Sophie! Welcome HOME!!!

This is to YOU, who we've missed sooooooo much. I am elated that you are now HOME. Your home, the one that you have cherished and nurtured and maintained for so many years, missed you. Probably not nearly as much as you missed it! And I've had the privilege of helping get it into the kind of shape that we all know you would have done had you been able. I hope that it brings you peace and relief. There is a Welsh word, hiraeth - that defies direct translation, but roughly, means, the longing for home. The Welsh were known to die from hiraeth--literally of broken hearts if they could not return to their own soil and breathe the air that was more than in their bodies, but in their souls.

I know that longing. When I heard that you were coming home finally, I felt my heart sing for you--(can you tell that I'm Welsh?!)

I want for you to know that everyone has been working really hard to prepare for this day and to make it as close to what you would have done as is possible!! You are a very hard person to replace! It's taken a virtual army!

But most of all , I want you to know that Ben, has done the most of all. During a time when he could have fallen apart, he stood up straighter, pulled back his shoulders and knuckled down to learn all the things he didn't have to know before because you took care of them! He has been the model of graciousness and kindness at a time when he was so worried about you. You two are my icons of what marriage is all about and I have come to love you both as I love my own family.

So, welcome home! Welcome Home! WELCOME HOME!!!

Steph

Update: Getting Ready to Bring Sophie Home!

Sophie wants to come home, now. She's out of acute care and was moved to a rehab facility about a month ago. She's made progress, from what Ben describes, and that is encouraging. We all miss her.

It's been a very busy couple of months. We all found that taking over all the business and tasks that Sophie managed has practically taken an army! (I am prone to exaggeration when I am happy!)

Ben has been on the move constantly, getting the house adapted for handicapped access, learning how to do all of the things Sophie took care of, taking care of his own business, not to say of himself, and now, renting out two apartments. He spends the majority of everyday with her in the rehab center and sometimes even spends the night. And one of their two daughters is normally there to help out-no small thing considering they live out of state and have families of their own.

Soon, it will be ready. The house is cleaned top to bottom, the garden tended and flowers planted, the car is being adapted for a wheelchair, the downstairs transformed into her rooms, including the bath. Every step along the way, people talk about Sophie with a smile. It seems that we all want to do things up to her standards, which were very high. But, as much as we try, we'll never be able to do it as well as she did!

I hope to soon go and see her. I held back because, from day to day, she had enough to deal with. But it seems to have leveled off and I hope to see her this coming week. I do miss her!

All Rehabilitation is NOT EQUAL...

I've been tip-toeing around this topic, but I realized that I should just come out and say what I think. All Rehabilitation is NOT EQUAL!. There, I said it. In fact, there are worlds of difference between facilities. The reason that I'm concentrating on this is that Sophie's 'progress' may not reflect her abilities or inabilities, but may be affected by the system that is qualifying her and its limitations.

Having worked in several rehab facilities years ago, it became clear to me that a person's recovery was dependent on the rehab's capacity to deliver the best quality of care. There were then, and still are I am sure, such a wide range of quality-- from those facilities which basically just 'did a job' and settled for minimal progress, to those that were dedicated to delivering the most up-to-date treatment possible. Even if the facility was run by people who were very caring, if the administration's focus was not forward-looking or if the general attitude of the staff was not enthusiastic and devoted to advancing the care they provided, then their quality of care reflected that.

Rehabilitation medicine used to be the dinosaur of the medical areas. But that has really changed. Today, so many advances are being made that it has become one of the most dynamic areas of medicine. For this reason, I encourage you to NOT necessarily take your doctor's conclusions as gospel.

Although the information below is six years old, it reflects the truth of what I'm saying. These are ranked hospitals in this specialty, named by at least 3 percent of board-certified physicians responding to U.S.News surveys in 2001, 2002, and 2003. (A link to the latest US News ranking is just below)

Rank Hospital Reputational score

1 Rehabilitation Institute of Chicago 72.2
2 TIRR- Inst for Rehab & Research, Houston 42.3
3 University of Washington Medical Center, Seattle 37.7
4 Mayo Clinic, Rochester, Minn. 30.7
5 Craig Hospital, Englewood, Colo. 26.7
6 Kessler Institute for Rehabilitation, West Orange, N.J. 26.1
7 Rusk Institute, NYU Medical Center, New York 15.1
8 Thomas Jefferson University Hospital, Philadelphia 15.0
9 Spaulding Rehabilitation Hospital, Boston 14.7
10 Ohio State University Medical Center, Columbus 14.2
11 Rancho Los Amigos National Rehab Center, Downey, CA. 13.5
12 Johns Hopkins Hospital, Baltimore 12.7
13 National Rehabilitation Hospital, Washington, D.C. 11.2
14 University of Michigan Medical Center, Ann Arbor 9.5
15 Moss Rehab Hospital, Albert Einstein Med Ctr, Philadelphia 8.1
16 Shepherd Center, Atlanta 6.6
17 Mount Sinai Medical Center, New York 5.3
18 Stanford Hospital and Clinics, Stanford, Calif. 4.4
19 Temple University Hospital, Philadelphia 4.0
20 UCLA Medical Center, Los Angeles 3.8
21 New York-Presbyterian Hospital 3.8
22 Cleveland Clinic 3.7
23 University of Alabama Hospital at Birmingham 3.3


In 13 of the 17 specialties, ranked hospitals initially had to meet any of three entry standards: membership in the Council of Teaching Hospitals, affiliation with a medical school, or availability of at least nine of 17 specified items of medical technology: magnetic resonance imaging, for example. Those criteria screened out all but 2,072 of the 6,003 hospitals.

Note the difference in the percentage points between the #1 ranked hospital, RIC, and the others!

Rehabilitation Institute of Chicago
345 East Superior Street
Chicago, IL 60611
Web site

U.S. News Ranking: 1 in Rehabilitation This is the latest US News rankings. The #'s are little different, but the line-up is essentially the same.

Stroke Services at Rehabililtation Institute of Chicago

The effects of a stroke on mobility, memory and communication can vary greatly from one person to another and the pace and progress of rehabilitation can vary too. What’s important to know is that the rehabilitation care provider you choose has the depth of experience and breadth of services to help you achieve the best life possible. At the Rehabilitation Institute of Chicago (RIC), we do.

A National Leader in Stroke Rehabilitation

• The Rehabilitation Institute of Chicago has been ranked the “Best Rehabilitation Hospital in America” by U.S. News & World Report every year since 1991.
• RIC helps more people with stroke than almost any other hospital in the country. Hundreds of stroke patients come to RIC each year, including people from across the country and around the world, for expert physical medicine and rehabilitation, and nearly half of them are younger than 55 years of age.
• New developments in stroke rehabilitation discovered in RIC laboratories are brought immediately to our patients, placing them at the forefront of scientific advancement through participation in the newest therapies and clinical trials.
• RIC is the only federally-designated Rehabilitation Research and Training Center for Stroke by the National Institute on Disability and Rehabilitation Research.
• RIC is the first rehabilitation hospital to be recognized with Magnet status, the prestigious award given to fewer than 3% of the nation’s hospitals for the very best nursing care.
• 95% of Prime of Life Stroke patients and their families would recommend RIC to family and friends.
• 99% of Prime of Life Stroke patients and their families rated their care as “excellent” or “good.”

For an appointment or information please call: 1-800-354-REHAB (7342), find a location or request an appointment .

You can Google any of the other hospitals listed above, to get a comparison, as well. I encourage you to do this, and, if you would like, I can help you with it.

Best,

Stephanie

Virtual reality improves stroke rehabilitation

Israeli hospitals have recently started to use virtual reality therapy for stroke patients. One commonly used program has the patient watch his virtual image on a screen. For example, tennis balls are virtually thrown at the patient from all directions and the patients' actual hand motions are recorded on screen. In the first stage of development of this new program, computer scientists Dr. Larry Manevitz of the University of Haifa, together with Dr. Uri Feintuch, a neuroscientist from Hebrew University and a research fellow at the Haifa's Caesarea Rothschild Institute for Interdisciplinary Applications of Computer Science, and Eugene Mednikov, a computer science graduate student, fed video sessions of this virtual reality therapy into their newly developed program. With the new program, the computer "learned" to differentiate between different types of brain injuries: cerebrovascular accident (CVA) and traumatic brain injury (TBI). During further testing, the computer was able to accurately diagnose, between 90%-98% of the time, whether the patient was healthy, or had suffered a traumatic brain injury or a stroke.

Diagnosis, says Dr. Manevitz, is the most basic part of treatment – any doctor and many healthcare workers can correctly diagnose severe brain injuries. While this study is an important advance in the field of computer science, it will not directly help society. What is important, however, is the next phase of development, in which the computer is able to do things that doctors cannot. "As soon as the computer identified the injury, we have a model that we can use for further testing and analysis – something that cannot be done on live patients. Using a computer model, we can experiment with different treatment options and decide which will be the most effective. The computer can also define how much the patient will be able to rehabilitate. These are things that would take a long time for medicine to accomplish, and some of them cannot be done at all," explained Dr. Manevitz.

For example, the computer can simulate how the patient will respond if the virtual reality therapy throws more balls to the patient's left side than to the right or if any other change would be beneficial for rehabilitation. The computer can quickly examine tens of different possibilities in a very short time. Using the computer will help avoid spending time on treatments that will not benefit the patient, or worse, cause harm.

"Our next step is to find similarities in the behavior of people in sub-groups of brain injuries. The human eye may not be able to see such similarities, but a computer would easily be able to pick them up. As soon as we are able to identify similarities in different sub-groups, new avenues of effective treatment will open up for doctors," summarized Dr. Manevitz.

Contact: Amir Gilat
agilat@univ.haifa.ac.il
972-482-40092
University of Haifa

So, What the Heck is Virtual Reality?

Virtual reality is used today in many ways from training simulations like driving a car or flying an airplane, to more advanced training exercises by the military, to video games. It's also being used in surgery, bomb diffusion, archeology, geology--just about any place where a three-dimensional rendering of the environment is helpful and where the users can simulate the reality of being in that 3-D place and interacting with it.

The next generation in the technology of virtual reality is called augmented reality where things in a real environment are mixed with 'virtual' things. Imagine giving firemen the ability to see through the smoke to search burning buildings for survivors? That's just one application--imagine all the others!

Although this video is about phantom limb pain, it demonstrates how virtual reality is being used in rehabilitation.

Researchers Use Stroke Patient’s Own Stem Cells For First Time

Thursday, April 16th, 2009

For the first time in the United States, a stroke patient has been intravenously injected with his own bone marrow stem cells as part of a research trial at The University of Texas Medical School at Houston.

Roland "Bud" Henrich, 61, was transferred to Memorial Hermann – Texas Medical Center on March 25 after suffering a stroke while working on his farm in Liberty. He arrived too late to receive tissue plasminogen activator (tPA), the only treatment for ischemic strokes. He became the first patient in the trial.

The Phase I safety trial, funded with a pilot grant from The National Institutes of Health and support from the Notsew Orm Sands Foundation, will enroll nine more patients who have suffered a stroke and can be treated with the stem cell procedure within 24 to 72 hours of initial symptoms.

Stroke occurs when blood flow to the brain is interrupted by a blockage or a rupture in an artery, depriving brain tissue of oxygen. It is the third-leading cause of death behind heart disease and cancer. According to the American Stroke Association, nearly 800,000 Americans suffer a stroke each year – one every 40 seconds. On average, someone dies of stroke every three to four minutes.

"It's still very early in this safety study, but this could be an exciting new therapeutic approach for people who have just suffered a stroke," said Sean Savitz, M.D., assistant professor of neurology at the medical school and the study's lead investigator. "Animal studies have shown that when you administer stem cells after stroke, the cells enhance the healing. We know that stem cells have some kind of guidance system and migrate to the area of injury. They're not making new brain cells but they may be enhancing the repair processes and reducing inflammatory damage."

Savitz said animal studies have shown that the healing effects of stem cells can occur as early as a week but cautioned it is too early to attribute Henrich's improvement to the stem cell treatment. "I'm hoping he will get better and it will be because of the cells, but it's just hope at this point," Savitz said.

The stem cells were harvested from the bone marrow in the iliac crest of his leg, then separated and returned to Henrich several hours later. Because they are his own stem cells, rejection is not expected to be an issue.

When he arrived at the hospital, Henrich could not speak and had significant weakness on his right side. When he was released after nearly two weeks of hospitalization and rehabilitation, he was able to walk and climb stairs unassisted and said his first words.

His wife, Reba Henrich, said she believes the stem cells have helped. He has spoken a few times with a single word or a phrase since his return home. "Too crowded," he told her at a megastore as they shopped for Easter gifts for their grandchildren and "senior" meal he told a waitress at a local restaurant. He also has fed the cows by himself, she said. They are hopeful he will eventually be able to return to his job as a painter.

"This study is the critical first step in translating laboratory work with stem cells into benefit for patients. If effective, this treatment could be helpful to a huge segment of stroke patients to reduce their disability," said James C. Grotta, M.D., Roy M. and Phyllis Gough Huffington Distinguished Professor of Neurology and chair of the Department of Neurology at the medical school. "We are fortunate here at UT Houston and the Texas Medical Center to have the resources needed to carry out this work, and to have attracted someone of Dr. Savitz's caliber to lead this study."


University of Texas Health Science Center at Houston: http://www.uthouston.edu

Thanks to University of Texas Health Science Center at Houston for this article.

This article was found on Lab Spaces has been viewed 274 times.

Note to Ben, June & Debra

This blog is just a sample for you all to check over. I thought it would be a good idea to make it really easy to share information with everyone, have it all in one place and create a way that everyone can share, report, or send in messages. It turns out that there is a very good network set up for just the purpose of keeping people connected during medical emergencies and it's called Caring Bridges.

It's set up the same as a blog, although more specifically for patients & families, and it may be a better way to share Sophie's progress with everyone you want. I'll look into what's involved in creating a webpage there for you. You may want to have both, one place where we can exchange information, research, etc. and another place where you'all can post and follow Sophie's day-to-day progress.

Ben, if you'd like for June or Debra to take over the 'computer' end of it, just send me their email addresses. But don't be intimidated by the technology--it can be easily learned, and you'll wonder how you managed without it once you know it!

Twitter is also a great way that people stay in touch moment to moment because it uses text messaging and I can show you how to do this if you're interested. My kids keep me techno-savvy, but trust me, it's not very complicated!

Please give Sophie my best. When do you think that she'll be ready for a visit?

My Stroke of Insight

Jill's vivid description of her stroke may give us a tiny insight into what Sophie experienced when she had hers. Warning: you may need some Kleenex...

Jill Bolte Taylor got a research opportunity few brain scientists would wish for: She had a massive stroke, and watched as her brain functions -- motion, speech, self-awareness -- shut down one by one. An astonishing story on TED.com

Inspiration of Bach-y-Rita's career

Click on the text to read from the book, The Brain That Changes Itself by Norman Doidge.

Vilayanur Ramachandran: A journey to the center of your mind

Really interesting speaker!

The Power of Plasticity

The dogma used to be that the adult brain was a rigid, unchangeable organ, but that pessimistic perspective is now being radically revised. Psychiatrist Dr Norman Doidge journeyed into the labs and lives of the 'neuroplasticians' -- once scientific mavericks, they're challenging the old neurological nihilism. Professor Jeffrey Schwartz is one. They both join Natasha Mitchell in discussion to reveal how the human brain has underestimated itself! Listen to the podcast, The Power of Plasticity part 1 .

The brain is more plastic than scientists once believed. But what does this mental malleability mean for humanity? More compelling stories from psychiatrist Dr Norman Doidge as he enters the labs and lives of the new 'neuroplasticians'. Here you will hear more about the Bach-y-Rita brothers and their findings in The Power of Plasticity, part 2.