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Secondary prevention after stroke

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regardless of whether you are a stroke survivor, a caretaker or just a good friend, the “never again!” thought will cross your mind sooner or later. This thought will transmute into fear once you are told that chances of a second stroke are pretty high. You can reject and deny it, you can agonize about it, but the most reasonable thing to do is try hard not to fall ill again.  A haunting vision of a second stroke (and every successive stroke) gives most of us sleepless nights.

Frankly, can we be sure that it will never happen again? Can we minimize the risk of a second stroke? Absolutely. Preventing the disease from recurring is called secondary prevention.   

kasia lewaczka.pl in the truck full of carrotsIt’s much better worded at the portal: PZH

Secondary prevention (2nd phase) is about early diagnosis and prompt intervention in order to arrest the disease process – and thus, about identifying risk factors and their elimination. It is addressed to persons at risk and encompasses, among others, screening tests like screening for breast cancer (mammography) or cervical cancer (cytology), periodic check-ups, control of risk factors, counselling.

It is commonly divided into secondary and long-term prevention – and the latter has to become a regular part of our lives. However, this doesn’t mean that every single day of your life your mind will go “oh gosh prevention prevention”. I believe, we can’t go on like that:) What I mean is rather the need to integrate new habits into our lives.

In the case of stroke survivors, the secondary prevention process starts (at least, should start …) in hospital. From the very beginning we, along with our closest family, are instructed what to do, what not to do, what to eat, what to avoid. Is it helpful? Sometimes yes, sometimes not too much, it depends on the medical staff. In some cases, doctors find the time and attention to give us some useful advice, sometimes not. How do I know that, me being the lucky one that, in most cases, received sound advice? I know it from your emails, and believe me, over these last 5 years (yes, this May it’s exactly five years since my first post on Lewaczka.pl!) I have mailed and talked to many people who felt like they were wandering in the fog, surrounded by darkness, after they had left the hospital.

The hospital discharge form contains a line which says: medical recommendations and patient care recommendations. I can’t recall anymore whether they come in the same line, but this is where the attending doctor puts what should be done next, e.g. consult a specialist in XXX, further diagnostics  …Generally, what needs to be checked and treated. Patient care recommendations, on the other hand, can be detailed or limited to just three words, e.g. “Mediterranean diet recommended”.

Ok, ok, let’s get to the point. There are a few basic rules to follow to help you regain health, strength and prevent strokes from recurring. And so

How to prevent a stroke from recurring – basic rules:

  1. Quit smoking. Sorry, chain smokers, and you, social smokers! Cigarettes are the biggest (along with age) risk factor for stroke. So start here. Quit. I did:) And I believe you too will manage to quit. Fingers crossed!
  2. Take your meds regularly – unfortunately, most probably, we will take some of them (e.g. anti-platelet drugs) until our very last breath. Sad, but true.
  3. Diagnostics and treatment of other diseases – knowledge about diabetes, hypertension, blood coagulation diseases, arrhythmia, aneurysms etc. – gives you a chance to treat them in time or limit their effects, including – surprise! – the chance of another stroke:)
  4. Regular medical checkups. We all understand their importance.
  5. Weight loss – insert a sad face here; I have been fighting this battle for years and at the moment I’m the fattest I’ve ever been. Nothing to boast about, and a lot to worry about.
  6. Move more – physiotherapy won’t do it all. You need to move more at home, outdoors, just about anywhere. Of course, this is super difficult for bedridden patients, but those of you who use a wheelchair or are able to walk, can move more. Although I’m doing pretty well, sometimes I sink into depression and I can’t drag myself out of bed. Fortunately, I found a solution. I got myself a dog! So now, I have to go on walks a few times a day, even when my body is heavy like a sack of flour and every step feels like a Mount Everest climb. And now guess: who walks whom?
  7. A healthy, well-balanced diet – yes, diet is very important. I mentioned above the Mediterranean diet, but generally it’s about eating healthy – fulfilling one’s nutritional needs in a balanced way, including foods that reduce the risk of stroke. Take vitamins! Vitamin deficiencies are one of the stroke risk factors.
  8. Of course, those of you who are able to exercise, would benefit from 3-4 cardio sessions a week, but now I can see some of your faces saying “yeah, sure”. It’s good to do that routine, but sure – after TIA your workout is limited to dangling a cane – so what you can do then is just a walk, some stretching or swimming. Let’s stay reasonable.
  9. Stop or cut down on alcohol consumption. Sorry!. After my first stroke, my attending said to me, roughly: „Miss Kasia, stick rather to a wine of glass with your lunch and not a bottle of vodka at a party, ok?” I’m fine with that:) These days I don’t drink at all because of the antiepileptic meds. From a party girl (university days) I turned into a teetotaler. And I’m fine!:)
  10. Less stress – yes, really. Again it’s something that’s easy to say, difficult to incorporate in our lives. By the way, there is no hard proof that stress leads to strokes, but… ongoing, constant stress undoubtedly exhausts human body, and according to some doctors, increases the risk of stroke.
  11. Drink water – plenty of it – it’s incredibly important for our bodies. If I remember right, research shows that 60% of patients admitted to stroke wards is dehydrated. And in such case, blood becomes thicker. You well know what it means for patients who were hospitalized because of a thrombus (blood clots). No need to convince you any further how important it is to stay hydrated, right?
  12. Change your lifestyle – I find this point hilarious, as this one is usually a summary of all the previous tips. Cause a change of diet, quitting smoking, almost daily exercise etc. sounds like a revolutionary change, right?

A lot of new habits need to be incorporated into our lives, but nothing is too much or too difficult to prevent another stroke.

The list may look daunting, but in fact it can be shortened to just two points: take care of your health and change your lifestyle. The rest may be intimidating, but let me tell you why it’s just a first glance impression.

All of the above things are interconnected; one stems from the other, and the other from yet another one. And still, the most important thing is to make changes in your lifestyle.

Ultimately, it’s about creating new habits and routines. It’s tough, but doable. And yet, if you ask me if I have changed my life to incorporate all of the above points – I have to say, not really. Not all of them. Unfortunately. But I’m still working on it! I know how important the new routine is.

PS

This post is based on my experience and input I found here:

https://neurologia-praktyczna.pl/a517/Wtorna-profilaktyka-udaru—–nowe-wytyczne.html

https://podyplomie.pl/medycyna/31904,prewencja-wtorna-udaru-niedokrwiennego-mozgu?page=4

https://journals.viamedica.pl/polski_przeglad_neurologiczny/article/viewFile/20071/15774

https://www.mp.pl/oit/krazenia/56313,rozpoznanie-leczenie-i-profilaktyka-wtorna-udaru-niedokrwiennego-mozgu-i-napadow-przemijajacego-niedokrwienia-mozgu-wytyczne-european-stroke-organisation-2008

KTYKA WTÓRNA PO UDARZE MÓZGU

 

my stroke

Sharjah, NCD Alliance Gobal Forum, day 1 (noon;))

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konferencjaAs I was informing you on a stroketales facebook page, I was attending the NCD Alliance Global Forum 2017.

This is the translation of my polish text with some small amendments. Keep in mind that I wrote this text on a first day of the conference, after a whole day spent in planes, now it’s a week later.

My question is: do you even know what NCD is? Well, until I was invited to this conference, I had no clue what this term means.

NCD is an acronym for non-communicable disease. What is it? It’s an illness which you can’t catch someone or something. So stroke, lupus and depression fit the term, but AIDS, plague and flu don’t.

Actually, even Wikipedia doesn’t say ow wide this term is – it can be used only to chronic diseases, but it doesn’t have to;) But, for the sake of this blog let’sBut basically, that’s it. (by the way in polish we have term ‚choroby niezakaźne’. But it’s rather used only because we use term ‚communicable or infectious diseases’. ‚non-communicable ‚ is just waaaaaaaaaaaaaaaaaaaaaaaaaaaay to wide. But who I am to judge all of it;)

Let me go back to the main translation ( text from Dec 9th)

As you can suspect being a part of NCD Alliance Forum 2017 is, on one side an honour, on the other adventure, both for personal and ‚professional’ (stroke survivor’s;) causes. My blogs are the most precious thing for me, therefore being recognised for them is rewarding. Continue reading

my stroke stroke survivors Uncategorized

My huge success. Happy World Stroke Day!

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I was thinking about it a lot. I knew that for World Stroke Day (29.10). Maybe even video… But I’m so tired that I haven’t though about anything sensible.

Among others, creativity is not my strong side lately. So I decided do something else. To say proudly that I’m a journalist again and to tell you about some things around it event.

If you want to see my article, click here. 

I’m writing about it because of few things.

14924850775_a05bfebd73_oOf course I’m very proud but it’s not only about it. I wanted to say that wasn’t easy. Even process of writing itself was very tough and I even stopped rehabilitation (seriously!), I have constant headache and I’m stressed out of millions of reasons. Maybe my work is not unassisted enough, as my friend (the best editor ever) edited my text (she says that not much, but still..). Maybe the text is not good enough. Maybe I will not send next text on time. Maybe they will thank me for my help and I will lose internship. Maybe, maybe, maybe…

It’s just internship, they are not too demanding. But still I’m full of fear and doubts. But let’s go further.

I sent CV to the Foundation just before second stroke. When they contacted me lately I had millions of doubts.  But I wrote the text, noone read it, I was accepted without any help. it wasn’t easy for me, but I did it! But you know I’ve been working for it since 9th of May 2015, when I published my first note on m Polish stroke blog, www.lewaczka.pl.

I write daily. I write here, on my Polish site, I write private things just to exercise. I’ve never been so hard-working in my job I have to admit:) But it’s like 1,5 year or daily rehabilitation. It didn’t come over a day. And I wouldn’t be so determined if I didn’t know about my readers. When I get messages like this I’m over the moon.

meaning: thanks for another motivation for me. I've had my elliptical trainer for 2 years, but now I'm feeling bored with it. But from now on I'm starting training again:)

meaning: thanks for another motivation for me. I’ve had my elliptical trainer for 2 years, but now I’m feeling bored with it. But from now on I’m starting training again:)

Because I see it’s sensible. And after messages like his

i wish you fast

meaning: I wish you quick return to your home

it’s so moving for me that my eyes sometimes get wet. I can’t help it.

And when you share your stories or ask for help, i feel more than honored. And you know what – without your support, without support of my family and friends, this article wouldn’t have happened.

But ok – let’s add something bitter to this sweetness;) I’m fully aware that many people after strokes will not regain full functionality.  I’m somehow convinced that even me myself will not recover fully. I might look well, but this ‚might’ thing is nothing in comparison the ‚healthy’ i remember.

Some of us may struggle or regaining something really basic, I don’t know, like speaking or well balance while getting up. And I’m feeling guilty sometimes for talking so much about working out and faith while I stood up and moved my arms so quickly. But I see that good expectations management can bring plenty of good things to our lives. I always joke about my future literary Nobel prize, but I don’t expect it. It’s nice to dream though. It’s important to manage your goals and expectations well and always dream about bit better. The way is long and hard, and made of thousands of small steps. We go further with these baby steps, and feel this is slow. But when you look back on all the steps you’ve taken you see that road was super long. And the end is not even in sight. And when I think what I’ve achieved, it’s like a huge thing. Not only the article. Also being able to sit without any help. Walking by myself.

After second stroke (shame on it!) I feel rather depressed and full of doubts, but it’s temporary thing, not to be expressed loudly, cause I know that I’m not in a position to complain. In general there is some hope for me. And for all of us:)

Yeah. Now I’m sending all of you (all of us?) plenty of warm thoughts for a World Stroke Day. I wish all good, strokeless life, And if stroke is already here, I wish you no repetition:) And with these words I finish this exalted text and I’m going to Spanish conversation.

Un buen dia! have a nice (world stroke) day!

loosing weight project

meet my Fat Lady – how to motivate myself to losing weight…

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gruba baba

This  money is my Fat Lady. She is a handmade money box. From salt&flour dough (does English have the name for such thing? Polish has…;) She will be painted of course, but she already eats money. She has her meal after every day in which I don’t eat sweets and I don’t touch Coke.

I’m not sure whether I’ve already told you, but I’m addicted to Coke Light. Or Coke Zero. For sweets only my mom wouldn’t give me a single penny, but for sweets and Coke…;)

Anyways. I’ve been off the coke (Light, Zero) for the first time from immemorial . It’s been 5 full days already!  Hurray (?) I miss it so much…
My mom, the Fat Lady feeder must be glad.

I miss it.

She pays.

I cry.

I had to mobilize myself to leave the leavings of unhealthy lifestyle because  I still put on weight. I’m more and more convinced it’s all about hormones. Because my fight is a fight not for loosing fat, but for not crossing a magic line of 100 kilos. And I know that it’s not about being more sinful than my friends, because being active and saint doesn’t let me lose even one gram of my body weight. Something has to be wrong. Hormones. Or I have the slowest metabolism ever and my daily demand of calories is like 700 kcal. Let’s hope it’s not that.

I haven’t accomplished any of my goals yet.

PS

I’m lying. It’s not like I’m not able to loose weight at all.

Exactly a year ago I lost 3 kilos. But I was running every day or once in two days. And I was walking like 10-17 km daily. And I was cycling. I ate well, not too many sins. Well, I’m not able to do it again. 2 km walk is a lot for me now.