Medication – what have I been prescribed?

MedicationsWhat they do

Antiplatelet drugs: Aspirin Clopidogrel	Reduce blood clotting They do this by making the cells in your blood, known as platelets, less “sticky”. This lowers the chance of another clot forming.
Anticoagulants: Warfarin Apixaban Dabigatran Rivaroxaban	Reduce blood clotting Anticoagulants interrupt part of the process involved in the formation of blood clots stopping your blood from clotting as quickly or easily. This lowers the chance of another clot forming.If you are taking an anticoagulant you should be issued with either an alert card or booklet specific to the drug you have been prescribed. It is important that you carry this on you so that in case of emergencies, a doctor attending to you knows which anticoagulant you are taking and at what dose.
Statins: Simvastatin Atorvastatin Pravastatin Rosuvastatin	Lower cholesterol If you have a high cholesterol level, fatty deposits can start to build up in blood vessels and increase your risk of stroke. Statins work by reducing the amount of cholesterol in your blood by blocking the chemical in the liver that produces it.
Blood Pressure medication:	Lower Blood Pressure If you have high blood pressure you may have been given a tablet to help lower it. These tablets may cause side effects, but they are doing an important job in helping to lower your risk of another stroke or heart attack. To find out more about high blood pressure treatments and medications see more information

Key point

As every patient and stroke is different, medication is tailored to meet each individual’s needs.

More information

Booklets and factsheets:

Websites:

Blood Pressure UK

Help with stress

Helping hand

Stress is “normal” and everyone copes in different ways.

You might feel reluctant to ask for help but If you are finding it difficult to cope, there is help available.

Knowing how stress makes you feel and the things that can cause it can help you to cope better.

Here are some common causes of stress. Select the areas that are relevant to you to see what help is available:

Money matters

money

Speak to Citizens Advice for financial, housing, benefits and legal advice. This is a free service. To find your local Bureau visit: Citizens Advice Bureau. If you live in Scotland visit: Citizens Advice Scotland and enter your postcode.
Make an appointment with your bank or building society to receive advice about managing your money.
If you are struggling with mortgage repayments, let your lender know as soon as possible. They can discuss options such as reducing your payments or pay the interest only.
Arrange an overdraft if you feel that you are going into the red. It is cheaper than an unauthorised overdraft.
Consider changing your gas and electricity supplier, you may save money by switching to a new tariff. There are many comparison websites to compare prices.
If you would like advice to help keep your house warm, The Energy Saving Trust manages delivery of the Affordable Warmth and Energy Assistance Schemes on behalf of the Scottish Government. Call the Home Energy Scotland hotline on 0808 808 2282.
If you are worried about debt, the National Debtline can give, confidential and impartial advice. You do not have to give your personal details. This service is Free on 0808 808 4000.

Work demands

ringing phone

Talk to your manager or Human Resources about reducing your workload or getting some extra help.
You could ask for some training that you feel would support you, such as time management.
If you feel you are being discriminated or unfairly treated and you are a member of a union, ask to speak to your representative. Acas provides a free advice line for issues within the workplace on 0300 123 1100. You could also contact the Equality Advisory and Support Service (EASS) or helpline on 0808 800 0082.
The Scottish Centre for Healthy Working Lives provides information and services to give you the opportunity to work in ways to sustain and improve your health and wellbeing.

Relationships

2 people talking

Good relationships can help to support you, keep you happy and well, but when relationships go wrong, they can be the cause of stress. Set aside time to talk through important issues and discuss your feelings.
Relationships Scotland provide couple counselling, family mediation and family support on 0845 119 2020.

Unemployment

Unemployment benefit

If you are not able find employment but are actively looking for work, you should be able to claim job seekers allowance. You may also be able to claim housing benefit and council tax benefit. You may be entitled to Employment and Support Allowance (ESA). Visit your local job centre or visit the website: Gov.uk
The Alliance – Health and Social Care Alliance Scotland is an organisation that support people with long term conditions to self manage. They have a project called My skills, my strength, my right to work, which could help you access and maintain employment.

Moving house

Removals van

Try to be as organised as possible; it is much easier to deal with the frustration of unexpected difficulties when you have everything reasonably planned.
Consider hiring a professional removal company rather than hiring a self-drive van. This will reduce the stress of the move. Shop around for companies as the prices charged can vary considerably.
Keep a notebook for lists, appointments, phone numbers and anything else you need to remember.
Label boxes according to their designated room in the new house.
Get family and friends to help to you clear any unwanted items before you move and to help you unpack in your new home.
Try and maintain your routine where possible. During the hectic days of moving, people often lose sleep and forget to eat properly. Make sure that you allow time to rest.
Expect to go through various emotions when you arrive in the new location, and know that you will need a period of time to adjust to your new home.
To find out what is available in your new local area you can contact Chest Heart & Stroke Scotland or call free on 0808 801 0899

Illness / disability

Wheelchair

Talk to your GP or practice nurse.
You may have had support from a Stroke Nurse Specialist who can be contacted through the Stroke Unit within your hospital.
Chest Heart & Stroke Scotland’s Advice Line offers free, confidential advice from trained nurses. Call Free from landlines and mobiles: 0808 801 0899 for information about stroke illness and support services in Scotland.
NHS 24 can provide advice for any health issue. Call Free on 111.

Something to try

When you feel stressed you can often feel that there is nothing you can do to help. Take time to have a look through the filing cabinet to see what might work for you.

Let’s go onto look at what else you can try to help reduce your stress.

David’s story

Since his stroke David feels upset, frustrated and a bit ‘down’. Now that he is no longer getting therapy his mood has dropped further.
He can’t be bothered with reading or looking at the TV; food doesn’t interest him and he is having trouble sleeping.

Select the arrow keys to hear more about David’s story.

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Scene 1

Wife: ‘Why don’t we go to the park to get some fresh air?’
David shouts: ‘What’s the point. I can’t do anything like this and everyone stares at me in the wheelchair. I hate it.’

Scene 2

David: thinks ‘I’m fed-up being like this. If I don’t talk to someone about this it will only get worse.

Scene 3
David feels bad that he shouted at his wife and recognises he needs someone to talk to. He calls his stroke nurse to ask her advice.

David: ‘Hi Susan, I wonder if I can ask your advice’
Susan (the stroke nurse): ‘Hi David, yes of course. Let’s see what we can do…’

By calling his stroke nurse David took the first step to addressing his warning signs. Chatting to the nurse allowed him to get things off his chest and to look at his goals again.

Key point

If you do not have a stroke nurse you can always phone the Chest Heart & Stroke Scotland Advice Line Nurses on 0808 801 0899 for advice and support. This is free from landlines and mobiles.

Let’s remind ourselves about how to set goals.

Daily activity diary

Remember, this was Jane’s activity diary. Notice how she has not filled every slot full of tasks and has left space for rest and relaxation.

Day	Morning	Afternoon	Evening
Monday 6^th	Stroke Club, 10.00	At home, rest / make tea	Watch TV programme
Tuesday 7^th	Relaxed start, tidy living room	Walk to corner shop	Rest
Wednesday 8^th	Laundry	Rest	Cinema with Sam
Thursday 9^th	Relaxed start, tidy bedroom	Potter in Garden	Rest
Friday 10^th	Ironing	Rest	Art class
Saturday 11^th	Rest	Shopping with Sam	Watching television
Sunday 12^th	Walk in park	Rest	Dinner with family

Download the Daily activity diary [.pdf, 50KB]

Something to try

Why don’t you try filling in your own activity diary.
Remember to keep at least one slot free each day for a relaxing activity e.g. music listening, relaxation schedule, quiet reading.

Neil’s visits to the gym and back playing golf

Neil has adapted with his golf playing and by interacting with others at the gym, Neil has also gained more confidence in being more sociable again.

This was filmed with the kind permission of Edinburgh Leisure.

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“I find going for to the gym for the first time was actually quite a relaxing experience. When I was in hospital I met Andrew (the coach) and it was he who encouraged me to go to the gym so that when I was there I was aware of what it was I was actually going to be doing.

I use both the bike and the treadmill to warm up. I find both of them are easy to use. Again, I had very good instructions on how to work them. I feel very comfortable with the amount of control I had, the way I could warm up and the speed at which I was warming up. At all times I felt in full control. I used the exercise machine both to tone and strengthen my muscles. Because of my stroke, I lost my right hand side, and in particular my arm and leg but I find both of these machines help me get my stroke back.

There are some exercises I do at home and I don’t really need any specialist equip like you do here in the centre. Using things like Squeeze balls for my hand and also by quickly going up and down my stairs helps. You can also lean against a wall and treat it like a push-up.

The thing I think is most important is that I’m very conscious that exercise is beneficial to me and even without equipment at home I can do exercise and the more I do it, the better it is for me.
I will be definitely coming back to the centre and regularly the physical and fitness side is very important to me but the actual psychological of actually meeting people outside my home is very important to me too. Last but not least I would like to get back to playing golf soon and the physical exercise is helping me with that aim in life.”

This was filmed with the kind permission of Edinburgh Leisure.

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“Having had my stroke, one of the things I have to do is plan my time and make sure I have plenty time to get organised with my equipment and get myself on to the tee at the right time. Also I have to ensure I have time to get a proper warm up before I even hit the first ball. There are two aspects of my life that have really affected myself and my goal: One was the physical challenges that I had to recover from and the second was the mental challenge – Not to be too hard on myself if I was not in a position to go on to the course and play the way that I used to. I had to start working on that very slowly. Also, getting out of the house and meeting friends in the golf club as well as on the course was great but one of the aspects that really helped me was going to the leisure cent and working hard on my physical fitness so I could get back to playing golf again.”

More information

Scottish disability golf partnership.
What’s in my area?

What’s in my area?

To find out what is available to help you stop smoking where you live please select your area below.

NHS Lothian

South East Edinburgh

Telephone Number: 0131 672 9532

For Stop For Life in South East:

call 0131 672 9532 or text/call 07800 776 327

South West Edinburgh

Telephone Number: 0131 537 7154

For Stop For Life in South West:

call 0131 672 9532 or text/call 07800 776 327

North East Edinburgh

Telephone Number: 0131 536 6247

For Stop For Life in North East:

call 0131 536 6247 or text/call 07881 517 317

North West Edinburgh

Telephone Number: 0131 552 8671

For Stop For Life in North West:

call 0131 536 6247 or text/call 07881 517 317

East Lothian and Midlothian

Telephone Number: 0131 537 9914

For Stop For Life in East Lothian and Midlothian:

call 0131 537 9914 or text/call 07771 975 453

West Lothian

Telephone Number: 01506 651 829

For Stop For Life in West Lothian:

call 01506 651 829 or text/call 07867 502 884

If you are a young person please text or call 07969 530 266

NHS Lanarkshire

For information and advice about stopping smoking contact the stop smoking service Monday to Friday 9am to 5pm:

Telephone: 08452 177 707 or text 81066

NHS Ayrshire and Arran

For information on how to stop smoking:

Call free on 0800 783 9132
Email [email protected]

Telephone support service:

Freephone: 0800 783 9132

NHS Greater Glasgow & Clyde

Smokefree services run in NHS Greater Glasgow and Clyde are available under one name and one number:

Freephone: 0800 389 3210 (9am-9pm)

NHS Dumfries and Galloway

The Smoking Matters Service offers smokers throughout Dumfries and Galloway help in stopping smoking.

Telephone Number: 0845 602 6861
Email: [email protected]
By post:
The Smoking Matters Service
Garden Hill Primary Care Centre
2 Gardenhill Road
Castle Douglas
DG7 1EE

NHS Borders

NHS Borders Quit 4 Good:

Telephone: 0844 8118180 (local rate call office hours Monday- Friday 24 hour answer machine)
Email: [email protected]

NHS Fife

Stop Smoking Services:

Telephone: 0800 025 3000

The groups are very relaxed and informal and are run by trained staff. They are suitable for anyone who wants to give up: heavier smokers may find this intensive support especially helpful. The group support provides an opportunity for quitters to share how they are getting on – their ups and downs – and provide general encouragement. The groups run for about 8 weeks on average.
Two new group support sessions have been set up, one on Wednesday evenings at Glenrothes Hospital, and the other on Thursday afternoons at Pitteuchar Health Centre.
Individual support sessions with a trained adviser are available in a number of local GP practices and community venues and are available at different times, including evenings. The support consists of a 7-12 week programme of support to help you stop smoking, plus advice on medication such as NRT and Champix®.

NHS Tayside

Throughout Tayside, community groups, stop smoking classes and one to one support is available from GPs and Pharmacies. In Dundee, the Dundee Healthy Living Initiative also provides stop smoking sessions.
For more information or to book a place please:

Telephone the Tayside Smoking Helpline: 0845 600 9996

NHS Grampian

NHS Grampian Smoking Advice Service:

Freephone 0500 600 332
Helpline open Monday to Friday: 9.00 a.m to 5.00 p.m
Email [email protected]

NHS Highland

NHS Highland Smoke-Free Service:

Telephone: 0845 757 3077
Website: NHS Highland – Smoke Free Highland

NHS Orkney

For an appointment or informal chat:

Telephone: 01856 888084 or 07500121900

NHS Shetland

To make an appointment, or for further advice:

Telephone: 01595 80 7494

Come to your nearest drop-in clinic:

LERWICK Gilbert Bain Hospital Outpatients Wednesday 6-7pm and Health Improvement Department, Grantfield Thursdays 12-1.30pm
Walls Health Centre 12 – 2pm and 4-6pm every Tuesday
Ollaberry Hall 3-6pm every Tuesday

NHS Forth Valley

Falkirk Stop Smoking Clinics:

Drop-in Clinics Every Wednesday 5.30pm – 7.30pm Camelon Health Centre
Champix Clinic – The Champix Clinic is run by trained pharmacists who can prescribe Champix without the need to visit your GP. Every Wednesday 5.30pm – 7.30pm St Ninians Health Centre

Stop Smoking Groups:

Denny Carronbank Health Centre Tuesdays 5.30-7.30PM
Grangemouth Health Centre Mondays 5.00 – 7.30pm
Meadowbank Health Centre and Slamannan Clinic Mondays 5.00-7.00pm
Redding & Westquarter Community Group Tuesdays 5.30 – 7.30pm
Slamannan Surgery Wednesday 5.30 – 7.30pm
Stenhousemuir Health Centre Thursdays 5.30 – 7.30

Stirling Stop Smoking Clinics:

Drop-in clinics Every Wednesday 5.30pm – 7.30pm St Ninian’s Health Centre

Clackmannanshire Stop Smoking Clinics:

Drop-in clinics Every Tuesday 5.30pm – 7.30pm Clackmannanshire Community Healthcare Centre

NHS Western Isles

Health Promotion Department 1 Bank Street, Springfield Road Stornaway HS1 2XG
Telephone: 0800 848484 (free) / 01851 701 623 / Helpline: 01851 701623 / Chat online 7 days a week 8am -10pm
Email: [email protected]
Web: Smokeline – Western Isles QUIT Smoking Service

Smoke Free Hebrides provides free confidential, advice, help and support to anyone in the Western Isles who would like to quit smoking. We offer one-one, group, telephone, text or email at times suited to the needs of each individual. Why not contact us?

Lewis and Harris: Telephone: 01851 701623
Uists: Telephone: 01870 602588
Barra: Telephone: 01871 810895

Something to try

Do you like using you smartphone or tablet? There are many apps designed to help you stop smoking. Why not explore these?

Low mood

View text transcript

Anxiety and depression are often mentioned together, both are common – however they are different. To find out more about anxiety look at the section on stress.

Many people experience low mood or depression following a stroke, up to half experience this. Feeling down for some of the time is a natural reaction. It is important though to recognise if you are depressed and let someone know how you are feeling as it can be treated.

Being depressed affects how you feel and can come on slowly over a period of time. It can affect how you think and we look at this more in the section on how emotions can affect decisions.

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Change in appetite – this may mean “comfort eating” or not feeling like eating at all. Try to eat small amounts of food that appeal to you.
Feeling more irritable – you may feel grumpier or others may comment that you snap at them. Being like this can be a sign of low mood.
Sleeping problems – you may find it difficult to get to sleep or waken early and are unable to get back to sleep as thoughts keep you awake, lack of sleep can impact on how you feel. Read information sheet on getting a good nights sleep and talk to your GP
Crying a lot – are you more easily upset or feel sad all the time? This can be normal after a stroke as there is adjustment and loss of who you were. However if it continues you may need some help to move forward.
Loss of interest – feeling you can’t be bothered. Try to set your self a small goal look at the goal setting section
Extreme tiredness – feeling exhausted after a stroke can be common. Try to pace your self in order to feel you achieve some things. Try not to take to your bed. Ask your GP for help
Loss of confidence – Feeling frightened of going out or doing anything by your self can be normal following a stroke, By adjusting over time this should improve. Don’t be afraid to ask for help. If it does not get better speak to your GP
Feeling alone – many people feel alone even if they have others around them. Meeting up with other people who have had a strokes and similar experiences and feelings can help. Ask your GP/nurse about your local groups or phone the CHSS advice line

Something to think about

Depression can creep up slowly over time. So how do I know if I am depressed or I am just experiencing grief – it might help to ask yourself these questions:

how long ago was your stroke?
how long you have felt like this?
how does your mood affect your life?
do you recognise that your mood is low?

More information

NHS inform Sleep
The Sleep Council
NHS Inform – Fatigue

Conclusion

It’s important that we can talk about how we feel.
Your relationship may have changed and it takes time to adjust and adapt to changing roles.
Try to use some of the suggested ideas and remember that there is help and information on this website.

What affects our communication?

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Lets look at all the things that effect how you communicate.

Emotion – Hiding our emotions when talking to others is very difficult. After a stroke it can be even more difficult to control emotion and this can be embarrassing. It changes your voice and disrupts your speech.

Thoughts – When we have a lot on our mind our thoughts drift. Proper conversations need full concentration from everyone. You can work on improving this.

Effects of Stroke – A stroke can change how speech sounds or make it more difficult to find the right words. Getting used to this can take some time.

Communication Partner – A communication partner is anyone you are having a conversation with. Everyone knows some people are easier to talk to than others. This can be about how well they listen and share talking time.

Environment – The obvious problem is noise, but other things like seating arrangements, privacy and formality change how we chat with each other.

Method of Communication – The most important thing is getting your message across. It is less important how you do this. Using gesture, drawing and writing are all relevant. Whatever works for you.

Hopefully you now have some ideas about what works well and what you need to work on. This will vary depending on who you are with, where you are and how you are feeling.

Lets look at what you can do about these.

It’s all about the NHS saving money

THE DAILY NEWS

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“It’s all about the NHS saving money”

Alec, 61 years. “If I do more for myself it saves them money, all they want to do is save a pound or two at my expense. Its all about cutbacks, nothing to do with what I want “.
Agnes, 62 years takes the self management approach: “It’s not just about saving money; I also want to be able to help myself. It’s my responsibility to look after my own health for now, and in the future”.

Key point

If I self manage I will have a better quality of life and I will be less likely to need health services in the future.