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Stroke: An American Academy of Neurology Press Quality of Life Guide

Stroke: An American Academy of Neurology Press Quality of Life Guide When health care providers communicate with patients and their families, we may use a different language than when we talk to our colleagues. We discuss the single case rather than an entire cohort. Our language must be simplified without being condescending. We try not to bother our patients with information they do not need nor scare them with information that is not relevant to their situation. How then might we write a book that is aimed at “both stroke survivors and individuals wishing to learn more about the condition and how to prevent it”? It should be written in nonprofessional language but explain some of the terms commonly used by physicians. It should be thorough and informative but not too elaborate. It should be well organized with a clear structure that allows the patient and family members to receive the information they seek and communicate more efficiently with their health care providers. In the American Academy of Neurology Press Quality of Life Guide on Stroke, almost all of these points are met. It is an excellent guide for anyone with a deep interest in neurology and stroke. In easy-to-understand language, Caplan provides the reader with a detailed description of how our brain works, how it is supplied with oxygen and nutrients, and what happens in the brain when a stroke occurs. He touches on the medical conditions that may lead to stroke and the methods that health care providers use to find out more about the stroke: they rely heavily on a thorough history and physical examination to identify certain stroke symptoms and continue with a variety of tests. Caplan discusses treatment options for all types of stroke, including a few examples of individual cases in which the treatment decision is not straightforward and where other stroke specialists may have chosen a different treatment. This comprehensive review starts out by introducing the reader to 4 patients: Robert, the “typical” vasculopathic man, who has several transient ischemic attacks followed by a large ischemic stroke due to a carotid artery occlusion; Claire, the young healthy woman with a stroke in the setting of a patent foramen ovale; Tom, the middle-aged man who likes to drink and has a small cerebellar intraparenchymal hemorrhage; and Sam, the healthy elderly man with a stroke in the setting of atrial fibrillation. By referring to these patients in subsequent chapters, Caplan neatly explains these different types of stroke and puts complicated issues into the proper context. His analogy to house plumbing when explaining ischemia is a good example of Caplan's ability to turn a complex concept into a comprehensible one. The only trouble with such a mechanistic explanation is when it comes to treatment, the plumber typically removes the blockage rather than trying a chemical to reduce the degree of blockage. The layperson will, thus, ask why surgical interventions are not the preferred approach to stroke. The vascular neurologist will question the appropriateness of comparing the ischemic brain to a wilting lawn. Caplan's descriptions of what happens after a stroke, including complications, recovery, rehabilitation, and residual dysfunctions, and the effect of the stroke on caregivers and family members are as indispensable as the Appendix with its helpful guide through “the Insurance Maze” written by 2 true experts in the field. In conclusion, this book is thorough and informative, and the illustrations are excellent. Its organization could be improved. This 231-page book is designed to read from front to back rather than to sample as interested. While some readers will be overwhelmed and alarmed by the amount and detail of information, this book can be confidently recommended to an educated layperson who has a basic medical understanding, an intense curiosity, and the desire to become an expert in stroke. Health care providers may also find the book rewarding to keep up with patients and to gather tips on effective communication. Prose ★★★ Illustrations ★★★★ Science ★★★ Usefulness ★★ Correspondence: Dr Creutzfeldt, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (clairejc@u.washington.edu). Financial Disclosure: None reported. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Stroke: An American Academy of Neurology Press Quality of Life Guide

Archives of Neurology , Volume 67 (2) – Feb 1, 2010

Stroke: An American Academy of Neurology Press Quality of Life Guide

Abstract

When health care providers communicate with patients and their families, we may use a different language than when we talk to our colleagues. We discuss the single case rather than an entire cohort. Our language must be simplified without being condescending. We try not to bother our patients with information they do not need nor scare them with information that is not relevant to their situation. How then might we write a book that is aimed at “both stroke survivors and individuals...
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Publisher
American Medical Association
Copyright
Copyright © 2010 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneurol.2009.325
Publisher site
See Article on Publisher Site

Abstract

When health care providers communicate with patients and their families, we may use a different language than when we talk to our colleagues. We discuss the single case rather than an entire cohort. Our language must be simplified without being condescending. We try not to bother our patients with information they do not need nor scare them with information that is not relevant to their situation. How then might we write a book that is aimed at “both stroke survivors and individuals wishing to learn more about the condition and how to prevent it”? It should be written in nonprofessional language but explain some of the terms commonly used by physicians. It should be thorough and informative but not too elaborate. It should be well organized with a clear structure that allows the patient and family members to receive the information they seek and communicate more efficiently with their health care providers. In the American Academy of Neurology Press Quality of Life Guide on Stroke, almost all of these points are met. It is an excellent guide for anyone with a deep interest in neurology and stroke. In easy-to-understand language, Caplan provides the reader with a detailed description of how our brain works, how it is supplied with oxygen and nutrients, and what happens in the brain when a stroke occurs. He touches on the medical conditions that may lead to stroke and the methods that health care providers use to find out more about the stroke: they rely heavily on a thorough history and physical examination to identify certain stroke symptoms and continue with a variety of tests. Caplan discusses treatment options for all types of stroke, including a few examples of individual cases in which the treatment decision is not straightforward and where other stroke specialists may have chosen a different treatment. This comprehensive review starts out by introducing the reader to 4 patients: Robert, the “typical” vasculopathic man, who has several transient ischemic attacks followed by a large ischemic stroke due to a carotid artery occlusion; Claire, the young healthy woman with a stroke in the setting of a patent foramen ovale; Tom, the middle-aged man who likes to drink and has a small cerebellar intraparenchymal hemorrhage; and Sam, the healthy elderly man with a stroke in the setting of atrial fibrillation. By referring to these patients in subsequent chapters, Caplan neatly explains these different types of stroke and puts complicated issues into the proper context. His analogy to house plumbing when explaining ischemia is a good example of Caplan's ability to turn a complex concept into a comprehensible one. The only trouble with such a mechanistic explanation is when it comes to treatment, the plumber typically removes the blockage rather than trying a chemical to reduce the degree of blockage. The layperson will, thus, ask why surgical interventions are not the preferred approach to stroke. The vascular neurologist will question the appropriateness of comparing the ischemic brain to a wilting lawn. Caplan's descriptions of what happens after a stroke, including complications, recovery, rehabilitation, and residual dysfunctions, and the effect of the stroke on caregivers and family members are as indispensable as the Appendix with its helpful guide through “the Insurance Maze” written by 2 true experts in the field. In conclusion, this book is thorough and informative, and the illustrations are excellent. Its organization could be improved. This 231-page book is designed to read from front to back rather than to sample as interested. While some readers will be overwhelmed and alarmed by the amount and detail of information, this book can be confidently recommended to an educated layperson who has a basic medical understanding, an intense curiosity, and the desire to become an expert in stroke. Health care providers may also find the book rewarding to keep up with patients and to gather tips on effective communication. Prose ★★★ Illustrations ★★★★ Science ★★★ Usefulness ★★ Correspondence: Dr Creutzfeldt, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (clairejc@u.washington.edu). Financial Disclosure: None reported.

Journal

Archives of NeurologyAmerican Medical Association

Published: Feb 1, 2010

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