{"id":9421,"date":"2022-10-29T06:53:09","date_gmt":"2022-10-28T19:53:09","guid":{"rendered":"https:\/\/recoveryafterstroke.com\/?p=9421"},"modified":"2022-10-29T06:54:51","modified_gmt":"2022-10-28T19:54:51","slug":"world-stroke-day-2022-dr-j-mocco-md-ms","status":"publish","type":"post","link":"https:\/\/recoveryafterstroke.com\/world-stroke-day-2022-dr-j-mocco-md-ms\/","title":{"rendered":"World Stroke Day 2022 – Dr. J Mocco MD, MS"},"content":{"rendered":"
World Stroke Day 2022. <\/span>A great interview to share with your loved ones so we can help others get ahead of stroke and have better recovery outcomes. <\/span><\/p>\n Get Ahead Of Stroke<\/a> Highlights:<\/span><\/p>\n Transcription:<\/p>\n Dr. J Mocco 0:00 Intro 0:27 Bill Gasiamis 0:39 Bill Gasiamis 0:55 Bill Gasiamis 1:16 Bill Gasiamis 1:53 Bill Gasiamis 2:10 Bill Gasiamis 2:28 Dr. J Mocco 2:45 Bill Gasiamis 2:47 Bill Gasiamis 3:17 Dr. J Mocco 3:39 Dr. J Mocco 3:58 Dr. J Mocco 4:23 Dr. J Mocco 4:49 Dr. J Mocco 5:11 Dr. J Mocco 5:38 Bill Gasiamis 6:08 Bill Gasiamis 6:47 Bill Gasiamis 7:10 Bill Gasiamis 7:38 Dr. J Mocco 8:01 Dr. J Mocco 8:18 Dr. J Mocco 9:00 Dr. J Mocco 9:19 Bill Gasiamis 9:37 Dr. J Mocco 10:05 Bill Gasiamis 10:31 Bill Gasiamis 10:54 Dr. J Mocco 11:23 Bill Gasiamis 12:02 Dr. J Mocco 12:09 Dr. J Mocco 12:33 Bill Gasiamis 13:06 Bill Gasiamis 13:39 Bill Gasiamis 14:09 Bill Gasiamis 14:28 Dr. J Mocco 15:01 Dr. J Mocco 15:37 Dr. J Mocco 15:57 Dr. J Mocco 16:22 Dr. J Mocco 16:41 Bill Gasiamis 17:05 Bill Gasiamis 17:37 Bill Gasiamis 18:01 Bill Gasiamis 18:21 Bill Gasiamis 18:44 Dr. J Mocco 19:27 Dr. J Mocco 19:49 Dr. J Mocco 20:21 Dr. J Mocco 20:45 Dr. J Mocco 21:12 Dr. J Mocco 21:31 Dr. J Mocco 22:13 Bill Gasiamis 22:29 Bill Gasiamis 22:47 Bill Gasiamis 23:02 Bill Gasiamis 23:27 Bill Gasiamis 23:47 Bill Gasiamis 24:08 Dr. J Mocco 24:26 Bill Gasiamis 24:31 Dr. J Mocco 24:35 Bill Gasiamis 24:57 Intro 25:27
\nTwitter<\/a><\/p>\n
\n08:38 Stroke Affects Our Thinking Ability
\n15:02 You Can Keep Getting Better
\n21:49 Seek Out Specialists
\n27:48 Dr. J Mocco’s Challenge
\n35:20 A Numbers Game
\n42:19 B.F.A.S.T
\n46:09 The Get Ahead of Stroke Campaign
\n52:26 Making Lives Better<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
\nAnd, but I want to highlight a positive thing that you just touched on that I think is worth broadcasting, which is people would say that after two years they tied their shoelaces, after three years they walked a few miles. So that’s important. With stroke, one of the amazing things is you can keep getting better, even two years and three years later.<\/p>\n
\nThis is the recovery after stroke podcast, with Bill Gasiamis, helping you navigate recovery after stroke.<\/p>\n
\nHello, and welcome to episode 222 of the recovery after stroke podcast. To learn more about my guests including links to their social media and other pages and to download a full transcript of the entire interview. Please go to recoveryafterstroke.com\/episodes<\/a>.<\/p>\n
\nIf you would like to support this podcast, the best way to do it is to leave the show a five-star review and a few words about what the show means to you on iTunes, and Spotify. And if you’re watching on YouTube, comment below the video, like this episode and to get future notifications of new episodes as they become available, hit the notifications bell.<\/p>\n
\nNow sharing the show with family and friends on social media will make it possible for people who may need this type of content to find it easier. And that may make a difference to somebody that is on the road to recovery after their own experience with stroke.<\/p>\nIntroduction – Dr. J Mocco<\/h3>\n
\nBill Gasiamis 1:30
\nNow as part of World Stroke Day on October 29. My guest today is special guest Dr. J Mocco MD a Cerebro Vascular and Endovascular neurosurgeon with clinical interest in stroke, brain aneurysms, subarachnoid hemorrhage, arteriovenous malformations, cavernous malformations, carotid artery stenosis, intracranial stenosis, and brain tumors.<\/p>\n
\nDr. Mocco has published more than 525 peer-reviewed publications, edited three textbooks on neurosurgical techniques, and runs numerous national and international clinical trials to improve the treatment of patients with cerebral vascular disease.<\/p>\n
\nDr. Mocco’s research interests focus on translational efforts to treat ischemic and hemorrhagic stroke. Now this is the kind of person that I’m eternally grateful for the person who decides that they’re going to do all that study put all that time and effort into helping people with conditions like mine.<\/p>\n
\nWhich ended up in me having three hemorrhages, then brain surgery and all of the recovery that came after that, that’s still going nearly 10 years beyond the first incident. So I hope you enjoy this episode. Now it’s on with the show. Dr. J Mocco, welcome to the podcast.<\/p>\n
\nThank you very much, very glad to be here.<\/p>\n
\nI hope you like people saying fantastic things about you. Because from what I’ve read in your bio, you’re the kind of person who I get really excited to meet, and I’m really thankful that you guys exist, you’re gonna have to tell me a little bit about yourself, because I want to know, how is it possible that somebody wakes up one day and decides they’re going to spend their life they’re going to dedicate their entire life to helping people they haven’t even met yet.<\/p>\n
\nAnd I’m one of those people because somebody did that for me, when I experienced a brain hemorrhage as a result of an AVM when I was only 37. And I didn’t even know that I needed people like you. How did you get to that point where you started down this path and became a neurosurgeon?<\/p>\n
\nIt depends on how many hours we have to discuss. But, I don’t think it’s the kind of thing that happens in one sort of, you know, cataclysmic moment on the road where light shines in front of you, it’s more of life leading you.<\/p>\n
\nI had unfortunate circumstances, experience, you know, some tragedies and some challenges in my early life with family members and that was very inspiring and having to be good at science and math and those sorts of things. And so that sort of made sense. But I’ll tell you, when I went to med school, I didn’t have any idea what I didn’t know the difference between a pediatrician and a psychologist and a surgeon.<\/p>\n
\nBut as you start doing it, you start to realize the kind of life you want the kind of care you want to provide. So even though I didn’t know that I wanted to treat stroke. As I started going through medical school, I knew what I did want to do was to help people that were in distress where if I was good at doing what I could do, and I could commit my time to make a larger difference.<\/p>\n
\nIt would be a life and death event and really make a dramatic impact. And there isn’t a lot of medicine that’s specifically that acute in that way. And so I was drawn to the field, it wasn’t so much that I chose it, but that it fit what I was looking for in terms of making a difference in the world.<\/p>\n
\nAnd I think I think all physicians get into their career to find that way that they feel their best. So I hope all physicians to find a place where their personality and their skill set can make the greatest difference. For me, this just happened to be the place where I could do it. And it happens to be a place where time matters, and were getting people to the right expertise matters.<\/p>\n
\nAnd so you can be focused on becoming a good surgeon, that was a big part of my career. But then the next part is focusing on not just how good are you at doing something? But how do you help the larger community? How do we work on getting patients to the right place every time, as you may know, from your experience, getting in the right hands quickly, can be absolutely crucial.<\/p>\n
\nYeah, that’s definitely the most important thing as far as the layperson is concerned, because we don’t know that we need to know these things until it happens to us. And then we become guided by our instincts, which aren’t sometimes telling us that we need to be taking action, because what we’re doing is, then we’re letting our head getting in the way our thinking get in the way, which says, this can’t be happening to me, or I’m too young, or I don’t need to take any action about this.<\/p>\n
\nAnd I’m one of those people, I ignored the symptoms of a brain hemorrhage for seven days before I did anything about it. And many people told me to go and get help and see somebody. And I ignored it, because I didn’t know any better. And I’m glad that once the wheels were in motion, and I was in the right place, which was a hospital in Melbourne in Australia.<\/p>\n
\nThen from there, there was a lot of people that came around me to make things better for me. And thankfully, they took that decision-making part out of my hands because I was not in any shape. Nor did I have the Gosh, for lack of a better word, the intelligence that I needed to have around physical health.<\/p>\n
\nSo if there’s such a thing as emotional intelligence, and if there’s such a thing as IQ, I didn’t have physical intelligence, I didn’t understand that my body had dramatically given me feedback by going numb on the entire left side, I didn’t understand that it was communicating that you need to go and get some help. So I didn’t go for a long, long time.<\/p>\n
\nWell, it’s really interesting you say that, because maybe I’ll make you feel a little bit better. Because first of all, that’s normal. In general, for human beings, right? It’s fundamental to our nature, that we don’t think about bad things happening to us. Otherwise, you’d be walking around afraid all the time.<\/p>\n
\nSo that that’s a natural human instinct, right? And everyone’s heard about this for heart attacks, right? If you feel chest pain, if you feel pressure, you gotta go in because people will say, oh, I’ll just leave it off, or I’ll ignore it. So we have that problem with stroke and brain hemorrhage as a stroke as well.<\/p>\nStroke Affects Our Thinking Ability – Dr. J Mocco<\/h3>\n
\nDr. J Mocco 8:38
\nWe have that problem with stroke, but then and this might make you feel a little better. But when you have injury to your brain, it specifically affects your ability to really understand what’s going on. I once took care of a stroke doctor, a neurologist who specialized in doing emergency room call and taking care of patients with strokes.<\/p>\n
\nWho was having a stroke, and couldn’t move half his body. But because of the stroke, he was not aware that he couldn’t move his body. So we asked him to lift up his arms, he lift up just one arm, right? That’s one of things we look for his arm weakness. And I’d say you realize that he’s like, no, everything’s fine.<\/p>\n
\nBecause the stroke, your brain is who you are your awareness of the world is all processed in your brain, all of the matrix. And so if there’s something going on in there, it actually limits your ability. So it wasn’t just you being a little stubborn and denying it. Your brain had a little bit to do with that too.<\/p>\n
\nGood. It’s a bit of story to tell people that I was stubborn and denying it. But I do appreciate the fact that I’m having a stroke at the same time and it’s impacting my my thinking. It’s very common because almost everybody I interviewed tells me the same thing. Very few people that I’ve interviewed, about their stroke will say to me, I knew I was having a stroke. I went to the doctors immediately, and I did the best thing, most people don’t get that opportunity.<\/p>\n
\nA reason why I emphasize that is for loved ones and family members, like you said, people took it out of your control, they took it out of your ability to continue to deny. And so I would say that to anyone listening, that’s a loved one. Nobody wants to tell their father or mother or brother or sister. Stop it, you’re going to the hospital right now. But actually, we have to feel empowered to do that, in those sorts of circumstances.<\/p>\n
\nI completely agree with you. Because a little while after that happened to me, a friend of mine had a mini stroke. Again, she was in her late 30s. And her son who was about 16 at the time, of course pays attention to what mum tells him to do or not do so when his mum said, I’m fine, do not do anything, do not call the ambulance, I’m not going to go.<\/p>\n
\nHe paid attention to her, he did what she said his instinct was saying that something was wrong. But of course, he’d listen to his mom, he didn’t know what was exactly happening. And at some point, I think I got involved in the conversation because she was nearby my house, this friend of mine, and I said ignore what she’s telling you just get her the help that she needs. And they ended up taking her to the hospital. And it was a mini-stroke she was also 37 years old. I mean, it’s ridiculous.<\/p>\n
\nYou bring up a really important second point there, which is that’s the other tool of denial is people say, “Well, I’m young” or “I’m healthy”. That doesn’t matter, stroke strikes everybody. I have treated so many 20 and 30 and 40-year-olds, it is not uncommon. Certainly, as we get older, we suffer more healthcare problems. But it’s important for people to realize that just because they’re in their 30s, they still could be having a stroke. And unfortunately, I’ve even had personal friends that have experienced that.<\/p>\n
\nYeah, what did they say it’s one in four people will experience a stroke in their lifetime.<\/p>\n
\nIt’s shockingly common. And I challenge you to talk to any friend or person you know, obviously, for your case, it’s everyone you know, because of yourself, but I tell people talk to your friends, I would be dumbfounded if your life hasn’t been touched by stroke, if you are one of your loved ones, or one of your friends haven’t been significantly affected.<\/p>\n
\nBecause it is ubiquitous it’s extremely common. And on top of it, there’s an additional challenge in that it’s the leading cause of long-term disability. So it’s not only something that can be devastating, but it’s something that can leave people in a very dependent state. When you poll populations about what situation they don’t want to experience where they don’t want to be in the future. Stroke is the most feared because nobody wants to be left dependent.<\/p>\n
\nIt is and it does stay with you for life. It’s something that even though I’ve had brain surgery to remove the faulty blood vessel, and it’s no longer possible for it to bleed, I’m still left with a deficit on my left side, the numbness, the altered sensation, the proprioception issues, the balance issues, all those things that came as a result of the life-saving surgery now are with me forever, and they’re never gonna go away.<\/p>\n
\nAnd that’s the hard part. It’s a hard thing to reconcile, especially for people who end up more physically unable than me, for example, people who end up in a wheelchair, or people who end up with hemiplegia. They can attest to the fact that not only does it change your life instantly, it then changes your identity, and then getting that back is often difficult and a hard road.<\/p>\n
\nAnd I just posted on my Instagram, I just posted a question that my followers asked. And one of the questions that I posted was, what is one of the little wins that people have had recently on their journey to stroke recovery?<\/p>\n
\nAnd some of the simple things that they’ll tell you is that after five years, they were able to tie their shoelaces, or after three years they were able to walk a few miles or some little things that most of us took for granted and thought insignificant at the time, have all of a sudden become really serious and amazing accomplishments for people who have been trying to get back there for months, for years, if not decades.<\/p>\nYou Can Keep Getting Better<\/h3>\n
\nI think that is so true. You know, someone once told me, try to walk around for a day with not being able to use one arm, you don’t realize all that. You think about it for obvious things, but all the little things you do during the day, if you’re limited in that way, but I want to highlight a positive thing that you just touched on, that I think is worth sort of broadcasting, which is, people would say that after two years, they tied their shoelace, right, after three years, they walked a few miles.<\/p>\n
\nSo that’s important. With stroke, one of the amazing things is you can keep getting better, even two years and three years later. And so for any person listening, or anyone who’s been through that the recovery potential exists, and it exists for a long time.<\/p>\n
\nSo obviously, the most important thing is to not have it or to avoid it, or to fix it quickly enough that there’s no injury to the brain. But I always meet with my patients, at three months at six months, mainly want to make sure they’re getting the right therapy and rehab and such, but also to make sure they understand that there’s still lots of potential for recovery, even two years and three years later, to continue to improve.<\/p>\n
\nA lot of times, you know, if you injure some part of your body, after a month or two, it’s still the way it is, that’s just the way it’s going to be, it doesn’t really change dramatically over the delay time period. But your brain has incredible plasticity.<\/p>\n
\nAnd you can still affect improvement over a long period of time. So keeping that positive attitude, and keeping the tenacity of working at it and working to improve it, will allow someone who can’t tie their shoelaces at six months to be able to tie their shoelaces in two years. I hope that brings a positive message to people that they realize potentials there.<\/p>\n
\nI think it does, because some of your colleagues, and I don’t want you to speak on behalf of them or comment on what your colleagues may be doing that’s not right, or that’s a little flawed in their thinking is some of your colleagues will say to people, that person is never going to walk again, I get people on my podcast, who I interviewed who will tell me often that that’s what the doctor said to them when they were in the ward.<\/p>\n
\nAnd it’s crazy that someone would say that to a patient who’s just in the acute phase of stroke. And I feel like the reason is because they miss that opportunity to understand what you understand, because of the additional work that you’ve done to have your master’s in science, which is the research part of the work that you do.<\/p>\n
\nWhereas some other doctors perhaps have gotten to that point where they’re treating people in hospitals, and don’t have that additional skill set of understanding research and data and numbers and then seeing long term impacts of stroke on people after a certain period of time, not just in the acute phase.<\/p>\n
\nSo I think that’s kind of what they’re missing. They’re missing that understanding of the long-term view. And perhaps they didn’t get to see a lot of stroke survivors many years, or the same ones many years after they first came across them. And therefore they don’t get the opportunity to go, wow, that person wasn’t able to do all those things when I first met them, and now they can do all these things.<\/p>\n
\nAnd I think that they also don’t realize that there’s power in their words. And it could be for the case of power for evil rather than good. And I know that’s not their intention, and maybe they’re trying to decrease the expectation. So people don’t get disappointed, but stuff that you know, I hear that most stroke survivors would rather have some kind of hope at the beginning that there’ll be an improvement and then they can work towards getting there rather than having all hope crushed at the beginning.<\/p>\n
\nYeah, that’s a tough one. I do think that there’s a couple things going on there. I think number one, I think it’s really important to realize that there are a lot of doctors out there who are all trying to do their very best. But the reality is also expertise matters.<\/p>\n
\nAnd a lot of times still stroke is cared for because of work force needs and allocation of resources and all the rest. Stroke is carried for by people who are not specialists, or in places where there aren’t specialists. And I do think that causes a real problem, because, as you said, there’s a selection bias. If you’re not a specialist, if you’re not someone who really lives and breathes it every day, and dives into that, it’s hard to know those things.<\/p>\n
\nAnd so frankly, the fault here is with myself and with my colleagues who are specialists to make sure we get the word out there well enough to the broader medical community. Because you are right, unless you see these patients a year and two years and three years later, unless you’re working with them, it is hard to realize, I’ll tell you, one of the things I do is when I see a stroke patient a year later, two years later.<\/p>\n
\nYou know, I’ve had patients where there were people in the healthcare team who felt that patients should not receive for their care. And then two years later, they’re essentially normal. You know, they’ve got things like you said, but no one on the street would know. And, you know, what I do is I always ask those patients, and they’re almost always willing to are able to, I asked him, would you mind coming with me up to the ICU?<\/p>\n
\nWould you mind talking to some of the other ICU doctors and the nurses and letting them see because they don’t remember, because when we see a sick stroke patient with a breathing tube, and all the wires and the connections, it’s hard to see and now this person comes in, and they’re quaffed and they’re dressed normal, and they look great.<\/p>\n
\nAnd they say, oh I’m a Mr. And Mrs. Smith, that was in bed 12 for three months, two years ago, and then the light shine in their eyes, and they realize, so I do believe that the vast majority of physicians are in it to help people and do their very best.<\/p>\nSeek Out Specialists – Dr. J Mocco<\/h3>\n
\nDr. J Mocco 21:49
\nAnd so it’s a call to arms for the physicians that are specialists who have put that extra time and gotten those extra degrees to get the word out to our colleagues, you know, along the crew. But on the flip side, I would encourage any listeners, seek out specialists seek out the people that live and breathe this.<\/p>\n
\nI do think in the end, it matters you know, I used to say you go to a Ford guy to fix your Ford and the Chevy guy to fix your Chevy. You know, don’t go to a generalist go to the people that really know what they’re doing for that part of your body, that brain.<\/p>\n
\nCouldn’t be more important look, I did sack, a few doctors in my time going through the early stages. And that was exactly because of that I just didn’t feel cared for properly. And that wasn’t part of the conversation. And I was the person they were talking about at the end of the bed.<\/p>\n
\nAnd it’s kind of like, I need to be involved guys, you need to let me know what’s going on good, bad or indifferent, I need to know and they weren’t doing that. So I just packed my bags and we left we went elsewhere with a referral etc. we did it properly.<\/p>\n
\nAnd then we sought out exactly the kind of person that I knew was going to talk to me the way that I needed to be spoken to. And, she was amazing, an amazing neurosurgeon, who’s a professor of neurosurgery now at Royal Melbourne Hospital in Melbourne where I’m from Dr. Kate Drummond absolutely amazing lady.<\/p>\n
\nAnd she just told me straight down the line exactly the way that it was and the confidence that she gave me an her ability and her team’s ability to sort out this difficult-to-get-to AVM in the middle of my brain near my cerebellum, and about four centimeters in from the ear.<\/p>\n
\nThere was I felt like handing myself over to her was the smartest and best decision I’ve ever made in my life. And it turned out to be exactly that. So that’s why I’m eternally grateful for people like you because it’s life altering and life changing.<\/p>\n
\nIt’s giving us a second opportunity, it’s important to pump your feathers up a little bit every once in a while, I’ll let you know I’m sure people do. But I think it’s still important to say that. And I’ll tell you why. Because how many years does it take to become a doctor, a medical doctor?<\/p>\n
\nIt depends on the person, here in the United States that process was eight years.<\/p>\n
\nOkay, and then you did your master’s in science. How long did that take?<\/p>\n
\nWell, I did a neuro (inaudible) which was seven years. And during that time, I did a master’s in science. And then I also did a fellowship to be a true specialist in stroke, which was another two years. So when you add that all up, I don’t really want to do the math. It’ll get me depressed, but I wouldn’t trade it for the world. It’s an amazing job.<\/p>\n
\nI get it right so this is the thing people need to appreciate the people on the other side of the screen listening to this or stroke survivors, they do appreciate it. I just don’t think they realize how much and in that time, you’re hard on yourself, because you say, now I’ve got to come up with a time to tell everybody about all the things they should know. And here you are, it looks like you’re in your scrubs. You’re in the room in the hospital, I imagine. And you’ve jumped on Zoom, and we’re going to do this conversation. We’re here, because of world stroke day on the 29th.<\/p>\n
\nIf you’ve had a stroke, and you’re in recovery, you’ll know what a scary and confusing time it can be, you’re likely to have a lot of questions going through your mind. Like, how long will it take to recover? Will I actually recover? What things should I avoid in case I make matters worse?<\/p>\n