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.
It’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:
- 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!
- 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.
- 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:)
- Regular medical checkups. We all understand their importance.
- 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.
- 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?
- 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.
- 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.
- 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!:)
- 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.
- 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?
- 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
