Wednesday, June 8th, 2016
By Ira Rashbaum, MD, Special to Everyday Health
Strokes occur in more than 795,000 in the United States each year, killing about 130,000. Survivors have an increased risk for long-term disability and face challenges completing daily activities.
Rehabilitation is a crucial component of care following a stroke. At top stroke centers some form of rehabilitation begins virtually immediately after a patient is admitted to the hospital — to get them on the right path to the best possible outcomes.
However, there are several things patients can do to ensure they are maximizing their recovery starting the second they suspect a stroke.
1. Seek urgent care immediately.
It is absolutely critical to seek emergent care when a stroke is suspected. Patients who arrive at the emergency department within 3 hours of their first symptoms tend to have less disability months after a stroke than those who received delayed care.
We at NYU Langone’s Comprehensive Stroke Care Center are fortunate to have recently opened the Ronald O. Perelman Center for Emergency Service, which serves as the first line of urgent care for patients that are suspected of having a stroke. A stroke alert prompts a team of experts from our center to come to a patient’s bedside within minutes to confirm or rule out a stroke, allowing treatment and rehabilitation to begin as soon as possible.
If you’re worried about clogging the emergency room or just want to wait things out, you could be delaying life-saving care.
2. Keep your medical information handy.
A stroke can affect parts of the brain responsible for cognition and communication, leaving a patient unable to tell a doctor their medical history. That can be worrisome, because some stroke treatments can’t’ be given with other medications.
I urge people to carry with them a patient health profile that lists their medical conditions and any medications they’re taking. This piece of paper carried in your wallet might contain vital information that doctors can use to ensure you’re on your way to an optimal recovery.
3. Choose a top care center for your rehabilitation.
Whenever possible, you want a patient to be involved in acute inpatient rehabilitation following a stroke. Data suggest the more acute, intensive rehabilitation you get after a stroke, the better the outcomes.
NYU Langone’s Comprehensive Stroke Care Center is a leading center of its type in our region and offers a sophisticated rehabilitation program that includes care from a rehabilitation physician (known as a physiatrist), physical therapist, occupational therapist, specialized nurses, speech-language pathologists and psychologists. Other facilities like nursing homes may provide adequate rehabilitation services, but the point here is to maximize recovery.
4. Eat well.
A healthy and consistent diet is crucial when recovering from a stroke, from the hospital bed to your outpatient care at home.
One reason food choice is important is because patients in early stages of recovery may experience weakness or incoordination of the swallowing muscles. A care team might recommend soft foods or thicker liquids, because swallowing problems can lead to fluid aspiration which might lead to pneumonia.
Also, certain medications may interact with certain foods, so a rehabilitation specialist can direct you to the best choices.
5. Compliance is key.
I tell my patients if you don’t remember anything in the weeks you’ve been here as an inpatient, the one thing I want you to remember is to see your primary care doctor for regular follow-ups and checkups. Your primary care doctor is essential to your recovery from a stroke, and can make sure your medication needs and health issues are being attended to properly.
Some people may be in denial after a stroke and instead avoid their doctors. But poor compliance with physicians and medications may have got them into these health problems in the first place.
6. Exercise, but within your limits.
Safe levels of physical activity as prescribed by a physical or occupational therapist can go a long way when rehabilitating from a stroke.
What’s important though is you don’t overdo it. People may be excited by improvements in their ability to exercise, but falls are a very real risk following a stroke. That’s why it’s important to stick to your prescribed routine.
7. Limit stress.
I urge patients to keep their lives as stress-free as possible after a stroke. This is not meant to imply that leading a stressed life in some way contributed to their stroke in the first place, but keeping your life more balanced without undue psychological pressures is associated with better outcomes.
8. Stay positive.
It’s very common to have a negative attitude after a serious illness, and some patients experience depression after a stroke — sometimes weeks or months later. However, it is absolutely critical to keep a realistic or positive attitude during rehabilitation to maximize results. Psychologists, psychiatrists and other therapists, who are part of your care team, may recommend therapy and/or medication.
9. Do your homework.
For every stroke patient, treatment at a rehabilitation center eventually comes to an end. When you continue onto the outpatient setting, it is essential you do any homework — otherwise known as a home exercise program — assigned to you by one of your rehabilitation care specialists.
I can’t tell you how many times a patient comes back with a family member or partner to report they’re not getting better, only for a loved one to point out they’re not following their assignments.
It’s never fun to have a stroke or disabling illness, but even if it feels like it’s a grind, do whatever you can to stay up-to-date with your homework.
10. Stay vigilant.
Patients following a stroke face an increased risk of second stroke compared with the general population. Your brain helps you recover from a stroke by asking the unaffected brain regions to do double duty, which means a second stroke can cause far more dangerous effects.
If heaven forbid something gets worse again or you suspect you’re having another stroke, seek out medical attention immediately.
Ira Rashbaum, MD is chief of stroke rehabilitation at NYU Langone Medical Center’s Rusk Rehabilitation.