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Ischemic Stroke

WHAT YOU SHOULD KNOW:

  • An ischemic (is-KE-mik) stroke is a condition that affects the brain and the blood vessels supplying it. This happens when blood flow to a part of the brain suddenly decreases or stops. Blood carries oxygen and other nutrients to parts of your brain. When oxygen cannot get to your brain, cells may become damaged or even die. An ischemic stroke may begin suddenly and develop quickly. Brain tissue can die in a short period of time (minutes or hours). Certain body functions controlled by that part of the brain may die, causing loss of movement in parts of your body. You may have trouble talking, swallowing, or walking. A blood clot, or fat blocking a blood vessel may cause an ischemic stroke. Ischemic strokes can be caused by diabetes, hypertension (high blood pressure), and high cholesterol (fat) levels in the blood.
    Brain


  • Caregivers use tests such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) to learn if you have had an ischemic stroke. You may also need a carotid ultrasound or angiography. Treatment may include breathing support with a machine (ventilator), medicines or surgery. You may also need to make diet and lifestyle changes to prevent having another stroke. Having an ischemic stroke may cause loss of body functions, such as walking or talking, forever. It can also change the way that you think or act. You may need physical, occupational and speech therapy to help you learn new ways to do your usual tasks.

INSTRUCTIONS:

Medicines:

  • Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.

  • Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.
  • Blood thinners: Blood thinners are medicines that help prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners may cause you to bleed or bruise more easily. If you are taking a blood thinner:

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.

    • Many medicines cannot be used when taking medicine to thin your blood. Talk to your caregiver about all of the other medicines that you use. Tell your dentist and other caregivers that you take blood thinning medicine. Wear a bracelet or necklace that says you are taking this medicine.

    • You will need to have regular blood tests while taking this medicine. Your caregiver uses these tests to decide how much medicine is right for you to take. Take this medicine exactly how your caregiver tells you to. Tell your caregiver right away if you forget to take the medicine, or if you take too much.

    • Talk to your caregiver about your diet. This medicine works best when you eat about the same amount of Vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods.

  • Antiplatelets: These medicines work against platelets to prevent blood clots from forming. Platelets are a type of blood cell that form blood clots.

  • Warfarin: Warfarin is a type of medicine that helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Using warfarin may cause you to bleed or bruise more easily. If you are taking warfarin:

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.

    • Many medicines cannot be used when taking warfarin. Talk to your caregiver about all of the other medicines that you use. Tell your dentist and other caregivers that you take warfarin. Wear a bracelet or necklace that says you are taking this medicine.

    • You will need to have regular blood tests while taking warfarin. Your caregiver uses these tests to decide how much medicine is right for you to take. Take warfarin exactly how your caregiver tells you to. Tell your caregiver right away if you forget to take the medicine, or if you take too much.

    • Talk to your caregiver about your diet. Warfarin works best when you eat about the same amount of Vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods.

  • Aspirin to stop blood clots: Aspirin helps thin the blood to keep blood clots from forming. If caregivers tell you to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take.

  • Cholesterol medicine: This type of medicine is given to help decrease (lower) the amount of cholesterol (fat) in your blood. Cholesterol medicine works best if you also exercise and eat a healthy diet that is low in certain kinds of fats. Some cholesterol medicines may cause liver problems. You may need to have blood taken for tests while using this medicine.

Ask your caregiver when to return for a follow-up visit.

Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Blood sugar and blood pressure checks:

  • If you have diabetes, you will need to check your blood sugar many times each day. To do this, you will need to use a glucose monitor. This is a small device that tells how much sugar is in your blood. The monitor uses a small drop of blood from a prick of your finger. Write down your blood sugar level each time for your caregiver to review. Your caregiver will tell you what your blood sugar level should be.

  • If you have high blood pressure, you will need to check and write down your blood pressure readings. Caregivers will teach you or your family how to check your blood pressure, and tell you how often to do this. Keep track of your blood pressure readings, along with the date and time you took them. Take this record with you to your caregiver visits.
    Picture of how to take your own blood pressure
    Picture of how to take another person's blood pressure

Preventing another ischemic stroke:

  • Control other health problems: These health problems may include diabetes, high blood pressure, heart disease, or high cholesterol. Take your medicine as directed by your caregivers.

  • Avoid alcohol: Do not drink alcohol, because it can make your illness worse. Alcohol includes beer, wine, and liquor, such as vodka and rum. Drinking a lot of alcohol can damage your brain, heart, and liver. The risks for high blood pressure, stroke, and certain types of cancer are greater for people who drink too much alcohol. Tell your caregiver if you drink alcohol. Ask him to help you stop drinking.

  • Diet: Ask your caregiver if you should be on a special diet. You may be told to eat foods that are low in fat or cholesterol. You may also be told to limit the amount of salt you eat. If you have diabetes, you may need to change the way you eat to control your blood sugar. Ask caregivers to help you make changes to your diet.

  • Keep a healthy weight: Weighing too much can make your heart work harder and can cause serious health problems. Talk to your caregiver about a weight loss plan if you are overweight.

  • Quit smoking: If you smoke, you should quit. Quitting smoking will improve your health and the health of those around you.

Rehabilitation program:

  • Rehabilitation (rehab) is a program to help you return to doing your usual activities. Rehab helps you learn new ways to do things that you do every day, such as bathing, walking and talking. Physical and occupational therapists work with you to exercise and strengthen your arms, legs, and hands. They may work with you to improve how you walk (gait training). A speech therapist may help you talk and swallow. Rehab exercises may be hard to do and make you tired when you first start doing them. Over time, they should become easier and less tiring.

  • In rehab, you will have several exercise goals after you have had a stroke. These include increasing muscle strength by doing things such as lifting weights. You will work on stretching body parts to make them more flexible. You will work on improving your balance and ease in moving your body. This will reduce your risk of falling and injury. You will also be working to increase your overall fitness level. You may walk or ride an exercise bicycle on this program. With these exercises you may be able to do things such as housework for a longer time without needing to rest.

Skin care:

You may need a special mattress called an egg crate or an air mattress. Ask someone to help you turn in bed if you cannot do this yourself. Changing your position in bed often will help prevent bed sores. Bed sores can happen when pressure on your skin and tissues decreases blood flow, causing sores to form. Ask your caregivers for more information about preventing pressure sores.

How can I tell if someone is having a stroke?

Use the quick and easy-to-remember F.A.S.T. test to check for signs that someone is having a stroke:

  • F = Face: Ask the person to smile. Drooping on one side of the mouth or face is a sign of a stroke.

  • A = Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.

  • S = Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or strange sounding is a sign of a stroke.

  • T = Time: If you see that the person has any of these signs, this is an emergency. Call 911 or 0 (operator) to activate the EMS (emergency medical service). Ask for an ambulance to take the person to the nearest hospital.

CONTACT A CAREGIVER IF:

  • You are having trouble with any of your therapy or exercises.

  • You have a pressure sore on your skin.

  • You have a fever (increased body temperature).

  • Your blood pressure is higher then what your caregiver has told you it should be.

  • You have any questions or concerns about the stroke, or your medicine or care.

SEEK CARE IMMEDIATELY IF:

  • You have chest pain that spreads to your arms, jaw, or back.

  • You have one or more of the following signs or symptoms of a stroke:

    • A very bad headache. This may feel like the worst headache of your life.

    • Confusion and problems speaking or understanding things.

    • Not able to see out of one or both of your eyes.

    • Too dizzy to stand, trouble walking, or loss of balance.

    • Weakness or numbness of your face, arm, or leg, especially on one side of your body.

  • You have trouble breathing.
This is an emergency. Call 911 or 0 (operator) to activate the EMS (emergency medical service). Ask for an ambulance to take you to the nearest hospital. Do not drive yourself.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Ischemic Stroke (Aftercare Instructions)

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