATIENT O.T., THEY'RE NOT TALKING TO EACH OTHER.

THEY HAVE NO IDEA WHAT GOALS THEY'RE WORKING ON OVER HERE OR OVER HERE.

HERE ALL THE STUDENTS AND ALL THE FACULTY GET TOGETHER TWICE A SEMESTER AND WE DEVELOP GLOBAL GOALS SO EVERY SINGLE DISCIPLINE KNOW THE GOALS OF ALL THE PARTICIPANTS AND WE ARE ALL WORKING TOWARDS ALL THE GOALS ALL THE TIME.

>> I THINK THAT THIS EXPERIENCE HAS REALLY TAILORED TO THE PARTICIPANTS AND WE ASSESS EACH AND EVERY ONE OF THEM AND WE MAKE EVERY SUNG WILL INTERVENTION SPECIFIC TO THEIR NEEDS AND WE MAKE SURE THAT THEIR NEEDS ARE MET, THAT THEIR GOALS ARE MET AND THAT EACH INTERVENTION IS SOMETHING THAT THEY ENJOY DOING.

>> PHYSICAL THERAPY IS MOST IMPORTANT TO ME BECAUSE IT FOCUSES ON MY LEGS AND THAT'S IMPORTANT TO ME.

MY GOAL IS TO WALK WITHOUT MY HUSBAND HELPING ME.

>> FOR THE GROSS MOTOR ACTIVITIES, IF THE PEARNTS WERE ABLE PARTICIPANTS WERE ABLE TO GET OUT OF THEIR SEAT, THEY GOT OUT OF THEIR SEAT AND VISUALLY SCANNED THE ROOM TO FIND THE EGGS AND YOU WOULD HAVE TO DO SEQUENCING, FIND THE EGG, OPEN IT, READ IT.

MORE HIGHER LEVEL EXECUTIVE SKILLS TO DO WHATEVER THEY NEED TO DO DURING THE DAY.

A STRONG VALUE IN OCCUPATIONAL THERAPY IS BEING CLIENT CENTERED, GETTING TO KNOW THE PERSON, GETTING TO KNOW THE CLIENTS.

SO IT'S BUILTING THE SKILLS THAT WE MIGHT SOMEHOW NEED IN THE REAL WORLD AND ALSO IT'S JUST SO FUN.

>> AS PEOPLE BECOME MORE INDEPENDENT AND MORE HEALTHY, IN GENERAL, THEY'RE DRAWING LESS FROM-- THEY HAVE LESS NEEDS FROM OTHERS.

THEY ARE GOING TO REQUIRE LESS CARE AND LESS PROGRAMS AS PEOPLE BECOME MORE WELL AND INDEPENDENT.

IT WILL COST YOUR COMMUNITY LESS MONEY TO SUPPORT THEM AS PEOPLE BECOME MORE INDEPENDENT.

>> SO ONE OF THE THINGS I WAS THINKING WHILE WE WERE WATCHING THE VIDEO THAT AFFECTS THE OUTCOME IN HOW MUCH REHAB, ET CETERA, IS THE TIME.

TIME IS A RISK FACTOR.

IF YOU ARE AT RICK OF HAVING POOR OUTCOME IS TAKING TOO LONG TO GET TO THE HOSPITAL.

>> ABSOLUTELY.

WE WANT TO ENCOURAGE THAT WITH THE T. IN THE FAST.

WE WANT YOU TO GET TO US AS SOON AS POSSIBLE.

AND THAT'S WAS WE STRESS IN THE COMMUNITY AND THAT'S WHAT WE STRESS WITH EMS.

AT KRAUSE, WE ARE CONSTANTLY DELIVERING THE FASTEST TREATMENT TIMES IN THE REGION AND WE DO THAT BY KIND OF FOCUSING ON A TEAM APPROACH TO OUR MODEL.

WE USE ARTIFICIAL INTELLIGENCE, COMMUNICATING APPS ON OUR PHONES AND WE ARE ALL TALKING TO EACH OTHER CONSTANTLY.

WORKING WITH THE E.R.

AND OTHER TEAMS WITHIN THE HOSPITAL TO LET US KNOW, HEY, A PATIENT IS COMING.

WE ARE RATE THERE.

WE HAVE SOMEONE 24/7 IN-HOUSE READY TO RESPOND AND IT'S ALMOST LIKE A NASCAR TEAM.

EVERYBODY IS KIND OF FILLING THEIR ROLE BUT GETTING READY TO DELIVER TREATMENT AS FAST AS POSSIBLE TO THE PATIENT.

PART OF IT IS ENQURNLGING-- ENCOURAGING THE PATIENT AND KNOWING THE SIGNS BUT THE OTHER PART OF IT IS WORKING WITH THE EMS AND E.R.

AND COORDINATING ACTIVITIES TO DELIVER THE CARE AS FAST AS POSSIBLE TO THE PATIENT.

THE SOONER WE CAN GET THE INTERVENTION, THE BETTER THEIR GOING TO DO LONG-TERM, THE LESS REHAB THEY'RE GOING TO NEED, THE LESS THERAPIES THEY'RE GOING TO NEED AND THE BETTER THE ABILITY TO REACCLIMATE TO NORMAL LIFE AND TO GET BACK INTO LIFE.

>> AND THE EARLIER PEOPLE GET THERE, THE QUICKER WE CAN WORK THEM UP, TRY TO FIND OUT WHAT IS GOING ON AND PROVIDE THAT TREATMENT.

SO SOME OF OUR GOALS ARE TO TRY TO GET CLOT BUSTING MEDICATIONS, THROMBOLITTICS WITHIN 30 MINUTES UNDERSTAND THROMBECTOMY WITHIN 90 MINUTES AND A LOT GOES ON VERY QUICKLY WITH THE ENTIRE GROUP TEAM EFFORT IN ORDER TO MAKE THESE TIME TARGETS A REALITY.

THEY'RE VERY DIFFICULT TO ACHIEVE UNLESS YOU HAVE A GROUP APPROACH.

>> WE HAVE TIME CONSTRAINTS AS FAR AS THE THROMBOLYTICS ARE CONCERNED, THEY STAND A GOOD CHANCE OF BUSTING THE CLOT.

WE CANNOT CHOOSE THEM FURTHER AWAY FROM FOUR AND A HALF HOURS OF ON SET OF SYMPTOMS AND THE MECHANICAL THROMBECTOMY HAS TO BE DONE IN GENERAL 24 HOURS.

NOW WE ARE RELYING MORE AND MORE ON THE TECHNOLOGY THAT WE HAVE, WHEN I MENTIONED BEFORE, THE DIFFERENT PART OF THE BRAIN, WE CAN EXTEND IT FURTHER.

>> AND IF YOU CAN GET BOTH THROMBOLYTIC THERAPY AND THE THROMBECTOMY AS EARLY AS POSSIBLE, THOSE PATIENTS DO THE BEST.

I WOULD NOT SAY IF I MISS THE FOUR AND A HALF HOUR WINDOW, AT LEAST I HAVE ANOTHER OPTION.

IF YOU GET BOTH, YOU DO BETTER.

THE EARLIER YOU GET THERE, THE BETTER.

>> EVEN IN OUR THROMBECTOMY PATIENTS, THE ONES THAT WERE ABLE TO DO THROMBECTOMY, THEY DO BETTER.

THE LONGER WE WAIT, THE HIGHER THE RISK FACTORS AND OUR ABILITY TO DELIVER LOWERS.

TIME IS VERY IMPORTANT.

>> I IMAGINE RECOVERY WOULD BE VERY CHALLENGING FOR SOME PEOPLE , BOTH PHYSICALLY, AND ALSO PSYCHOLOGICALLY.

HOW DO YOU HELP FOLKS GET OVER THAT?

>> SO, WHAT I CAN SAY IS THAT EACH PERSON IS UNIQUE AND EACH STROKE IS UNIQUE.

SO, THAT BEING SAID, THEIR STROKE JOURNEY CAN BE VERY UNIQUE AND EACH PATIENT'S STROKE JOURNEY IS EITHER SHORTER OR LONGER, DEPENDING ON THE SEVERITY OF THEIR DEFICITS SO YES, IN ADDITION TO MAYBE SOMEBODY HAS A REALLY WEAK SIDE AND WE ARE JUST TRYING TO GET THEM TO SIT ON THE EDGE OF THE BED MAYBE TO SIT BY THEMSELVES AND THEN ADVANCE THEM TO MAYBE WALKING TO THE BATHROOM.

BUT THEN LIKE YOU SAID, THERE ARE THESE PSYCHOLOGICAL COMPONENTS MAT THIRD BASE THE STROKE-- MAYBE THE STROKE CAUSED THEM TO HAVE A CHANGE IN PERSON ALITY.

MAYBE SOMEONE CAN'T CONTROL CRYING OR LAUGHING OR MAYBE IT CHANGED THEIR COGNITION WHERE MAYBE THEY'RE NOT MAKING SAFE CHOICES OR NOT HAVING THE ABILITY TO REMEMBER CERTAIN INFORMATION THAT IS REALLY CRITICAL FOR DIFFERENT KINDS OF MEDICATION MANAGEMENT OR TURNING OF STOVE OFF AT HOME.

SO WE DO, WHAT WE HAVE IN REHAB IS CALLED A BAG OF TRICKS.

AND YOU KNOW, WHEN I GO INTO A ROOM, I AM GOING TO TALK TO MY PATIENT, I'M GOING TO TALK TO THE FAMILIES AND SEE LIKE WHAT THIS PERSON NEEDS.

BUT I HAVE A VARIETY OF THINGS THAT I'M GOING TO PICK OUT TO CHOOSE TO WORK WITH THIS PERSON TO MAXIMIZE THEIR FUNCTION.

SO, YEAH, EVERYBODY IS DIFFERENT.

>> HOW COMMON IS IT FOR PEOPLE TO MAKE A TOTAL OR NEAR TOTAL RECOVERY?

IS THAT COMMON?

>> IT IS OUR HOPE THAT FOLKS WILL BE ABLE TO REACH THEIR GOAL AND BE INDEPENDENT AND REGAIN WHAT THEY HAD LOST.

NEUROPLASTICITY.

>> MEANING THE ABILITY OF THE PLAIN TO GROW NEW CONNECTIONS AND REGAIN-- >> YEAH SO THE BRAIN HAS THIS ABILITY TO CHANGE AND ADAPT AND MAKE NEW CONNECTIONS.

AND SO THAT'S THE CRITICAL PIECE FROM OCCUPATIONAL, PHYSICAL AND SPEECH THERAPY, LANGUAGE PATHOLOGY, THAT WE ARE TRYING TO WORK ON REBUILDING THOSE CONNECTIONS SO THESE FOLKS CAN LIVE MEANINGFUL LIVES AND THAT'S THE MOST IMPORTANT PIECE.

>> WHAT ABOUT SUPPORT GROUPS?

SOME PEOPLE, YOU KNOW, THEY'VE HAD A STROKE.

THEY'VE LOST SOME FUNCTIONING.

THEIR LIVES ARE PRETTY CHANGED AROUND.

SUPPORT GROUPS?

>> JAMESOS VERY MUCH.

>> WE HAVE A BRAIN ANEURYSM AND VASCULAR STROKE GROUP AND ISCHEMIC STROKE GROUP.

WE MERGED THE GROUPS TOGETHER ABOUT SIX MONTHS AGO NOW AND EVERY MONTH Dr.

THE GROUP MEETS TOGETHER.

DURING THE PANDEMIC THINGS GOT WEIRD SO WE CONVERTED TO A VIRTUAL SETTING FOR THESE, BUT WHEN THESE STROKE SUPPORT GROUPS FIRST STARTED, I MEAN WE HAD MAYBE TWO OR THREE PEOPLE ATTENDING.

I THINK AT THE LAST ONE WE WERE AT, WE HAD ALMOST 30 PEOPLE THERE AND IT'S REALLY NICE, NOT JUST FOR THE PATIENTS WHO HAVE SUFFERED FROM THE STROKE BUT ALSO FOR THEIR FAMILIES.

OFTEN THEY COME WITH THEIR SIGNIFICANT OTHER OR CAREGIVER AND THESE PEOPLE ARE RELATING TO ONE ANOTHER SAYING THIS IS WHAT I WENT THROUGH, YOU WENT THROUGH SOMETHING SIMILAR.

WHAT HELPED YOU GET THROUGH THIS.

WHAT RESOURCES DID YOU UTILIZE?

AND IT'S A REALLY COOL THING TO SEE THESE PEOPLE INTERACT WITH EACH OTHER AND TO BUILD ON IDEAS AND TO HELP EACH OTHER THROUGH THE PROCESS BECAUSE THERE IS SUCH, YOU KNOW, AS YOU GUYS MENTIONED, A HUMAN ELEMENT TO THIS.

IT'S A DEVASTATING THING THAT HAS HAPPENED IN YOUR LIFE IN MANY OF THESE SCENARIOS AND IT'S, YOU KNOW, PSYCHOLOGICALLY BRINGING YOURSELF THROUGH IT AN INSTANTANEOUS DEPRESSION THAT SOMETIMES OCCURS WITH THESE PEOPLE AND BRINGING IT TO THE NEXT STEPS IN LIFE.

WHAT DO I DO NEXT?

HOW DO I MODIFY MY HOME SO IT'S ADAPTABLE SO I CAN LIVE.

HOW CAN I GET HELP OR ASSISTANCE FROM FAMILY OR FRIENDS AND IT'S JUST BUILDING ALL THOSE BRIDGES THAT YOU NEED TO HAVE A FUNCTIONAL RECOVERY.

>> AND I THIS I TO ADD TO THAT-- AND I THINK TO ADD TO THAT, THE PATIENTS GOING BACK TO HOW MANY PEOPLE GET BACK TO THE NORMAL FUNCTIONAL LIFE AND HOW MANY HAVE PERMANENT DEFICITS.

WHEN YOU LOOK AT THESE STUDIES THAT EXAMINE PATIENTS WHO WERE CANDIDATES FOR THROMBOLYTIC THERAPY AND THROMBECTOMY THERAPIES AND YOU HAVE THE BEST OUTCOMES YOU CAN GET, YOU ARE STILL LOOKING BETWEEN 30 AND 40% OF THEM RETURNING TO A FUNCTIONAL INDEPENDENCE.

BUT THERE IS A LARGE NUMBER OF PEOPLE WHO STILL HAVE LONG-TERM DEFICITS, WHICH IS WHY THERAPY IS SO IMPORTANT, SUPPORT GROUPS ARE SO IMPORTANT, LEARNING HOW TO LIVE WITH YOUR DEFICITS ISN'T THE END OF THE WORLD.

IT'S A VERY DIFFICULT CHALLENGING TASK THAT REQUIRES A LOT OF SUPPORT.

>> SO REALLY IN THE BIG PICTURE THOUGH, I'M HEARING THAT THERE IS A LOT OF GOOD NEWS, LIKE THINGS HAVE REALLY CHANGED FOR THE BETTER IN THE LAST 60 YEARS SINCE MY GRANDFATHER HAD HIS STROKE AND MY FATHER HAD HIS STROKE MAYBE 50 YEARS AGO AND SO I'M FEELING A LOT BETTER.

THANK YOU VERY MUCH FOR BEING HERE.

UNFORTUNATELY, THAT'S ALL THE TIME WE HAVE.

BUT I WANT TO THANK OUR PANELISTS AGAIN FOR JOINING US.

MR. JAMESON CRUMB: CLINICAL PROGRAM DIRECTOR FOR CROUSE NEUROSCIENCES DR. DAVID PADALINO: NEUROSURGEON AT CROUSE DR. SAMI ABDUL-MALAK: CHIEF OF NEUROLOGY AT CROUSE AND MS. KELLY VAN AUKEN: CERTIFIED DOCTOR OF OCCUPATIONAL THERAPY AT CROUSE BE SURE TO VISIT WCNY.ORG/CYCLEOFHEALTH TO SEE ADDITIONAL CONTENT, PRIOR EPISODES, AND OUR WEB SERIES CHECKUP FROM OUR NECKUP.

FOR THE CYCLE OF HEALTH, I'M PSYCHOLOGIST DOCTOR RICH O'NEILL.

THANKS FOR CHECKING IN.

ON THE NEXT "CYCLE OF HEALTH," SUICIDE PREVENTION.

IN NEW YORK, SUICIDE IS THE 15th LEADING CAUSE OF DEATH AND THIRD LEADING FOR AGES 10 TO 24.

HEAR FROM A FAMILY MEMBER OF A LOVED ONE LOST TO SUICIDE AND FROM A SUPERVISOR A FORMER PATIENT AT AN INNOVATIVE PROGRAM THAT BREAKS THE CYCLE OF MENTAL ILLNESS.

LEARN WHAT TO DO TO SAVE A LIFE.

MAYBE YOURS OR SOMEONE ELSE'S NEXT ON "CYCLE OF HEALTH."