Recovery After Stroke

Recovery After Stroke
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A Community And Podcast For Stroke Survivors And Carers

  1. 4d ago

    Losing Confidence After Stroke – Jaemin Frazer

    Losing Confidence After Stroke: Why It Happens and How to Get It Back Jaemin Frazer has spent nearly two decades and around 16,000 coaching hours on a single question: what is actually going on when a capable person stops trusting themselves? He founded The Insecurity Project to work on it directly. He is not a stroke survivor – and that turns out to be the reason this conversation is useful, because he arrives without any assumptions about what stroke recovery is supposed to look like. What he does have is a precise account of what happens to a person when their ordered world collapses, which is, more or less, the definition of a stroke. “I Just Want to Be Who I Was” Almost every survivor says some version of this. Six weeks out, six years out – the sentence barely changes. Jaemin’s response is to ask what is actually being requested. His answer: not the past. Certainty. They’re looking for certainty. They’re looking for comfort. They’re looking for safety. They’re looking through rose coloured glasses in many ways, because no one’s life was perfect before anything. That last part is the uncomfortable bit. The life you want back had its own problems. What memory offers is not a better life but a known one – and the nervous system will take known over good almost every time. Certainty Is the Real Request Humans need certainty the way they need food and shelter. We don’t function in chaos. But we also can’t get certainty from the outside world, because the outside world doesn’t have any to give. It never did. The stroke didn’t remove your certainty; it removed your ability to keep believing in it. Which leaves one option. As Jaemin puts it: The most resourceful form of certainty is to embrace uncertainty and back yourself. That distinction – external certainty versus internal certainty – is the whole conversation. When your sense of safety lives outside you, you have to control your circumstances to feel all right, and after a stroke your circumstances are largely uncontrollable. When it lives inside you, circumstances can do what they like. This is the same territory covered in stroke recovery mindset (https://recoveryafterstroke.com/stroke-recovery-mindset/), approached from a completely different angle. Self-Doubt Is Useful. Insecurity Is Not. Jaemin draws a hard line between the two, and it’s worth holding onto. Self-doubt is accurate information about a skill gap. If you can’t yet climb the stairs unaided, self-doubt is what stops you attempting it alone. It says nothing about your worth. It’s wisdom. Insecurity is different. Insecurity is the belief that a failure would expose something defective about you. Jaemin argues that most people misdefine it – it isn’t fear of judgement, failure, or rejection. It’s one level deeper: No one’s actually afraid of being rejected. They’re afraid of: if I put my best foot forward and it’s not enough, and then people don’t accept me – what does that confirm about my own inadequacy? The threat isn’t out there. It’s a verdict you’ve already passed on yourself, waiting for the world to co-sign it. What Insecurity Costs Your Recovery This is where it stops being philosophy. Jaemin frames insecurity as a resource problem. Proving yourself, defending yourself, covering and compensating – all of it consumes energy. When life is going well there’s enough spare capacity that you never notice the drain. After a stroke, there is no spare capacity. A stroke puts you into survival mode, and now you’ve got no resources to survive, because all your best resources are directed elsewhere to make sure no one sees your inadequacy. Survivors already know that fatigue after stroke is not ordinary tiredness. An injured brain rewiring itself is metabolically expensive. Every unit of energy spent managing how you appear to other people is a unit unavailable for healing. Attending to the emotional side of recovery isn’t separate from the physical work – it’s what frees up the capacity to do it. That connection runs through emotional recovery after stroke (https://recoveryafterstroke.com/emotional-recovery-after-stroke-dr-bradley-nelson/) as well. Why Your Friends Push Back Many survivors have to change how they live – what they eat, what they drink, where they go, who they spend time with. And many report losing friends over it. Jaemin’s framing here is bracing. Resistance from the people around you isn’t a malfunction. In any story worth telling, the character who transforms does so by overcoming obstacles, and those obstacles almost always arrive in the form of other people. Remove the resistance and nothing in the hero is enlarged. So when someone says you’ve changed and doesn’t mean it kindly, they are – without intending to – handing you the exact thing you need to become someone who no longer requires their approval. Grief and Insecurity Are Not the Same Thing This distinction matters, and conflating them causes real harm. Losing the use of a limb is a genuine loss. Grief is the appropriate response, and it deserves acknowledgement rather than management. The damage begins when the loss becomes a statement about your worth. I can’t run, therefore I’m not a runner, therefore who am I? That is no longer grief – that’s insecurity wearing grief’s clothes, and it needs a different response entirely. Survivors working through that identity question will recognise it in craniotomy stroke recovery and identity reset (https://recoveryafterstroke.com/craniotomy-stroke-recovery-identity-reset/), and it sits close to the ground covered in anxiety after stroke (https://recoveryafterstroke.com/anxiety-after-stroke/). That’s Not the Tragedy. That’s the Setup. The line Jaemin returns to twice in the episode is this: being lost and confused doesn’t disqualify you from a meaningful life. It’s what qualifies you to begin one. Nobody reaches adulthood with an accurate picture of who they are. Everyone arrives confused. The confusion isn’t damage to be repaired before you can start – it’s the starting position. This reframes the disorientation of early recovery as the opening move rather than evidence that something has gone permanently wrong. The same reframe underpins post-traumatic growth in stroke recovery (https://recoveryafterstroke.com/post-traumatic-growth-stroke-recovery/). And Jaemin is firm that this is solvable – not managed, not coped with. Solvable. Because the inadequacy you’ve been protecting everyone from isn’t real. It’s a conclusion you drew as a child and have been gathering evidence for ever since. There is no monster under the bed. Only the idea of one. Where to Start Start by being precise. When you catch yourself saying I lost my confidence, ask what you actually mean. Confidence at what? In front of whom? What exactly are you afraid would be revealed? Abstract language hides the levers. Precise language shows you where they are. Closing Links If this episode is useful to you, Bill’s book The Unexpected Way That A Stroke Became The Best Thing That Happened covers ten tools for recovery and personal transformation – you can find it at https://recoveryafterstroke.com/book. If you would like one-on-one support with your own recovery, you can apply at https://recoveryafterstroke.com/momentum. If this show has helped you, you can support it at https://patreon.com/recoveryafterstroke. Footer Disclaimer This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Losing Confidence After Stroke – Jaemin Frazer (Interview) You don’t need your old life back. You need to trust yourself again – and Jaemin Frazer explains exactly why that feels impossible after stroke. Highlights: 00:00 Introduction – Losing Confidence After Stroke 08:54 Embracing Uncertainty and Personal Resourcefulness 20:43 The Role of Self-Doubt and Insecurity 38:26 Transformational Journeys: Overcoming Obstacles 46:14 The Hero’s Journey and Storytelling 52:07 Understanding Bullies and Personal Growth 59:21 The Role of Parents in Identity Formation 01:11:17 The Cost of Insecurity in Recovery 01:20:55 Finding Purpose Beyond Insecurity Transcript: Introduction – Losing Confidence After Stroke Jaemin (00:00) A stroke puts you into survival mode, and now you’ve got no resources to survive because all your best resources are directed elsewhere So then it costs you everything. It costs you your future. It costs you your ability to heal, to make sense of this, to come out the other side and reinvent or do whatever you need to be present for yourself. It’s a slow descent into madness really, if all your best resources are proving and defending, covering and compensating, then you stop being human, you stop being alive, you stop being present, you become hypervigilant around what others are thinking, and your world keeps getting smaller. Bill Gasiamis (00:35) Welcome back to Recovery After Stroke. I’m Bill Gasciamas. Before anything else, thank you to everyone supporting the show on Patreon, becoming a YouTube member, and to everyone supporting it in all other ways. Sharing episodes, leaving reviews, sending them to someone who needs them, buying the book. This show has reached over a million and a half downloads because of people doing exactly that. And I don’t take it for granted. If you’ve ever caught yourself saying, I just want to be who I was, this episode is going to sit with you for a while. My guest today is Jaemin Fraser. Jaemin is a coach, the founder of the Insecurity Project, a TEDx speaker, and as of this year, a novelist. He spent nearly two decades, around 16,000 coaching hours, on one problem. What happens to a person when they stop trusting themselves and what it costs them? Jaemin has not had a stroke. I w

  2. 6d ago

    Citicoline for Brain Recovery: What the Major Trials Actually Found

    Citicoline and Stroke Recovery: What the Major Clinical Trials Actually Found If you’re recovering from a stroke or brain injury, there’s a familiar, exhausting question that shows up once the rehab schedule is set: is there anything else a supplement, a nutrient, something that could genuinely support the brain while it rebuilds itself? Citicoline comes up in that search constantly, across nootropic forums, supplement stores, and even some hospital protocols. It also happens to have one of the largest clinical trial records of any brain-recovery compound available. So rather than trusting a product label, it’s worth going straight to what those trials actually found, including the parts that didn’t work. What Citicoline Is Citicoline (cytidine diphosphate-choline, or CDP-choline) is a compound your body already produces. It’s a building block for phosphatidylcholine, a major structural component of neuronal cell membranes. The theory behind supplementing it is straightforward: give the brain more raw material to repair damaged membranes and support neurotransmitter production after an injury. It’s sold over the counter as a supplement (often branded as “Cognizin”), and in some countries it’s used clinically, including intravenously, in hospital stroke and TBI protocols. What the Major Trials Actually Show This is a case where the size of the evidence base is unusually large, and the results are humbling rather than triumphant. The ICTUS trial, published in The Lancet in 2012 with 2,298 patients, tested citicoline for acute ischemic stroke and found no significant benefit over placebo for global recovery at 90 days; the trial was stopped early for futility (PMID 22691567). The COBRIT trial, published in JAMA the same year with 1,213 traumatic brain injury patients, tested a higher dose of 2,000 mg per day for 90 days and again found no meaningful difference in functional or cognitive outcomes at 90 or 180 days (PMID 23168823). A 2020 Cochrane review pooling ten randomized trials and more than 4,000 stroke patients concluded there was little to no difference between citicoline and placebo in mortality, disability, or neurological recovery, and rated the overall evidence quality as low, noting six of the ten trials were industry-sponsored (PMID 32860632). Here’s where the picture becomes more interesting. A separate trial gave stroke survivors citicoline continuously for twelve months, rather than just during the acute phase, and found real improvements in attention, executive function, and temporal orientation compared to usual care, along with a non-significant trend toward better long-term functional outcome (PMID 23406981). A broader 2020 systematic review across neurological conditions similarly found citicoline useful for slowing dementia progression and enhancing cognition in healthy adults, while describing its effect on TBI specifically as “unclear” (PMID 33053828). A separate meta-analysis of twelve trials found citicoline significantly improved functional outcomes overall, even while showing no significant difference on several other individual outcome measures a genuinely mixed result rather than a clean positive or negative (PMID 28458415). The pattern that emerges: as a short-term rescue treatment for acute stroke or acute TBI, the largest, best-designed trials say no, it doesn’t move the needle. As a longer-term support for post-stroke cognitive function, taken consistently over months, there’s a more modest but real signal. What This Means for Stroke Survivors – The Honest Limits Citicoline is not an acute miracle treatment, and the largest trials in the field say so plainly. If you were hoping for a supplement that meaningfully changes outcomes in the days or weeks after a stroke, the evidence doesn’t support that expectation. The more genuine finding of better attention and executive function with twelve months of continuous use comes from a single open-label trial that wasn’t blinded, so it deserves a more cautious read than the large, definitive negative trials. There’s also a dosing gap worth knowing about before anyone assumes a supplement bottle reflects the research: clinical trials used 500 to 2,000 mg per day, often for months, while most over-the-counter citicoline products are dosed at 250 to 500 mg per day, meaningfully lower than the doses that produced the modest cognitive signal. Practical Takeaways – Questions to Bring to Your Treating Team Ask your neurologist or doctor whether citicoline makes sense for your specific recovery stage. Acute stroke support and long-term cognitive support are different questions with different evidence behind them. If you’re considering a supplement, check the label dose against what was actually studied. A product dosed well below 500 mg per day is not comparable to the trials that showed a cognitive benefit. Search “ICTUS citicoline,” “COBRIT trial,” or “citicoline cognitive stroke” on PubMed yourself, and form your own view. The honest picture here is nuanced enough that it’s worth reading past the marketing copy. The value of citicoline, if it exists for you, isn’t as a substitute for rehab, sleep, movement, and nutrition; it’s a small addition on top of everything else you’re already doing well, chosen because you understand the actual trial record rather than a supplement label. For the broader framework I used to separate genuine evidence from supplement hype throughout my own recovery, see my book: https://recoveryafterstroke.com/book. If breakdowns like this one are useful to you, the Recovery After Stroke Patreon (https://patreon.com/recoveryafterstroke) directly funds more of them. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Citicoline for Brain Recovery: What the Major Trials Actually Found appeared first on Recovery After Stroke.

  3. Aug 21

    Curcumin and Brain Bleed Recovery: What the Research Actually Shows

    Curcumin and Brain Bleed Recovery: What the Research Actually Shows If you’re recovering from a hemorrhagic stroke or a ruptured aneurysm, you’ve probably noticed that most “brain health supplement” advice online is written for the other kind of stroke: the clot type. It rarely addresses what’s actually happening inside a bleed injury: blood breaking down inside brain tissue, swelling, and a wave of secondary inflammation that can do as much damage as the bleed itself. So when someone in this community asked whether there’s any real research behind supplements for healing the brain after a bleed, it was worth digging into properly. One compound kept surfacing: curcumin, the active constituent in turmeric. What Curcumin Is and Why It Showed Up in This Search Curcumin is the primary bioactive compound in turmeric, long studied for its anti-inflammatory and antioxidant properties. It’s an unusual candidate for brain-bleed research because most stroke supplement research focuses on ischemic stroke clots where the biology is different. A bleed involves blood pooling in or around brain tissue; as red blood cells break down, iron released from hemoglobin triggers an inflammatory cascade that increases swelling and pressure inside the skull. Anything that can interrupt that cascade is scientifically interesting, at least in principle. What the Evidence Actually Shows The research specific to bleed-type brain injury is more developed than you might expect, but it comes with an important caveat covered below. In animal models of intracerebral hemorrhage, curcumin reduced swelling by blocking aquaporin-4 and aquaporin-9, water-channel proteins involved in brain edema, and by calming the NF-kB inflammatory pathway that drives secondary damage after a bleed (PMID 26119880). A separate mouse study found that curcumin given within six hours of an induced brain bleed helped shrink the resulting hematoma, reduced inflammatory gene activity, and improved neurological recovery scores compared to untreated animals (PMID 21417704). The finding most relevant to aneurysm-type bleeds specifically comes from a mouse model of subarachnoid hemorrhage, the same category of bleed caused by a ruptured aneurysm. Curcumin, administered shortly after the bleed, reduced brain water content and improved neurological scores, apparently by protecting the integrity of the blood-brain barrier (PMID 27979493). On the human side, the picture shifts. There is currently no published human clinical trial testing curcumin specifically for hemorrhagic stroke or brain-bleed recovery. What does exist is human evidence in an adjacent area: two separate placebo-controlled trials in older adults found that a bioavailable (“lipidated”) form of curcumin improved working memory and helped prevent the cognitive decline seen in the placebo group over time (PMID 27102361; PMID 32512782). That’s genuinely encouraging evidence for brain health broadly, but it is not the same as proof that curcumin aids recovery from a bleed specifically. A 2024 systematic review pooling curcumin and traumatic brain injury research examined eighteen studies. Every one of them was an animal study (PMID 38798711). That single fact is the most important piece of context in this entire topic. What This Means for Stroke Survivors – The Honest Limits Here is the line between promising and proven: everything specific to brain-bleed recovery hematoma size, inflammation, neurological scores after hemorrhage comes from mouse studies, not human trials. Mice are not small humans, and preclinical results routinely fail to replicate in people, particularly in stroke research, where decades of promising animal data have not translated into approved acute therapies. There is also a safety consideration that matters more here than in most supplement discussions: curcumin has a mild blood-thinning effect. If you are recovering from a bleed, on anticoagulant medication, or scheduled for any procedure, that is not a detail to skip past; it is the single most important thing to raise with your medical team before considering curcumin or turmeric extract in any form. Practical Takeaways – Questions to Bring to Your Treating Team Ask directly about bleeding risk before considering any curcumin or turmeric supplement, especially if you are on blood thinners or still in the early recovery window after a hemorrhage. Ask whether the standard turmeric found in food or basic capsules is even comparable to the “bioavailable” or “lipidated” curcumin formulations used in the human trials. Standard turmeric is poorly absorbed, and the studies that showed a benefit did not use it. Ask your doctor, or check ClinicalTrials.gov yourself, whether any human trials specific to your diagnosis are currently recruiting or have published results since this was written; the evidence base here is still moving. The goal isn’t to decide for or against curcumin based on a YouTube video. It’s to walk into your next appointment with a specific, well-informed question instead of a vague one about “brain supplements” so your medical team can give you a real answer. If you want to go deeper on evidence-based approaches to stroke recovery, my book covers the broader framework I used to rebuild my own recovery plan: https://recoveryafterstroke.com/book. And if this kind of research breakdown is useful to you, the Recovery After Stroke Patreon (https://patreon.com/recoveryafterstroke) directly funds more of it. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Curcumin and Brain Bleed Recovery: What the Research Actually Shows appeared first on Recovery After Stroke.

  4. Aug 17

    The Things Getting In The Way Of Your Recovery – Dr. Robert Hedaya

    What Blocks Brain Recovery After Stroke: The Exposures Nobody Tests For Introduction In 1987, Dr. Robert Hedaya found an office he loved. It overlooked a stream and a forest, and it had a balcony. Within about an hour of arriving each morning, he would become tired and mentally foggy, something he describes as unlike him. It took him time to work out what was happening. The building had mold. He is a Clinical Professor of Psychiatry at Georgetown University Medical Center and a pioneer of functional medicine psychiatry. He had spent his career studying why brains underperform. And he still didn’t see it until it was affecting him personally. That story is worth sitting with, because it goes to the heart of a question most stroke survivors eventually ask: if I’m doing the therapy, the exercises, the sleep, the diet, why am I still stuck? Why this question matters more than any rehab program When Dr. Hedaya returned to Recovery After Stroke for his third conversation with Bill Gasiamis, the topic was not a new treatment. It was the opposite: the things that get in the way of treatments already working. His argument is structural. After a stroke, the brain rebuilds by growing new connections between neurons. That process is physical. It requires materials, energy, and an absence of interference. If something is interfering, no amount of repetition in a rehab gym will overcome it. So the useful question is not only what helps my brain recover but also what blocks brain recovery after stroke and whether any of it is happening in your own house, your own mouth, or your own bloodstream without anyone having looked. Dr. Hedaya raised three: mercury, mold, and Lyme. Mercury: how a metal stops neurons from branching Picture a neuron as a tree in winter: a trunk with branches extending outward. After a stroke, under the right conditions, neurons grow new branches to make new connections. To do that, the cell has to lay down a structure for the new branch to grow through. It uses a protein called tubulin, small oval molecules that link together into a tube, the way Lego pieces connect to form a ring. Mercury interrupts that linkage. Dr. Hedaya points to footage from the University of Calgary, filmed in 1999, showing the process under a microscope: the growing nerve branch shrivels and retracts within seconds of mercury exposure. It runs about two and a half minutes and is worth watching, because seeing it is more persuasive than reading about it. Where does mercury come from? Two main sources. Dental amalgam fillings, the dark grey ones, were largely phased out from roughly the 1970s onward, which means people now in their fifties and sixties are the most likely to still have them. And fish. Mercury accumulates up the food chain, so large predatory fish such as tuna and swordfish carry substantially more than small fish. Sardines, anchovies, herring, and mackerel carry very little, and bring DHA and B12 with them, the raw materials neurons need. Testing involves a baseline urine sample, then a challenge dose of DMSA (a sulfur-containing compound), then a second sample. A jump between the two indicates mercury was being stored and is now being pulled out. If you have amalgam fillings removed, Dr. Hedaya is emphatic that it should be done by a biological dentist who follows a protocol: preparation with sulfur-containing compounds beforehand, a dam in place during the procedure, and rinsing afterward. Removal done badly can expose you to more mercury than leaving it alone. Mold: the ceiling Dr. Hedaya says he has never seen broken This is his strongest claim, and he states it without hedging: he has not seen anyone fully recover from a neurological problem while living in a mold-exposed environment. His estimate of the ceiling is around fifty percent improvement. There are two separate things at work. The spores the visible organism. And the mycotoxins, which are molecular, airborne, invisible, and travel far beyond the patch you can see. They inhibit mitochondria, which is how cells produce energy, and they increase oxidation, which is hard on neurons. You cannot rule mold out by smell or by looking. Dr. Hedaya has every patient run an ERMI test Environmental Relative Mold Index. You mark ten areas in the home that don’t get cleaned, wipe them down, leave them for a month, then collect dust with a supplied cloth and send it to a lab. He uses Mycometrics. The second test asks a different question: is your immune system actually reacting? A lab such as MyMycoLab measures IgE (an immediate response, within minutes to hours) and IgG (a delayed response that can begin a day or two later and persist for weeks). You then compare which molds are in your home against which ones your immune system is responding to: Aspergillus, Cladosporium, Chaetomium, Stachybotrys, and others. In Dr. Hedaya’s experience, the two lists usually overlap. Remediation is where it becomes expensive and inconvenient. Cleaning the visible growth achieves little on its own. You have to find the water: poor grading, a roof leak, blocked downspouts, a badly installed HVAC system, damp ductwork, because if the water source remains, so does the mold. As Bill put it in the conversation: there is no point putting a year of work into a rehabilitation program and then walking out of it into a moldy house. The cost of remediation is real. So is the cost of never getting past fifty percent. Lyme disease: the great imitator Lyme is a close relative of syphilis, which was historically called the great imitator because it could present as almost any disease. Lyme behaves the same way, and a single tick can carry around twenty pathogens that affect humans, including Bartonella and Babesia, both of which drain cellular energy. Dr. Hedaya’s issue is with the testing. It relies on antibodies, and antibodies take weeks to develop, so testing soon after a bite returns a negative that means nothing. The result is also reported as a binary against an optical density threshold: above the cutoff you have it, below it you don’t. His comparison: a blood glucose of 120 is not diabetes; 121 is. The line does not reflect biology. He also rejects the common reassurance that a tick embedded for under 24 hours is safe. His word for it was “insanity.” Where to start Asked which of the three to address first, his answer was immediate: mold. Mercury needs no test to begin acting on; switch to smaller fish, eat more cruciferous vegetables, garlic, cilantro, and greens, and you are doing something useful whether or not you had a problem. Test in six to twelve months if you want to know. Lyme comes last, unless you have had a recent tick bite. And mold has to be dealt with before Lyme treatment is worth attempting. How to raise this with your doctor Dr. Hedaya’s advice here is practical, and it applies well beyond this topic. Don’t arrive with a theory. Arrive with a literature review. He suggests using SciSpace over PubMed; ask it for a literature review on the effects of mold on the human nervous system, and it will assemble one in fifteen or twenty minutes. Print it, along with a couple of the underlying papers. Then add the step most people skip: ask it for the counter-argument. Ask why mold might not be a factor in brain function. You are not there to win. You are there to have a real conversation, and a doctor is far more likely to engage with someone who has already tested their own position. If they refuse outright to order the testing? His view was blunt: find another doctor. Getting out of your own way None of this replaces rehabilitation. It removes the obstacles to it. That distinction matters, because the work you are already doing is not wasted; it may simply be running into something invisible. Checking your fillings takes a minute and someone willing to look in your mouth. Testing your house takes a month and a cloth. Neither is a treatment. Both are ways of making sure the treatment can do its job. This is the third conversation with Dr. Hedaya on this show. The first covered photobiomodulation and laser therapy (https://recoveryafterstroke.com/photobiomodulation-stroke-recovery/). The second covered hormones, thyroid function, and fatigue (https://recoveryafterstroke.com/hormones-and-stroke-recovery-dr-robert-hedaya/). Both are useful companions to this one. If you want a fuller framework for thinking about recovery, Bill’s book The Unexpected Way That A Stroke Became The Best Thing That Happened walks through ten tools for recovery and personal transformation. You can find it at https://recoveryafterstroke.com/book. And if this show has helped you, you can support it financially at https://patreon.com/recoveryafterstroke. Footer Disclaimer This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Related links: Dr. Hedaya’s practice First conversation, photobiomodulation Second conversation, hormones The mercury video, University of Calgary Background on that video ERMI mold testing lab Mould antibody blood testing Tick-borne and Lyme testing Literature reviews in minutes Research database The toxins textbook he mentions The post The Things Getting In The Way Of Your Recovery – Dr. Robert Hedaya appeared first on Recovery After Stroke.

  5. Aug 10

    Jekyll, Hyde, and the Stroke That Changed Everything: Ben Sautter’s Story

    Personality Changes After Stroke: How Ben Sautter Discovered His “Hyde” and Became a Better Man  For nearly a decade, Ben Sautter carried a story he didn’t fully understand. He was a respected superintendent for the City of Helena, a devoted father, and a man his colleagues trusted. He was also someone who, years earlier, had been convicted of drug trafficking and spent over a year in prison, a period he now describes without shame or remorse, feelings he says he simply didn’t have access to. “I never felt guilty about doing anything,” he told me. “I never had no shame, no remorse. I still don’t.” Then, on a morning in 2017, Ben woke up with his left leg buzzing like an electrical current, from his hip to his toe. He dismissed it as sciatica, worked out to try to shake it off, and drove himself to a doctor’s appointment while slurring his words. By the time he reached his physician’s office, she recognized what was happening immediately: Ben was in the middle of a stroke. What followed wasn’t just a physical recovery. It became the beginning of a profound psychological reckoning one that reshaped how Ben understood himself, his marriage, and the two very different versions of the man he’d been his entire adult life. What Personality Changes After Stroke Can Actually Look Like When people talk about the effects of stroke, the conversation usually centers on physical deficits: weakness, speech difficulty, mobility. Less discussed but just as real for many survivors are the personality changes after stroke that surface in the weeks, months, and even years that follow. For Ben, this didn’t show up as a dramatic before-and-after moment. It took roughly six months before he began to notice his own cognitive shifts, and years more before he could name what he was experiencing. “I feel like two different people,” he eventually admitted to himself, a recognition that came into sharp focus only after his wife, Helen, described what she called his “Jekyll and Hyde” pattern: a caring, grounded version of himself, and a sharper, more reactive one that could surface without warning, particularly under emotional pressure. Ben also discovered something else in the process something many survivors don’t expect. Before his stroke, he says he operated almost entirely on three emotions: happy, sad, and angry. It wasn’t until his wife introduced him to a “feelings wheel” years after his stroke that he realized how narrow his emotional range had actually been. That flattened emotional landscape, paired with a striking absence of guilt or fear around risky behavior earlier in his life, points to something researchers increasingly recognize: strokes can affect not just movement and speech, but emotional regulation, impulse control, and self-awareness, particularly when the affected regions touch circuitry involved in processing feeling and consequence. The Unexpected Overlap With PTSD One of the more striking parts of Ben’s story is how he came to understand his own symptoms. Watching a 60 Minutes segment on a military veteran with PTSD, Ben recognized his own thoughts, words, and behaviors reflected back at him patterns his psychologist at the VA had already been treating with PTSD-informed techniques, without Ben fully grasping why. “That’s when I realized my family suffered the stroke as much as I did,” he said. This overlap isn’t unusual. Post-stroke psychological symptoms hypervigilance, emotional reactivity, difficulty processing what happened can closely resemble trauma responses, even in survivors who never experienced combat or acute crisis in the traditional sense. Recognizing this early, and getting connected with the right kind of psychological support, can make a meaningful difference in how survivors and their families move through recovery. Turning Reflection Into Change What makes Ben’s story remarkable isn’t just that he noticed these changes; it’s what he did with them. Nearly ten years after his stroke, and after years of separation from his wife, Ben sat down and wrote his memoir, Mr. Hyde and Me, in just ten weeks. “I called this therapy on steroids,” he said. “Writing this book was incredibly therapeutic.” The process gave him a framework to finally understand the dual nature he’d lived with since childhood, shaped, he believes, by an upbringing where feelings were dismissed, and risk-taking was treated as fun rather than dangerous. “That guy that I was, that guy’s gone. I am not going to be that guy ever again.” — Ben Sautter Today, Ben and Helen are reconciled. He describes himself as calmer, more deliberate, and a better listener than he was before his stroke, not despite the personality changes it triggered, but in some ways because of the self-awareness they eventually forced him to confront. As he put it plainly: “We would not be having this conversation if I hadn’t had a stroke.” If You’re Noticing Changes in Yourself or a Loved One If you or someone you love has experienced personality changes after stroke emotional flatness, increased irritability, impulsivity, or a sense of feeling like “two different people” you’re not imagining it, and you’re not alone. These changes are a recognized part of many stroke recoveries, and they respond well to the right combination of professional support, honest communication with family, and time. Ben’s full story, including his path through incarceration, his stroke, and the years-long process of understanding his own mind, is available in The Unexpected Way That A Stroke Became The Best Thing That Happened, where survivors share the tools that helped them navigate recovery, available at recoveryafterstroke.com/book. If this show has helped you, you can support it at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Jekyll, Hyde, and the Stroke That Changed Everything: Ben Sautter’s Story (Interview) Bill’s Book: The Unexpected Way That a Stroke Became the Best Thing That Happened Support Bill on: Patreon Bill’s one-on-one coaching program: Momentum Highlights: 00:00 Introduction – Personality Changes After Stroke 03:51 Realizing Something Was Wrong 12:51 Discovering His Dual Personality 21:05 Living With Only Three Emotions 31:50 Where the Pattern Began 39:55 Writing the Memoir That Helped Him Understand Himself 50:37 Stroke as a Catalyst for Change Transcript: Introduction – Personality Changes After Stroke Bill Gasiamis (00:00) Welcome back to Recovery After Stroke. I’m Bill Gassiamas, and today’s guest is Ben Sautter, a stroke survivor from Montana who in 2017 suffered an ischemic stroke caused by a carotid artery blockage. Ben was in his mid-50s working as a superintendent for the city of Helena when he woke up one morning with his leg buzzing like it was electric and his speech starting to slur. But this episode isn’t really about the stroke itself. It’s about what the stroke uncovered. Ben spent decades living what he now calls a Jekyll and Hyde existence, including a period of incarceration for drug trafficking that he says he felt no guilt over at the time. And after his stroke, that started to change. We talk about emotional flatness, PTSD like symptoms he didn’t recognize until years later. The marriage he nearly lost and the memoir he wrote in just ten weeks that finally helped him understand himself. Before we get into it, if you haven’t already, check out my book, The Unexpected Way That a Stroke Became the Best Thing That Happened, over at recoveryafterstroke.com/book. And if this show has helped you, you can support it at Patreon.com/recoveryafterstroke, and you can help me keep it going so that we can get to one thousand episodes. If you’re feeling stuck in your recovery and want more structure and one-on-one support, I also offer a coaching program called Momentum. You can find out more at recoveryafterstroke.com/momentum. Now let’s get into it. Here’s my conversation with Ben. Bill Gasiamis (01:42) Benjamin Sautter welcome to the podcast. Ben Sautter (01:45) Thanks much for having me. Bill Gasiamis (01:49) Can you tell me a little bit about what life was like before twenty seventeen and the stroke? Ben Sautter (01:55) Well, I was on it back then before the stroke. I was had a job that I really enjoyed. I was working for the city of Helena as a superintendent of streets and traffic division. And life was going really good for me there. And then it kind of came to a an abrupt halt. Bill Gasiamis (02:15) what was life like as far as what kind of work were you doing? What was family life like? Ben Sautter (02:23) Well, our family was pretty close at the time. We have two children and we were busy, we were really close, busy traveling. We had a motor home, we had lots of fun. we hunt and fish, a lot of outdoor activities here. We we have a little cabin that we spend all our weekends at. if we weren’t traveling, that is. so Home life was pretty good. My wife and I were struggling a bit before I had my stroke. but we were a close family. And and work was good. I I I’d progressed up into mid-level management and I I had great great people, great staff underneath of me, and we got a lot of good work done for the city and had a lot of fun at work. work was going good. Everything was going pretty good. Bill Gasiamis (03:25) Was there any sign that something was amiss with your health that perhaps there was something looming that wasn’t going to be fun? Ben Sautter (03:36) No, I was I was in great shape. I had had no signs of anything coming. so it was yeah, it was out of the blue. The stroke was out of the blue. Realizing Something Was Wrong Bill Gasiamis (03:51) What was that day like? Was there any kind of deficit defic

  6. Aug 3

    Kylie Ralston: Stroke, Bulgaria, and the Friend Who Flew Across the World

    Next of Kin After Stroke: When Your 19-Year-Old Has to Decide For You Kylie Ralston was 56, living alone in Sofia, Bulgaria, and getting back into shape after a divorce. Three mornings a week she ran. On the morning everything changed, she was doing a local park run with her friend Rebecca when she slowed to a walk, then tried to run again and couldn’t. “It was like the message wasn’t getting through from my brain to my legs,” she says. No headache. No fatigue. Nothing that felt like an emergency. She finished the run, registered her time, and went home. It wasn’t until she collapsed getting out of the car that anyone understood what was happening. By the time Kylie reached hospital, she had suffered a left frontoparietal haemorrhagic stroke, a spontaneous brain bleed roughly 7.5cm across, with none of the usual risk factors. No high blood pressure. No cholesterol history. No aneurysm, no AVM. She was placed in an induced coma for four days. When she woke, she couldn’t move her right side, and she couldn’t speak. What “Next of Kin” Really Means When a Stroke Hits Abroad Kylie was a permanent resident of Bulgaria, not a citizen, divorced from her daughter’s father, and living on her own. When the hospital needed someone to authorise emergency surgery, there was exactly one person available to make that call: her daughter, then 19 years old, splitting her time between her separated parents’ homes. It’s a detail easy to skim past, but it sits at the centre of this episode: next of kin isn’t a role most of us think about until a hospital needs an answer immediately. Kylie hadn’t nominated her daughter out of any formal planning process; it simply fell to her, because she was the only adult relative in the country who met the age threshold. A 19-Year-Old Signing Consent-to-Operate Forms Kylie’s friends contacted her daughter directly. She rushed to the hospital, and unconscious, unable to advocate for herself, her mother’s care now depended on decisions made by a teenager under enormous duress. Kylie’s first memory afterward is her daughter arriving in the ICU in a hairnet and scrubs, holding her hand, telling her she loved her. It’s the kind of moment that rarely makes it into conversations about stroke recovery, because the focus so often lands on rehabilitation milestones: walking, speaking, returning to work. But before any of that, someone has to be legally empowered to say yes to surgery, and for Kylie, that someone hadn’t expected the responsibility for another few decades. The Gap Between Acute Surgery and Real Rehabilitation Bulgaria’s acute care, Kylie and her friend Nicole Nott both stress, was world-class surgery within roughly two hours of the stroke, the kind of outcome her friends still describe as a miracle given the size of the bleed. What came next was a different story. In the public hospital, physiotherapy visits totalled two sessions. There was no speech therapy. After 14 days, still unable to move her right side or speak, Kylie was expected to go home. Her partner, Guido, refused to accept it, and the couple began privately funding rehabilitation themselves. This is a distinction worth sitting with if you or someone you love is navigating stroke recovery in a country or even a region with limited public rehab funding: acute survival and functional recovery are not the same fight, and they are not always resourced the same way. When a Friend Becomes the Rehab Team Nicole Nott, an occupational therapist and Kylie’s friend since they were 16, found out about the stroke through a message she initially suspected was a scam. Within days she’d cleared her schedule and flown from Australia to Bulgaria. What she found in the private rehab hospital was a caring but under-trained care team, kind staff with, as Nicole puts it, “no rehab expertise.” Nicole spent close to two weeks restructuring Kylie’s room and routine around basic stroke rehabilitation principles: approaching from Kylie’s affected right side to address her spatial inattention, built-up cutlery to force use of her weaker hand, a balloon tapped back and forth for shoulder strength, word games layered on top for speech practice, pegs and curtains repurposed into arm exercises. She also pushed back hard against hospital staff who tried to stop her from helping Kylie transfer to a shower chair or toilet, at one point being told outright she wasn’t permitted because she was a woman. Her single goal before flying home: get Kylie toileting independently again, for dignity as much as mobility. Kylie called her from Dubai airport, mid-transit, to tell her it had happened. Living With Aphasia Fourteen months on, Kylie’s right-side weakness has largely resolved. What remains, she says, is the hardest part: expressive aphasia. “I can’t express myself like I used to.” It’s a small, telling detail of the condition that even the phrase “I can’t” is itself shaped by the aphasia; the words available to describe the loss are affected by the loss. The Unexpected Gains Both women point to what came out of the crisis alongside the hardship: Kylie’s relationship with her daughter deepened. Her circle of friends in Bulgaria proved itself in ways she hadn’t anticipated. And in the rehab hospital, her partner Guido proposed something; he told her he’d already decided before the stroke but simply hadn’t gotten around to asking. If this episode raises questions about who is legally positioned to make decisions for you and whether that person actually knows it, it may be worth a conversation with your own family before a crisis forces the issue. For a deeper account of navigating identity, recovery, and unexpected transformation after stroke, Bill’s book The Unexpected Way That A Stroke Became The Best Thing That Happened is available at recoveryafterstroke.com/book. If this show has helped you, you can support it at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Kylie Ralston: Stroke, Bulgaria, and the Friend Who Flew Across the World When Kylie had a stroke abroad, her 19-year-old daughter became her next of kin, and a friend flew in to help her recover. Bill’s Book: The Unexpected Way That A Stroke Became The Best Thing That Happened  Support the Recovery After Stroke On Patreon Highlights: 00:00 Introduction – Next of Kin After Stroke 03:47 The Day of the Stroke 08:55 Rehabilitation Challenges in Bulgaria 16:32 Coping with Language Barriers 22:08 Reflections on Healthcare Systems 32:50 Setting Goals and Achievements 38:29 Family Dynamics and Support Systems 45:36 Finding Meaning in Recovery 54:44 The Impact of Caregiving 58:22 Reflections on Recovery and Gratitude Transcript: Introduction – Next of Kin After Stroke Bill Gasiamis (00:00) And one of my first horrible thoughts was, is this a dreadful hoax? Is someone, you know, is this some horrible scam? And it made me feel quite sick actually And then I rang her son who lives in Australia and he’s like, Yeah, I’m so sorry. I haven’t told you. Yes, it’s true, mum’s had a stroke. Bill Gasiamis (00:16) Welcome back to Recovery After Stroke. I’m Bill Gasiamis, and today I’m joined by two guests, Kylie Ralston and her friend Nicole Nott. Kylie was 56 living in Bulgaria when she suffered a left frontoparietal hemorrhagic stroke, a spontaneous brain bleed with none of the usual risk factors. Nicole is an occupational therapist and one of Kylie’s closest friends since they were teenagers. And when she found out what happened, she got on a plane to Bulgaria to help. In this episode, we get into what it means to have a stroke far from home in a country where you don’t speak the language, and public rehabilitation funding barely exists. We talk about who becomes your next of kin when you least expect it, what it’s like to advocate for a friend inside a hospital system that won’t always listen. And what recovery actually looks like 14 months on, before we get into it, if you want a deeper look at identity, recovery, and unexpected transformation after stroke, my book, The Unexpected Way That Stroke Became, the best thing that happened, is available at recoveryafterstroke.com/book. And if this show has helped you And you can support it to keep me on the path of getting to a thousand episodes, you can do so At patreon.com/recoveryafterstroke Bill Gasiamis (01:37) Kylie Ralston and Nicole Nott, welcome to the podcast. lovely to be here, Bill. Thanks for having us, Bill. Kylie, tell me a little bit about what life was like before the stroke. I was very active and I had a full life and I was working full time. and I was living in Sofia in Bulgaria, in my on my own, in my own apartment. I was renting, actually. and I was getting back to fitness. So I was g getting I was running regularly. So two two or three times a week I was hitting the gym and hitting the tr the treadmill. And that had been happening for like a few month like six months or something like that. but before that I was very fit and active. What kind of work were you involved in? I was a HR work. I was a ha HR leader and so I had my own consultancy I had a team of people that I’ve managed. I had thirty five people, so and that they were people in Germany, Poland, Czechia, Portugal, France, so everywhere in in Europe, basically. Yeah. Wow, how how does an Aussie end up in Bulgaria with staff or clients in that many countries? short answer is I came here with my family, so with my ex husband. and shortly after I arrived we separated and and ultimately got divorced. and I stayed on because my daughter is here. So she was only eleven at the time and I could just couldn’t leave her. The Day of the Stroke So you were living at home with your daughter? she was sharing her t

  7. Jul 27

    The One-Percenter Biker Who Turned His Stroke Into a Documentary

    How Making a Stroke Recovery Documentary Helped a Former One-Percenter Reclaim His Life Shayne DeMarce spent most of his adult life defined by physical strength. He rode Harleys through the Canadian Rockies in every season, ran a plumbing and heating business, and had recently begun prospecting with a one-percenter motorcycle club drawn there, he says, by the brotherhood at a time when his wife’s cancer diagnosis and a failing business were pulling the rest of his life apart. Then, on a low-speed group ride at under 20 kilometres an hour, his back wheel slid on loose gravel. To avoid landing on a fellow rider, he dove off his bike into a ditch and broke nine of his twelve ribs, his collarbone, and his scapula, punctured a lung, and tore his aorta. What nobody caught for another thirteen hours was that he’d also had a stroke. A Low-Speed Crash With High-Speed Consequences Shayne’s accident is a reminder that the danger in a fall isn’t always where it looks like it is. He walked away from the crash site convinced his injuries were broken bones, painful, but familiar territory for a man who’d spent a lifetime playing football, doing judo, and dirt biking. It wasn’t until he was in the truck heading to hospital, feeling suddenly and inexplicably worse, that anyone suspected something else was happening. By the time doctors in Edmonton confirmed it was a bilateral carotid artery dissection that had cut off blood flow to his brain, the left side of his body was already gone. He spent five months in hospital and ICU, then seven more in inpatient rehab. Non-weight-bearing for most of that time, he had to relearn how to exist in a body that no longer matched the identity he’d spent decades building. Losing the Body He Built His Identity On “I was a physical guy,” Shayne said. “My job was physical, everything about me was physical. So it wasn’t just my identity; it really was who I was.” For a man whose sense of manhood was tied to strength, work capacity, and being able to hold his own, losing the use of half his body wasn’t just a medical setback. It was, in his words, “very humbling.” The turning point came from an unexpected source: a blunt question from the principal at his rehab facility’s education centre. When Shayne told her his only goal was getting his body back, she asked him plainly, “So what if you don’t get your body back?” It’s a question that stroke survivors and their families rarely get asked directly, and it’s often the one that needs asking. Shayne describes it as heartbreaking in the moment, and something he’s since come to be grateful for. Why He Turned to a Camera Instead of a Gym That question pushed Shayne toward a skill he’d never have considered before his stroke: typing, then editing, then filmmaking. He describes teaching himself to type as doing more for his affected hand than any of his occupational therapy, and it opened a door to something bigger. Once home, he noticed a gap: plenty of content from doctors and news stations about stroke, but very little from survivors themselves, talking honestly about what recovery actually looks like. So he started the UpStroke Podcast. Then, within days of getting home from inpatient rehab, he set himself an ambitious goal: make a full-length stroke recovery documentary about his own experience, and finish it within six months. No film background, no crew, no guaranteed audience just early mornings, self-taught editing, and a refusal to let pride keep him from trying something that scared him. Making a Stroke Recovery Documentary From the Ground Up The finished film runs 55 minutes and represents hundreds of hours of work planning, scripting, filming, and re-filming after the inevitable rookie mistakes (forgotten microphones, unrecorded interviews, background noise nobody caught until the edit). Shayne interviewed his own kids and friends for the film, describing the process as “ripping the same band-aid off fifty times a day for six months straight.” What makes a stroke recovery documentary like this different from a polished studio production is exactly what makes it valuable: it was built by someone still living the recovery it documents, using the same self-taught persistence he’d once applied to fixing pipes and riding through winter. Screening the Film for the People Who Understand It Most The most meaningful moment of the entire project, Shayne says, wasn’t a premiere or a review; it was screening the documentary at the rehab facility where he’d been an inpatient, for a room that was roughly 80% stroke survivors and staff. He remembers patients in that same gymnasium who never had a single visitor in six months, and he now sees his film and podcast as a way to reach exactly those people: the ones running out of hope in a system that doesn’t always have room to give them much of it. A New Club Shayne no longer rides with the one-percenter club he’d started prospecting with before his accident. He describes his community now as “a bunch of stroked out strokers,” the friends, fellow survivors, and families he’s met through the podcast and the film. It’s a different kind of brotherhood than the one he set out to find, but by his own account, it’s the one that’s carried him. His documentary is now available free on YouTube, so that as many stroke survivors, caregivers, and healthcare professionals as possible can watch it. If Shayne’s story resonates with where you are in your own recovery, Bill’s book, The Unexpected Way That A Stroke Became The Best Thing That Happened, walks through ten tools for recovery and personal transformation built from these same kinds of conversations: recoveryafterstroke.com/book. If this show has helped you, you can support it at patreon.com/recoveryafterstroke. Footer Disclaimer: This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The transcript will be available soon… The post The One-Percenter Biker Who Turned His Stroke Into a Documentary appeared first on Recovery After Stroke.

  8. Jul 21

    Hormones, Fatigue, and the Brain: Dr. Robert Hedaya Returns

    Why Your Stroke May Not Be Causing Your Brain Fatigue For a long time after my brain surgery, I assumed my body worked like this: the stroke happened in my head, so whatever went wrong afterward would also happen in my head. Fatigue, brain fog, slow thinking all of it filed under “neurological,” all of it explained by the injury I already knew about. That assumption turned out to be wrong, and the way I found out was almost accidental. About eighteen months after my brain surgery, I had thyroid surgery to remove a nodule so large it had pushed my windpipe and esophagus six centimeters out of place. I had no idea it was there. No lump I could see, no difficulty swallowing or breathing that I’d noticed. It was found only because I had a chest X-ray to rule out an infection, and a doctor spotted something that had nothing to do with why I’d walked in. What followed was a slow, confusing recovery from that second surgery, and a wave of fatigue I automatically blamed on my brain, because that was the injury I already understood. It took time to realize the fatigue might be coming from somewhere else entirely: my thyroid. Hormones and Stroke Recovery: The Connection Nobody Talks About I brought this experience to Dr. Robert Hedaya, a Clinical Professor of Psychiatry at Georgetown University Medical Center and a pioneer of functional medicine psychiatry, to understand what actually happened, and to ask a bigger question: how many other stroke survivors are dealing with fatigue, brain fog, or mood changes that they’ve written off as “just the stroke,” when the real driver is a hormonal system that’s quietly stopped working properly? Hormones and stroke recovery turn out to be far more entangled than most of us are told. As Dr. Hedaya put it plainly: the brain is a hormonal organ. Thyroid hormone, cortisol, testosterone, estrogen every one of them acts directly on brain tissue, and every one of them can be knocked off balance by the stress of a major medical event. Why “Normal” Thyroid Bloodwork Can Still Mean Something’s Wrong One of the most important things Dr. Hedaya explained is that a “normal” TSH result doesn’t rule out a thyroid problem, especially after a stroke. TSH is a signal sent from the pituitary gland, and if a stroke has affected the brain’s signaling pathways, the pituitary itself may not respond the way it should. A survivor can have genuinely low thyroid hormone while their TSH sits comfortably inside the standard reference range, because the system responsible for raising that number in response to a deficiency isn’t functioning correctly. He also raised a striking data point: population studies suggest the average TSH in a healthy population is closer to 1.4, yet most labs still use an upper reference limit of 4.5, a range wide enough, statistically, to miss a real problem. His advice for survivors going into a GP appointment: ask specifically for TSH, free T4, free T3, and reverse T3, not just the standard single-marker test, and come prepared with symptoms written down if a doctor pushes back. A Nodule That Grew in Silence The brain is a hormonal organ. It’s an immune organ. It’s a neurological organ… there’s not one hormonal axis when it’s abnormal that cannot cause neurological or psychiatric problems. -Dr. Robert Hedaya My own nodule is a case study in exactly this kind of silent progression. Dr. Hedaya explained that because it grew inward rather than outward, it never created the visible lump most people associate with a thyroid problem, and because it didn’t press on my vocal cords or laryngeal nerve, I never developed the hoarseness that might have flagged it sooner. My body adapted gradually, and the fatigue that eventually surfaced was easy to misattribute to the injury I already knew I had. Cortisol, Stress, and the Difference Between Pain and Suffering Beyond the thyroid, Dr. Hedaya walked through the role of cortisol, the body’s primary stress hormone, and why survivors often struggle to answer a deceptively simple question: “Are you stressed?” His distinction between pain and suffering is worth sitting with: pain is often unavoidable, but suffering is shaped by the story we tell ourselves about a situation, and a stroke can compromise the very brain systems that regulate that stress response in the first place. Testosterone, Estrogen, and the Brain’s Need for Hormones to Rewire The conversation closed on sex hormones, testosterone and estrogen, relevant to both men and women, and their role in neuroplasticity. Dr. Hedaya drew a direct comparison to adolescence: the teenage brain rewires itself while hormone levels are surging, and the same principle applies after a stroke. A brain trying to rebuild pathways needs adequate hormonal support to do that work. Without it, recovery can stall in ways that have nothing to do with effort or physiotherapy. What You Can Do About It If any of this sounds familiar fatigue that doesn’t track cleanly with other recovery milestones, or symptoms a doctor has waved off as “just stress,” Dr. Hedaya’s PNIE (psycho-neuro-immuno-endocrinology) questionnaire is a useful starting point. PNIE Questionnaire download: https://drive.google.com/file/d/1S7kC5uMFgBfS-gWcUOIHp0kOjGnrzZK5/view?usp=sharing If thyroid function specifically is what you’re navigating, the earlier conversation with Dr. Elena Zinkov, “Stroke Fatigue and Thyroid,” goes deeper into that piece (https://recoveryafterstroke.com/stroke-fatigue-and-thyroid/). And for more from Dr. Hedaya, the first conversation on photobiomodulation and stroke recovery is a good companion listen (https://recoveryafterstroke.com/photobiomodulation-stroke-recovery/). Getting your body back after a stroke is rarely just about the brain. My book, The Unexpected Way That A Stroke Became The Best Thing That Happened, goes further into the mindset shifts that came out of my own recovery (recoveryafterstroke.com/book). And if this podcast has helped you, you can support its continuation at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Hormones, Fatigue, and the Brain: Dr. Robert Hedaya Returns (Interview) A baseball-sized thyroid nodule hid in plain sight after Bill’s stroke. Dr. Hedaya explains the hormone testing every survivor should ask for. Support The Recovery After Stroke Podcast Bill’s Book: The Unexpected Way That a Stroke Became Thethe Best Thing That Happened Highlights: 01:45 Hormones and Stroke Recovery 02:11 Understanding Thyroid Function and Its Impact 17:07 Navigating Thyroid Health with Healthcare Providers 27:09 The Role of Stress and Cortisol 39:09 Nutrition’s Impact on Brain Recovery Transcript: Hormones and Stroke Recovery Bill Gasiamis (00:00) And they noticed a massive lump in my throat and my esophagus and my windpipe were pushed six centimeters. And they said to me, well, can you swallow? Can you breathe? Can you do it? And I was like, yeah, I’m all fine. There’s nothing wrong with my throat. that was the first sign that there was something wrong with my thyroid Bill Gasiamis (00:19) Welcome back to Recovery After Stroke. I’m Bill Garciamas, and today I’m joined again by Dr. Robert Hedeya, clinical professor of psychiatry at Georgetown University Medical Center and a pioneer of functional medicine psychiatry, whose highland approach to brain health first brought him onto the show for our conversation on episode 404, where we discussed, amongst other things, photobiomodulation, a type of transcript. cranial laser therapy helping some stroke survivors recover lost function. He’s back today for a conversation I wanted to have for a while, the hormonal side of stroke recovery. We’re going to talk about thyroid function, cortisol, and stress physiology, and sex hormones like testosterone and estrogen, and why every one of these systems can directly affect how well and how fast your brain recovers. I’ll also share my own story of a thyroid nodule that grew undetected, which was discovered after my brain surgery completely by accident. if this conversation resonates with you, my book, The Unexpected Way That a Stroke Became Thethe Best Thing That Happened goes deeper into the mindset shifts that shaped my own recovery. You can find it at recoveryafterstroke.com/book. And if you’d like to help keep this podcast going, you can support it financially at patreon.com/recoveryafterstroke. Bill Gasiamis (01:46) Robert Hedaya, welcome back to the podcast. Dr Hedaya (01:49) Thank you for having me, Bill. Understanding Thyroid Function and Its Impact Bill Gasiamis (01:51) thank you for being here. The last conversation we had was very well received. And it’s always difficult in a one hour interview to ask all the questions that we could possibly ask about the brain and stroke recovery and all the things that people go through. And… I’ve got a lot of other questions that are related to the brain and the link between other parts of the body and the brain, because we have this sense. Well, I did at least when I was first diagnosed that whatever happens in my head is kind of isolated, that it just impacts my head. But there seemed to be some other impacts and cascading effects. that were occurring, uh, that I didn’t know were linked to the brain injury, Dr Hedaya (02:45) Yeah. Bill Gasiamis (02:46) maybe indirectly, but they were perhaps. But one thing specifically that happened to me about, uh, 18 months after my brain surgery was I had thyroid surgery to remove a nodule on my thyroid. And when I was going through the recovery after that, surgery, I noticed that I had fatigue and I thought it was neurological fatigue related to my brain surgery. But it took a long time to develop an understanding that perhaps tha

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A Community And Podcast For Stroke Survivors And Carers

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  • Creator
    Recovery After Stroke
  • Years Active
    2019 - 2026
  • Episodes
    297
  • Rating
    Explicit
  • Show Website
    Recovery After Stroke

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