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REFERENCES and ADDITIONAL DATA
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Ministroke explained
Updates on Strokes
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| PREVENTION OF FURTHER STROKES |
| REHABILITATION IS MANDATORY |
 DON'T IGNORE THE OBVIOUS |
Q. What is a stroke?
A. A stroke is an illness in which not enough blood gets to your brain. A stroke also can be caused by bleeding in the brain. Too little or too
much blood in your brain means that your brain cannot tell certain parts of your body how to work. You may have trouble speaking, walking,
or seeing.
Q. What are the signs of a stroke?
A. These are the signs that you might be having a stroke:
sudden loss of feeling or weakness in your face, arm, or leg on one side of your body;
sudden trouble speaking or understanding someone else speaking;
sudden trouble seeing out of one or both eyes;
sudden trouble walking;
sudden very bad headache with no known cause;
sudden confusion; and
feeling dizzy, losing your balance, or falling.
Q. What should I do if I think that I'm having a stroke?
A. Do not drive! Call 911 or your local emergency number right away. Doctors can give you medicine that can save your life.
Q. What is TPA?
A. TPA is a new medicine that keeps problems from your stroke from getting worse. You must get TPA within three hours of having your
stroke for the medicine to work. Remember, call for help right away.
Q. How can I lower my chances of having a stroke?
A. Here are things you can do to lower your chances of having a stroke.
Take care of your high blood pressure. Take your high blood pressure medication as prescribed by your doctor. Eat healthy foods, stay at
a healthy weight, and gets lots of exercise.
Talk to your doctor about ways to lower your high blood cholesterol.
Stop smoking. There are lots of products like nicotine patches and gums, and support groups and educational materials to help you stop
smoking.
Take care of your heart disease. See your doctor and take your heart disease medicine. If you are over 50, talk to your doctor about
aspirin therapy.
Take care of your diabetes. Take your diabetes medicine, check your blood sugar, eat healthy foods, and get lots of exercise.
Get help if you have a small stroke (called a transient ischemic attack). Talk to your doctor to see if you need medicine or surgery.
Q. Can I get better after having a stroke?
A. Yes! More than one million people who have had strokes have little or no health problems from their strokes. However, about two million
people who have strokes have more serious problems, such as paralysis (not being able to move parts of the body), and speech or memory
loss. That?s why it is so important to know the signs of stroke and get help right away if you think you may be having a stroke.
For More Information…
You can find out more about stroke by contacting the National Women's Health Information Center (800-994-9662) or the following
organizations:
National Institute of Neurological Disorders and Stroke
Internet Address: http://www.ninds.nih.gov/
American Heart Association
Phone: (800) 242-8721
Internet Address: http://www.americanheart.org/
National Stroke Association
Phone: (800) 787-6537
Internet Address: http://www.stroke.org/
NATIONAL STROKE ASSOCIATION
STROKE PREVENTION GUIDELINES
National Stroke Association's (NSA) Prevention Advisory Board is releasing its Stroke Prevention Guidelines, the first-ever national expert consensus set of recommendations on what the public can do to prevent the third leading cause of death in the United States. The public will be encouraged to seek their physicians' advice and assistance with implementation of the guidelines.
Later this year, the panel will unveil a second set of prevention guidelines for physicians, recommending best practices of managing patients at increased risk for stroke.
NSA formed the Prevention Advisory Board in August, 1997, comprised of the nation's leading experts on stroke prevention. The Board provides guidance and lends expertise in helping NSA shape and direct its stroke prevention programs and initiatives.
Stroke Prevention Guidelines
1. Know your blood pressure. Have it checked at least annually. If it is elevated, work with your doctor to keep it under control.
2. Find out if you have atrial fibrillation
3. If you smoke, stop.
4. If you drink alcohol, do so in moderation.
5. Find out if you have high cholesterol.
6. If you are diabetic, follow your doctor's recommendations carefully to control your diabetes.
7. Include exercise in the activities you enjoy in your daily routine.
8. Enjoy a lower sodium (salt), lower fat diet.
9. Ask your doctor if you have circulation problems which increase your risk for stroke.
10. If you experience any stroke symptoms, seek immediate medical attention.
National Stroke Association Stroke Prevention Guidelines
1. Know your blood pressure. Have it checked at least annually. If it is elevated, work with your doctor to keep it under control.
High blood pressure (hypertension) is a leading cause of stroke.
You can check your blood pressure at your doctor's office, at health fairs, at home with an automatic blood pressure machine, or at your local pharmacy or super market.
If the higher number (your systolic blood pressure) is consistently above 140 or if the lower number (your diastolic blood pressure) is consistently over 90, consult your doctor.
If your doctor confirms that you have high blood pressure, s/he may recommend some combination of changes in your diet, regular exercise, and medication.
Medication for blood pressure has been improved. Once you and your doctor find the right medicine for you, it will almost never cause side effects or interfere with your quality of life.
2. Find out if you have atrial fibrillation.
Atrial fibrillation (AF) is an irregular heart beat that changes heart function and allows blood to collect in the chambers of your heart.
This blood, which is not moving through your body, tends to clot.
The beating of your heart can move one of these blood clots into your blood stream, and can cause a stroke.
Your doctor can diagnose AF by carefully evaluating your pulse.
AF can be confirmed or ruled out with an ECG -- which can probably be done in your doctor's office.
If you have AF, your doctor may choose to lower your risk for stroke by prescribing medicine -- blood thinners such as warfarin or aspirin are the most commonly prescribed treatments.
3. If you smoke, stop.
Smoking doubles the risk for stroke.
If you stop smoking today, your risk for stroke will immediately begin to drop.
Within five years, your stroke risk may be the same as that of a non-smoker.
4. If you drink alcohol, do so in moderation.
Drinking a glass of wine or beer or one drink each day may actually lower your risk for stroke (provided that there is no other medical reason you should avoid alcohol).
Heavy drinking increases your risk for stroke.
Remember that alcohol is a drug -- it can interact with other drugs you are taking, and alcohol is harmful if taken in large doses.
5. Find out if you have high cholesterol.
Know your cholesterol number.
If your cholesterol is high, you may be at increase risk for stroke.
Lowering your cholesterol (if elevated) may reduce your risk for stroke.
High cholesterol can be controlled in many individuals with diet and exercise.
Some individuals with elevated cholesterol may require medication.
6. If you are diabetic, follow your doctor's recommendations carefully to control your diabetes.
Often, diabetes may be controlled through careful attention to what you eat.
Work with your doctor and your dietitian to develop a nutrition program that fits your needs and your lifestyle.
Your doctor can prescribe lifestyle changes and medicine that can help control your diabetes.
Having diabetes puts you at an increased risk for stroke; by controlling your diabetes, you may lower your risk for stroke.
7. Include exercise in the activities you enjoy in your daily routine.
A brisk walk for as little as 30 minutes a day can improve your health in many ways, and may reduce your risk for stroke.
Try walking with a friend; this will make it more likely that you'll make it a habit.
If you don't enjoy walking, choose another exercise activity that suits your lifestyle; bicycle, golf, swim, dance, play tennis, or take an aerobics class.
Make time each day to take care of yourself by exercising. GO TO: http://www.maxpages.com/resurrection/The_Importance_Of_Exercise, on this site.
8. Enjoy a lower sodium (salt), lower fat diet.
By cutting down on sodium and fat in your diet, you may be able to lower your blood pressure and, most importantly, lower your risk for stroke.
Work towards a balanced diet with plenty of fruits, vegetables, grains, and a moderate amount of protein each day.
9. Ask your doctor if you have circulation problems which increase your risk for stroke.
Strokes can be cause by problems with your heart (pump), arteries and veins (tubes), or the blood which flows through them. Together, they are your circulation. Your doctors can check to see if you have problems in the circulation supplying blood to your brain.
Fatty deposits - caused by atherosclerosis or other diseases - can block the arteries which carry blood from your heart to your brain. These arteries, located on each side of your neck, are called carotid and vertebral arteries.
This kind of blockage, if left untreated, can cause stroke.
You can be tested for this problem by your doctor. Your doctor can listen to your arteries just as s/he listens to your heart, or look at ultrasound or MRI images.
If you have blood problems such as sickle cell disease, severe anemia, or other diseases, work with your doctor to manage these problems. Left untreated, these can cause stroke.
Circulation problems can usually be treated with medications. If your doctor prescribes aspirin, warfarin, ticlopidine, clopidogrel, dipyridamole, or other medicine for circulation problems, take it exactly as prescribed.
Occasionally, surgery is necessary to correct circulation problems such as a blocked artery.
10. If you experience any stroke symptoms, seek immediate medical attention.
Sudden weakness or numbness of your face, arm or leg -- especially if it's on one side of your body;
Sudden blurred or decreased vision in one or both eyes;
Difficulty speaking or understanding simple statements;
Dizziness, loss of balance or loss of coordination, especially when combined with another symptom, such as slurred speech, double vision, numbness, or weakness;
Sudden, unexplainable, and intense headache -- often described as the "worst headache ever;"
If you have experienced any of these symptoms, you may have had a TIA or mini-stroke -- ask your doctor if you can lower your risk for stroke by taking aspirin, or by other means.
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| CREATIVITY |
| It's time to get smart. |
| CHANGE TO A HEALTHIER LIFESTYLE, IT'S A MUST. |
More Stress-Busters
o Eat nutritious meals. Avoid sugar, salt, fat and caf- feine and load up on foods containing vitamins Band C, essential to stress-busting. They include whole grains, eggs, nuts, lean meats, citrus fruits and leafy green vegetables.
O Get seven to eight hours of sleep a night. Exhaus- tion from lack of sleep lessens your ability to handle stress. One study has found that proper sleep adds years to life expectancy. It's best to go to bed and get up at the same times each day.
O Maintain a healthy weight. Aside from the stresses obesity places on your body, a positive self-image makes you feel good about yourself and helps to alleviate stress. O Plan for financial security. Few things in life can cause
as much stress as money worries and the hand-to- mouth living that comes from not having a savings cushion. Develop a family budget and make long-term plans for saving.
O Resolve daily family problems. Take to heart the old saying about not going to bed angry. Be open and honest with family members as problems arise and deal with them on the spot. Carrying troubles over from day to day is extremely stressful.
O Develop an optimistic attitude. Studies show that op- timists have less mental and physical stress symptoms. So it pays to find the silver lining in each dark cloud. Try not to overreact to stressful situations. Think about the problem and what solutions worked for you in the past. Take the attitude that whatever life throws at you, you can meet the challenge and come out ahead.
O Limit your caffeine intake. Caffeine can destroy vital Band C vitamins in your body and it doesn't take much -only two cups of coffee! Caffeine is a stressor that makes you irritable and nervous and can disrupt your sleep and digestion. It's also highly addictive, caus- ing withdrawal symptoms if you suddenly stop -head- aches, lethargy, depression, anxiety and irritability. When you do cut down, do it gradually. The recommendation is no more than one caffeinated beverage a day.
O Limit alcoholic beverages. Have no more than four per week -none at all is even better. Most people think alcohol relaxes them, but the opposite is true. Alcohol cre- ates a chemical imbalance in the body that produces high- er levels of tension and anxiety. In fact, five or more drinks a week can create an artificial state of stress. A drinknow and then won't hurt you, but if you're feeling stressed and tense, use another method to relax.
O Stop smoking. Many people believe that ciga- rettes relax them. But nicotine is a drug that produces an artificial stress response in your body. Today, there are many products available to help you quit smoking -nicotine patches and gum are available over-the- counter and a prescription drug that was recently in- troduced is helping many hard-core smokers. You may also try hypnosis therapy or join a stop smoking sup- port group.
O Reflect, meditate or pray each day. Your body knows how to relax itself if you allow it. Many people can get powerful de-stressing results from sitting quietly for a few minutes. Sit comfortably, breathe in and out slow- ly for five minutes, clear your mind of stressful thoughts by focusing on the breathing and pretend you're float- ing. Notice specific muscles that may be tense and pur- posely relax them. Just a few minutes of this quiet time each day can be a powerful factor in being stress- free. If you practice, you can make quiet time a regular and essential part of your daily lifestyle.
O Get negative emotions off your chest. Bottling up your anger, anxiety and depression is a recipe for dam- aging your health. Express your emotions appropriately -communicate to others openly and honestly, but al- ways be sensitive to their feelings when you do.
O Do something fun for yourself! At least once a week, make a "date" and put it on your schedule. Make it immovable. Too many people plan to do fun things, then put them off at the last minute, as though the ac- tivities were trivial. They're not, not if you want to live along and healthy life. People who play at least once a week feel less stress from job demands and family pressures, feel better about themselves, have less mar- ital problems and fewer stress-related symptoms than those who say they never have any fun.
O Manage your time effectively. If you've ever felt like you're running around in circles trying to do things but not getting anything done, you've got a perfect situation for high stress. You must plan your time and prioritize your tasks, so you're not under constant "deadline" pressure. Set realistic goals for yourself and break large tasks down into smaller components so you're not over- whelmed by the enormity of them.
O Develop a positive attitude. Studies show that peo- ple with positive attitudes suffer fewer symptoms of phys- ical and mental stress. They spring back easier and more quickly from problems. Work to become more pos- itive in your outlook. When faced with a challenge or difficult situation, recall past successes to gain clues to dealing with your current problem.
O Learn not to overreact. Practice talking to yourself, reminding yourself to be calm. Analyze the situation be- fore you react. Don't dwell endlessly on the situation or its possible consequences. Lift yourself up and literally straighten yourself up -studies show that body posture can actually stimulate the creation of certain brain
; chemicals -you can feel more positive simply by chang- ing your physical reaction to a situation.
1 There are two sides to any stressful situation. Try to look at any benefits you might derive from a situation before you react. You may find that a broader and more optimistic perspective will allow you to handle the sit- uation with less stress and anxiety. The more you curb your stress, the healthier you will be.
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| INDEX of APPROVED SITES |
View in alphabetical order
National Stroke Association - http://www.stroke.org/
Dedicated to stroke victims in the United States
American Stroke Association - http://www.strokeassociation.org/
American Heart Association's Stroke sub-chapter with lot of information for the professional and the consumer.
Internet Stroke Center at Washington University - http://www.neuro.wustl.edu/stroke/
A comprehensive web resource for stroke patients, family members and health professionals. Includes a database of stroke clinical trials, listings of more than 100 US stroke centers, meetings calendar, stroke guidelines and links to teaching sites.
Brain Attack Coalition - http://www.stroke-site.org/
group of professional, voluntary and government organizations whose mission is to reduce the occurrence, disabilities and death associated with stroke
MCW HealthLink: Stroke - http://healthlink.mcw.edu/stroke/
News and information about stroke from the physicians of the Medical College of Wisconsin.
The Stroke Association - http://www.stroke.org.uk/
Charitable organization for stroke victims in the UK
National Heart Foundation - http://www.ahaf.org/hrtstrok/about/hsabout.htm
American Health Assistance Foundation division, established in 1985 to fund research on and educate the public about heart disease and stroke. Site includes a stroke FAQ and articles concerning stroke symptoms and risk modification.
Peninsula Stroke Association - http://www.psastroke.org
A not-for-profit organization serving Californians in San Mateo and Santa Clara counties. Site offers answers to common questions about stroke and listings for community resources, volunteer opportunities, and related Web pages.
Hemi-Kids - http://www.hemikids.org
Resources related to childhood hemiplegia, hemiparesis, and stroke. Features the Hemi-Kids e-mail list, answers from experts, helpful hints for daily living, inspirational writings, and many links to sites of interest.
Stanford Stroke Awareness - http://www.stanford.edu/group/neurology/stroke/part1.html
An illustrated guide describing types of stroke and new diagnosis and treatment options.
Heart and Stroke Foundation - http://www.heartandstroke.ca
Canadian organization offering healthful tips and recipes, news items related to stroke, and information on provincial resources for survivors.
Megan's Notebook - http://www.angelfire.com/pa2/mdrummond
Inspirational site created by author and childhood stroke survivor Megan Drummond. Features essays on Megan's experiences during and after her stroke.
Strokes on medbroadcast.com - http://www.medbroadcast.com/health_topics/health_conditions/stroke/index.shtml
Strokes can happen at any age, find out more on medbroadcast.com. Discover information on stroke prevention, treatment, and recovery; check your personal risk level through an online quiz; and visualize stroke through multimedia presentations.
Stroke and Brain Attack - http://www.vh.org/Providers/ClinGuide/Stroke/Index.html
A clinical guideline to the diagnosis and treatment of stroke and other cerebrovascular disease. Includes interepretation of the NIH stroke assessment materials, protocols for the use of thrombolytics. Includes references, tables and line drawings.
Mediconsult.com: Strokes Condition Center - http://www.mediconsult.com/mc/mcsite.nsf/conditionnav/strokes~sectionintroduction
Stroke resources for patients, caregivers and professionals. Features include educational materials, research digests, drug information, listings for clinical trials, and a support group.
Mayo Clinic Stroke Education - http://www.mayo.edu/cerebro/education/stroke.html
Patient-oriented information from the Clinic's Division of Cerebrovascular Diseases. Covered topics include the physical and emotional effects of stroke and the impact of stroke on families.
Brain Stem Stroke and Locked-In Syndrome - http://www.strokenetwork.org/brainstem/
Source of information and support. Provides background details and links to educational materials, assistive-device companies, survivors, and caregivers.
University of Pittsburgh Center for Cerebrovascular Surgery - http://www.neurosurgery.pitt.edu/cerebrovascular/index.html
Description of the Center, which is dedicated to the treatment of carotid stenoses, aneurysms, arteriovenous malformations, and other vascular conditions associated with stroke.
Pediatric Stroke Network - http://sites.netscape.net/pedstrokenet/index.html
Information and support for families who are dealing with stroke in infancy, childhood, or adolescence. PSN's highlights include traditional and alternative therapy links, a message board and mailing list for young survivors, and complementary forums for parents.
StrokeHelp.com - http://www.strokehelp.com/
Rehabilitation information, educational training videos and discussion forums for clinicians, families and survivors of stroke.
Artists Recovering from Stroke - http://www.tassie.net.au/stroke-artists
Submit your artwork for inclusion in an online gallery, view samples from an Australian exhibition, and read articles about post-stroke syndromes that are of particular importance to recovering artists.
NIH Stroke Information Page - http://www.ninds.nih.gov/patients/Disorder/strokehtr/text.htm
Information on treatment guidelines and ongoing studies from the National Institutes of Health
Human Neuron Implantation Trial - http://www.neurosurgery.pitt.edu/imageguided/neuron/index.html
Description of a multicenter trial designed to evaluate the implantation of human neurons as a treatment for stroke. Patient acceptance criteria are provided and noted to include stroke-induced injury to the basal ganglia region of the brain and resulting paralysis or partial paralysis of the arm and/or leg.
StrokePage/Slagsiden - http://home.world-online.no/~truud/
Home to the StrokePost news pages, StrokeList discussion group, and numerous other resources for stroke survivors and their loved ones. Content is presented in both English and Norwegian.
Stroke: Lifeclinic.com - http://www.lifeclinic.com/focus/stroke/diagnosis.asp
Features prevention, diagnosis, and rehabilitation fact sheets, in addition to a risk survey.
The Neuroscience Institute - http://www.health-alliance.com/neuroscience/NeuroInstitute.html
Regional neuroscience center of excellence based at The University Hospital in Cincinnati, Ohio. Offers comprehensive, compassionate, specialized care for patients with diseases or disorders of the brain and nervous system.
HealthMed Solution: What Is Stroke? - http://www.healthmedsolution.com/stroke.htm
A review of stroke, authored by physical-medicine-and rehabilitation specialist Peter Rappa, MD. Explores complications, medical management, rehabilitation care plans, and further subjects of interest to survivors and their families.
Product information for Stroke Recovery Systems' AM800 -- an EMG-biofeedback device that is designed to teach healthy regions of the brain to take over lost motor functionality.
Diagnosis and Treatment of Post-Stroke Depression - http://www.brown.edu/Departments/Clinical_Neurosciences/articles/ch18197.html
A clinical review of depression after stroke. Case reports and references are included.
Prevention Plus - http://www.strokepreventionplus.com
Provides stroke and carotid vascular ultrasound screening services for stroke detection and prevention. Educational information and risk assessment.
Stroke Survivors - http://www.stroke-survivors.com
Tips for everyday living and opportunities to read and share recovery notes and personal therapy reviews, courtesy of survivor Rowland Gale.
Stroke Incidence Rises as High Blood Pressure Control Falls - http://www.drkoop.com/news/focus/feb/stroke_rise.html
After more than two decades of steady decline, stroke rates are increasing in the United States, according to new research detailed at drkoop.com.
Project Stroke Hope - http://www.angelfire.com/fl2/projectstrokehope
Presentation by a family hoping to help others who are affected by stroke. Offers notes on disability benefits and insurance matters, fundamental information on stroke, and links to stroke-related sites.
Terri's Stroke Recovery - http://homepages.tesco.net/~Terrihorne/MyWEBsite.htm
Story of stroke and continuing recovery, from the rehab unit to independent living. Written in support of other survivors who are on the "long journey back" from stroke.
Constraint-Induced Movement Therapy: Online Publications - http://www.stroke-info.com/ci_therapy.htm
Reading list featuring reports on CI Therapy--a "massed practice" approach to limb weakness. Intended as a research aid for stroke survivors, clinicians, and others who wish to investigate the therapy online.
Angels for Amanda - http://pages.ivillage.com/ps/sheilatheadvocate/index.html
Supportive page created by the family of Amanda Carvalho, a survivor of prenatal stroke. Includes details about Amanda's life and treatment plan, as well as links to sites that have been helpful to her family.
Greater Cincinnati / Northern Kentucky Stroke Team - http://www.stroketeam.org
Case studies, protocols, and further resources for medical personnel involved in the care of stroke patients.
HealthlinkUSA: Stroke - http://www.healthlinkusa.com/Stroke.htm
Listings for stroke education and support sites. Updated regularly.
Rhythm Therapy Institute - http://rhythmtherapy.ckt0.com
Practice offering Rhythm Therapy--an alternative method of stroke rehabilitation harnessing musical rhythms. Locations in New York City and Gnesta, Sweden.
Stroke, Brain Attack, and Paralysis - http://brainattacks.net
An introduction to stroke, linking to related incidence information, news, chats, and a directory of neurologists. Hosted by NeurologyChannel.
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