Archive for the ‘Baby Boomer in Nursing Homes,’ Category

Since I have come to live in in the convalescent home  I have had to learn many new things.  Since my last stroke in 2005 I have much difficulty getting everything to move around on my body.  At first I couldn’t even speak clearly, but after much speach therapy I got  better.  I still have trouble , but I have gotten used to the different feeling.  To See what this was like  just pretend sometime  that you can’t move around.  All of the things, you used to do  you now can’t do.  The thought is very scary.  Basically that’s what happens when you have a stroke.  One of the things people don’t realize about a stroke is you have to change your thinking.  As you once moved around without giving it a thought  now requires a great deal of thought and attention to move certain parts of your body.

In fact you have to relearn completely new steps inside your mind to move around.  God  has given us a great machine called the brain.  Believe it or not, you can actually re-program  things that have been damaged.  As for myself, I have chosen to do this. This thinking requires a great deal of effort .  Typically we are not programmed to do this.  So, those who are helping you need to be patient and understanding with you.

I heartily recommend this attitude.  This challenge gives your mind something to focus on.  Mentally, you begin to realize that you can be in control again.  Now, granted the control is not what you are used to having but it is the beginning of a great life adventure.

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May 27, 6:05 PM (ET)

By MARIA CHEN

LONDON (AP) – Special stockings commonly given to stroke patients to prevent blood clots don’t work, a new study reported Wednesday.

Doctors often prescribe the tight, thigh-high stockings to patients who have suffered a stroke, seeking to prevent blood clots in patients’ legs – which could prove fatal if they break off and reach the heart or lungs.

About two-thirds of stroke patients can’t walk when admitted to hospital, and up to 20 percent of those patients develop a blood clot in their legs. The stockings squash the legs and force the blood to circulate better, and can be used in place of, or alongside, anti-clotting drugs like heparin.

But in a study of more than 2,500 stroke patients in Australia, Britain and Italy, doctors found the stockings did nothing to reduce the chances of a clot. Not only that, but they caused problems like skin ulcers and blisters.

The results were simultaneously published in the Lancet medical journal and presented at the European Stroke Conference in Stockholm on Wednesday.

Some experts were surprised by the findings.

“We have used these stockings because we assume they work,” said Dr. Ralph Sacco, president-elect of the American Heart Association, who was not linked to the study. “But sometimes you’re surprised when you find out the truth with a randomized trial.”

The stockings have been proven to reduce clots in surgery patients, so experts had long thought the low-cost solution might also help stroke patients.

In the study, about half of the patients got standard care in addition to the stockings. The other half just got standard care. Experts took an ultrasound of patients’ legs after about 7 to 10 days, and then again after 25 to 30 days. About 10 percent of patients in both groups developed blood clots.

In the group wearing stockings, 5 percent reported side effects like skin problems and blisters. That compares to 1 percent in the group not given the stockings.

The study was paid for by Britain’s Medical Research Council, the Scottish government, the health charity Heart and Stroke Scotland, Tyco Healthcare in the United States and the U.K. Stroke Research Network.

In Britain, draft guidelines recommend patients wear the stockings and they are used to treat an estimated 80,000 patients per year. Martin Dennis, of the University of Edinburgh and one of the study authors, said he has contacted British officials to suggest they reconsider their advice.

“This should cause a big change in how patients are treated,” Dennis said, noting that in 2002, 90 percent of stroke units in Britain used the stockings.

In the United States, stockings for stroke patients are far less popular than in the U.K.

Dr. Marc Mayberg, co-director of the Seattle Neuroscience Institute, said he hadn’t recommended the stockings for patients in about 20 years. He said the stockings were cumbersome and difficult for many patients, whose legs were paralyzed, to put on and take off.

Recommendations from the American Heart Association published in 2005 advised doctors to consider using the stockings in addition to an anti-clotting drug, or for patients who can’t take such drugs.

Sacco said American doctors were more likely to use drugs instead of stockings to prevent clots. He thought the guidelines promoting stockings might now have to be revised.

“With this lack of effect, doctors may be much less inclined to use them,” he said.

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On the Net:

The Lancet http://www.lancet.com

Why does a diploma from Harvard cost $100,000 more than a similar piece of paper from City College? Why might a BMW cost $25,000 more than a Subaru WRX with equally fast acceleration? Why do “sophisticated” consumers demand 16-gigabyte iPhones and “fair trade” coffee from Starbucks?

If you ask market researchers or advertising executives, you might hear about the difference between “rational” and “emotional” buying decisions, or about products falling into categories like “hedonic” or “utilitarian” or “positional.” But Geoffrey Miller, an evolutionary psychologist at the University of New Mexico, says that even the slickest minds on Madison Avenue are still in the prescientific dark ages.

Instead of running focus groups and spinning theories, he says, marketers could learn more by administering scientifically calibrated tests of intelligence and personality traits. If marketers (or their customers) understood biologists’ new calculations about animals’ “costly signaling,” Dr. Miller says, they’d see that Harvard diplomas and iPhones send the same kind of signal as the ornate tail of a peacock.

Sometimes the message is as simple as “I’ve got resources to burn,” the classic conspicuous waste demonstrated by the energy expended to lift a peacock’s tail or the fuel guzzled by a Hummer. But brand-name products aren’t just about flaunting transient wealth. The audience for our signals — prospective mates, friends, rivals — care more about the permanent traits measured in tests of intelligence and personality, as Dr. Miller explains in his new book, “Spent: Sex, Evolution and Consumer Behavior.”

Suppose, during a date, you casually say, “The sugar maples in Harvard Yard were so beautiful every fall term.” Here’s what you’re signaling, as translated by Dr. Miller:

“My S.A.T. scores were sufficiently high (roughly 720 out of 800) that I could get admitted, so my I.Q. is above 135, and I had sufficient conscientiousness, emotional stability and intellectual openness to pass my classes. Plus, I can recognize a tree.”

Or suppose a young man, after listening to the specifications of the newest iPhone or hearing about a BMW’s “Servotronic variable-ratio power steering,” says to himself, “Those features sound awesome.” Here’s Dr. Miller’s translation:

“Those features can be talked about in ways that will display my general intelligence to potential mates and friends, who will bow down before my godlike technopowers, which rival those of Iron Man himself.”

Most of us will insist there are other reasons for going to Harvard or buying a BMW or an iPhone — and there are, of course. The education and the products can yield many kinds of rewards. But Dr. Miller says that much of the pleasure we derive from products stems from the unconscious instinct that they will either enhance or signal our fitness by demonstrating intelligence or some of the Big Five personality traits: openness, conscientiousness, agreeableness, stability and extraversion.

In a series of experiments, Dr. Miller and other researchers found that people were more likely to expend money and effort on products and activities if they were first primed with photographs of the opposite sex or stories about dating.

After this priming, men were more willing to splurge on designer sunglasses, expensive watches and European vacations. Women became more willing to do volunteer work and perform other acts of conspicuous charity — a signal of high conscientiousness and agreeableness, like demonstrating your concern for third world farmers by spending extra for Starbucks’s “fair trade” coffee.

These signals can be finely nuanced, as Dr. Miller parses them in his book. The “conspicuous precision” of a BMW or a Lexus helps signal the intelligence of all the owners, but the BMW’s “conspicuous reputation” also marks its owner as more extraverted and less agreeable (i.e., more aggressive). Owners of Toyotas and Hondas are signaling high conscientiousness by driving reliable and economical cars.

But once you’ve spent the money, once you’ve got the personality-appropriate appliance or watch or handbag, how much good are these signals actually doing you? Not much, Dr. Miller says. The fundamental consumerist delusion, as he calls it, is that purchases affect the way we’re treated.

The grand edifice of brand-name consumerism rests on the narcissistic fantasy that everyone else cares about what we buy. (It’s no accident that narcissistic teenagers are the most brand-obsessed consumers.) But who else even notices? Can you remember what your partner or your best friend was wearing the day before yesterday? Or what kind of watch your boss has?

A Harvard diploma might help get you a date or a job interview, but what you say during the date or conversation will make the difference. An elegantly thin Skagen watch might send a signal to a stranger at a cocktail party or in an airport lounge, but even if it were noticed, anyone who talked to you for just a few minutes would get a much better gauge of your intelligence and personality.

To get over your consuming obsessions, Dr. Miller suggests exercises like comparing the relative costs and pleasures of the stuff you’ve bought. (You can try the exercise at nytimes.com/tierneylab.) It may seem odd that we need these exercises — why would natural selection leave us with such unproductive fetishes? — but Dr. Miller says it’s not surprising.

“Evolution is good at getting us to avoid death, desperation and celibacy, but it’s not that good at getting us to feel happy,” he says, calling our desire to impress strangers a quirky evolutionary byproduct of a smaller social world.

“We evolved as social primates who hardly ever encountered strangers in prehistory,” Dr. Miller says. “So we instinctively treat all strangers as if they’re potential mates or friends or enemies. But your happiness and survival today don’t depend on your relationships with strangers. It doesn’t matter whether you get a nanosecond of deference from a shopkeeper or a stranger in an airport.”

By JOHN TIERNEY

Imagine that you have ditched your laptop and turned off your smartphone. You are beyond the reach of YouTube, Facebook, e-mail, text messages. You are in a Twitter-free zone, sitting in a taxicab with a copy of “Rapt,” a guide by Winifred Gallagher to the science of paying attention.

The book’s theme, which Ms. Gallagher chose after she learned she had an especially nasty form of cancer, is borrowed from the psychologist William James: “My experience is what I agree to attend to.” You can lead a miserable life by obsessing on problems. You can drive yourself crazy trying to multitask and answer every e-mail message instantly.

Or you can recognize your brain’s finite capacity for processing information, accentuate the positive and achieve the satisfactions of what Ms. Gallagher calls the focused life. It can sound wonderfully appealing, except that as you sit in the cab reading about the science of paying attention, you realize that … you’re not paying attention to a word on the page.

The taxi’s television, which can’t be turned off, is showing a commercial of a guy in a taxi working on a laptop — and as long as he’s jabbering about how his new wireless card has made him so productive during his cab ride, you can’t do anything productive during yours.

Why can’t you concentrate on anything except your desire to shut him up? And even if you flee the cab, is there any realistic refuge anymore from the Age of Distraction?

I put these questions to Ms. Gallagher and to one of the experts in her book, Robert Desimone, a neuroscientist at M.I.T. who has been doing experiments somewhat similar to my taxicab TV experience. He has been tracking the brain waves of macaque monkeys and humans as they stare at video screens looking for certain flashing patterns.

When something bright or novel flashes, it tends to automatically win the competition for the brain’s attention, but that involuntary bottom-up impulse can be voluntarily overridden through a top-down process that Dr. Desimone calls “biased competition.” He and colleagues have found that neurons in the prefrontal cortex — the brain’s planning center — start oscillating in unison and send signals directing the visual cortex to heed something else.

These oscillations, called gamma waves, are created by neurons’ firing on and off at the same time — a feat of neural coordination a bit like getting strangers in one section of a stadium to start clapping in unison, thereby sending a signal that induces people on the other side of the stadium to clap along. But these signals can have trouble getting through in a noisy environment.

“It takes a lot of your prefrontal brain power to force yourself not to process a strong input like a television commercial,” said Dr. Desimone, the director of the McGovern Institute for Brain Research at M.I.T. “If you’re trying to read a book at the same time, you may not have the resources left to focus on the words.”

Now that neuroscientists have identified the brain’s synchronizing mechanism, they’ve started work on therapies to strengthen attention. In the current issue of Nature, researchers from M.I.T., Penn and Stanford report that they directly induced gamma waves in mice by shining pulses of laser light through tiny optical fibers onto genetically engineered neurons. In the current issue of Neuron, Dr. Desimone and colleagues report progress in using this “optogenetic” technique in monkeys.

Ultimately, Dr. Desimone said, it may be possible to improve your attention by using pulses of light to directly synchronize your neurons, a form of direct therapy that could help people with schizophrenia and attention-deficit problems (and might have fewer side effects than drugs). If it could be done with low-wavelength light that penetrates the skull, you could simply put on (or take off) a tiny wirelessly controlled device that would be a bit like a hearing aid.

In the nearer future, neuroscientists might also help you focus by observing your brain activity and providing biofeedback as you practice strengthening your concentration. Researchers have already observed higher levels of synchrony in the brains of people who regularly meditate.

Ms. Gallagher advocates meditation to increase your focus, but she says there are also simpler ways to put the lessons of attention researchers to use. Once she learned how hard it was for the brain to avoid paying attention to sounds, particularly other people’s voices, she began carrying ear plugs with her. When you’re trapped in a noisy subway car or a taxi with a TV that won’t turn off, she says you have to build your own “stimulus shelter.”

She recommends starting your work day concentrating on your most important task for 90 minutes. At that point your prefrontal cortex probably needs a rest, and you can answer e-mail, return phone calls and sip caffeine (which does help attention) before focusing again. But until that first break, don’t get distracted by anything else, because it can take the brain 20 minutes to do the equivalent of rebooting after an interruption. (For more advice, go to nytimes.com/tierneylab.)

“Multitasking is a myth,” Ms. Gallagher said. “You cannot do two things at once. The mechanism of attention is selection: it’s either this or it’s that.” She points to calculations that the typical person’s brain can process 173 billion bits of information over the course of a lifetime.

“People don’t understand that attention is a finite resource, like money,” she said. “Do you want to invest your cognitive cash on endless Twittering or Net surfing or couch potatoing? You’re constantly making choices, and your choices determine your experience, just as William James said.”

During her cancer treatment several years ago, Ms. Gallagher said, she managed to remain relatively cheerful by keeping in mind James’s mantra as well as a line from Milton: “The mind is its own place, and in itself/ Can make a heav’n of hell, a hell of heav’n.”

“When I woke up in the morning,” Ms. Gallagher said, “I’d ask myself: Do you want to lie here paying attention to the very good chance you’ll die and leave your children motherless, or do you want to get up and wash your face and pay attention to your work and your family and your friends? Hell or heaven — it’s your choice.”