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Stroke - discharge

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When You Were in the Hospital
You or your loved one was in the hospital after having a stroke. Stroke happens when blood flow to part of the brain stops.

First, you or your loved one received treatment to prevent any further damage to the brain, and to help the heart, lungs, and other important parts of your body.

After you were stable, doctors did testing and treatment to help with recovery from the stroke and prevention of a future stroke. You may have stayed in special units that help people to recover after a stroke.

What to Expect at Home
Because of possible injury to the brain from the stroke, you may notice problems with: You may need help with many daily activities you used to do alone before the stroke.

Depression after stroke is fairly common as you or your loved one learns to live with the changes. It may develop soon after stroke, but symptoms of depression may not be present for up to 2 years after the stroke.

Do not drive your car without your doctor's permission.

Moving Around
Moving around and doing normal tasks may be hard after you or your loved one have a stroke.

Make sure your home is safe. Ask your doctor, therapist, or nurse about making changes in the home to make it easier to do everyday activities.

Learn to make your home safer if your loved one has memory problems from the stroke and could wander away inside the home or away from the home. Find out about what you can do to prevent falls and keep your bathroom safe to use

Family and caregivers may need to help with: If you or your loved one is using a wheelchair, follow-up visits to make sure it fits well are important to prevent skin ulcers.
Thinking and Speaking
Tips for making clothing easier to put on and take off are: People who have had a stroke may have speech or language problems. Tips for talking with your loved one are: When giving someone instructions after a stroke: Try using other ways of communicating:
Bowel Care
Nerves that help your bowels work smoothly can be damaged after a stroke. Have a routine. Once you find a bowel routine that works, stick with it. Avoid constipation: Ask your doctor about medicines you, or your loved one, are taking that may cause constipation (such as some medicines for depression, pain, bladder control, and muscle spasms).

Medication
Have all of your prescriptions filled before you go home. It is very important that you take your drugs the way your doctor or nurse told you to. Do not take any other drugs, supplements, vitamins, or herbs without asking your doctor about them first.

You may be given one or more of the following drugs. These drugs are meant to control your blood pressure or cholesterol, or keeping your blood from clotting. They may help prevent another stroke: Do not just stop taking any of these drugs, as well as drugs for your diabetes, high blood pressure, or any other medical problems you may have.

If you are taking a blood thinner, such as warfarin (Coumadin), you may need to have extra blood tests.

Staying Healthy
If you have problems with swallowing, you must learn to follow a special diet that makes eating safer. Ask your doctor what the signs of swallowing problems are. Learn tips to make feeding and swallowing easier and safer.

Learn more about what you should eat to make your heart and blood vessels healthier. Try to limit how much alcohol you drink. Ask your doctor when you may start. Even if you are allowed to drink, limit yourself -- women may have one drink a day and men may have two drinks a day.

Keep up to date with your vaccinations. Get a flu shot every year. Ask your doctor if you need a pneumonia shot.

Do not smoke cigarettes. Ask your doctor for help quitting if you need to. Do not let anybody smoke in your home.

Try to stay away from stressful situations. If you feel stressed all the time or feel very sad and blue, talk with your doctor or nurse.

Many patients who have had a stroke feel sad or depressed at times. Talk to friends or family about this. Ask your doctor about seeing a professional to help you with these feelings.

When to Call the Doctor
Call your doctor if you have: Call 911 if the following symptoms develop suddenly or are new:
Alternate Names
Cerebrovascular disease - discharge; CVA - discharge; Cerebral infarction - discharge; Cerebral hemorrhage - discharge; Ischemic stroke - discharge; Stroke - ischemic - discharge; Stroke secondary to atrial fibrillation - discharge; Cardioembolic stroke - discharge; Brain bleeding - discharge; Brain hemorrhage - discharge; Stroke - hemorrhagic - discharge; Hemorrhagic cerebrovascular disease - discharge; Cerebrovascular accident - discharge

References
Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke . 2011 Jan;42(1):227-76. Epub 2010 Oct 21.

Legg L, Drummond A, Leonardi-Bee J, Gladman JR, Corr S, Donkervoort M, et al. Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials. BMJ . 2007 Nov 3;335(7626):922. Epub 2007 Sep 27. 

Update Date: 9/6/2012
Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Inc.
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