Making the Most of Life after Stroke

Your life after a stroke may change in small or large ways, depending on how much damage to the brain the stroke causes. Some people make a full recovery while others have long-term or lifelong disabilities.

Medical teams aim to get people back to the highest level of function possible, while at the same time preventing another stroke. After having a first stroke, women have a 24 percent chance of having another stroke within five years, says the National Stroke Association. For men, about 42 percent have another stroke. So, taking steps to prevent stroke recurrence is extremely important.

Neurointerventionalist Bryan Ludwig, MD, Stroke Neurology Chair, Premier Health Neuroscience Institute, says, “Our stroke team needs to figure out why you had a stroke and how to prevent it in the future.” Dr. Ludwig explains how the stroke team assesses possible causes of stroke and works with patients to make needed changes to prevent another one.

Click play to watch the video or read the transcript.

After someone has a stroke, what can be done to reduce their risk of having another stroke?

If someone suffers a stroke one of the most important things that we do as a stroke team is identify why they had that stroke. It's been easier, because of imaging of late, to know definitively the person’s had a stroke on MRI. It identifies it very quickly, very easily. But that's only 10% of the picture I would argue. I mean yes now we can identify you had a stroke, but we need to figure out why you had it and how to prevent it in the future. Which is much more important to the overall health of this individual. And that's a tough question to answer. What we do on our stroke service is we run a series of tests while the patient’s in the hospital. Usually over a day or two. We work through the various possibilities that could have caused the stroke, which include looking at the arteries in their neck and their head to make sure that there's not plaque. The same plaque we talk about in people in people's hearts and other arteries in their body can form in the arteries in the neck and in the head and block arteries, causing stroke. We look for arteries that might be damaged from trauma or other things with these same images. We also, of course, use MRI to look at the brain tissue, to make sure they don't have underlying genetic disorders that might lead to further strokes that we could potentially ward off. We look at their heart with specific tests that again identify risks that could cause stroke coming from the heart. And after doing all of this we then check labs that look for their cholesterol counts to assure that their cholesterol count is well-controlled. Of course, throughout the whole stay we monitor their blood pressure. Again if they are found to have high blood pressure, we start medications that would work to lower that pressure as they exit out of the hospital and hopefully go home or to rehab. We look at various factors about smoking and stopping smoking and having people counsel them. And if they are diabetic we have diabetic counselors and of course specialists to come in and talk about good eating habits, exercise and those types of things that could control your blood sugars if you are a diabetic patient. All of those things happen in the hospital but it doesn't just stop there. The continuity of care is very important for stroke patients to continue those trends throughout their whole lives. So we start medications to prevent stroke and then we follow them up in clinic, usually shortly thereafter. And there's a very set and strict guideline that we use to assure that no one falls through the cracks and that they receive their medications and screening tests that they need to continue to try to protect them in the future from having another stroke.

 

Recovering from a Stroke

If you are working to recover full movement in your arms and/or legs, activities of daily living can help restore muscle strength and function. Challenge yourself, but also be patient with your progress and reward yourself for improvements you make.

Prevent fall risks by making changes in your home, such as removing loose rugs or installing hand railings in your bathroom. A doctor or therapist may recommend an assistive device such as a walker or cane to help you with balance.

For showering or bathing, install grab bars, a shower seat, a hand-held showerhead or anything that will keep you from losing your balance and falling.

When you are getting dressed, sit down. If an arm is affected, wear shirts that pull easily over your head, and skirts or pants with elastic waistbands. A loop on a zipper pull tab also may make dressing easier.

After having a first stroke, women have a 24 percent chance of having another stroke within five years.

Lifestyle Changes to Prevent Future Strokes

Smart lifestyle choices will help give you the best odds for preventing another stroke.Making the Most of Life after Stroke - In Content

  • Take medications exactly as prescribed. Medicines to prevent clot formation, control high blood pressure, lower cholesterol, normalize heart rhythms and control diabetes all help to lower risk for another stroke. Do not skip doses, change doses or suddenly stop taking medicine without strict instructions from your doctor. Let your doctor know about any side effects you’re having. You may need routine blood tests to confirm that medicines are working as they should.
  • Make changes in your diet. The food you eat has a direct impact on the health of your heart and blood vessels. A heart-healthy diet protects you from stroke. Follow these guidelines to help prevent another stroke:
    • Eat plenty of fruits and vegetables.
    • Reduce fat, cholesterol and salt.
    • Choose lean proteins, such as fish, poultry, beans and peas and eat less red meat and processed meats.
    • Consume low-fat dairy products.
    • Limit vegetable and nut oils, sweets and processed foods such as chips, cookies and baked goods.
    Try tasty, healthy recipes from the American Stroke Association.
  • Stay as active as possible. Discuss with your doctor or rehab team what you can do on your own to keep moving. It may be simple activities such as walking, gardening or performing household tasks. The more you are physically active, the healthier it is for your heart and blood vessels.
  • Limit the alcohol you consume. American Heart Association guidelines suggest no more than one alcoholic drink per day for women, and no more than two drinks for men.
  • Don’t smoke. If you smoke, stop immediately to prevent further damage to your heart and blood vessels. Ask your doctor about smoking cessation programs, medication or other techniques to quit smoking.
  • Manage your stress. Good stress management techniques will help keep your blood pressure under control.
Small Steps: Set Realistic Goals.
Small goals for walking, talking or self-care can help you regain independence and mobility step by step.