Transcription:
Living a Healthy Life After Stroke

Melanie Cole (Host):  If you had a stroke, the chance of having another one is increased. But you can take steps to control this risk. What you do now can help reduce your chance of another stroke in the future. My guest is Dr. Payal Fadia. She’s the medical director of post-acute brain injury services at the Shepherd Center. Welcome to the show, Dr. Fadia. Tell us, what happens when someone has a stroke? What does the outcome look like for their life after stroke? 

Dr. Payal Fadia (Guest):  Well, you know, Melanie, the outcome of a stroke can vary depending on how quickly folks can get in and get treated. It’s extremely important to know your warning signs and know when it’s time to call 911 and get the help that you need. We know that outcomes are much worse for those that are not treated acutely. Warning signs that I’m speaking of: face drooping on one side, difficulty speaking, arm weakness, difficulty walking or moving, even sometimes changes such as severe headaches, dizziness, changes in vision, and difficulty speaking. 

Melanie:  If you get in in time and you are given treatment, you recognize these really important symptoms and you get in and you get treatment, then after you’ve gotten your treatment, what can life be like? Are you somebody who is not going to be able to go back to work, or what does after stroke entail? 

Dr. Fadia:  Well, here at Shepherd Center, we work quite a bit with folks with stroke, with outpatient therapy, speech therapy, to work on folks that have difficulty speaking, swallowing, thinking clearly. And there is therapy that can help these patients improve their ability to communicate and get better. A lot of it depends on the location of the stroke as far as what outcomes they have. We do find that early therapy and early intervention can make a difference as far as helping people communicate better and speak better as well as improve their thinking and their swallowing ability. The same is true for physical therapy and occupational therapy in terms of being able to walk better. Early physical therapy has been shown to improve one’s ability to walk, sometimes with an assistive device, but still be able to walk in a functional way, increasing their independence. Occupational therapy is also important in addressing self-care. Being able to dress yourself, bathe yourself, being able to take care of your daily life in terms of simple cooking. Then the higher activities of daily living, which also include returning to driving, returning to work, returning to school. We’ve seen an increase in our younger stroke population. These are kids that do have the potential to return to a school setting whether it’s as young as high school or even college. It’s very important to get the therapeutic interventions in early. 

Melanie:  How important is it, Dr. Fadia, for nutrition after stroke to help prevent another stroke? 

Dr. Fadia:  It’s extremely important. Lifestyle changes is one of the biggest things that we like to emphasize after a stroke, especially since we know that once you’ve had a stroke, you increase your risk of up to 10 times higher for having a second stroke compared to someone who’s never had a stroke. When we speak about lifestyle, that does include nutrition in terms of watching your cholesterol, no salt or low salt, because that obviously affects other systems in your body, such as your kidneys, such as your blood pressure. We want to make sure that your blood pressure is low, your cholesterol is low. Smoking cessation is extremely important because smoking increases all kinds of risks. There’s chemicals in tobacco that absorb into the blood vessel walls. It speeds up hardening of the arteries and increasing your blood pressure further. We know that regardless of how long you’ve been a smoker, once you stop, your risk of a stroke decreases tremendously. The same goes for, as we said, your diet. Staying away from the processed food, the fast food, eating as naturally as possible and taking the time to read the ingredients or nutritional facts on the labels of the food products that you purchase and having much more fruits, vegetables, and fiber in your diet as well. 

Melanie:  Dr. Fadia, what about medications for life after stroke? Are you now going to be on blood thinners for the rest of your life, and what about adherence to those medications? Is that something a support system is supposed to help you with? 

Dr. Fadia:  Well, a support system is extremely important after a loved one has had a stroke. It’s important to know that depression runs extremely high in patients that have had a stroke, as they are grieving for the loss that they’ve had in terms of their lack of independence potentially and lack of control over what’s happened. The support system that you have is very important as far as your mood and keeping you positive. We do know that your mood and how you choose to have your attitude every day makes a big difference in how you can function. That’s a huge, important barrier sometimes that we see in patients, and sometimes the antidepressants can be useful for that population. We do find that other medications that are useful are the ones that decrease blood pressure, can help to address cholesterol. Some folks have abnormal heart rhythms that do require the blood thinner, such as Coumadin. Now, other folks may benefit from an aspirin once a day, and that is most likely something they will need to take indefinitely at that point.  

Melanie:  What about… you mentioned depression medication. Life changes after a stroke. What is the importance of psychological counseling and/or that support system for the whole family about those life changes that happen after a stroke? 

Dr. Fadia:  Well, it’s extremely important. Shepherd Center, in Pathways, recognized the need for counseling not just for our patients but equally, if not more important, for their loved ones, who are their support systems in terms of understanding the stroke itself, providing stroke education as well as helping folks cope and adjust to the lifestyle changes that they’re facing in their future. I think it’s one of the most valuable things we can offer is that counseling. It’s sometimes easier to speak with somebody more objectively that’s not a member of the family and then come back to your family feeling better about things and being more positive and helping your family or your loved one, in that sense, being stronger for that support that you can offer them when you have the counseling as an option. 

Melanie:  Dr. Fadia, give us your best advice for life after stroke with the therapies that are involved and the support system that you need and what goes on at Shepherd Center to help that really better quality of life after suffering a stroke. 

Dr. Fadia:  The best advice, I feel, as far as living after a stroke, is recognizing risk factors, modifying the things that we can change, such as the blood pressure, cholesterol, diabetes, weight gain, watching your diet, and also keeping your loved ones close and making sure that you try to stay positive in your recovery. 

Melanie:  Why should listeners come to Shepherd Center for their stroke recovery care? 

Dr. Fadia:  Well, here at Shepherd Center, we offer a very comprehensive, almost a holistic and functional approach to stroke rehabilitation with a variety of therapeutic options, occupational therapy, physical therapy, speech therapy, counseling. We also have a vocational counselor to help work with our folks in their return to employment as well as having folks working on return to school for our younger patients. And we offer a very comprehensive look at the big picture in looking at recovery from stroke. 

Melanie:  Thank you so much. You’re listening to Shepherd Center Radio. For more information, you can go to shepherd.org. That’s shepherd.org. This is Melanie Cole. Thanks so much for listening, and have a great day.