The OSR also includes a category called “Living,” which is not one of the 5 actionable areas of a full recovery because it supports all five areas. The posts in Living are also about ideas and lifestyle changes that will make the journey go faster and be more tolerable, pleasant, and satisfying. Also, while the OSR is very focused on the stroke survivor, the Living area broadens that focus to include other people involved in, or affected by, the stroke’s full recovery efforts.
Few things are more important to a full recovery than deep, restful sleep and a muscle-and-neuron-friendly diet. Yet in my stroke inpatient hospital, patients were often two to a room with no nighttime lights out, no calls, or TV off policies. Patients were awakened several times in the night for announcements, to draw blood, check vitals, and administer medication. This is standard practice in most hospitals, and much of this is to be ready for doctors’ rounds typically scheduled for first thing in the morning. How big a deal is this? Well the latest research shows sleep deprivation increases stroke risk by 400 percent.
Secondary stroke risk could be reduced and patient recovery could be enhanced by creating a nightly quiet time and scheduling tests, checking vitals, and dispensing medications so as not to awaken patients. If doctors’ rounds were scheduled later in the morning, stroke patients could sleep in. The caregivers and patient should continue to focus on a good night’s sleep for the entirety of their recovery. In future articles we’ll discuss specifics.
Another of the most important areas of living for full recovery is nutrition. Nutrition is already complex and difficult to sort out, even before a stroke, but is doubly hard to get right for your recovery. For example, protein shakes are good for addressing muscle atrophy, but may contain supplements like glutamate (or glutamine, which can become glutamate in the body), which is suspected of inhibiting neuron growth. There is little research specifically on stroke recovery nutrition, but excellent research is becoming available for nutrition supporting neuron health in dementia, Alzheimer’s, Parkinson’s, and epilepsy.
The food in my stroke inpatient hospital was heavily biased toward tasty comfort food. I can very much understand the compelling argument for good tasting comfort food at this critical point after a severe stroke. But this comfort food was almost all carbohydrates, highly processed starches, refined sugar, and high fructose corn sugar. When I asked the hospital nutritionist for more protein, she said she could only offer Ensure (which in addition to 25g of protein has another 31g of carbs).
In the first few therapy sessions I was shocked at how exhausting physical and occupational therapy was, especially since I was already in great shape (I had finished a 4 hour, 50-mile triathlon just 1 week before my stroke). After just a few hours of therapy I felt exactly as exhausted as I did after the 50-mile triathlon. It was then that I realized I needed to stay on the same nutrition plan I used for my triathlon training.
Despite the universal intractability of institutional food services, the hospital medical staff was very supportive of my desire for a fitness diet, and my wife backpacked in two meals a day for 6 weeks (for which she should be sainted). I firmly believe this is one of the major reasons my recovery got off to such a good start. When I left the stroke inpatient hospital, I had not gained a single pound, despite being bedridden all day, save for 4 hours of therapy. In future articles we will get into the details of full recovery nutrition.
But first, before there can be any productive discussion about optimal nutrition for a full stroke recovery, we need to get on the same page due to the overwhelming conflicting information about nutrition today. I normally try not to recommend books, especially about nutrition, which is becoming about as touchy as religion and politics, but I just finished a new book that is a game changer. It does a great job summarizing what I’ve learned from many years of personal research, plus adds details and insights way beyond my pay grade. Don’t worry, it is really more of a history, investigation, or mystery book, and does not advocate a particular diet or lifestyle.
The book is Death by Food Pyramid by Denise Minger. Despite a cover graphic, title, and book description that was likely conceived by the publisher to drive sales, this is a serious and scholarly work. I believe this is the one must-read nutrition book that should be read prior to any discussion or work on nutrition.
The biggest problem facing anyone seeking, or giving, advice on nutrition is that there are entrenched beliefs resulting from nearly 50 years of bad science, flawed research, and government and food industry interfering with the science and research by trying to reconcile the study results with other agendas, such as corporate growth and profits, and controlling the cost of government food programs, such as food stamps.
Since the newest research is largely telling us everything we have been taught for a generation about nutrition is almost totally wrong, it is going to be almost impossible to get anyone to listen to the compelling new direction nutrition research is directing us. This book teaches us how to interpret the research going forward and gives us guidelines for what type of research we can and cannot trust.
Death by Food Pyramid shows step by step how and why we got it so wrong in the past, and it does it without anger, hostility, agenda, rancor, or vilifying anyone… mostly it’s just the way it all worked out, despite the best intentions. Oddly, despite how disconcerting it’s revelations are, the book is very well written and enjoyable to read. The way the author non-judgmentally and methodically picks apart and exposes the agenda, biases, and just plain errors in virtually all the major nutrition research that has been the basis for all our nutrition advice for the past 50 years is convincing and compelling. For example, most of the major studies have been observational studies that we now see confused correlation with causality. The author does not champion a particular diet, but makes it clear what is known and unknown, and what that latest research is really telling us.
It could be one of the most important books ever in nutrition, because until we are willing to give up the ingrained misconceptions of the past, we will never be able to make any sense of the new research or reach a consensus on a healthy diet for full recovery.
 Fractured Sleep Exacts a Heavy Toll http://www.medscape.com/viewarticle/820529?nlid=50103_1521&src=wnl_edit_medp_wir&spon=17
 Is Glutamine Supplementation Helpful or Harmful? http://articles.mercola.com/sites/articles/archive/2004/05/01/glutamine.aspx
 Protecting the Brain from a Glutamate Storm http://www.dana.org/Cerebrum/2007/Protecting_the_Brain_from_a_Glutamate_Storm