Stroke patients adjust routineA stroke means something...

Healthwatch

July 30, 1991

Stroke patients adjust routine

A stroke means something different for every patient. Some of the half million or so Americans who will have one this year will regain almost all of their normal functioning. But most will have to learn to live with handicaps that can range from memory loss and impaired vision to poor coordination or paralysis. Rehabilitation trains patients to take back what was lost. Therapists who work with stroke patients advise making simple adjustments at home so that routine tasks become easier and safer. Some suggestions:

* If your balance is shaky, special chairs can be attached to the bathtub that swing back and forth to help you get in and out easier. It also helps to install grab bars throughout the bathroom.

* Cars can be equipped with devices that help stroke patients reach the brakes or steer more easily with one hand.

* There are one-handed fishing poles, needlepoint clamps and other appliances that can be used to help compensate for disabilities and rebuild dexterity.

For more help, contact:

* Easter Seal Society, 70 E. Lake St., Chicago, Ill. 60601. "Handy, Helpful Hints for Independent Living After Stroke" is available for $1.20.

* National Stroke Association, Dept. EH, 300 E. Hampden Ave., Suite 240, Englewood, Colo. 80110-2622. "Living at Home After a Stroke" is available for $2.

* Courage Stroke Network. Stroke support group hot line: (800) 553-6321.

School paddling problems:

Each year 2 million American schoolchildren are paddled by their teachers, 20,000 of them so harshly that they require medical attention. Though these numbers are shocking, only 20 states prohibit corporal punishment. It's still common in rural areas, smaller schools and in the Southeast -- almost two-thirds of all recorded cases occur in Alabama, Arkansas, Florida, Georgia, Texas and Tennessee. Black children are twice as likely to be struck as white children. Boys and children with learning disabilities are also more likely targets. Studies show that hitting a child because he misbehaves causes more problems than it solves. Usually it only makes the child more unruly. In severe cases, it can result in headaches, nightmares, eating disorders and poor concentration. The American Academy of Pediatrics and the National Education Association hold that corporal punishment should be banned and replaced with methods such as detention, loss of privileges or counseling. There's at least one group organized to outlaw paddling. It's called People Opposed to the Paddling of Students in Houston. Consider writing letters to your state representatives if corporal punishment is still legal in your state. Get involved.

Herpes in hiding:

You'd think you'd know if you had genital herpes. But several studies have found that many people who harbor the virus may never show any symptoms. In the most recent study, researchers at the University of Washington tested 776 women who visited a clinic for sexually transmitted diseases. Forty-three percent were told they had herpes even though two-thirds of the infected women couldn't remember ever seeing any symptoms, such as lesions. The researchers then tested 636 female college students and registered similar results: Of the 9 percent who had herpes, 71 percent were unaware that they had it. This means that having a doctor examine you for lesions may not always be enough. If you want to be sure you don't have herpes, ask to have a cell culture taken from the cervix.

Blood tests can lie:

Believe it or not, you can alter your blood test results simply by lying down. The standards for most blood tests, such as those for red blood cell and cholesterol levels, were established among people who were standing when their blood was drawn. When you stand, gravity pushes fluid from your blood into surrounding tissues. Red blood cell levels, for instance, can jump as much as 8 percent higher in some patients. This jump, says Simon Dimmitt, a doctor at the University of Western Australia, could result in faulty diagnoses. According to Dimmitt, most hospital patients have blood samples taken when they first enter the hospital -- standing. But subsequent samples are taken when they're in bed. The difference is sometimes made up by blood transfusions, asserts Dimmitt, but I'll bet most practitioners are wise to this by now. Still, it's worth noting the importance of assuming the same position every time blood is drawn.

AIDS discovery?

A treatment used in the past to bolster immune defenses in some patients also significantly reduces serious bacterial infections in some children infected with the AIDS virus, a study shows. But unfortunately, the intravenous immune globulin did nothing to reduce death rates. Among children receiving the globulin, a sterile solution of disease-fighting antibodies derived from human blood, only 30 percent had serious infections, compared with 42 percent of the children who did not get the treatment, report the researchers from 28 centers, including Dr. Ellen Cooper of Boston City Hospital. They findings appear in the New England Journal of Medicine. Immune globulin, which must be given periodically and could cost $306 for a child's monthly dose, has been used in the past to treat patients who are unable to produce their own antibodies as a result of illness or who have other immune deficiencies. The study looked at 372 children, all of whom had some symptoms of HIV infection.

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