What to Do After a Stroke
Strokes occur when a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot or bursts. About 700,000 Americans each year suffer from a stroke. If you have one stroke, you are at a greater risk for having another within the next year.
“Risk factors for stroke build up over years, even decades, to cause changes in blood vessels and the heart that may take years to reverse,” says Bruce H. Dobkin, M.D. Dr. Dobkin is director of both the UCLA Stroke Center and the Neurologic Rehabilitation and Research Program in Los Angeles.
Stroke may cause physical and mental difficulties. These can include near paralysis on one side of the body, difficulty understanding words or speaking, slow thinking, and fatigue.
The good news? You can recoup some or all of your previous abilities. Here’s what Dr. Dobkin recommends to speed your recovery and reduce the odds for another stroke.
Know your numbers
High blood pressure (greater than 140/90) is a leading cause of stroke. This is because the added pressure can damage and weaken blood vessels.
“As many as 50 percent of people who have high blood pressure still don’t have their blood pressure well controlled after a stroke,” says Dr. Dobkin.
To get your blood pressure on track, Dr. Dobkin recommends buying a digital blood pressure monitor with an automatic arm cuff. A device like this costs about $60 at pharmacies. Routinely take your blood pressure at home. Do this in the morning and the evening, both sitting up and lying down, for several weeks or more. Record the readings in a log.
To play it safe, “make sure your blood pressure isn’t running much higher than 130/70,” says Dr. Dobkin. “If it does, see your doctor, and take your blood pressure log with you to the appointment.”
If you have diabetes, keep a log of your blood sugar, as well. Uncontrolled blood sugar also is a risk factor for recurrent stroke.
“If your blood sugar isn’t well-regulated, ask your doctor if you should check it more often,” he urges. “The more information you give your doctor about your blood pressure and blood sugar, the better able he or she is to make decisions about your medication and treatment plan.”
Watch for side effects
Based on the data you provide, your doctor may put you on new medication or adjust the medication you’re already taking. In any event, take your medicine as directed. Don’t stop taking it unless your doctor tells you to do so, even if you feel fine.
But if you feel lightheaded, dizzy, confused, weak, or achy, tell your health care provider immediately. Don't wait until your next appointment. These symptoms could be side effects of diabetes, high blood pressure, or medication to lower cholesterol.
“Those side effects mean the medication isn’t working properly and may cause other serious medical problems,” says Dr. Dobkin. “In that case, your doctor will probably need to adjust your medication or find an alternative to reduce your risk factors.”
Keep up the good work
As another part of your recovery, you may need rehabilitation to recover the use of an affected arm or leg. Rehab can also help you regain your mental abilities. Inpatient and outpatient rehab may be part of your treatment plan for up to six months post-stroke. But progress doesn’t end there.
“There’s a myth that recovery happens only in the first three to six months after a stroke,” says Dr. Dobkin. “The reality is, if you have some problems with language skills or control of the affected arm or leg, you can continue to improve long after that if you practice the tasks you want to improve.” Some of that practice may need to be supervised by a physical therapist or a physician, and certainly family members can help. But much of it has to be done on your own.
He suggests practicing what you want to do, then doing it faster or with greater precision. Use objects of different sizes and weights, and under different circumstances, such as in the kitchen and when dressing. If, for example, you’re trying to recover full use of your hand, you’ll want to practice reaching for a cup, picking up objects, bringing things to your mouth, feeding yourself, brushing your hair, and putting a key in a door lock.
Practice your skills
It all depends on how much strength and sensation you have at any given time. You may need to practice the tasks you want to improve several hours each day, if necessary. Encourage family members to let you do as much as possible yourself, even if you’re struggling.
For the best results, decide what you want to work on and get some help in setting up the best conditions for doing just a few of the activities several hours a day. Aim for small advances day by day, and concentrate on how and what you’re doing.
Similarly, try different strategies to accomplish tasks that are no longer possible.
“For example, if you have trouble multitasking, which is often more difficult after any type of nervous system injury, do only one thing at a time,” Dr. Dobkin says. “To become acclimated to your new situation, experiment to see what works best.”