Tips to Prevent Strokes

Feb. 21, 2002 -- Do you know the important, practical things you need to know about stroke? If you are not sure, the following ABCs will help you understand the basic approaches to dealing with it. Mainly, how to avoid it, how to beat it if you get it, and finally how to recover from it.

'A' for Avoid It:

It is of utmost importance to avoid stroke or prevent it from happening, as this is the most effective way of dealing with it. How to do it? Answer the following questions:

Risk Factors

1. Am I 65 years or older?2. Do I have high blood pressure?3. Do I have diabetes or high blood sugar?4. Do I have atrial fibrillation (a specific heart rhythm irregularity)?5. Do I have heart disease?6. Do I smoke cigarettes?7. Do I drink alcohol heavily?8. Do I do very little or no physical activity?9. Do I have one or more members of my family that had strokes?10. Did my doctor tell me I have blockage in the vessels in my neck?11. Did I ever have a stroke or TIA (transient ischemic attack or mini-stroke)?

If you answered "yes" to any of these questions, you should be aware that you are at risk for stroke. You are at higher risk if you have already suffered a stroke or TIA, or if you have answered "yes" to two or more of the questions. If you are at risk for stroke, then answer the following questions:

Prevention

1. Did I stop smoking?2. Is my blood pressure well treated?3. Is my blood sugar well controlled?4. Am I drinking one or two alcoholic drinks a day?5. Am I doing moderate physical activity regularly?

Medication or Treatment

1. I have atrial fibrillation. Am I on warfarin or Coumadin?2. I had a stroke or TIA or I have heart disease: Am I on an antiplatelet medication (mild blood thinner, like aspirin or others)?3. I have heart disease or high cholesterol: Am I taking a medication to lower cholesterol?4. I have a narrowing of the blood vessels in my neck: Should I have surgery or not? Did my doctor discuss it with me?

If you address these questions appropriately, you are indeed doing the best you can to avoid a stroke.

'B' for Beat It:

If you ever suffer a stroke, you need to be in the best place that will provide you with the best treatment. If you have found out from the questions above that you are at risk for stroke, you should be knowledgeable about the hospitals that will provide you with the best treatment in case you suffer a stroke.

Hospital Care

1. Does my hospital have a stroke center?2. Does my hospital have a stroke team available all the time?3. Does my hospital have a stroke expert?4. Does my hospital provide treatment with tPA (a clot buster) for stroke?5. Do I know what types of treatments are available for stroke in my hospital?

Family Awareness

1. Does my family know the following major signs and symptoms of stroke: weakness or numbness on one side of the face or body, difficulty speaking or understanding, loss of vision, sudden loss of balance, or sudden severe headache? 2. Does my family know to call 911 immediately if I am having a stroke?

'C' for Cure It:

After a stroke happens, and you get the best treatment, there is still a good chance that you will be left with deficits (weakness, numbness, swallowing, speech or vision problems). It is important to focus on the recovery from these deficits.

1. Do you know that, in general, the deficits from stroke will improve on their own over the next weeks to months, and sometimes years?

2. Do you know that that the brain has the ability to compensate for the deficits you have by expanding the role of other parts that have not been damaged?

3. Rehabilitation therapies (physical, occupational and speech therapy) can help you speed up getting faster back on your feet, regain use of your arm and enhance your communications skills. It is important to have the therapy with persons who have significant experience in stroke.

4. Swallowing difficulties can be common after stroke, but swallowing assessment and therapy can help improve them.

5. Depression happens in more than half of stroke patients, but they generally respond well to medications.

6. You will need to be actively involved in trying to exercise and follow the treatments in order to restore your impaired abilities.

7. Having family and social support and being active socially will help you adapt better to your new situation.

8. Finally, keep in mind that after having a stroke, you are at highest risk of having another stroke. So go back to the questions at the beginning and make sure you follow them.

Dr. Pierre Fayad is a Reynolds Centennial Professor and Chairman of the Department of Neurological Sciences at the University of Nebraska Medical Center.