Discharge Instructions for Stroke

You have a high risk for a stroke, or a TIA (transient ischemic attack). During a stroke, blood stops flowing to part of your brain or there is bleeding in the brain. This can damage areas in the brain that control other parts of the body. Symptoms from a stroke depend on which part of the brain has been affected.

After you've had a stroke, you're at greater risk for another one. Other things that can raise your risk for a stroke include:

• High blood pressure.
• High cholesterol.
• Cigarette or cigar smoking.
• Diabetes.
• Carotid or other artery disease.
• Atrial fibrillation, atrial flutter, or other heart disease.
• Not being physically active.
• Obesity.
• Certain blood disorders, such as sickle cell anemia.
• Drinking too much alcohol.
• Abusing street drugs.
• Race.
• Gender.
• A family history of stroke.
• A diet high in salty, fried, or greasy foods.

Doing some everyday tasks may be hard after you've had a stroke. But you can learn new ways to manage. In fact, doing daily activities may help you to regain muscle strength. This can help your affected limb work more normally. Be patient. Give yourself time to adjust. And appreciate the progress you make.

You may be at risk of falling. Make changes to your home to help you walk more easily. A therapist will decide if you need an assistive device, such as a cane or walker, to walk safely.

You may need to see an occupational therapist. Or you may see a physical therapist. These health care providers can help you to learn new ways of doing things. For example, you may need to make changes in how you bathe or dress. You may also need a speech therapist. This is someone who helps you speak normally again and be able to swallow.

• Test the water temperature with a hand or foot that was not affected by the stroke.
• Use grab bars, a shower seat, a handheld shower head, and a long-handled brush.
• Use any other device as advised by your therapists.

• Dress while sitting, starting with the affected side or limb.
• Wear shirts that pull easily over your head. Wear pants or skirts with elastic waistbands.
• Use zippers with loops attached to the pull tabs.

• Take your medicines exactly as directed. Don't skip doses.
• Start an exercise program. Ask your doctor how to get started. Ask how much activity you should try to get every day or week. You can benefit from simple activities, such as walking or gardening.
• Limit how much alcohol you drink.
• Control your cholesterol level. Follow your doctor's advice about how to do this.
• If you smoke, quit now. Join a stop-smoking program to improve your chances of success. Ask your doctor about medicines or other methods to help you quit.
• Learn stress management methods. These can help you deal with stress in your home and work life.

Your doctor will guide you on changes you may need to make to your diet. They may advise that you see a registered dietitian for help with changes. The changes can improve your cholesterol, blood pressure, and blood sugar. Changes may include:

• Reducing the amount of fat and cholesterol you eat.
• Reducing the amount of salt (sodium) in your diet, especially if you have high blood pressure.
• Eating more vegetables and fruits.
• Eating more lean proteins, such as fish, poultry, and beans and peas (legumes).
• Eating less red meat and processed meats.
• Using low-fat dairy products.
• Limiting vegetable oils and nut oils.
• Limiting sweets and processed foods, such as chips, cookies, and baked goods.
• Not eating trans fats. These are often found in processed foods. Don't eat any food that has hydrogenated oils listed in its ingredients.

• Go to your medical appointments. Close follow-up is important to stroke rehabilitation and recovery.
• Some medicines need blood tests to check for progress or problems. Go to all follow-up appointments for any blood tests ordered by your doctors.

Call 911 right away if you have any symptoms of stroke, such as:

• Weakness, tingling, or loss of feeling on one side of your face or body.
• Sudden double vision or trouble seeing in one or both eyes.
• Sudden trouble talking or slurred speech.
• Trouble understanding others.
• A sudden, severe headache.
• Dizziness, loss of balance, or a sense of falling.
• Blackouts or seizures.

B.E. F.A.S.T. is an easy way to remember the signs of stroke. When you see these signs, you know that you need to call 911 fast.

• B is for balance. This means a sudden loss of balance or coordination.
• E is for eyes. Be aware of vision changes in one or both eyes.
• F is for face drooping. This means that one side of the face is drooping or numb. When the person smiles, the smile is uneven.
• A is for arm weakness. One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.
• S is for speech difficulty. You may notice slurred speech or trouble speaking. The person can't repeat a simple sentence correctly when asked.
• T is for time to call 911. If someone shows any of these symptoms, even if the symptoms go away, call 911 right away. Make note of the time the symptoms first appeared.