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Second Stroke - The risks
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theborg38 posted:
I suffered my initial stroke over 2 months ago develping Wallenburgs syndrome. I was well on the way to recovery with just some minor balance and vision issues, along with no deep pain sensation on my right side. However, i have just had a repeat stoke of the same area and this time lost all movement on my right side. I am just starting to hobble again and am possitive I will continue to improve.
Unflortunetly i work overseas in the Falkland Islands where there is no scanner and had to be evacuated to a hospital in Chile. Owing to this my employers are now seeking to remove me and i have to return, unemployed to the UK. What are the feelings on repeat strokes and the liklyhood and should I go through life fearing another attack and believe like my misguided employer that i need to be within 3 hours of a scanner, especially has it took 7 day's to identfy my first stoke (they thought it was an ear infection).
any advice appreciated
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Richard C Senelick, MD responded:
This is one of those "good news-bad news" stories. The news you don't want to hear is that having a stroke does put you at an increased risk for having another stroke. The good news is that there are many things you can do to modify your risk factors and decrease that risk. Hopefully your physicians have identified your risk factors and started you on a program to reduce them. Likewise, you most likely should be on a medicine, like aspirin, to make your blood "less sticky" and prevent another stroke This recommendation should be made by your physician as their are other factors in this choice.

Here is a list of things you can do to reduce your risk of another stroke.
  • Carefully control any high blood pressure and diabetes. Adopt an attitude of excellent control as opposed to "that looks pretty good."
  • If you smoke, stop.
  • Aggressively control your blood lipids and cholesterol. If you did not have a bleed in your brain, taking a "statin" medicine can reduce the risk of another stroke
  • Exercise and diet are important. Eat healthy and ask a therapist what type of exercise you can do.Even with your stroke, we can be creative in designing exercise programs.
  • Find out if you have atherosclerosis elsehwere in your body , like in the arteries of your heart and legs.
  • Have your heart checked to make sure it was not the source of a blood clot that went to your brain.
  • If you drink alcohol, do so only in moderation. That means one drink a day.
You do need to be closer to excellent medical care. Learn the warning signs of a stroke and seek medical care at the earliest symptoms.

Keep up your positive attitude and good luck.
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
 
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theborg38 replied to Richard C Senelick, MD's response:
Many thanks, I am determined to make as full recovery as possible. One further question is relating to surgery. My consultant was Chillian and difficult to understand, however he did mention the future possibility of a stent or surgery. what are the success rates and do you believe this approach is one worth taking, especially in my case when i have already suffered 2 strokes? my strokes were both brain stem on the lft artery and as a result of clots, the second was a break off from the first and may of been related to a GP reducing my medication (asprin reduced from 250 to 75mg and lipito from 80 to 40mg).
 
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Richard C Senelick, MD replied to theborg38's response:
A suggestion on surgery or stenting should only be done by someone who looks at your angiograms ( MRA or regular) and also has extensive experience in these areas. Stenting has significant risks and should only be done in facilities that do a great many of these. The same is true with vascular surgery.

As for your medications, studies have shown low dose aspirin to be just as effective as higher dosage. If you had a stroke on aspirin you should ask your physician about other strategies since you fall in the category of an "apsirin failure."

Good luck.
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.


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Richard C. Senelick M.D. is a physician specializing in both neurology and the subspecialty of neurorehabilitation. He did his undergraduate and medic...More

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