Recovery After Stroke

EWOT for Stroke Recovery: The Affordable Alternative to Hyperbaric Oxygen Therapy

Brad Pitzele did not set out to become an oxygen therapy equipment maker. He set out to survive. After years of battling significant health challenges, conventional medicine had given him answers that kept failing him. He tried around 200 treatments. Some helped. Many did not. Then he found EWOT Exercise With Oxygen Therapy, and something finally shifted.

Brad’s journey is not the same as a stroke. But what he discovered about oxygen, inflammation, and cellular energy maps directly onto one of the most stubborn obstacles stroke survivors face: the feeling that the brain has gone offline, that the body is running on empty, and that the path back is either impossibly expensive or simply does not exist.

In Episode 407 of the Recovery After Stroke podcast, Brad shares what EWOT is, why it works, and why he now makes affordable EWOT systems through his company, One Thousand Roads, specifically so survivors do not have to remortgage their homes to access oxygen-driven recovery.

What Is EWOT?

EWOT stands for Exercise With Oxygen Therapy. The concept is straightforward: you breathe high-concentration oxygen through a mask while exercising even lightly, and that combination pushes oxygen into parts of the body that normal breathing cannot reliably reach.

Most people assume oxygen therapy means a hyperbaric chamber: a pressurized tube, a clinic, a course of treatments costing tens of thousands of dollars. Hyperbaric oxygen therapy (HBOT) is effective. Brad describes it as “a heroic treatment.” But it is also inaccessible for most survivors, financially and logistically.

EWOT operates on a related principle without the chamber. The key mechanism is not about oxygenating red blood cells; they are already carrying close to their maximum load under normal breathing. The target is the blood plasma. Plasma does not carry oxygen efficiently under resting conditions, but during exercise, even light exercise, blood pressure and circulation increase enough to force dissolved oxygen into the plasma. That plasma can then reach the micro-capillaries, the tiny vessels that feed tissues deep in the body, including areas of the brain that become inflamed and oxygen-starved after a stroke.

The Post-Stroke Energy Problem

One of the most commonly reported and least-explained symptoms after stroke is fatigue that does not go away, no matter how much a survivor rests. Most survivors are told that is just part of it. Brad’s framework centres on mitochondrial dysfunction.

Mitochondria are the energy-producing structures inside cells. After stroke, the cells in and around the affected area are often not dead; they are in a kind of low-power state. Brad describes it as a “brownout”: the lights are on, but dimly. The mitochondria are not producing energy at full capacity, and one significant reason for that is insufficient oxygen supply to the tissue.

“The cells that are offline after a stroke are not all dead. Some of them are just starving. Oxygen is part of what feeds them back.” — Brad Pitzele, Episode 407

When EWOT increases plasma oxygen during exercise, it can reach those inflamed, under-oxygenated micro-capillaries that larger vessels cannot access. The result, for some survivors, is a gradual improvement in energy, cognition, and physical capacity, not because the therapy is miraculous, but because it addresses a specific physiological deficit that conventional post-stroke care often does not target.

EWOT vs. Hyperbaric: What’s the Real Difference?

The honest answer is that EWOT and hyperbaric oxygen therapy are not equivalent. HBOT delivers oxygen under pressure, which drives it into tissue more forcefully. For certain conditions, particularly in acute or severe cases, hyperbaric oxygen has a stronger evidence base. 

But for many stroke survivors in the subacute or chronic phase of recovery, access is the defining variable, not theoretical ceiling. A home-based hyperbaric unit costs $50,000 to $75,000. A clinical course can run to $60,000 or more. EWOT systems are available for under $2,000. 

The question Brad puts to survivors is not “which is better in a lab?” It is: “Which one can you actually do, consistently, at home, over the months and years that brain recovery requires?” Consistency matters more than peak intensity in long-term neurological recovery. 

Starting EWOT With Deficits

EWOT does not require running on a treadmill. The exercise component can be a stationary bike, a recumbent bike, or simple seated leg movements with one limb strapped in. The goal is to raise circulation enough to push oxygen into the plasma, not to hit a cardiovascular fitness target.

For survivors exploring this option, Brad’s team has built a specific resource at onethousandroads.com/stroke-recovery with a listener discount of $100 to $500, depending on the package. There is also a broader introduction to EWOT at onethousandroads.com/pages/exercise-with-oxygen-therapy.

Recovery Is Possible — And It Does Not Have to Be Expensive

If this episode resonated with you or if you want to explore more conversations about recovery options that do not require a second mortgage, Bill’s book, The Unexpected Way That A Stroke Became The Best Thing That Happened, is available at recoveryafterstroke.com/book.

And if the Recovery After Stroke podcast has been useful to you, you can support it financially at patreon.com/recoveryafterstroke. Every contribution helps keep the show going and these conversations accessible to survivors around the world.

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.

EWOT for Stroke Recovery: The Affordable Alternative to Hyperbaric Oxygen Therapy

Why pay $60,000 for hyperbaric oxygen? EWOT brings oxygen therapy into your living room — and could help the brain cells that are only offline.

One Thousands Roads

Exercise With Oxygen Therapy (EWOT)

YouTube Channel

Highlights:

00:00 Introduction and Background

05:37 Challenges in Stroke Recovery and Treatment Options

13:45 Understanding Oxygen Therapy and Its Mechanism

15:51 Oxygen Toxicity Explained

19:24 The Importance of Oxygenating Blood Plasma

24:53 Oxygen and Mitochondrial Function

31:16 Adapting Exercise for Stroke Survivors

38:27 Cost and Accessibility of Oxygen Therapy Devices

Transcript:

Introduction – EWOT for Stroke Recovery

Brad Pitzele (00:00)

like many of your listeners, when you have a medical issue that isn’t treated by traditional medicine and you’re desperate to get your life back, you’ll try just about anything. You, the lens it goes through is like, Well, how bad can this hurt me?

BIll Gasiamis (00:15)

Welcome back to Recovery After Stroke. I’m your host, Bill Gassiamas. Today’s guest is Brad Pitzele, founder of 1000 Roads, who overcame significant health challenges of his own and along the way discovered the science behind exercise with oxygen therapy. In this conversation, we get into how increasing oxygen saturation in the blood, specifically in the blood plasma, can help reach the inflamed microcapillaries.

That are blocking oxygen delivery to cells in the recovering brain. We talk about mitochondrial dysfunction, post-stroke fatigue, and why Ewatt is worth understanding as an accessible alternative to hyperbaric oxygen therapy. Before we get into it, if you’ve found value in this podcast and want to support it financially, you can do that at patreon.com/slash recovery after stroke.

And if you haven’t yet read my book, The Unexpected Way That a Stroke Became the Best Thing That Happened, it is available at recovery after stroke dot com slash book. Here’s my conversation with Brad.

BIll Gasiamis (01:19)

Brad Pitsley, welcome to the podcast.

Brad Pitzele (01:22)

Thank you so much.

BIll Gasiamis (01:24)

Thanks for reaching

out and ⁓ connecting with me to educate me on another thing that I can bring to stroke survivors that could potentially help them in the rehabilitation side of their brain. The the thumbnail that people found on YouTube is probably gonna have E W O T on it somewhere. E what. And it sounds something like something out of that ⁓ space war out of out of what is it?

Brad Pitzele (01:53)

Star

Wars. Star Wars.

BIll Gasiamis (01:54)

Star Wars.

Like the Ewok, right? And it doesn’t really mean anything to me. But before we descri tell people what Ewok is, ⁓ tell me a little bit about your background, the work that you do and how it is you came to be on the podcast today is for s for for the specific discussion that we’re gonna have.

Brad Pitzele (01:58)

Yep.

Sure. ⁓ yeah, so I ⁓ I I’m an e recovering engineer. I like to joke. I spent my first decade of my life engineering. later on in life, I left engineering and went into different pursuits and I became chronically ill, had a variety of medical issues, ⁓ cancer, autoimmunity, and eventually Lyme disease.

And I was in really bad shape. And a doctor recommended I look into either hyperbaric oxygen or this exercise with oxygen therapy, EWAT, that almost no one had heard of, and I’d never heard of it. ⁓ I I I had tried like everything to get better at this point. I was many years in special diets, ⁓ all sorts of supplements and ⁓ all sorts of modalities and things. And

nothing really worked. There was nothing in a matter of fact, some of the medications I took actually gave me cancer. So it kind of forced me on this road to try something different. ⁓ and eventually I found my way back to health through exercise with oxygen when so many things weren’t working. ⁓ and actually later paired that with ⁓ red light therapy. ⁓ and along the way I started because I’m an engineer and I’m inquisitive, I like

It was Lyme disease is kind of a do-it-yourself disease. ⁓ so I started digging in and pouring into research, not just on Lyme disease, but autoimmunity, ⁓ chronic illness, ⁓ trying to figure out what the heck was going on with me. And so ⁓ what I found about exercise oxygen therapy along the way was really fascinating to me. and about a year into using it, I went back to that same doctor and he was kind of shocked.

At my turnaround, and he was like, What did you use? Did you do oxygen? And I said, I did. And he was like, Who’d you buy it from? I want to tell my patients about it. And I said, I didn’t buy it, Doc. I actually ended up making my own. And he was kind of surprised by that for obvious reasons. And then he said, Well, gosh, would you consider making it for my patient? And so, my patients, and so

that’s how we got into this business back in two thousand eighteen. We launched one thousand roads to kinda make exercise with oxygen therapy accessible to people who are dealing with chronic health conditions.

BIll Gasiamis (04:39)

Okay. And it stems from science, right? There’s scientific data that backs up this exercise with oxygen therapy. Before you go into that a little bit, we don’t have to go deep into it, but we can just ⁓ chat about it. ⁓ when I talk to stroke survivors, they get stuck always with what should I do? What should I do? What should I do? They want the

The blue pill, take that one, everything gets fixed. I mean, stroke is not like that, right? And it’s and it’s stroke is also a you’re on your own kind of thing. Because once you get out of the acute phase, once you get sent home, the ⁓ follow up and the medical fraternity doesn’t have a system to kind of say to you, we can’t help you. Speak to that guy. ⁓ that guy might not be able to help you, but but there’s a guy over there.

Brad Pitzele (05:09)

Yeah.

Challenges in Stroke Recovery and Treatment Options

BIll Gasiamis (05:33)

Like there’s none of that. And stroke survivors need podcasts. They need ⁓ people selling all sorts of crazy stuff that they will almost try almost all the time. They’ll try everything. And then they’ll pick and finally stumble into one that helps and gets them a result. But before we talk about all of that, what I want to do is also go back to what you said about ⁓ a year later, you went to your doctor, he was stunned at the result.

We can’t put that down just to eat what? We can’t put that down just to exercise with oxygen therapy. Give me the brief steps on the other things that you also attended to because people miss that.

Brad Pitzele (06:15)

Yes.

Yeah.

I well, here’s what I’ll tell you. I started I started to get arthritis in my hands in like 2010 or eleven. and then I started taking traditional drugs for it. And one of the side effects of the drugs is higher risk of cancer and specifically melanoma, which I developed in two thousand thirteen, I wanna say, maybe two thousand fourteen.

And that kicked me off the traditional medical path. ⁓ to your point, you don’t you don’t in the stroke recovery, there’s not a traditional path. There it was a traditional path, but it was clear that it was a you know it was a choice between cancer and autoimmunity, and neither one seemed great to me. ⁓ from there I tried so many things, Bill. I did s I actually made a list recently and looked at it because I had it like just off the top of my head, I came up with 200 different things I did try. We’re talking special diets.

Eating all sorts of weird, strange things, all sorts of supplements, antibiotics, because it’s Lyme disease, herbal protocols, ⁓ ozone treatments, sa various different types of saunas, ozone sauna, infrared sauna, ⁓ heat steam saunas, ⁓ colonics, coffee enemas, ⁓ weird stuff, you know, you’d never think you’d do. I mean

BIll Gasiamis (07:39)

You are committed

Brad Pitzele (07:42)

‘Cause

like many of your listeners, when you have a medical issue that isn’t treated by traditional medicine and you’re desperate to get your life back, you will you’ll try just about anything. You the the lens it goes through is like, Well, how bad can this hurt me?

Like like ’cause I know where I’m going right now. For me at least it was a I was just like this gradual step down.

It was like I knew like I I couldn’t do this. I had a young family. so, you know, that doctor, I remember him saying, like, look, Brad, we’re trying all these things, we’re gonna get you on thyroid medications and get that right, and we’re gonna do this. ⁓ there on that list of 200, there were about eight things that gave me any kind of benefit that I could identify. ⁓

But I remember he’s like, Brad, we’re gonna take out the big dog. We’re gonna do this ozone treatment. And it’s a special kind where we remove the blood from your body, we inject ozone, put it through UV light, and put it back into your blood. And this helps everyone. Like if nothing else works, this helps, but it’s really expensive. So we’re saving it, kind of. So he he did it. He’s like, do a course of three of them. And he’s like, You might feel bad after it the next day because it kills a bunch of stuff and might you might feel toxic. Or you might feel better. We’re not sure.

And give it a few days. And like I did all three of them, I never noticed a difference. And it was ⁓ the most depressing, scary part was like going through that. So when he said go do oxygen, I was like, Okay, like I’ve done everything else. I’m just gonna check the box so the doctor knows that’s not gonna work, so we can go try to find something else. ⁓

And I didn’t believe it was gonna work. I I you know, I didn’t jump on the the bandwagon gung-ho. I was, you know, kind of kicking and screaming. And that was part of the reason I built my own, is because at the time they were so expensive and the they were five to twenty-five thousand dollars. And I was like, I just can’t spend, you know, ten thousand dollars on an experiment. I just can’t do that. ⁓

And he also suggested maybe hyperbaric and that was like fifty or seventy-five thousand dollars. And I was like, geez, if I knew this was the the blue pill, as you said it, if I knew this was the blue pill, I’d go mortgage the house and I’d go do it because like then I could work full and I could do all the things, I could be present for the family, but ⁓ I couldn’t.

BIll Gasiamis (10:05)

And and and

you know what? And it’s not, and and the reason it’s not for a lot of people is because you need to have penumbras the brain from a stroke survivor perspective that are recoverable and that you can bring back to life that are offline, not dead by ⁓ cell death because of the stroke. And there’s no diagnostic process in the majority of the people I’ve spoken to, you can’t diagnose somebody and then work out whether they’re a candidate, and that really

Brad Pitzele (10:20)

Yeah. Right.

BIll Gasiamis (10:33)

Pisses me off to somebody gonna have to spend 50 grand to find out if they’re gonna get a result, right? The s the guys that who I’ve interviewed about hyperbaric oxygen therapy, ⁓ Viv clinics, ⁓ those guys will do a thorough diagnostic beforehand to determine whether somebody is a candidate. And whatever that costs, even if it’s five grand, I don’t know what it does cost, but even if it’s five grand, at least you can go, you’re not a candidate, don’t spend any more money.

Brad Pitzele (10:38)

Yeah.

Right.

higher yes, you have a higher level of certainty

before you spend the money.

BIll Gasiamis (11:04)

Yeah. And if you do do it, you’re doing it for the other ⁓ non-brain related benefits that you’re gonna get from hyperbaric oxygen therapy. And that’s totally up to you. But it’s not the thing to supposedly fix the arm or the leg that doesn’t work, or to ⁓ repair the damaged cells in your brain. So that part really frustrates me. And if I’m gonna spend that much money, then there’s the opportunity cost as well. It’s like

Brad Pitzele (11:33)

Yes.

BIll Gasiamis (11:34)

Now I

can’t spend that somewhere else.

Brad Pitzele (11:36)

Exactly. That was me too. It was like you you knew you had and I was like, man, if I spend this kind of money on it and it doesn’t work, like nothing’s worked for the last, I don’t know, almost ten years at this point. Like how many of these shots do I have in the cannon, right? Like you you know, now I’m I’m depleted and I’m still sick. And that’s even i and you know this, when you’ve got a chronic health condition, sometimes the psych psychology of it all is just as hard as the condition. And

If you’re like, wow, now I don’t have money. I feel trapped. There’s nothing I can try. Then hope starts to dwindle. And I

say like hope is is like the most potent weapon in recovering from a chronic health condition. It’s a double-edged sword because like you’re s afraid to get hope up because you’ve been let down. But it’s also the thing you need. You ha like when when you start losing hope, and I and I’ve been at that point, it just gets incredibly dark.

⁓ and incredibly scary.

so I I think that was part of it. I just wouldn’t allow it. It was the financial part. I you’re right. You only have so many shots out of the bow. But it was also like if it doesn’t work and I am depleted financially you know, I don’t like that that brings me to a a level of hopelessness I I’m not sure I can confront.

BIll Gasiamis (12:53)

Yeah. And then in order to get back up, you’re getting back up, you’re financially depleted, you’re energetically depleted, your health is depleted. And it’s like, my God, that is a that is like the lowest place that you can find yourself and to get back up is a lot harder. And yet people have still done that, but I know the task is harder. I’ve been in a similar sort of situation.

Brad Pitzele (13:12)

Yeah.

We all love

we all love reading that inspirational story. No one wants to live it if they can avoid it, I’ll tell you.

Understanding Oxygen Therapy and Its Mechanism

BIll Gasiamis (13:23)

Avoid it. Yeah, a

hundred percent. ⁓ so so you’ve tried all this stuff, you’re unwell, and then somebody says to you, try oxygen. Now, what I imagine when I hear oxygen is get a can from the local gas supplier, ⁓ pop pot in a tube, put it on the back of your chair, wheelchair. You know, I’ve seen a lot of older guys who have got it, and then they’ve got oxygen attached to their face and they’re breathing in oxygen. What specifically did

your doctor tell you to get and if you didn’t get what he suggested, like w what did it look like for you?

Brad Pitzele (14:00)

Yeah, so the challenge with bottled oxygen is number one, it’s almost impossible to get. number two is when you exercise, you can take in a massive amount of oxygen, and that’s part of what makes the the therapy really cool. So y you and I sitting here, maybe we’re taking in three liters of oxygen a minute, okay? ⁓ three liters of air a minute, maybe something like that. ⁓

When you’re exercising, you can easily take in 50 or 60 liters. So it’s a massive multiplier. So you need something that’s going to give you a large amount of oxygen. Now, there’s two ways you can get oxygen in your home. One is that bottle you mentioned, and then you’re always refilling it, and you can imagine lugging one of those things around. ⁓ the other way is there’s a device called an oxygen concentrator, and all you do is you plug it into the wall.

And it turns the it purifies the oxygen in the room. So, you know, at sea level, the oxygen in the room has 21% oxygen and it can purify it to 93%.

Now, the challenge with these devices is they put out either five or ten liters of oxygen in a minute. So not enough to exercise with. If you were to try to exercise with it, you would also be sucking in this air at 21% and diluting it. ⁓ and so what you do is you take this device and you fill a large reservoir, it’s about a thousand liters, ⁓ and you fill it up.

using this device and then you hook up a hose with a mask on it and then you breathe through the mask while you do a fifteen minute exercise session.

BIll Gasiamis (15:41)

Okay. A reservoir, ⁓ water tank.

Oxygen Toxicity Explained

Brad Pitzele (15:45)

It well it it’s like it looks like a big pillow. So it’s like six you know, two meters by two meters, sort of ⁓ big pillow, six feet by six feet for us still on Imperial. And you fill it up so a thousand liters and it’s you know it’s it’s thin film and so it’s not a a rigid body of something, and then yeah, it’s a bag.

BIll Gasiamis (16:06)

It’s a bag. Like

a bagpipe, a massive bagpipe.

Brad Pitzele (16:10)

There you go.

BIll Gasiamis (16:12)

Okay. Okay. W I’m sure there’s an image of that, right? We’ll put it on the screen. People can see it while we’re talking about it, trying to work out what it is. Okay. So this thing is something that you accessed and you used specifically for yourself, how many years ago?

Brad Pitzele (16:16)

Yeah. Yeah.

I’ve s I’ve been using it for a decade straight now.

BIll Gasiamis (16:33)

Okay. This stuff’s been around for about a decade. This

Brad Pitzele (16:37)

It’s well, the the research on it goes back to the nineteen sixties and seventies. This it’s really fascinating. actually some of the early research goes back to the turn of the ⁓ twentieth century, the nineteen hundreds. So in the early nineteen hundreds, a gentleman named Otto Warburg won a Nobel Prize for proving that he could turn any cancer or any regular cell into a cancerous cell by depriving it of oxygen.

⁓ and so there’s this really well-established linkage between oxygen and cancer. Even today, a ton of research on that. So in the 1960s and 70s, there was a a German physicist and prolific inventor named Manfred von Arden. Now, and he started to want to do research on Otto’s work, and he he actually started doing research on exercising with oxygen as an anti-cancer protocol.

And some of the research he found was really fascinating. what without getting overly technical, basically it our circulatory system, obviously, this is really relevant to stroke, ⁓ people deal in strokes, is as you get down into the the end runs of your circulatory system, there’s capillaries and they’re like thinner than a human hair. And this is where your nutrients and your oxygen are actually exchanged with the cell.

And what he found is as we age naturally this inflammation builds up on the lining of our capillaries. And it actually causes the capillaries to swell shut so that now none of your red blood cells can get by. Now, I mean, this is how exquisite our body is designed. ⁓ our capillaries are actually thinner than a red blood cell. So under the most healthy of conditions.

A red blood cell actually needs to fold up like a taco to get into our capillaries and deliver that oxygen in the last mile of our circulatory system. So any

swelling in that capillary can cause a blockage. And now all the cells downstream are not getting oxygen and in a sufficient quantity. And so they kind of go into what they what he kind of referred to as like a brownout, right? Like it’s a low energy state. They’re doing anaerobic respiration to get some energy. Maybe some of the smaller red blood cells might squeak by here and there and give a little bit, but they’re not getting the full oxygen they need. And what he found is by doing this procedure,

just a few times he had very elderly people with very inflamed ⁓ capillaries. He was able to re-establish normal blood flow. And the reason is is oxygen is incredibly anti-inflammatory. ⁓ and a lot of research on that we can go into a little bit later.

The Importance of Oxygenating Blood Plasma

So, number one, it causes this anti-inflammatory reaction inside these inflamed capillaries to reopen them. But it also does something really amazing that he discovered is when you’re doing this procedure, ⁓ it causes the oxygen to not just attach to our red blood cells like it always does, but it also saturates our blood plasma, which is this clearish liquid that our red blood cells ride on. And

Our blood plasma is a thousand times thinner than a red blood cell. So if you imagine these blockages, red blood cells are not getting through, but obviously the blood plasma can get through as long as it’s like as thin as water. So as long as there’s any opening there, and it can immediately deliver oxygen downstream, both to cause an anti-inflammatory impact in the capillaries, but also to all those cells that are starving. And so you can obviously, as we’re talking through this, you can kind of

see how this fits folks who are dealing with various different strokes ⁓ and how that can help them as well.

BIll Gasiamis (20:32)

Yeah. Okay. I d before we spoke I did a little bit of research and found ⁓ as well that there’s some there’s a lot of relevant data with regards to oxygen and ⁓ increasing the oxygenation in the blood. you so tell me a little bit about oxygen. I I don’t understand exactly what that is. I’ve heard of people becoming ill.

Because of too much oxygen, ⁓ ill because of not enough oxygen. So what is what what is becoming ill of too much oxygen and why is ninety nine percent saturation not that?

Brad Pitzele (21:18)

Yeah, yeah. ⁓ good question. So oxygen toxicity can occur if you get too much oxygen under certain circumstances. So if you’re in a hyperbaric chamber too long, it can cause oxygen toxicity. And basically that’s when oxygen gets trapped in your bloodstream and it can’t get out. and

You can actually get it without hyperbaric. So hyperbaric is oxygen under pressure. You can get it at normal barracks. So if you were just sitting on the couch breathing oxygen, you could eventually get oxygen toxicity. Now, it would take over twenty-four hours. So if you were breathing just pure oxygen, no exercise, sitting on your couch for 24 plus hours, it starts to get into the risky zone.

When you’re doing exercise with oxygen, that’s actually one of the cool things about it that because of the synergies of exercise and oxygen, it’s impossible to get oxygen toxicity for two reasons. one is that reservoir is only a thousand liters. it’s not a high enough dose that you could get a oxygen toxicity. It is a massive dose, it’s about the same amount of oxygen you take in in a day, and you can take it in in 15 minutes, but it’s not more than.

And the second reason, even if we could make our reservoir 10x, 100x, and you could exercise nonstop, you still couldn’t get oxygen toxicity because when you’re exercising, your body produces a massive amount of carbon dioxide gas.

And that goes into our bloodstream and it increases pressure in our circulatory system. And that actually forces the oxygen out of the circulatory system and into the cells. So it works as a protectant as well from oxygen toxicity. So that’s oxygen toxicity. It’s a real risk. ⁓

Most of the time it’s a very controllable risk. You know, if you’re doing hyperbaric, they’re gonna keep you in there for so long so that you’re not gonna be at risk generally. ⁓ if you’re assigned to do oxygen while you’re stationary at home, they have protocols to make sure you’re not doing it, you know, twenty-eight hours nonstop sort of thing. ⁓ or they have you wear a cannula where where you’re also taking in air and it’s diluting it.

⁓ and in exercised oxygen therapy, it’s not really possible because of the massive amount of carbon dioxide. ⁓ now, not enough oxygen. So if you if you want to measure your oxygen in your blood, the way they normally do it is a device called the pulse oximeter. You can get one for 20 bucks off Amazon. What it does is it looks at how much how many of your red blood cells are saturated with oxygen. And what you’re gonna find in most folks.

Is it’s close to a hundred percent. It’s ninety-eight percent, it’s ninety-six percent, ninety-seven percent. ⁓ there’s not a lot of room in our blood for more oxygen. So that’s why it’s important that ewak can actually oxygenate our blood plasma. The same with hyperbaric does the exact same thing, it oxygenates our blood plasma. So

BIll Gasiamis (24:26)

Okay. I think before you go on,

that’s the key ingredient. It’s oxygenating the plasma as well. Where where previously you’ve got let’s say ninety seven, ninety eight percent saturation of your red blood cells. What we’re doing is adding that little bit of extra oxygen into the space where the plasma is. That’s kind of the key difference.

Brad Pitzele (24:36)

Yes.

And there’s two reasons why it’s important. so normally, just for comparison, you and I sitting here, maybe 2% of all the oxygen in our blood is in our plasma, so it’s not very much. ⁓ but under these conditions of IWAT and hyperbaric, we can saturate that blood plasma. And it’s important for two reasons. One, obviously, it increases the oxygen carrying capacity of the blood, but that’s the more minor one. The more major one is that the blood plasma can get into

let’s just say the nooks and crannies, smaller spaces in our body where inflammation is blocking off access of red blood cells to downstream cells. And so it can deliver a dose of oxygen where it normally is not able to get.

BIll Gasiamis (25:40)

You you’ve spent a lot of time on this topic by the sound of things. ⁓ and that’s really awesome. So before we talk about how to actually use a device, how to get a device, how to how to behave while you’re using a device, I wanna understand like how

Oxygen and Mitochondrial Function

Brad Pitzele (25:52)

Yeah.

BIll Gasiamis (26:02)

How you notice the difference in yourself? Because a lot of people ask me what I did in my own stroke recovery. And Brad’s experience is going to be different from the stroke survivor’s experience. My experience was ⁓ I’ve got nothing from the doctors other than let’s monitor your bleed, let’s give you brain surgery. I mean, that’s not nothing. That’s amazing. Like I’m very

Brad Pitzele (26:05)

Yeah.

Yes.

BIll Gasiamis (26:31)

Grateful for all of that. That removed the the blood vessel that was leaking that was going to potentially kill me. ⁓ so the immediate risk was gone. And then what what I mean I I got nothing is the specialists did their specialty and then I got nothing because they don’t do nutrition, they don’t do exercise, they don’t do meditation, they do brain surgery. And it’s really important for stroke survivors to understand that when you go to a doctor, a neurologist, whoever.

Brad Pitzele (26:55)

Yeah.

BIll Gasiamis (27:00)

They do a specific thing, and once they’ve done it, they can’t do anything else. And you need to get over the fact that you ⁓ might feel disappointment at the at that I don’t know where to go next, and they don’t know where to send you. Okay, they’re not trained and they cannot legally send you elsewhere. That’s why you’re kind of on your own. So I did meditation, I did nutrition, I did all this kind of stuff and

Brad Pitzele (27:16)

Yeah.

BIll Gasiamis (27:27)

Somebody who’s interviewed you is Dave Asprey. I would I’ve been following Dave Asprey and a whole bunch of other guys ⁓ probably since around 2012, 2013. And what I learned was how do I reduce the inflammation in my brain? And I had that one area of inquiry, the one area of inquiry that I could personally impact positively by taking out inflammatory foods from my diet.

And before that it was, you know, ⁓ processed white bread, it was alcohol, it was cigarettes, ⁓ it was all the stuff that you get in a packet that doesn’t really help to nourish the body, right? So I went back to basics. We’ll call it just for the simplicity of the explanation, we’ll call it protein, ⁓ vegetables and basic carbohydrates like rice or potato.

And then what I found was that inflammation decreased, and that was a game changer in how I experienced my brain. And it was a game changer in how quickly I improved neurologically. But just so that people know, it wasn’t the be all end all, it didn’t remove the damaged cells that still are in my head that mean I experienced my the left side of my body in a completely different way than my right side.

I’ve got numbness, proprioception issues. I’ve got ⁓ tingling, I’ve got burning, I’ve got ⁓ spasticity, you know, the muscles are tight. So all that stuff is still there. But I have a better experience of the rest of my body and brain because of the things that I took out. But what I didn’t have was the link between exercise, which I do, light exercise, because I’m a stroke survivor. I can’t.

use the left side of my body like I used to. so I would do exercise ⁓ like riding an electric bike because it’s easier to pedal, like walking and like doing very light weights at the gym. ⁓ but I didn’t have that oxygen part of the the therapy. And that’s kind of why I interviewed the guys about hyperbaric to understand how oxygen supports how

mimicking i a hypoxic brain in the chamber supports ⁓ so how how does like what’s the next part like how does that support the brain to heal let’s give stroke survivors an understanding so that they can kind of grasp that I know we spoke about how oxygen gets into the ⁓ into the red blood cell we spoke about how it gets into the plasma but like

Brad Pitzele (30:15)

Yeah.

BIll Gasiamis (30:20)

Why is that the next step?

Brad Pitzele (30:21)

What’s it too?

Yeah. It’s a good question. I think you’re right. I you know, we don’t I will say we don’t try to go out and pitch like exercise with oxygen therapy is a panacea or it’s everything for everyone. Even the name of our company, ⁓ one thousand roads, is about paying homage to everyone’s own healing journey and recognizing everyone’s unique journey.

So I’ll say that, but

So I’ll say that, but what I found about oxygen was in IWA in particular. What was fascinating to me was for me when I was dealing with Lyme disease, which similar to folks who are dealing with the stroke, there’s a variety of different symptoms and s from different causes. And I was trying to treat all these things with different protocols, different supplements that and I found that when I started digging into oxygen, I was shocked at how many of them came back to it. So when you have

A stroke, often there’s a lot of ⁓ emerging research about mitochondrial dysfunction. And this is interestingly, mitochondrial dysfunction. Now ten years ago when I was researching it, no one heard of it or cared about it. And it’s really burst onto the scene because you’re gonna find it

⁓ At the heart of so many chronic health conditions, right? ⁓ you’re gonna it’s actually they’re looking at it in cancers, ⁓ chronic illnesses of all sorts, Alzheimer’s, all sorts of cognitive and ⁓ autoimmune conditions, etc., etc. So ⁓ you have this disrupted mitochondria, right? So there was a period of time when your cells were not getting enough energy, whether it was a hemorrhagic stroke and

Blood wasn’t being delivered to those cells, so no nutrients, no oxygen, or an ischemic stroke where they were just cut off ⁓ because of a clot or whatnot. And so they were not getting nutrients. In each of these cases, what happens immediately when the cell runs out of oxygen, like I was talking about that brownout, it goes from aerobic respiration to anaerobic respiration. And anaerobic respiration, ⁓ it’s

It only can produce 5% of the energy as aerobic. So the cell is in a low energy state, which is the first problem, which means it doesn’t have energy to repair, it doesn’t have energy to take out the trash, detoxify. so it’s kind of stuck. But also ⁓ it creates a lot of metabolic waste. So it creates lactic acid, it creates free radicals, all these things produce more inflammation, like you were talking about. So

Now we’ve got these mitochondria, which are dysfunctional. They don’t have the energy to repair. They don’t have the energy to take out all these dead cells or ⁓ you know, all these other byproducts of the immune system and the natural kind of response to this damage, which then leaves more of it hanging around to produce more damage, and they’re producing more damage themselves. So it’s kind of like this swirl, and it’s ⁓ you know, it’s a downward swirl, if you will. ⁓ so

When you can re-oxygenate the mitochondria, the first thing you’re doing is you’re giving them the energy to do whatever it is they need to do. ⁓ and that can be the immediate like feeling sharper, like, ⁓ I feel like I can get my thoughts together quicker. ⁓ it can be, ⁓ I feel like I’m more in control of my emotions. And I I don’t feel like sometimes I have a disproportionate emotional response to something. It can be I I don’t have that brain fog.

⁓ you know, that sort of thing. Or I literally have energy. So our brain actually consumes like 20% of all the oxygen in our body. And it’s only like two percent of the mass. So it’s like punching 10x its weight, right? So when your body starts running low on oxygen, it starts conserving. And the one of the things it tells you to do is like cool it, like stop using your muscles. You’re tired. You need to just sit there and veg out.

BIll Gasiamis (34:06)

Mm-hmm.

Brad Pitzele (34:27)

while our mitochondria try to catch up. And so that’s often that chronic fatigue that folks with a variety of health conditions, including stroke, feel, which is their bodies like, stop using energy, we don’t have enough. We need to redeploy it for something else more pressing. And so

When you can reestablish normal oxygenation, it improves energy. ⁓ it improves sleep, it improves memory. and the the cells have energy to start repairing and detoxifying. ⁓ and then obviously I always think it’s cool because we’re pairing it with oc with exercise. And there’s so much research on the benefits of exercise. You mentioned it was so important, Bill, in in your healing journey.

And you know, we know how important exercise is for a stroke survivor.

Well, now we’re pairing it with oxygen and we’re using that exercise to catapult more of that oxygen around the body through the circulatory system while your blood vessels are dilated and opening up. So if you’re still dealing with blockages in your microcirculation, which most stroke survivors are.

You’re opening them as wide as they they naturally can at that moment, and that’s when we’re feeding more oxygen to them. So it works it kind of hand in hand in that respect.

BIll Gasiamis (35:48)

All right. Now one glitch. Stroke survivors often are struggling to get into the physical recovery, right? Because the body goes offline, one of the legs doesn’t work, one of the arms doesn’t work. It’s a real challenge, right? So how how can we benefit from that even though we are at just after the acute phase where there is not a lot of capability for

Brad Pitzele (36:00)

Yes.

It’s perfect.

Yeah.

BIll Gasiamis (36:17)

physicality and I I say that so that the stroke survivors listening know that what I’m leading to is that early on it’s probably harder to do ⁓ physical therapy, exercise, et cetera. But again, with time and hope, all of those things can improve. Right. So I I wanna put that out there for stroke survivors, but also like it’s a can it’s a it’s a constraint.

Brad Pitzele (36:48)

Yeah. And you know, because a lot of our customers are dealing with chronic illness, this is a question that’s not uncommon is like, yeah, but I can’t I’m not out here to run a mile, Brad. I’m like eighty years old and I’m sick or whatever it is. The really ⁓ the really cool thing about ⁓ Ewatt is that it will meet you where you are at. So there is something all of us can do. The goal is to increase your heart rate and your circulation.

Cost and Accessibility of Oxygen Therapy Devices

and breathe the oxygen. So there’s a few ways you can do it. you know, it doesn’t have to be banging it out on a treadmill trying to get your seven minute mile. ⁓ you don’t need to do that. We have folks, you know, depending on where they are, you can start with slow walking on a treadmill. You can start with calisthenics. You can start with stretching.

⁓ gentle aerobics in your living room. You can start by, you know, lifting weights. You could be sitting and lifting weights with the the hand that’s not. We have folks, and this is probably not so much for ⁓ stroke survivors, but maybe jumping on a ⁓ a rebounder, like a little trampoline if you’ve got the balance one with the handle. ⁓ we have people using under-the-desk pedal bikes, the ones you can get for $49 on Amazon while you’re sitting.

BIll Gasiamis (38:03)

Beautiful.

Brad Pitzele (38:04)

while you’re sitting in a chair. And then for the folks who can’t do any of that, we have we even have them doing what I call passive Ewatt, which is they will breathe the oxygen while they get in like a an infrared ⁓ sauna blanket. So infrared sauna will increase your heart rate. And so you will get some benefit out of it. And what normally happens, the the really cool thing about exercising with oxygen is

The first thing folks notice, the very first benefit most folks notice when they start doing is the exercise is easier. So I always describe this like if you were ⁓ jogging on a treadmill at, I don’t know, pick a number, you know, four miles an hour and you put the mask on, you wouldn’t feel like you were getting the same exercise at four miles an hour. You you crank it up to four and a half, and then later you crank it up more. And

Your endurance actually improves much more quickly than if you were just doing exercise alone. ⁓ and there’s a ton of actually research on you know Olympic athletes using it for performance enhancement, which is not what we’re using for in this, but it’s kind of a nice little side effect. So we have folks who come to us who who are out of condition. We’re not talking about the physical disabilities, but out of condition, we’re like, I couldn’t do.

And they’re shocked at what they’re doing and they come back and tell us in three months, look what I’m doing, sort of thing. ⁓

But it will meet you where you’re at. So if you want to do passive Ewatt, you can do that for a while as you’re working and as you start to feel better. Then maybe you’re using the under desk pedal bike. And as you’re getting your balance back and feeling better, maybe it’s a a real stationary bike later or walking on a treadmill and so on and so forth. ⁓ the goal isn’t to bust hump and like try to, you know, get a new record. As a matter of fact, I find that for most folks that sets you back. You wanna kind of you wanna

do within an envelope that you’re comfortable with because

If we work out too hard, also we set ourselves back because in most chronic health conditions and in stroke, additionally, we talked about this fatigue that’s due to an energy deficit. So if you go out there and overwork, you’re just putting your body in more of a deficit and potentially putting it in more of an inflammatory environment. And we’re trying to do this at a level that’s in you know anti-inflammatory and helping you recover.

BIll Gasiamis (40:30)

I love that. I love your whole explanation. So in my what I was hoping was you were gonna say that I could just sit there and almost do nothing ⁓ as a stroke survivor, where I’m completely in in just, you know, like week three of the acute after the acute phase, and fatigue is a massive issue and energy is a massive issue, and I’m barely able to stay awake, ⁓ and all of that stuff. And then ⁓ you could do just I hope you I was hoping you were gonna say,

But you said the equivalent of ⁓ chair yoga, you know, where all I had to do was just move an arm or move a leg and do something just to get me physically going and then it would benefit. That’s what I love about it. The under-the-leg pedal bike, ⁓ under-the-desk pedal bike is one of the best things because you can strap in your leg with the deficits if you have a leg that has deficits, and you can do all the or the majority of the pedaling with the other leg, which is strapped in.

Brad Pitzele (41:07)

Mm.

BIll Gasiamis (41:29)

And you don’t you’re not gonna fall over ’cause you sit in in a chair. ⁓ probably you’re doing it inside your house so the the temperature, the weather is always perfect and ⁓ and you don’t have to door for long, right? You only have to door for a few minutes to start with.

Brad Pitzele (41:45)

And you’re pulling that other leg around and it’s starting to fire inside here and rebuild those connections. And and as you know, exercise increases ⁓ brain drive neurotrophic factor, which is a growth factor in our brain for

BIll Gasiamis (41:51)

Mm.

Brad Pitzele (42:00)

neuroplasticity. So you’re getting you’re getting all of these benefits. So you to your point, for someone who’s if it’s my right leg’s not working and I’m strapped in and my left leg’s doing it, my right leg is firing and it’s firing those neurons at the exact time you have that B D N F as it’s called. So

BIll Gasiamis (42:17)

BDNF’s amazing. And I also interviewed ⁓ recently a gentleman who ⁓ had spoken about ⁓ Jack Clifford on episode 402 who spoke about kind of ⁓ a protocol that enables you to regenerate blood vessels around the area that’s injured ⁓ to increase the oxygenation and the blood flow ⁓ to potentially those areas where

⁓ brain is offline, not dead. ⁓ so all of these things, ⁓ the previous episode that I recorded with Jack, your episode right now, like all are things that you can do that support brain health, brain recovery, ⁓ overcoming all the some of the challenges that stroke causes. And what I love about this specifically is that you can do it from your house.

and you don’t have to go anywhere, but there is a cost. So let’s talk about the cost a little bit because I I want to mention it because of the massive difference to hyperbaric, which can cost up to sixty grand if you go on the right protocol. And ⁓ that’s unattainable for most people, let alone a stroke survivor who just lost their ability to earn ⁓ and may not have sixty grand to splash.

Brad Pitzele (43:48)

Yeah.

BIll Gasiamis (43:48)

⁓

so what is the cost of getting a machine, setting it up and putting it in your house?

Brad Pitzele (43:54)

Yeah. So we sell two different machines. ⁓ we have one machine that’s eighteen hundred and ninety-nine dollars and the other one that’s twenty-four ninety-nine. ⁓ that’s everything you need to get going other than the exercise equipment. and the machines last a long, long time. I think I

You know, I think we actually we’ve been in business since 2018 and we had our first customer come back and tell us they wore out their machine like this year. So I have to stop saying we’ve never had one wore wear out yet. So we’ve had one. ⁓ so it it’s one of I think that’s one of the things that’s great about it is it’s something you can do in your house. It’s something that doesn’t take a lot of time. When I was dealing with my chronic health issue, I was

joke around about the ceremonies of counting pills and doing this modality and doing that. And they all in stroke survivors, I think, recognize the same thing. It starts to crowd out your life. And then eventually you kind of throw your hands up. You’re like, I it might be helping, but I just don’t have four hours a day for all this stuff. Like I just I need to go on and and live my life too. So it’s something that ⁓ it’s 15 minutes. You do it three to five times a week in your home.

⁓ it’s a one time expense and then it’s you know, it’s something you’ll have for many, many years.

BIll Gasiamis (45:12)

I love it. Where are you located?

Brad Pitzele (45:15)

We’re in a Dallas, Texas area.

BIll Gasiamis (45:17)

Okay. And are these things easy to get and distribute throughout the United States and other places in the world? I don’t know I’ve never heard of it before. So are there other people around who who sell a product that’s similar or can you access them easily?

Brad Pitzele (45:35)

Well, we do ship worldwide. ⁓ we ship with US power, so people get a power converter we’ve sold to the UK, to Australia, to all over Europe, Asia, ⁓ South America, ⁓ and of course across North America as well. So ⁓ they’re readily accessible. Kind of our mission was

You know, when the doctor asked me if I’d make him first patients, I I I I thought about what you were saying about how like spending sixty grand to find out if something’s gonna work. And I felt like I was taking advantage a lot when I was very ill. So we wanted to make something that was accessible to people who are chronically ill. They might not have the ability to earn money. They’re on a fixed in like I

have a I guess a deep personal experience and empathy there sort of thing. So ⁓ that’s yeah. So we ship worldwide.

BIll Gasiamis (46:27)

Yeah. If somebody wanted to reach out to you just to get more information, to have a chat with you, to look at your website, where would they go?

Brad Pitzele (46:35)

They would go to 1000roads.com slash stroke recovery. We do. And you can find it at the bottom of that webpage, but it’s 1000 Roads HQ.

BIll Gasiamis (46:42)

And you have a YouTube channel.

Okay. What kind of ⁓ things can people find on the YouTube channel?

Brad Pitzele (46:56)

you can find everything about protocols, benefits, ⁓ how to use it. ⁓ we hit have some customer testimonials and parts of that. ⁓ just talking about the science of it, people’s experience with it, et cetera, et cetera, different use reasons people use it.

BIll Gasiamis (47:17)

I think it’s very important to bring information like this to stroke survivors so that they can access things in their own home that’s going to make their life better. I wrote a book, The Unexpected Way That a Stroke Became the Best Thing That Happened, for the explicit reason to give people like a

path forward, a journey forward as to how to ⁓ s how to kind of obtain the silver lining in stroke recovery. And when I wrote it ⁓ in 2018, when I started writing it, something like that, 2018, 2019, I was lacking a lot of the extra pieces that I could put into ⁓ the mindset chapter, for example, or the exercise chapter, or, you know, the nutrition chapter. And

In the last five or six years, I’ve been picking up those pieces to sort of attach to those chapters because they’re really relevant. And with the exercise chapter, I think this protocol was the one thing that was missing because I made the point of how important exercise was. I didn’t make the point of how you can exercise and get more bang for your buck during that exercise by

Increasing the amount of oxygen that you were getting into your ⁓ bloodstream. How would I have known that if I hadn’t come across the science, which I hadn’t? Plus, there’s only so much you can put in each chapter, but this is the perfect addition. Like, and I love it. So I can go on and on about how much I think this is amazing. Brad, I really ⁓ want to thank you for reaching out and joining me on the podcast.

Thanks for the work that you do. I’m glad that you’ve been able to get your health back and now you’re helping other people.

Brad Pitzele (49:06)

Thank you so much, Bill. I appreciate you having me on.

BIll Gasiamis (49:08)

Well, that’s it for another episode of the Recovery After Stroke podcast. I hope you enjoyed this episode. Might be worth listening to it again. The science here is worth sitting with, oxygenating the blood plasma, reopening inflamed microcapillaries, giving mitochondria what they need to shift out of that low energy state. And the fact that it can be done at home at a fraction of the cost of hyperbaric oxygen therapy makes it worth knowing about. If you want to learn more,

or explore the equipment, head to 1000Roads.com Stroke Recovery. Brad has arranged a discount for listeners of this show of between one and 500 dollars, depending on the package you choose. This episode pairs well with the episode 402 with Jack Clifford, which covers a protocol for regenerating blood vessels around the injured area of the brain.

The two conversations complement each other. Worth going back to if you haven’t heard it yet. Now, if this episode was useful, please share it with someone who could benefit. And my book, The Unexpected Way That a Stroke Became, the Best Thing That Happened, is available at recoveryafterstroke dot com slash book. And if you’d like to support the show financially, I would love it if you could. You can go and do that via patreon.com/slash recovery after stroke. I’m Bill Garciamas.

Thanks for listening. See you on the next episode.

The post Brad Pitzele – How Exercise With Oxygen Therapy Brings Hyperbaric-Style Benefits Home appeared first on Recovery After Stroke.

Microplastics and Stroke Risk: What a Landmark 2024 Study Found Inside Human Arteries

In 2024, a team of Italian researchers published a study in the New England Journal of Medicine that stopped the cardiovascular science community in its tracks. They found microplastics, tiny synthetic fragments embedded inside the carotid artery plaque of more than half the patients they examined. And the patients who had them faced more than four and a half times the risk of a serious cardiovascular event compared to those who didn’t.

This isn’t a distant, theoretical risk. These are living people who had already been identified as having carotid artery disease, and plastics were found inside their arterial walls. For stroke survivors and those at elevated risk of stroke, this study raises important questions that the medical system has not yet caught up with.

What the Research Found

The study by Marfella et al., published in the New England Journal of Medicine (2024), enrolled 304 patients who were undergoing carotid endarterectomy, a surgical procedure to remove plaque from the carotid arteries. Researchers analysed the excised plaque for the presence of microplastics and nanoplastics.

Their findings:

58% of patients had detectable levels of polyethylene, polyvinyl chloride (PVC), or polystyrene in their arterial plaque. This was not contamination from the surgical procedure; it was already there.

Over a 34-month follow-up period, patients with microplastics in their plaque had a 4.53 times higher risk of a combined endpoint: non-fatal myocardial infarction, non-fatal stroke, or death from any cause.

Inflammatory markers were significantly elevated in the microplastics-positive group. IL-18 and TNF-alpha proteins associated with systemic vascular inflammation were markedly higher in plaque samples that contained plastics. This suggests the mechanism is not simply physical obstruction, but an inflammatory cascade triggered by the presence of synthetic material in arterial tissue.

What This Means for Stroke Survivors

The carotid arteries are the primary conduits supplying oxygenated blood to the brain. Plaque accumulation in these vessels is one of the leading causes of ischaemic stroke, and carotid artery disease is a condition many stroke survivors are already living with.

“The patients with microplastics in their plaque had a 4.53 times higher risk of stroke, heart attack, or death over the 34-month follow-up. That’s not a marginal finding. That’s a signal the research community needed to take seriously.”

The NEJM study doesn’t yet tell us whether removing microplastic exposure after the fact reduces risk. It doesn’t confirm that healthy individuals with no existing carotid disease are accumulating plastics at the same rate. And it cannot tell us which plastic sources are most responsible because we’re exposed to microplastics through drinking water, food packaging, air, and a dozen other vectors simultaneously.

But what it does tell us clearly and with high statistical significance is that microplastics in arterial plaque are associated with dramatically worse cardiovascular outcomes.

What the Research Does Not Yet Tell Us

Science at the frontier moves in one direction at a time. This study establishes association, not causation. It cannot yet answer:

Whether people without existing carotid disease are accumulating microplastics at comparable rates. Whether reducing exposure actively reverses or slows plaque-associated risk. Which types of microplastics are most biologically harmful? Whether there will be a clinical screening tool for this in the near future.

These are the questions the next generation of research will need to answer. In the meantime, it’s reasonable to act on what we do know.

Practical Steps to Reduce Exposure

No clinical screening currently exists for microplastics in arterial plaque. There is no blood test, no imaging, no biomarker that your GP can order today. What you can do is reduce your ongoing exposure, particularly through food and water contact with plastics.

Evidence-informed steps worth discussing with your treating team:

Use glass, stainless steel, or ceramic containers rather than plastic for food and drink storage. Avoid microwaving food in plastic containers; heat accelerates the leaching of plastic particles. Filter your drinking water; some filters (carbon block and reverse osmosis) reduce microplastic levels significantly. Reduce consumption of highly processed foods in plastic packaging. Bring this study to your vascular neurologist, cardiologist, or GP and ask whether it’s relevant to your personal risk profile.

This is not a recommendation to take a supplement or start a treatment. It’s an invitation to have an informed conversation with the people responsible for your care using the best available evidence.

If you found this useful, my book walks through the science of stroke recovery in the same evidence-first, no-hype way. Find it at recoveryafterstroke.com/book.

Want to go deeper and support the channel? Join the community at patreon.com/recoveryafterstroke.

The post Plastics in Your Arteries: The Stroke Risk Study You Must Know appeared first on Recovery After Stroke.

Stroke Symptoms Dismissed – What Happens When the CEO of Canada’s Optometry Body Has a Stroke

Stroke Symptoms Dismissed: François Couillard has spent his career protecting people’s vision. As the CEO of Optometry Canada, the national body representing every optometrist in the country, he understands better than almost anyone how much vision matters, what threatens it, and how to preserve it.

Then he had a stroke. And it only attacked his eyes.

The irony is not lost on François. But what makes his story essential listening for every stroke survivor and caregiver isn’t the cruel symmetry of it; it’s what happened at the emergency department before his stroke even reached its worst point.

His symptoms were dismissed. He was sent home.

When Stroke Symptoms Are Dismissed

François arrived at the ER with symptoms. He was assessed and sent home. What the medical team didn’t know and what François didn’t yet know was that he was mid-stroke.

He walked home alone in the middle of the night.

This is not an isolated story. Stroke symptoms dismissed at the emergency department are more common than most people realise, particularly when the presentation is atypical. Symptoms that don’t match the classic FAST criteria, such as facial drooping, arm weakness, speech difficulties, and time to call, can be overlooked, minimised, or misattributed. Visual disturbances, in particular, are frequently missed.

For François, the consequences became clear the next morning.

Waking Up With Vision Loss After Stroke

François woke up having lost the right visual field in both eyes permanently. The condition is called homonymous hemianopia: a stroke-related vision loss that removes the same portion of the visual field from each eye simultaneously.

Here is what makes it disorienting: the brain doesn’t show you the gap. It fills it in. You don’t see darkness where the vision is missing, you see what your brain invents to complete the picture. You look normal. You appear, in many ways, almost normal.

But you are not.

The Hidden Cost of Stroke Vision Loss

What François describes and what many survivors with stroke-related vision changes will recognise is the extraordinary cognitive load of compensating for what you can no longer see.

The brain works continuously to fill in the missing visual field. That work is invisible to everyone around you. There’s no cast, no limp, no obvious marker. But the fatigue it generates is profound and relentless.

This is the invisible disability that follows many stroke survivors: the gap between how they appear and the effort required to simply exist in a world that assumes full function. Stroke vision loss recovery is rarely straightforward, and the fatigue accompanying it is one of the least-discussed consequences of stroke.

François knows this intimately. He continues to live it.

One Week Post-Stroke: 100km on the Bike

One week after his stroke, François completed a 100km cycling event.

One week. 100 kilometres.

This isn’t recklessness, it’s the character of the man. A pragmatist who processes by doing, who defines himself not by what has been taken but by what remains. His approach to his stroke carries a dark honesty: he hasn’t minimised what happened, but he hasn’t surrendered to it either.

The 100km ride is not a metaphor. It happened.

Returning to Lead a National Health Organisation

François returned to his role as CEO of Optometry Canada. He leads a national health organisation while navigating permanent vision loss, invisible fatigue, and the ongoing adaptation that stroke demands.

He also carries the particular weight of professional identity intersecting with personal experience. The man who has advocated for Canadians’ vision health now lives with the consequences of a stroke that targeted exactly that. He has become, in a specific and irreversible way, both the professional and the patient.

That dual perspective, the insider who became the survivor, gives his voice a precision that very few stroke stories carry.

What This Episode Is Really About

Episode 406 of the Recovery After Stroke podcast is not simply about vision therapy after stroke, although François discusses that too. It is about what happens when stroke symptoms are dismissed and the cascade that follows. It is about the invisible burden of neurological fatigue. It is about identity, adaptation, and the kind of resilience that doesn’t announce itself.

If your stroke symptoms were dismissed, or you know someone whose were, François’s story will feel familiar in a way that is both validating and important. If you are navigating stroke vision loss and wondering whether the fatigue you feel is real, it is, and François names it plainly.

Listen to Episode 406 with François Couillard available now on all major podcast platforms.

Bill’s book – The Unexpected Way That A Stroke Became The Best Thing That Happened

Support the show: https://www.patreon.com/recoveryafterstroke

Sent Home Mid-Stroke: CEO of Optometry Canada on Vision Loss and Recovery – Francois Couillard

When François Couillard, CEO of Optometry Canada, went to the ER with stroke symptoms, he was sent home. By morning, he had permanently lost part of his vision. In this episode, he shares his experience with stroke-related vision loss, invisible fatigue, and the resilience required to adapt and move forward.

Highlights:

00:00 Introduction

01:13 The Stroke Experience

04:14 Diagnosis and Aftermath

13:05 Navigating Recovery and Support

17:13 Vision Challenges and Cycling Safety

23:10 The Impact of Stroke on Daily Life

29:47 Finding New Connections and Balance

37:40 The Importance of Downtime

46:08 Impact of Stroke on Daily Life

51:05 Understanding Stroke and Its Misconceptions

56:18 Mindset and Recovery After Stroke

Transcript:

Introduction – Stroke Symptoms Dismissed

François Couillard (00:00)

I had no other symptoms. Everything else was functioning. I could touch my nose. I could do everything. So they said you had that episode, you zapped a piece of your brain and now go home.

Bill Gasiamis (00:00)

What a nerd he is.

François Couillard (00:14)

it’s ironic that I worked in the field of the eyes of vision. And the only thing that got affected on my stroke was my vision.

BIll Gasiamis (00:25)

Hello everyone, welcome to the Recovery After Stroke Podcast. I am your host, Bill Gassiamas. My guest today is Francois Couliard, the former CEO of Optometry Canada, the national body that represents every optometrist in the country. Francois has spent his career at the intersection of vision health and leadership at the highest level. And then he had a stroke. His only symptom was visual. He went to the emergency department and was sent home.

And what happened in the months, hours, days and months that followed is a story about the gap between how you look and how you feel, about the invisible cost of neurological damage, and about what it means to keep leading an organization dedicated to the very thing your stroke attacks.

The Stroke Experience

Bill Gasiamis (01:13)

Francois Coulard, welcome to the podcast.

François Couillard (01:16)

Thank you, Bill. It’s a pleasure to be here.

Bill Gasiamis (01:18)

Thank you for coming to me all the way from sunny Canada, it looks like through your window there.

François Couillard (01:24)

It’s very sunny, but it’s cold. was like a few days ago, it was 29 Celsius and then yesterday morning was plus two Celsius. So it’s still a little nippy in the morning.

Bill Gasiamis (01:34)

Ugh.

It was 29 Celsius and plus two.

François Couillard (01:42)

Yeah, it went from 29 to plus two in 24 hours. That’s my part of the world.

Bill Gasiamis (01:46)

Wow,

I thought Melbourne was crazy like that. Often we have 40 Celsius days in summer and then the next day it will be 20 Celsius.

but I think I prefer the 20 Celsius one than the plus two Celsius one.

François Couillard (02:02)

Yeah, and we go in winter, we get to minus 30. So this is not bad. We don’t complain at plus two. Still nice.

Bill Gasiamis (02:11)

Whereas I would definitely complain. Tell me, tell me a little bit about what happened to you.

François Couillard (02:16)

So a few years ago, I was sitting at the kitchen table with my wife on Halloween and I’d worked all day at my desk. I’d done some strenuous exercise in the morning. Like I do a lot of exercise. ⁓ And my wife is sitting on my left. There’s just the two of us around the table. And I turned to her and I say, it’s funny. I don’t see you that well.

I can see the world, but you’re a little bit, I can’t describe it. It’s just difficult to explain, but I just don’t see you well. Now I happened, and she said, you look fine and everything. happened to, at that point I was working with the Canadian Association of Optometrists. My role was CEO of the Canadian Association of Optometrists. So anything site related, I’m gonna call an optometrist. I’m not an optometrist myself.

Diagnosis and Aftermath

So I called the president of the association. had just talked to him an hour or two ago. I said, hey, ⁓ I’m having this thing there. Should I worry? And he said, well, it could be one of two things. You’re either having a ⁓ migraine headache or you’re having a stroke. So go lie down for half an hour. And if it’s still there, head to emergency.

So that’s why I did not lie down for half an hour. I stood up and told my wife and that’s still there. We live five minutes from the hospital from a nice large tertiary care hospital. So she took me straight there. I was full of energy just like I am now bubbly, no pain, just this funny thing. So I walk in the emerge and I tell them, you know apparently I’m having a stroke with the looking at me and it’s like, you don’t look like you’re having a stroke, but okay. ⁓

So they got me through fairly quickly, maybe half an hour. They triaged me in. ⁓ they asked me all sorts of questions and, ⁓ I got the CT and came back and said, yeah, you had a stroke. So I, ⁓ they, they gave me a rain check. I walked back home in the middle of the night and, ⁓ I almost got lost cause my site was so bizarre. I couldn’t have my bearings. So I went back home and.

Then I started having a pretty bad headache and ⁓ that’s it. That’s the start.

Bill Gasiamis (04:45)

I was going to say that sounds very uneventful, but then they sent you home.

François Couillard (04:49)

Yeah, they just sent me home. Yeah. Yeah.

I had no other symptoms. Everything else was functioning. I could touch my nose. I could do everything. So they said you had that episode, you zapped a piece of your brain and now go home.

Bill Gasiamis (04:52)

What a nerd he is.

François Couillard (05:06)

the interesting thing which I learned after the fact, if you have another type of stroke, whether you become paralyzed to a certain extent, quickly they put you in touch with people that will help you with rehab, right? You’re going to have physiotherapists and all that.

And in this case, no, they were kind of happy that they, was out of danger, it’s a large emerge. So they’ve done their job. I’m not dying. And, but as far as treating what happened to me, which I actually lost a quarter of my field of vision. So I’ve got quadrantinopia. They said, go and get a field of vision, a proper field of vision test and get that done by an ophthalmologist.

And to argue with them, know what, optometrists can do that too, and I can get the appointment next day. Australia and Canada have pretty similar scopes of practice for optometrists. We’re lucky in the States as well. Other countries, it’s typically ophthalmologists, but in our countries, we have good optometry. So, anyhow, the next day I had an appointment with an optometrist, and I did the field test, and it showed, boom.

But then for the next several weeks, I personally figured out what sort of assistance I could get. Vision therapy. I got some help also to set up my screen so I wouldn’t get too much ⁓ glare and too many contrasts. So just getting that adjusted. And there’s organizations in Canada that help those that are vision impaired. And I was able to get in pretty quickly to get access to those people. I knew where to go.

But the system didn’t send me to any of that. And so that’s what prompted me to call you and share my experience because ⁓ unfortunately, for a minor, I call it a minor stroke for me. I was very, very lucky. ⁓ It seems that if it’s just a vision, there’s not too much out there. There’s not that much awareness that something can be done and should be done.

And we also need support. So that’s why I thought I could share my.

Bill Gasiamis (07:18)

That’s a great reason to share your experience. I’m still stuck on the fact that they sent you home. So if you’re having a stroke or had a stroke ⁓ and it was fresh, right? You were fine a few hours earlier. Now you’re having a stroke. You would think that the doctors would say, well, should we investigate the cause of this person’s stroke? It could still be an ongoing issue.

François Couillard (07:31)

Yep. Yep.

Right.

Well, they did some tests and blood work and all that and immediately they couldn’t find anything. It actually took them about eight months to figure out what might have happened. It was definitely a clot. And after a bunch of blood tests done by a very specialized neurologist, they discovered that I had a genetic mutation for prothrombin.

2 % of the population has that. I just happened to have that and also had a PFO. So it is possible and they found that I had little clots in my my low in one of my lower legs. So it’s possible that a clot left went on a field trip through my through my heart bypassed the lungs went straight to the brain. So that’s probably what happened. But no, they did.

They didn’t know for sure. Actually, when I showed up in eMERGE, and that’s the other thing, they were very poorly set up to diagnose and evaluate ⁓ site emergencies. ⁓ The guy that was like the resident that was assisting the emergency physician, I probed them while the emergency physician was out of the room. said, what do you think I have there? He says, it’s probably a retinal detachment.

And I said, I can’t be a retinal detachment just happening at both eyes at exactly the same time and exactly the same part of the world that is blocked. So that’s not retinal detachment. It has to be the brain. can’t be just the eyes. So, yeah. Anyhow, they saved me. I didn’t die.

Bill Gasiamis (09:20)

No, I love your nonchalant attitude. know, ⁓ it was a small stroke. I’m still here. didn’t die. Like I kind of get it. That’s a great way to be. And at the same time, there’s no such thing as a minor stroke. There is an underlying condition, a blood clotting disorder. There is a PFO, another underlying condition. And just on those two things, and I understand the blood clotting disorder may take longer to diagnose, but a PFO, it should be able to be diagnosed pretty rapidly.

even if it’s a day or two later. But I would have thought that there would have been an admission in that you would have been admitted into the hospital and I would have thought, this is a gentleman, he’s 63 years old, you are in the high risk category for a stroke, regardless of how you look, just because you’re 63, our risk of stroke increases. But ⁓ I’m still stunned by hearing those types of stories.

But also I’m not surprised because it’s not the first time. I’ve done 404 episodes, you it’s not the first time that somebody said to me the diagnosis was a shambles or I was sent home when I was having a stroke and I shouldn’t have been. It happens very often, not only in Canada, in America, in England, in Australia, all over the world, ⁓ people come from. And it’s just fascinating to hear that then,

You took it upon yourself to look into the support services that you needed, right? That reminds me of me. That’s exactly what I went through in 2012. So I had a bleed. The first bleed ⁓ was obvious. know, there was a, ⁓ in America, it’s probably the size of a dime, ⁓ shadow on my brain. The second bleed was six weeks later, about the size of a golf ball. And that blood was sitting in my head.

But if you looked at me, I looked completely fine on the outside. I didn’t have any visible signs that I was having a stroke other than the fact that cognitively I was a mess and I had fatigue and all the things that stroke survivors talk about. I couldn’t, ⁓ my balance was off. couldn’t communicate properly. There were so many issues. So they sent me home after three days after the second bleed, seven days after the first bleed.

They determined what the cause was roughly. They knew it was a blood vessel that had bled. They didn’t understand why. And then I went home unable to drive, walk, start, complete a sentence, remember who came to see me, ⁓ angry, ⁓ like emotionally unwell, all sorts of things. And no follow-up appointment to say you should go and see a

neuropsychologist, you should go and see this person for that, this person for that. And I went to a counselor, my ⁓ psychologist, and she realized that I was in a pretty terrible way as far as communication is concerned. And she said to my wife and I, maybe you should go and see a neuropsych. And I was like, okay, what does a neuropsych do? And she said, well, they’ll evaluate the level of your deficits. So not knowing that I could

François Couillard (12:16)

Yep.

Bill Gasiamis (12:41)

get a private appointment and see one immediately. I went to the public system and waited nine months to get an appointment with a neuropsychologist. Nine months. And by the time nine months came around, the bleeding had stabilized. And by then, deficits, my ⁓ neurological deficits had settled a little bit. And although I wasn’t back to normal, I was able to pass the neuropsychological assessment quite well.

François Couillard (12:48)

Nine months. Wow.

Navigating Recovery and Support

Bill Gasiamis (13:09)

where they didn’t recommend any further rehabilitation. But I struggled at home for six or seven months trying to work out what day it was, what was up, what was down, how to write a letter, how to type an email, how to communicate. It was horrific. at the same time, Christine and I were trying to, my wife, we were trying to solve that problem by researching and trying to understand what happened, how it happened, et cetera.

And it was 2012, which meant there was no YouTube channel about stroke recovery. There was no, hardly any books that you could buy. You you couldn’t reach out to anybody. It was a really difficult time. It’s partly the reason why the podcast exists. So I’m still surprised, you know, not, you know, not completely, I’m not, I’m not naive enough to think that.

mistakes don’t happen anymore but even after 14 years like I’m still surprised that people go through this it shouldn’t happen.

François Couillard (14:11)

Yeah,

it’s ironic that I worked in the field of the eyes of vision. And the only thing that got affected on my stroke was my vision. This is really ironic. So I don’t know what happened in the other world there. But something happened. And but if I hadn’t worked in that field, it would have been very complicated.

Bill Gasiamis (14:23)

Yeah.

François Couillard (14:37)

I would not have known that there was a thing called vision therapy. I would have waited to see an ophthalmologist because I would have believed them when they told me that, no, to get a field test you have to see an ophthalmologist. ⁓ It would have taken me a lot longer to get the sort of accommodations, the appointment to get an accommodation for my screen and my

Bill Gasiamis (14:37)

Mm.

Mm-hmm.

BIll Gasiamis (15:01)

We’ll be right back with France, why Cool yard in a moment. If you found value in this podcast and you’d like to support the show, you can do that at patreon.com/recoveryafterstroke. Every contribution helps keep the show going and helps me get to a thousand episodes. And if you’re navigating life after stroke, yours or someone you love my book, the unexpected way that a stroke became the best thing that happened is available at recoveryafterstroke.com/book.

Now back to Francois.

Bill Gasiamis (15:32)

were saying the irony was that CEO of an organization that sells glasses and you are experiencing ⁓ a stroke and the only thing that was affected was your eyes.

François Couillard (15:45)

Yes, that’s the irony. So while it’s ironic, at the same time, it couldn’t have happened to anybody. I’m the ideal person for whom this could happen, because I know where to find the resources for anything related to site. So that was very helpful. I keep thinking if you…

I’m sure a lot of your stroke survivors have experienced, maybe not all, but some have experienced sight issues and they probably wouldn’t know where to go or they might not know that there are things that can be done to try to recover some of that sight through vision therapy. yeah, I was lucky to know what resources I could get, I couldn’t get access to.

Bill Gasiamis (16:25)

Nothing. Well, move.

Yeah, what was life like before strike? I know you say, that’s a busy ⁓ job, but what else were you up to back in the day?

François Couillard (16:38)

So

Vision Challenges and Cycling Safety

I, very active, hyperactive, very, quite athletic actually. I do long distance ⁓ cycling and I do ski, cross country ski races and I’ve skied all over Europe. ⁓ So this was, this was end of November. So I’m starting, I’m finishing my cycling season about to get into my, into my ski season. ⁓ And like two days,

The day after my stroke, took it easy, but the next day I was in my basement doing an hour on my bike. And like a week after I did a hundred kilometers on my bike in the basement and I didn’t venture outside. So it’s like, this is me. have to be very active and, and, ⁓ I’m, I’m, so that hasn’t changed. ⁓ I work, I took, I took a little break. Well, what I call a break, I worked three days a week instead of five days a week, right after my stroke.

Bill Gasiamis (17:36)

And as if a CEO only works five days a week, there’s no way you worked five days a week.

François Couillard (17:41)

So I dropped a three and my staff was incredibly, my staff and the board I work with were incredibly supportive. I told them, okay guys, you’re pretty much on your own. You can come to me for advice, but you’re gonna run independently. Just bother me if you need help. And I was pretty open with the people I work with. I interface, I didn’t hide the fact. I didn’t see a stroke as a sign of weakness, something that I should hide.

And as a result, I got a lot of support. I live in the healthcare industry. I work in the healthcare industry. So healthcare workers are supportive, friendly. They know how to give care, whether it be psychological care or physical care. So I got a nice extended support group. After a couple of months, I went back to five days a week. even though my physical stamina was great.

my mental stamina ⁓ struggled, you know, like many stroke survivors, I didn’t sleep that well for a little while, kind of hyper. ⁓ And ⁓ I was not emotional, I didn’t become ⁓ depressed. So I was lucky from that perspective. But my mental stamina, I couldn’t work for as long hours and the screen is tiring. And I told you I’m a cyclist. So that’s interesting because

If you want to be a safe cyclist, usually you go on a bike path. That’s the way to go. You stay away from traffic. Well, I hate bike paths now because my blind spot is one quarter of my field of vision and it’s here. And in Canada, when we ride our bikes, we’re riding this way and people coming the other way are coming this way. If I’m on a small bike path and it’s curvy and bikes come this way,

Sometimes I hear them before I see them. I see them at the last minute. And same thing happens when I ski. If it’s a narrow trail, someone might come at me and only see them at the last minute because I hear swoosh and then I look. So I’ve had to compensate, learn to lift my head a little bit more and not rely on my field of vision. So other than the mental stamina, other than that, I haven’t had any.

and the fact that I don’t see that well, I’m okay.

Bill Gasiamis (20:09)

Yeah. I have a ⁓ stroke survivor who I coach ⁓ once a month and he has, I think, top left hand corner or right hand corner, doesn’t matter, but I think it might be top right hand corner, ⁓ vision loss, field of vision loss. And he has a, on one of his eyes and he has a ⁓ prism thing like a little…

François Couillard (20:36)

Yep.

Bill Gasiamis (20:37)

that he’s got

François Couillard (20:37)

Yep.

Bill Gasiamis (20:37)

attached to his glasses that when he’s driving brings the ⁓ vision from that side into the front of him. So you don’t have anything like that on your glasses.

François Couillard (20:44)

Cool.

Well.

Now I do have prisms, but that’s for a different reason. Actually, when I consulted with an optometrist to get vision therapy, they also at the same time, diagnosed and I had one eye that would see an object kind of here and the other eye would see the object here. So this therapy to try to realign that, but we didn’t get quite the full alignment. So she provided me prisms to realign that, but

Bill Gasiamis (21:08)

Mm-hmm.

François Couillard (21:19)

really this issue of not seeing in that top quarter, ⁓ it’s fascinating because all I have to do is scan once very quickly. right now when I look at the room, I see the whole room as if I had no sight impairment because the brain makes a picture, fills the void. As long as I took a look quickly once, the problem is when things move, it’s a moving picture. But that’s what’s so taxing.

especially in certain environments. If I’m in a social environment where the lights are very bright outside or I’m in a big room full of people with people moving, then the brain is working in overtime to try to fill that void, make that picture. And it becomes very, very tiring. It’s interesting. You don’t realize how much brain power the sight takes. I took a look at… ⁓

the neurologist showed me the CT slice that shows my damage. And it’s like a big thing like this. It’s a big oval shape of destroyed cells, just cooked. Yeah.

Bill Gasiamis (22:30)

Yeah.

So driving is driving an issue.

François Couillard (22:35)

I can drive, but I drive like a 90 year old man. So I stop at every sign and I look four times and okay, then I venture as long as, when I’m moving, I’m okay. It’s intersections I don’t do well. Yeah.

Bill Gasiamis (22:50)

In Melbourne, in Australia, we’re known as being really impatient. You would be a nightmare in one of our…

François Couillard (22:56)

I

get honked at. I’ve never had that before. They honk at me and I say, ⁓ too bad.

Bill Gasiamis (23:02)

Yeah, yeah.

The Impact of Stroke on Daily Life

And that’s the thing. It’s a great thing that you mentioned that because I actually made a very concerted effort in November last year. I said that I was going to no longer be angry, aggressive and yell at people from my car when I’m driving. And I’ve and I’ve made, put so much work into not doing that. And I’ve had to re-remind myself when I’ve caught myself.

François Couillard (23:21)

Good for you.

Bill Gasiamis (23:29)

jumping out of the correct way to behave. And then I even correct my wife who’s very calm and collected compared to me, but I even correct her now. You don’t know what’s happening to that guy. Maybe there’s just practicing more or they’re paying attention more or they’re trying to navigate something. even though I’ve done so many podcast episodes and so many people have told me about the vision issues and that they’re trying to get their driver’s license back.

It still doesn’t occur to you, to me when I’m driving, when I’m a hothead Melbourne driver, it still doesn’t occur to me that, just take it easy. If they’re going slow, they’re probably paying more attention or being more careful or whatever the situation is. It doesn’t matter. It’s not going to make a difference to your life if you just wait a few more seconds to get through. ⁓ But I totally get how now they would be, people would be honking you.

and trying to move you along thinking, what is this guy doing? And having completely, being completely ignorant about the fact that ⁓ different people are visioned differently, and drivers are also visioned differently. And that changes the way that they have to behave on the road. Was there an assessment that was done to ensure that you could drive or was that not even a thing?

François Couillard (24:48)

No, it was not even a thing in Canada. can legally drive with this. There’s a certain I can’t remember what the criteria is, but there’s a criteria in terms of I think the height of ⁓

the level at which you can see and maybe it’s a percentage, but I met that they were more concerned about the cognitive ability. So they had me do a test of cognitive ability ⁓ and I passed that. for 30 days I couldn’t drive and that was more to keep me in check in case I have another stroke right after. that was just, yeah, so that 30 days and then they said, no, you’re good to go.

I feel more at risk. Yeah, I feel more at risk on my bike than I do in a car. Because it’s more dynamic, it moves and moves all the time. So again, try to avoid bike paths, but there’s places we can ride around here where there’s no cars. It’s roads that are close to traffic. And we can we can ride our bikes or run or I do also roller skiing.

Bill Gasiamis (25:33)

Yeah.

Yeah, fair enough.

François Couillard (26:00)

I know they do that in Australia quite a bit, roller skiing. So we do that there. it’s why the worst thing you worry about is hitting a deer or a bear, but no cars.

Bill Gasiamis (26:15)

Everyone talks about how Australia is dangerous. A bear. You’re going for a bike ride and your biggest worry is you’re going to hit a bear. I don’t have to think about that when I go for a bike ride.

François Couillard (26:19)

Yeah. Yeah. Yes, that happens. I see

about, I see two a year or so, you know, through the summer and fall. Yeah, but they’re normally on the side of the road and, you know, they don’t purpose, they don’t go in the middle of the road.

Bill Gasiamis (26:31)

That’s too many there.

I know, every movie I’ve seen though, that’s what they do.

François Couillard (26:39)

No, no, it’s and we have ⁓ brown bears, black bears. We don’t have grizzly bears here. They’re the other part of the country. And the polar bears are up north here. They’re not so dangerous. Well, they’re still dangerous, but.

Bill Gasiamis (26:50)

the

the the brown bears the crazier ones or is it the black bears?

François Couillard (26:55)

The crazy ones are the grizzly bears, right? yeah. Yeah, we have, I think it’s the black bears we have here. I’m not a biologist, I apologize. They’re big, have fur.

Bill Gasiamis (26:59)

huh. Okay. Yeah.

Yeah, we don’t have large animals like that that will ⁓ kill you. We have little tiny animals that will kill Spiders, snakes, we have little animals that you can’t see that you only know they’re there after they’ve bitten you. ⁓ But we’re still doing all right here. We still seem to be able to survive. your and before I get to my next question, I just need to ask this. can’t.

François Couillard (27:14)

Oh, I know, it’s crazy, yeah. Yeah.

Bill Gasiamis (27:36)

Do you do the whole full Lycra gear when you go out for a bike ride? you a Lemel?

François Couillard (27:40)

Yeah,

full Lycra both on cross country skiing and in cycling. Yeah, full Lycra. Yeah, sorry. Yeah. We take ourselves very seriously. It’s like putting your Superman disguise and you go way faster. It’s just more comfortable. Really, it’s a matter of comfort, especially in the winter, cross country skiing. As soon as you start sweating, you freeze. So you have to have just the right…

Bill Gasiamis (27:49)

Yeah, no, that’s okay. I always

I hate you.

Uh-huh.

François Couillard (28:10)

You have to

have something that’s very breathable yet cuts the wind somewhat for when you go downhill. It’s a real science. Yeah. Yeah.

Bill Gasiamis (28:18)

I don’t doubt it. don’t doubt it. The problem is

the Simpsons put Flanders in a tight bodysuit skiing once and they showed off his butt and now the only thing I ever come back to is that image of Flanders doing that. So that’s all. That’s all that is. I love it. In Australia, we call people like you mammals.

François Couillard (28:26)

Yeah

Yeah, yeah, yeah, yeah, yeah.

man in Lycra or? Yes, yes, we have the same thing here.

Bill Gasiamis (28:42)

mutilates in in Lycra.

Yeah, I love it. love it. Now,

you seem very upbeat and I love it. It is actually fantastic to have this conversation with somebody who had a stroke and things went so well, all things considered. And did you have moments where this kind of hit you another way? Like you didn’t feel…

François Couillard (29:02)

Yeah.

Bill Gasiamis (29:12)

Good about this where you thought, my gosh, what happened? It’s a stroke. I’m 63. Like, did you have any of those moments?

François Couillard (29:13)

Yeah.

Well, a couple days after my stroke, had a really bad headache, really bad. So I called the 911, the ambulance came and I said, okay, you guys, should you take me back to the hospital? I need to? And is there something bad happening here? They said, well, depends. How do you feel? Would you like to go back or do you prefer to stay? I’m no expert.

Finding New Connections and Balance

I said, well, okay, I’m just gonna stay here. ⁓ I didn’t know I could take a painkiller for my headache. So I took a painkiller and it went away slowly. ⁓ Afterwards, ⁓ was more, I was never down ⁓ because I, yeah, because I felt, I didn’t feel that bad. And

But the uncertainty around figuring out what happened and could it happen again and how quickly could it happen? I think stroke survivors all struggle with that. ⁓ I pushed back when they wanted to give me statins and blood pressure pills and blood thinner. I pushed back and said, I don’t know, need that. But then they said, come on, put all the chances on your side, take the drugs. And I took them, no side effects. ⁓

And, ⁓ no, I don’t, I don’t feel sorry for myself. And maybe it’s cause I’ve, I’ve seen a lot worse. heard your podcast and seen people in much worse conditions. And in terms of sight as well, I’ve, I’ve seen in optometry, there’s all sorts of conditions where you completely lose your sight. And so it’s not that bad. And what am I to complain about? And I can still do pretty much all my daily activities. I just need to pace myself. As I said,

neurologically still. So I don’t, I mean, if I felt sorry for myself, it wouldn’t be of any use to anyone. So no, I think overall I’ve been, I’ve been lucky. I, but I was watchful. I was kind of observing myself saying, okay, I hear that I might get depressed and maybe I’ll have a little bit of a depression here. But so I was watching and, ⁓ but it didn’t happen.

So, but I think keeping my exercise routine, staying engaged at work, ⁓ had good support from my friends. Initially, I couldn’t do too much. So I had time to spend more time with my friends that I had, that I always, because I had such a busy life, I didn’t spend that much time just enjoying an hour chatting or something. So I started doing that again. And I…

as you say in your book, which I really liked and I liked the concept, having a stroke really, was not something that set me back. It’s something that provided me a new perspective, new experience in life and brought me to a new place. And I’ve learned so much that I would have never learned if I had not had a stroke. So in a way I was sent this thing and

It’s a nice, it’s an interesting experience. haven’t yet died from it. might, maybe something will happen. I get another stroke but I’m not going to worry about that until it happens.

Bill Gasiamis (32:41)

Mm-hmm.

I like hearing this version of it. It’s because I’m the same guy.

François Couillard (32:48)

Yeah,

no, I was reading your story and I felt this is is how I feel. Yeah.

Bill Gasiamis (32:53)

Yeah,

and I live with it every day and the neurological fatigue is still there and the deficits are still there and all that type of thing. Now I am quite mobile, I’m independent and all that kind of stuff, so I understand the difference between my experience and some other people’s experience. I totally do. And I don’t want to take away from how they are going, how they’re feeling and what’s happening to them. I don’t want to minimize their experience. I just want to say, you know, like,

If you can find a way to be more like my attitude, not like me as a human being, but just my attitude, know, Francois’s attitude, it’s like, it doesn’t help, it doesn’t harm, it only benefits. And I don’t know how it’ll benefit you, but it will definitely benefit you in a small way. And that might create a snowball effect of more and more benefits that you never expected that you were going to have. And that come your way.

and that make life more interesting to observe and experience, even though it’s hard, even though it hurts, even though it’s exhausting, even though it’s challenging, even though you have less independence. Whatever the situation is, if the attitude changes just a little bit and you think about it like this is another experience that I have to go through, I have no choice, what can I learn from it? How can I grow from it?

you will learn from it and you will grow from it and you will probably make your life better and the other people around you their life better as well. And that’s the whole reason why the podcast exists. I hope that that’s the message that people get, not me telling people, this is what you should do, know, do it the way I do it. I don’t want to, I don’t want to put it out there like that. ⁓ Now, also I’ve met people who have had a stroke and have had very minor

deficits from it. One particular stroke survivor who I met was ⁓ also a client of mine who I was coaching who had a, who was very athletic, ⁓ used to ride a bike a lot. He ended up getting a numb sensation in his, one of his feet as the final deficit that never went away. And it was about the size of a golf ball. And it was the most

difficult thing for him to deal with. He couldn’t grasp how much of an issue he was making it, like in his mind he was overthinking it and it was causing him anxiety etc and he couldn’t settle down the overthinking mind. And we were working together just so that I could get him to the point where he could focus on

the entirety of the rest of his body and the fact that he was still back on his bike and riding and doing a hundred kilometers and all those crazy things. And it was like, ⁓ I’m not sure how to bring you back there. You know, how to develop your understanding of how well you are after the stroke. And we got there and we’ve been able to move beyond that phase, but

he was really struggling just with the fact that that one part of his foot felt different and he was always noticing it. You know my entire left side feels different and I always notice it and it makes there’s no benefit to notice it more often so I kind of

François Couillard (36:31)

You know, I

can kind of understand him. ⁓ If you’re a high performance cyclist, which you might have been, ⁓ you become acutely aware of every little pain point. It could be your butt, could be your neck, top of your neck, back of your neck, could be your shoulders, could be your hands that go nimble. in order to do the sport you love and perform, you have to keep

Bill Gasiamis (36:36)

Tell me.

François Couillard (37:00)

all these little pain points in check or else they get worse. it and you’re so focused on your exercise that you think about that all the time. It is really nagging. So I can I can understand him in a certain way. I know in the big picture, nothing. But if that activity is a big part of his life, I can see that it could be really annoying.

Bill Gasiamis (37:25)

Yeah, I like that perspective. I appreciate you saying that because I was connecting it not to his bike riding. We never spoke about it from the perspective of bike riding. We spoke about it from the perspective of everyday life. When I’m not, et cetera, I’m noticing it. It makes me think of my stroke. makes me think of maybe having another one and all that kind of stuff. So if he had given me that version of it as well, it elaborated a little bit.

François Couillard (37:37)

Okay.

Okay.

The Importance of Downtime

Bill Gasiamis (37:54)

that would have made more sense. And then we would have been able to work ⁓ with how do we incorporate that feeling as being normal, for lack of a better word, in a cycling situation. And it’s not something that he then has to focus on ⁓ on the ride. It’s just a different feeling. It’s not related to the cycling. Let’s ride.

François Couillard (38:15)

Mm-hmm.

Right. It’s not a yes.

I think that’s a useful perspective.

Bill Gasiamis (38:24)

Yeah, it’s so interesting ⁓ to have your feedback from that. That’s so good because that’s closed the loop for me that opened about four years ago.

François Couillard (38:36)

Yeah.

Bill Gasiamis (38:37)

⁓ So you really enjoyed this opportunity where you had more time to connect with your friends and have conversations.

François Couillard (38:42)

Yeah, yeah.

And at the same time, I drop off a few things. I was overstretching myself between work and volunteer activities. And there’s one activity particularly that took me one evening every week and a lot of emails every day. And I told the group there, said, you know, guys, if you don’t mind, I need to get out of that. It’s too much for me. so I

I now had a kind of a reason to be able to say to give up something and clean up my act and focus on what was more important, which I should have done before because I was already overstretched, but I didn’t because I had a felt it was my duty or I’m enthusiastic. I want to let people down. So yeah, that was that was useful. Yeah. And connecting with the friends.

But what I found is as I got my energy back, and as you can tell, I’m pretty high energy, as I got my energy back, then I got back to my old, I’m too busy. I’m doing a lot of things now and I don’t have as much time for friends. I do have a bit more now because I retired in December. So now I have more time again. But ⁓ yeah, it’s a learning journey.

Bill Gasiamis (40:02)

Yeah, it is. And I found myself in a similar situation where I do the podcast Fridays and Saturdays, sometimes Sundays. ⁓ And that means that if I’ve got work Monday to Friday, if we’re busy Monday to Friday, Saturday and Sunday is the full days as well, recording, editing, uploading, all that stuff. So there’s no downtime. And sometimes I have to get out of this little shed in the back of my ⁓ yard.

which is my recording studio, and I actually physically have to just go, I’m going for a walk so that I can get a break. Otherwise I’ll be sitting here for seven hours solid.

François Couillard (40:41)

Well, that’s crazy. No, yeah. Yeah.

Bill Gasiamis (40:43)

It’s too much. And I do

that. And I could do that six or seven days a week. And as much as I enjoy it, I do look forward to someone breaking the cycle for me. So I didn’t have to have the responsibility to do it myself. My wife will say, are you going to be there all day? I’m like, where do you want to go? And she’ll say, want to go. Okay, let’s go. One hour. Can we do it in one hour? Yes. Bang. We’re out. Yesterday, a friend of mine called me and said to me, why don’t we go for a walk on Sunday? And I thought,

François Couillard (40:56)

Yes.

Bill Gasiamis (41:12)

Okay, perfect. Where do you want to go? He said, we’ll go down there and we’ll walk. I said, great. Let’s do it. I’ll be there at your house at midday and then we’ll go for a walk. So if somebody doesn’t interrupt me, I could go for another six or seven hours. And yesterday, my wife went out, today’s Saturday morning. Last time my wife went out with her friends that had dinner. And because I knew that she wasn’t going to interrupt me, I literally sat

François Couillard (41:19)

Good.

Bill Gasiamis (41:41)

in here doing work, editing videos, ⁓ connecting with my VA, having meetings, etc. for ⁓ from about 8.30 in the morning till around 7pm. I got out for about 45 minutes, maybe twice. It’s I know it’s not healthy. I totally get it right. And it’s what you say about over

François Couillard (41:57)

Ugh.

That’s not healthy, you know that Bill. Yeah. Yeah.

Bill Gasiamis (42:10)

What’s the word?

François Couillard (42:11)

extending yourself or committing.

Bill Gasiamis (42:13)

I very yeah, or I have a focusing or I have a fixating, which is something I couldn’t do many years ago because of the stroke. So I’m kind of grateful that I can do it. But I say that because you probably as a CEO, one of the busiest jobs out there was still able to do your 100 kilometers often. Right. And people like me will say, I don’t have time to go to the gym. don’t have when I say people like I’m actually talking about

François Couillard (42:16)

Yeah.

Mmm.

So I’ll tell you what I did and I still do it.

I’ll tell you what I do. I, when I was working, I get up early 5:30 or something like that. And at 6:30, 7AM on my, I’m on my bike. I ride about 50 kilometers and I grab a coffee in the countryside and the same coffee shop every day. And I see folks there and I come back and I’m back home around nine and I started my work. So before I even started my day, I

took care of my exercise and I had some social interactions with people. And I’m kind of on this, I’m full of endorphins from my biking and then I dose myself by adding a bit of coffee and I have enough coffee just to get in the right space where I’m not too hyper and I still have the effects of my endorphins and I run through the day like that.

Bill Gasiamis (43:21)

Mm-hmm.

It’s a science.

François Couillard (43:36)

It’s a science, yeah, it’s an art. Yeah, so that’s how I did it. And I still do my rides in the morning and I meet people at coffee and I come back. So I do both. get, it’s not just exercising. You need to have that social interaction. I find that so important, that human interaction and connection with people on a daily basis, on a daily basis, right?

Bill Gasiamis (43:40)

That’s the only thing Mr. Frenzy-

I do love that.

In the evenings, I like to go out. And you what’s weird in the evenings is as we age, my friends tend to be dozing off, you know, at 9.30, 10 o’clock. And I’m like, yeah, and they’re on their way home. And I’m like, ⁓ God, we’ve to go home early again. ⁓ To me, it’s too early to be going home at 9.30 and 10 o’clock.

François Couillard (44:03)

Okay.

I’m one of those.

So I have friends, they like to invite a little group of us for dinner. They invite us for dinner at four. Four. So like at 4.30, we’re starting to have dinner. all athletes. Some of them do triathlons and like at 7.30, we’re gone and we’re in bed at nine. But you know, we’re up at five and we’re very active during the day. But yeah, we’re boring. Slow in the car and early in bed.

Bill Gasiamis (44:40)

Yeah. Yeah.

Yeah, so I’m not up so early. So I know that at 5.30, you’re not setting an alarm. You’re probably just waking up naturally. It’s your time, know, 5, 5.30, especially if you’ve been in bed between 9 and 9.30. That kind of makes sense. That’s the right amount of hours to get out of bed. So it sounds weird for people that, oh my God, you get up at five o’clock and you go for a ride or you go to the gym. It’s just part of the normal cycle. It’s my cycle starts a bit later. So I’m probably

François Couillard (45:01)

Yeah.

Yeah.

Bill Gasiamis (45:22)

my brain, I’ve noticed the last two or three days, especially with a cold, I’ve noticed my brain isn’t switched on until around nine o’clock. Like it’s taken me an hour and a half, two hours for it to actually kick in. And I can’t do anything anyway. I would have probably been better off being at the gym or at Pilates, which is something that I am going to start. There is a Pilates near my place. And I’m thinking of starting that because going to the gym makes

my left side which is tighter even tighter so you know when you go to the gym and you get that muscle ache the next two or three days my left side feels like that all the time anyway and going to the gym kind of exacerbates it and just makes it less

François Couillard (45:56)

Mm-hmm.

Impact of Stroke on Daily Life

Bill Gasiamis (46:04)

⁓ more annoying and even though my left side is kind of not as there’s not as much muscle as there is on my right side I’ve been avoiding going to the gym and feeling really tight and stiff because then it puts all my all my back out all my body out and then I’ve got to go get massages it’s one thing after the other so thinking I’m gonna go and start Pilates it’s warm Pilates

They put you in a room on a machine with another 20 people or so and there’s an instructor and they just take you through some exercises. It’s light, it’s gentle. And I feel like that’s going to be the thing for me.

François Couillard (46:42)

Do

you do do you do cardio at all? Like bike or?

Bill Gasiamis (46:45)

⁓ I do bike

but not so often. I have an electric bike, ⁓ an e-bike where my left leg when I pedal ⁓ doesn’t fatigue. So I bought it because I used to enjoy a bike ride and I would jump on the bike on the weekend and go for a ride. And after the strokes and surgery, my left leg gets fatigued within about five minutes. And then

François Couillard (46:59)

Okay.

⁓

Bill Gasiamis (47:14)

getting back from wherever I’m going is a real problem. Getting there is okay, but getting back is real problem. And then it becomes really painful and tiring. And then my hand starts to feel numb and can’t hold on to the handlebar correctly.

François Couillard (47:19)

Okay.

Yeah,

yeah. So you can’t, you’re not able cardiovascularly to get into that endorphin generation ⁓ mode where you would then get filled with these endorphins and that might remove some of the pain on your left side. Yeah. Yeah, that’s tough. Yeah. Yeah.

Bill Gasiamis (47:44)

So I’ve got to push through that hard part to get the endorphins.

Yeah. So, and what happened

when I first started writing, I’d fall off my bike a fair bit because I had, ⁓ I had stirrups because my left foot would fall off the pedal. So I’m not a professional rider. So I just had a regular bike and my left foot would fall off and then the pedal would damage my shin and it would be a nightmare. So I got a stirrup and then I would ride with the stirrup. then when I got to a stop,

François Couillard (47:55)

Ouch.

Okay, yeah.

Bill Gasiamis (48:18)

My left leg is the one that I normally put down to ⁓ rest, to wait, to go forward, but my left foot would be in the stirrup. My brain wouldn’t remember that it was in the stirrup and then I would fall over at the lights. So that kept happening. And that’s when I got the electric bike because now my left leg doesn’t have to overexert itself to push and pedal. The motor helps up until 25 kilometers per hour and then

François Couillard (48:29)

Yeah.

Yeah. Yep.

That’s smart.

Yeah.

Bill Gasiamis (48:48)

and then I’m done. I go for my ride. I connect with, you know, what I love, the freedom, the movement and all that kind of stuff. I go into the city. I have a coffee and then I ride back. It’s about a 20 kilometer round trip and then I’m done. You know, it takes about three hours and I’m done.

François Couillard (48:49)

That’s great.

That’s great. That’s great.

That’s great. Listen, I want to tell you as well, one of your, as I was right after my stroke, was searching for information and I stumbled on, ⁓ I researched loss of sight from stroke or something like that. And I stumbled on one of your podcasts where you interviewed this woman, I forget her name, but who had experienced something similar. It was mainly sight loss, but for her it was bad.

Bill Gasiamis (49:09)

Thanks

François Couillard (49:33)

But it helped me anticipate what I might go through afterwards. Like she couldn’t go in the car, she’d get nauseated and all that. ⁓ And having that experience that I could go back to ⁓ helped me put things in perspective and again saying, okay, my case is not that bad, there’s a lot worse. ⁓ I should consider myself pretty lucky. ⁓ So yeah, every little thing you do, all these podcasts, are

Bill Gasiamis (49:58)

Hmm.

François Couillard (50:03)

I’m sure they’ve touched and you’ve had testimonials to that, but I’ve touched a lot of people worldwide. So thank you for what you do.

Bill Gasiamis (50:10)

Yeah, my pleasure. You know, there’s been over 1,200,000 downloads just on YouTube.

François Couillard (50:17)

Wow. Wow. Congratulations. What an impact.

Bill Gasiamis (50:18)

Yeah, it’s fantastic. And it’s still

not enough. It’s still not enough. We need to get it out there. That’s over 10 years, right? So it’s still not enough. We need to get it out there. I need people to share and people are doing great work. I people to comment. I need people to like, I need people to do all of that kind of stuff, interact in any way that they can. And they are, and it’s brilliant and I love it and it works. ⁓ You know what’s amazing? If people are watching and there’s an ad, if they don’t skip it and they

François Couillard (50:25)

Yeah.

Yeah.

Bill Gasiamis (50:47)

I make a few dollars that enables me to pay for all the things to keep it going. The book, that’s the purpose of the book. All the money that this thing makes just goes back into keeping it going, paying my VA, paying for hosting, paying for all that kind of stuff. And I think it gives me something to do on a Saturday and Sunday, Francois. It is just the most amazing thing that’s come into my life that helps me get through. Sometimes I have bad days and I don’t want to do it anymore. Very few of those, but…

François Couillard (50:49)

Good.

Yeah.

Understanding Stroke and Its Misconceptions

Bill Gasiamis (51:16)

⁓ Most of the time, the reward and what I get back from it is amazing.

Yeah. So thank you for saying that. I really appreciate it. I’m glad that it helped you. Tell me about your family a little bit. How did they react to your whole situation with the stroke and all the things that came after?

François Couillard (51:23)

Thank

My wife was, I’m married, we have a son, our son lives, lived in the States in those days now, he’s back in Canada. Of course, they were worried. My wife knows me, she knows and I tend to underestimate the, well, overdo things and poo poo risks and issues and I have a pretty high pain threshold.

So she doesn’t fully trust me when I tell her that things are okay. So I think she worried more than, ⁓ than she showed, but she was always there for me, very supportive. the one thing that was difficult is, getting her to, you know, as we sit at the kitchen, we have all our meals together. So we’re sitting and having a meal and she wants to share something. And especially when I was still working, ⁓ I just had nothing left in my brain to listen to her with empathy.

and she would get annoyed and I had to explain, it’s not you, it’s just my brain is fried, my brain is in ⁓ overdrive, the best thing, just accept it and that was tough on her, that was really tough. ⁓ So yeah, and I discovered a lot of people didn’t have a good understanding of a stroke and to this day people…

think I have a problem with my heart. Well, I have PFO, but 40 % of the population has a PFO. So that’s nothing. But people always ask me, how’s your heart? Well, I don’t have a problem with my heart. You know, it’s the brain. Well, it’s something that went to my brain. So a lot of misconceptions on what strokes are. In Canada, it might be the same in Australia, but there’s an organization called the

Well, the big charity is the Heart and Stroke Foundation. So they bundle together heart and stroke. So maybe that’s part of the confusion.

Bill Gasiamis (53:35)

Absolutely, that’s got to be that makes complete sense. What you said about your brain being fried, it is a absolute 100 % accurate description of what you’re saying because that’s, I get to that point still where my brain’s fried and all I can hear is just noises in the background and there is no computation in my brain. Nothing works. Nothing is happening.

François Couillard (53:36)

Yeah.

Bill Gasiamis (54:03)

You could be going on about something and I’ve got no idea. And that is such a strange thing to try and have a conversation with a normal person about, know, because often they’ll say, ⁓ you know, I get tired too sometimes. Or I know, I know when, you know, your brain’s fried. It’s like, you don’t know this level of frying. This is the next level. And I never want you to know. I wish you never find out. ⁓

François Couillard (54:25)

Yeah

Bill Gasiamis (54:32)

and I could have an inbox full, I could have the most important job that needs to be done. It will not get done at that time when my brain is fried. There’s no happening.

François Couillard (54:39)

No, no, and sometimes,

sometimes, you know, just I know I have this one email I need to send or I need this one little thing I need to do. And it’s just my brain has reached a tipping point. No, I cannot take anything more. ⁓ And in interactions like that, it’s it’s tougher because you’re trying to be nice to people.

Bill Gasiamis (54:57)

Yeah.

Yeah, I still get the odd, ⁓ strange look from my wife when we’ll have people over and I’ll just go and sit on the couch away from everybody, just daydreaming, trying to recover because a lot of noise, a lot of people, a lot of that just overstimulates me and I’ve got to go to the side and she’ll look over at me as if she’s saying, you’re so rude. I’m not being rude, my brain’s hurting. I to go over there.

François Couillard (55:27)

⁓ well, it’s great you allow

yourself to do that. Now you’ve got the wisdom to do that. Yeah. Yeah.

Bill Gasiamis (55:32)

Yes. It just gets so hard not to. It gets much harder to

be there. And then I go and reach out.

François Couillard (55:37)

People know, so

I tell people, say, you know, most, well, all my friends know I had a stroke. if I tell them, say, you know, we won’t be staying late. This is always tiring for me. So and they understand and it’s not a problem.

Bill Gasiamis (55:54)

Yeah. I also want to, as we wrap up, want to talk about that point that you made about your wife not fully trusting you and your high pain threshold and tolerance. That’s actually a very important thing because you could be going through something more serious. And because you’re a bike rider who rides for hundreds of kilometers and pushes through pain pretty much that entire time, you could definitely be underplaying

François Couillard (56:13)

Yes.

Yes.

Mindset and Recovery After Stroke

Bill Gasiamis (56:22)

the seriousness of what’s happening to you. And then other people have to kind of guess. You might have even gone to the hospital behaving like a completely normal person and downplaying the whole thing and then just them having to guess.

François Couillard (56:29)

Yes.

Absolutely. Yep,

it’s a risk. Absolutely. But there’s nothing I can do about it. I’m not gonna, it’s who I am. It’s how I am.

Bill Gasiamis (56:47)

Yeah, so it’s good to have that other person kind of on the side, just bringing you into awareness of that every so often.

François Couillard (56:48)

Yeah. Yeah.

At the same time, she’s kind of giving up on me. She knows I don’t listen. that’s the problem with spouses. Over time, we unfortunately tune out, which we shouldn’t. We should always listen attentively, of course.

Bill Gasiamis (57:11)

Yeah, I think she’s more intelligent than that. She’s just learned to stop having that endless argument with you that never gets anywhere, but she knows really what you’ll like. She knows you better than you know yourself.

François Couillard (57:16)

she’s very intelligent.

Yeah, you got it.

You got it. Yeah.

Bill Gasiamis (57:28)

I love it. Francois, I really appreciate you reaching out. I’m so glad that you get something out of my podcast that you appreciated my book, that it has made a difference for you in your recovery. It is lovely to connect with people who have your approach so that we can put it out there and then other people can hear that there is more than one way to do stroke recovery, like in the way that you think about it rather than

François Couillard (57:34)

Yeah.

Bill Gasiamis (57:55)

I get the physical parts and the deficits, I totally get that part. But just in the way that you can alter your mindset and think about it, my first chapter is the mindset chapter. I think it is the most important part of recovery is somebody’s mindset. And regardless of how bad their stroke ⁓ has impacted them and their deficits, if we can get the mindset on the right path 90 % of the time, I think there’s going to be a better outcome for that person. And I say that.

because I always remember Stephen Hawking, the great physicist who was completely disabled ⁓ from the neck down from murder neurons disease, Lou Gehrig’s disease or whatever else they call it, and still had a fully, totally active life in the highest level of his profession and was still considered one of the greatest physicists of all time. And

And I think that his mindset amongst other things would have definitely had something to do with how active he was even though his body had completely ⁓ not been able to support him.

François Couillard (59:07)

Mm-hmm. Yep, I totally agree.

Bill Gasiamis (59:10)

Well, on that note, my friend, thank you for joining me on the podcast.

François Couillard (59:14)

Thank you, Bill. It’s been a pleasure. And thanks again for all the amazing work that you do for all the stroke survivors around. Thank you.

BIll Gasiamis (59:22)

Well, that brings us to the end of another episode of the Recovery After Stroke podcast. I to thank my guest, Francois, for reaching out and joining me on the show.

What he shared today about being turned away at the emergency department, about living with vision loss that nobody around you can see, and about returning to lead at a national level is going to matter deeply to people who have had their own symptoms dismissed or who are carrying the invisible side of stroke every single day. If this episode resonated with you, subscribe to the Recovery After Stroke Podcast wherever you get your podcasts. And if this show has helped you,

A review goes a long way. It helps more survivors find us. My book, The Unexpected Way That a Stroke Became the Best Thing That Happened, is available at recoveryafterstroke dot com slash book.

and if you would like to support the show, you can do that at patreon.com/recoveryafterstroke.

until next time, take care of yourself and keep recovering.

The post Sent Home Mid-Stroke: CEO of Optometry Canada on Vision Loss and Recovery – Francois Couillard appeared first on Recovery After Stroke.

Rebuilding Life After Stroke: Why You Can’t Go Back – And Why That’s the Point

There’s a moment in stroke recovery that almost every survivor reaches. You look at the person you used to be. Your job, your relationships, your body, your identity, and you realise something that nobody prepared you for: you can’t get that person back. The question is what you do next.

Greg Graham knows this moment intimately. An AVM (Arteriovenous Malformation), a rare tangle of blood vessels in the brain, changed the course of his life in an instant. What followed wasn’t just physical recovery. It was the hardest work of rebuilding everything from the ground up.

What an AVM Stroke Takes From You

An arteriovenous malformation stroke happens when a cluster of abnormal blood vessels ruptures in the brain. Unlike ischaemic strokes caused by a clot, AVM strokes involve bleeding into the brain. The consequences depend heavily on where the bleed occurs, and for Greg, the impact was severe.

In the immediate aftermath, Greg found himself isolated. Six weeks of recovery largely alone. Relationships fractured under the weight of what had happened. The losses were not just physical; they were existential. The life he had built, piece by piece, was no longer available to him.

“I’ve lost everything. I don’t see a way forward.” This is the thought that lives underneath so much of early stroke recovery. It’s not self-pity. It’s the honest reckoning that comes when the gap between who you were and who you now are becomes impossible to ignore.

Why “Getting Back to Normal” Is the Wrong Goal

The dominant narrative around stroke recovery in hospitals, in rehabilitation settings, in well-meaning conversations with family is built around return. Return to work. Return to independence. Return to your life.

But for many survivors, this framing creates a wall they can never climb. The person they’re trying to return to doesn’t exist anymore. The brain has changed. The body has changed. The world has shifted in ways that can’t be reversed.

Greg’s insight, hard-won through the kind of experience that can’t be faked, is that rebuilding life after a stroke isn’t about restoration. It’s about construction. Not returning to a previous blueprint, but laying new foundations with the materials you actually have.

What Rebuilding Actually Looks Like

Rebuilding after a stroke is rarely dramatic. It’s the accumulation of small decisions made under enormous pressure. It’s choosing to engage with rehabilitation when nothing in your body wants to cooperate. It’s finding a reason to get out of bed when the reasons that used to work have stopped working.

For Greg, the path through began with a fundamental shift in framing. Instead of measuring recovery by what had been lost, he began to ask a different question: what is actually possible from here?

That question is deceptively simple. But it’s the foundation on which real recovery is built. Because once you stop trying to recreate the past, you free up everything you have to build something new.

The Identity Question Nobody Asks

One of the least-discussed dimensions of stroke recovery is identity. Who are you now? Not in a philosophical sense, in a practical, daily, operational sense. If your work defined you, and stroke took your ability to do that work, who are you on a Tuesday morning?

Greg’s experience speaks directly to this. The construction of a new identity after a stroke doesn’t happen overnight. It isn’t a single breakthrough moment. It’s a slow, deliberate process of discovering what you still are and what you’re becoming.

This is why Greg Graham calls himself the AVM Superhero. Not because recovery was easy, but because naming what you’ve survived and choosing to carry it with you rather than hiding from it is itself a form of strength.

Listen to the Full Conversation

Episode 405 of the Recovery After Stroke podcast is available on all major platforms. Greg’s story is one that will resonate with anyone who has faced the impossible question of rebuilding when going back is not an option. You can also find more resources at Bill’s book, The Unexpected Way That A Stroke Became The Best Thing That Happened, a practical guide to recovery and personal transformation written from lived experience.

If this show has helped you on your recovery journey, 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.

The post Greg Graham – AVM Superhero: How He Rebuilt Life After Losing Everything appeared first on Recovery After Stroke.

Does GABA Actually Help With Sleep? What the Research Says for Brain Injury Recovery

Someone in our community recently asked me about GABA for sleep. They’d seen it recommended online, understood that sleep was critical for their recovery, and wanted to know whether the supplement was worth exploring or just noise.

It’s a genuinely good question. And it deserves a proper answer.

In this post, I’m going to walk you through what GABA is, what the clinical research actually shows about its effect on sleep, why the blood-brain barrier debate matters (and why it might not derail the whole argument), and what the evidence says about the relationship between sleep and brain recovery. By the end, you’ll have enough to have an informed conversation with your medical team.

I’m not a doctor. I’m a three-time haemorrhagic stroke survivor who has spent years researching the science of brain recovery and interviewing hundreds of clinicians and survivors on the Recovery After Stroke podcast. What I offer is a careful read of the evidence, not a clinical prescription.

What Is GABA and Why Does It Matter for Sleep?

GABA (gamma-aminobutyric acid) is the brain’s primary inhibitory neurotransmitter. If your nervous system were a car, GABA is the brake pedal. It reduces neuronal excitability, quiets cortical arousal, suppresses the brain’s primary arousal centre (the locus coeruleus), and modulates the HPA axis, the stress-response system that drives cortisol.

Most sedative medications work by amplifying GABA activity. Benzodiazepines, for instance, bind to GABA-A receptors to increase chloride channel opening, producing their calming effect. GABA isn’t doing something unusual here – it’s doing something fundamental.

The question with supplemental oral GABA is more specific: Does taking GABA as a capsule or powder actually produce meaningful neurological effects?

What Does the Research Show?

Finding 1 — Oral GABA Reduces Sleep Latency (and EEG Can Measure It)

A 2015 clinical trial published in the Journal of Nutritional Science and Vitaminology by Yamatsu and colleagues used EEG measurement, actual brainwave monitoring, rather than self-reported sleep questionnaires. One hundred milligrams of oral GABA shortened sleep latency (time to fall asleep) by 5.3 minutes compared to placebo.

That might sound modest. But for someone lying awake for 30–40 minutes each night, it’s a meaningful shift. Crucially, this was objective neurophysiological data, not a survey response. (PMID: 26052150)

Finding 2 — A 90-Day RCT Showed Improved Sleep Efficiency and Mood

A 2024 randomised double-blind placebo-controlled trial published in the Journal of Dietary Supplements (Guimarães et al.) gave 200 mg of GABA daily for 90 days to sedentary overweight women also undergoing an exercise program. The GABA group showed significantly improved Pittsburgh Sleep Quality Index (PSQI) scores, significantly reduced depression scores, and improved heart rate variability, a marker of parasympathetic nervous system activity.

The HRV finding is particularly interesting. It suggests GABA may be doing something broader than simply reducing sleep latency – it appears to support the overall physiological state that makes rest restorative. (PMID: 38321713)

Finding 3 — But a High-Dose RCT Found No Effect

Here’s where intellectual honesty matters. A 2023 Dutch RCT (de Bie et al.) published in the American Journal of Clinical Nutrition gave participants 500 mg of GABA three times daily, 1,500 mg/day total, and found no significant effect on self-reported sleep quality. Fasting plasma GABA wasn’t significantly elevated either, raising real bioavailability questions at that dose.

This isn’t a reason to dismiss GABA entirely. It is a reason to pay attention to the dose. The evidence base supports 100–300 mg, not 1,500 mg. Higher is not better, and the non-linear dose response is clinically important. (PMID: 37495019)

The Blood-Brain Barrier Debate — and Why the Gut May Be the Point

The most common objection to oral GABA supplementation is this: GABA is a zwitterion at physiological pH, meaning it has low lipophilicity and poor predicted ability to cross the blood-brain barrier via passive diffusion. So if it can’t get into the brain directly, how does it produce neurological effects?

The emerging explanation involves the gut-brain axis.

The enteric nervous system, your gut’s own neural network, has GABA receptors. When oral GABA activates these enteric receptors, it can signal the brain via vagal afferents without needing to cross the BBB at all. Think of it as a side door rather than the front entrance.

Supporting this: a 2024 RCT (Li et al.) found that a probiotic strain engineered to increase gut GABA production significantly improved objective sleep duration as measured by wearable devices, alongside reduced cortisol and suppressed HPA axis activity. The mechanism wasn’t direct CNS access – it was gut-brain signalling. (PMID: 39385735)

The BBB debate doesn’t negate the clinical effect. It changes how we understand the mechanism.

Why Sleep Is Not Optional in Brain Recovery

This is the part that I think gets underweighted in recovery conversations — and the research is unambiguous.

A 2026 large retrospective cohort study (Muhtar et al., Sleep Medicine) matched over 35,000 stroke patients and found that post-stroke insomnia was associated with a 29% higher risk of post-stroke cognitive impairment and a 30% higher risk of all-cause dementia. The association with Alzheimer’s disease was also significant. (PMID: 41924789)

A 2024 observational study from Monash University and Alfred Health (Smith et al.) found that in stroke rehabilitation patients, poor sleep quality was significantly associated with higher fatigue severity and lower salivary BDNF gene expression. BDNF (brain-derived neurotrophic factor) is one of the primary molecular drivers of neuroplasticity. Less BDNF means a less receptive environment for the neurological rewiring that rehab is trying to build. (PMID: 38802847)

And then there’s the glymphatic system: the brain’s waste-clearance mechanism that is most active during deep sleep. Poor sleep means reduced clearance of metabolic byproducts, including proteins associated with neurodegeneration. This is not a theoretical risk. It is an active, ongoing process.

Sleep is not passive recovery. It is one of the primary mechanisms of recovery.

What to Do With This Information

Here are three practical steps if you’re exploring GABA for sleep:

1. Measure your sleep baseline first.

Use the Pittsburgh Sleep Quality Index (freely available online) before you make any changes. Understanding whether you’re struggling with latency, duration, or quality will determine what you actually need to address.

2. If you trial GABA, choose the right form and dose.

Look for PharmaGABA — naturally fermented GABA, derived from Lactobacillus hilgardii, which has the strongest clinical evidence base. A dose of 100–300 mg taken 30–60 minutes before bed is consistent with the positive studies. Avoid very high doses; the null result at 1,500 mg/day is important context.

Important drug interaction note: If you are taking benzodiazepines, anticonvulsants (gabapentin, pregabalin, valproate), or any other GABAergic medication, discuss GABA supplementation with your prescriber before adding it. The additive sedative effect is a real risk. The same applies if you drink alcohol regularly.

3. Don’t skip the foundation.

Sleep hygiene interventions, consistent sleep and wake times, a dark and cool room, and no screens in the 60 minutes before bed, are consistently among the highest-leverage sleep interventions in the literature. GABA may provide a genuine incremental benefit. But it cannot compensate for a fundamentally disrupted sleep environment.

The Bottom Line

The evidence for GABA and sleep is more substantive than I expected when I started researching it. The EEG data is real. The 90-day RCT showed meaningful clinical outcomes. The gut-brain axis mechanism is biologically plausible and now has direct RCT support. And the consequences of poor sleep in neurological recovery are not trivial – they are quantifiable, significant, and, to a degree, addressable.

GABA is not a guaranteed fix. Individual responses vary. The research is not yet definitive at the level of large multi-centre trials in neurological populations. But as one tool in a comprehensive approach to sleep quality alongside good sleep hygiene, appropriate medical support, and consistent rehabilitation, the case for cautious exploration is reasonable.

The next step is a conversation with your neurologist, GP, or rehab physician. Take the research with you if it’s useful.

Research References

All studies cited in this post are retrievable via PubMed:

Yamatsu et al. — GABA sleep latency EEG clinical trial (2015) — PMID: 26052150

Guimarães et al. — GABA 200mg RCT, sleep efficiency + mood (2024) — PMID: 38321713

de Bie et al. — GABA high-dose RCT, null sleep result (2023) — PMID: 37495019

Li et al. — Gut-brain GABA axis and sleep RCT (2024) — PMID: 39385735

Muhtar et al. — Post-stroke insomnia and cognitive decline cohort (2026) — PMID: 41924789

Smith et al. — Sleep, BDNF, and fatigue in stroke rehabilitation (2024) — PMID: 38802847

This post is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making changes to your supplementation or treatment plan.

If you or someone you care about is recovering from a stroke, brain injury, or any neurological condition, the Recovery After Stroke podcast and this blog exist for you. Subscribe on YouTube @BillGasiamis, or visit Recovery After Stroke to find episodes, resources, and community.

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