WJMC - West Jefferson Medical Center

WJMC - West Jefferson Medical Center

 

Stroke:
Hospital Arrival, Treatment, Stay and Leaving the Hospital


Strokes often happen suddenly and without warning and they can change your life and that of your family. If you or someone you love has had a stroke, you may be afraid and confused. You may have many questions about how this event will change your life. This book describes how strokes occur and the early stages of diagnosis, treatment, and recovery. This book will help you and your family understand what has happened, what you can expect and you can support each other. If you have questions, ask them. We are here to help you understand as much as possible about your stroke and respect your journey as a survivor.

If you have had a stroke or TIA, you can expect that we will teach you about signs and symptoms of stroke (what it looks like), how important it is to call 911 if you have these symptoms again, and what your risk factors are for stroke. Together, we will work to help you develop a plan for helping you manage your risk factors and your recovery.

Hospital Arrival:

As soon as you get to the hospital, doctors will run tests to discover the cause of the Stroke. They will learn where and how much damage has happened from the Stroke. The tests may include:

  • MRI Scan: (Magnetic Resonance Imaging) – a special x-ray which gives pictures of the brain so that areas with damage can be seen.
  • CT Scan: (Computerized Tomography) – a scan which also gives pictures of the brain to show any damage. Only certain kinds of Strokes are seen on CT scans.
  • Duplex Scan: A test that uses ultrasound waves to make pictures of the carotid artery (the main artery taking blood to the brain).
  • Echocardiogram: (Echo) – a test to find out if an opening in the heart allowed a blood clot to pass through to the brain.
  • Angiogram: Dye is placed in blood vessels to look at blood flow to the brain.

Treatment:

Some people with certain kinds of stroke may be eligible for treatment with tPA. tPA is a medication that dissolves blood clots. These medications are called thrombolytic agents or “clot busters.” It is given through an IV catheter in a vein in your arm. tPA has been approved to treat ischemic type strokes caused by blood clots that block the flow of blood to the brain within three hours of symptoms starting (sometimes up to 4 ½ hours).

The risks of tPA include bleeding in the brain or other parts of the body. In 6 out of 100 patients, bleeding may occur. People who have bleeding disorders or are on blood thinners may not be able to get tPA. 1 of every 3 patients who receive tPA have major improvement in their stroke symptoms.

Some people who get tPA or who may not be able to get tPA can be brought for a brain angiogram procedures where a doctor can try to pull the clot out of the vessel in the brain. This procedure is called a thrombectomy.

Hospital Stay:

Once the critical stage has passed, you or your loved one may need to stay in the hospital for a while. During this time you will learn more about the effects of the Stroke. Learn all you can so that everyone will be ready when you leave the hospital.

It’s normal to feel confused and overwhelmed during this time. When a sudden health change happens, there are many decisions to be made. A helper, or ‘advocate’ will be needed during this hospital stay and afterward.

A Stroke can cause changes in how a person:

  • Moves
  • Communicates
  • Eats, Drinks, Swallows
  • Controls his Bladder and Bowels
  • Senses (sight, touch, position)
  • Acts
  • Thinks

Accept the fact that you can’t force a person to get well faster by doing (or not doing) certain things. Having caring people around helps a lot, but recovery has its own time frame. FOCUS ON GOALS INSTEAD OF TIME DEADLINES.

While you are in bed (both in the hospital and later at home), you may need help changing positions every TWO hours. Blood flows better when weight is shifted off a part of the body. This also helps prevent pressure ulcers (bedsores). Towel rolls, pillows, and splints can keep weak limbs from becoming swollen, stiff, or sore.

While you are out of bed, good sitting posture is very important during recovery from Stroke. It helps improve balance and the person’s awareness of himself and things around him. Good posture makes it easier and safer to move weak limbs. It can also make a weak voice sound louder and help prevent choking while eating.

Learning how to move from one place to another is important for both your helper’s safety and yours. The physician or occupational therapist can teach you how to move from the chair, bed, toilet, tub, and car.

Leaving The Hospital:

There is a lot to learn before you go home or to another facility. Ask a family member to go with you to all therapies at least once so they can learn how to assist you. Ask the health team to write instructions for care and practice them before discharge.

Give yourself time to adjust to being home and try to limit the number of visitors at first. Try to avoid busy public places during your first few outings. It may take a while to adjust to changes and you may tire easily.

You may still face physical, communication, thinking, and/or behavior challenges when it’s time to leave the hospital. Talk to your provider about resources as your needs change. The best choice will depend on patient and family needs as well as finances. Insurance covers different types of care, but must be approved first.

Types of Care:

  • Acute Rehabilitation Facility
  • Skilled Nursing Facility or Nursing Home
  • Home Health Care
  • Outpatient Facilities
  • Living at Home
  • Respite Care
  • Assisted Living Communities
  • Local Senior Service Agencies and Statewide Independent Living Centers

Family Tips:

  • Your loved one needs to gain as much independence as he/she can, so help them only with what is needed
  • Learn about any changes needed to the home, such as building a ramp or adding handrails to stairs and bathrooms
  • If you need help at home, plan to have a number of caregivers. Both caregivers and the patient need breaks from each other to stay ‘fresh’
  • Stick to a daily routine at home. Post a schedule where all can see it

Return to Neuroscience Stroke Care Homepage

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