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Your Stroke Care Binder
Information about
Hamilton Health Sciences
Visiting
Current visiting hours – 11:00 am to 8:00 pm. Two visitors at a time. Visit only if you are feeling well and wash your hands when you arrive at the hospital. Hamilton General Hospital - 7 South
237 Barton Street East Hamilton, Ontario L8L 2X2 905-527-4322 • Victoria Street Parking Ramp is off Victoria Avenue on the left just past the hospital. There is a bridge-walkway to the hospital located on Level F. The parking ramp elevator is Your Stroke Care Binder – Information about Hamilton Health Sciences • Municipal parking lot is off Victoria Avenue across from • Meter parking on streets is close by but can be limited. You may get a parking ticket if your time runs out. • Wheelchair accessible parking: on Level B of the Victoria Avenue Parking Ramp on Level B. There is an outdoor Hamilton General Hospital
- Regional Rehabilitation Centre
300 Wellington Street North Hamilton, Ontario L8L 0A4 There is limited parking available at the Regional Rehabilitation Centre. You may also park across the street St. Peter’s Hospital
88 Maplewood Avenue Hamilton, Ontario L8M 1W9 905-777-3837 There is a parking lot at the back of the hospital. You can only use toonies and loonies as payment in the machine. Your Stroke Care Binder – Information about Hamilton Health Sciences Fragrance restricted
We are a fragrance restricted hospital. Please do not wear or bring perfume, cologne, aftershave, scented hair spray scented soaps, deodorants, aerosols or other scented We are latex-free
Out of consideration for the health of our patients and staff with latex allergies, please do not bring latex balloons or other unauthorized latex products into the hospital. Television, radio, telephones
• Televisions may be rented in most patient rooms. • Telephones may be rented for a flat rate. • You may bring in a small battery operated radio, The hospital is not responsible for lost articles.
Your Stroke Care Binder – Information about Hamilton Health Sciences Cellphones and wireless devices
Do not use cellphones or wireless devices in patient care areas at the Hamilton General Hospital. They can be used in the lobby, cafeteria, public hallways and business offices. Discharge
Your health care team will begin to plan for your discharge with you and your family when you arrive. Please plan to leave as early as 9:00 am on your day of discharge. We are a teaching hospital
Students may become involved in your care. If you would prefer not to have students involved in your care, please let Smoke-free hospital
Hamilton Health Sciences is smoke-free as of January 1, 2011. This means that smoking is no longer allowed anywhere on the grounds, including parking lots, Your Stroke Care Binder – Information about Hamilton Health Sciences • talk to a member of your health care team at Hamilton • contact Smokers’ Helpline toll free at 1-877-513-5333 or Prevent the spread of infections
Infections can spread easily. Prevent the spread by: • Delaying visiting if you do not feel well. • Washing your hands before and after visiting. Hand cleanser is located outside each room and by the elevator. • Not using the patient’s washroom. Public washrooms are • Following the directions about infection control if posted on the patient’s room door. You may be asked to wear a gown, • Calling a nurse if you see a patient needing help rather Your Stroke Care Binder – Information about Hamilton Health Sciences Information and giving consent for your care
Helping you understand your care is important to us. You have the right to refuse any care that makes you feel Please ask us questions whenever you are unclear about your care and why it is beneficial to your recovery. Taking part in research
Hamilton Health Sciences is a teaching hospital and does research to help make sure our patients get the best quality of care. You may be asked to take part in stroke research projects. You do not have to take part if you do not want to and saying no will not affect your care. Your Health Care – Be Involved
Hamilton Health Sciences takes part in the Ontario Hospital Association’s program, “Your Health Care – Be Involved”. The program provides 5 tips to encourage patients to be 1. Be involved in your healthcare. Speak up if you have questions or concerns about your care. Your Stroke Care Binder – Information about Hamilton Health Sciences 2. Tell a member of your healthcare team about your past illnesses and your current health condition. 3. Bring all of your medicines with you when you go to the hospital or to a medical appointment. 4. Tell a member of your health care team if you have ever had an allergic or bad reaction to any medicine or food. 5. Make sure you know what to do when you go home from hospital or from your medical appointment. For more information, ask a member of the healthcare team for a copy of “Your Health Care – Be Involved”. You can also print a copy at the Ontario Hospital Association’s website www.oha.ca. It is available in many languages. Compliments and concerns
Every staff member at Hamilton Health Sciences is part of a health care team dedicated to helping you with your care and treatment. If you wish to express your compliments or concerns, please call Patient Relations at 905-521-2100, Your Stroke Care Binder – Information about Hamilton Health Sciences The Hamilton Health Sciences is able to provide you with products and services which you may need. You will be • all procedures, products and services not covered by OHIP • elective procedures not covered by OHIP; your doctor will provide you with an estimated cost of the procedure or You will be given a bill to let you know if these charges apply to you and will be asked to sign a form. Payment may be made by cheque or credit card at the Cashier Office in the Main Lobby during regular business hours. You will be given a receipt after payment. You may also pay your hospital bill on-line directly from the hospital website at www.hhsc.ca. Select the tab Patient Accounts on the left hand side of the screen. This service is The extra cost of a private or semi-private room is not covered by OHIP and is your responsibility. Check your insurance plan or contact your employer to see if the cost Your Stroke Care Binder – Information about Hamilton Health Sciences Additional information
For more information, please go to our website: Your Stroke Care Binder – Your Stroke Care Your Stroke Care
What is a stroke?
A stroke is a sudden loss of brain function. It is caused by the blockage of the flow of blood to the brain or the rupture of blood vessels in the brain. The effects of the stroke depend on where the brain was injured and how much of the brain is damaged. A stroke can be frightening for you and your family. You will have new experiences in the hospital and you may have questions. This booklet will help answer some of your questions about your care and help you get to know your health care team. Any member of the health care team will be pleased to answer your questions at any time - no question is too simple to ask. Stroke care at Hamilton Health Sciences
We provide care after a stroke in many places at Hamilton Health Sciences. Your care will start on 7 South at the Hamilton General Hospital. On 7 South you will be assessed by a team of stroke care professionals. Your care will be personalized You will receive the best care at the right place at Your Stroke Care Binder – Your Stroke Care You may continue your rehabilitation on one of three locations: • Ward B2 North in the Regional Rehabilitation building at the • The Restorative Care Unit at St. Peter’s Hospital All areas work together to provide personalized recovery care. Your Stroke Care Binder – The Health Care Team The Health Care Team
Members of the health care team will teach you and your • what medications you are taking and how they help in • what to expect when you leave the hospital • your risk factors for stroke and what you can do to See the listing below of the health care team members you may Health Care team
How they help
Neurologist
Internist

Neuropsychologist
thinking and emotions common after stroke Your Stroke Care Binder – The Health Care Team Health Care team
How they help
Physiatrist
Registered Nurse and • helps you with your daily care
Registered Practical
Dietitian/
Dietetic Assistant
Occupational
Therapist/
Occupational
Therapy Assistant
equipment which allows you to do more for yourself Physiotherapist/
Physiotherapist
Assistant
Pharmacist
Your Stroke Care Binder – The Health Care Team Health Care team
How they help
Social Worker
ways of coping with the changes in your lives Speech-Language
Pathologist,
Communications
Disorder Assistant
Respiratory
Therapist
Chaplain
Therapeutic
Recreation
Therapist

Stroke Navigator
when you move between the areas of stroke care at Hamilton Health Sciences Your Stroke Care Binder – Welcome to 7 South Welcome to 7 South
Hamilton General Hospital
Visiting on 7 South
Families and friends may visit the unit. Visiting hours are between 11:00 a.m. to 8:00 p.m. daily. Talk to a member of your health care team if you need to come in at a different time. Rest is an important part of recovery. Please delay visiting if you find If needed, visiting hours on the unit may be restricted. How do I contact 7 South?
A family member can call 7 South for information to pass on to The number to call is: 905-527-4322, ext. 46700 Your Stroke Care Binder – Welcome to 7 South What can I expect the first week on 7 South?
When you are admitted to 7 South, the doctor will order a • the location of the stroke in your brain and, See pages 20 and 21 for more information about these tests. The health care team will assess the effects of your stroke and determine the treatment you need to help you learn how to do things that you did before the stroke. This is called rehabilitation and it will start on 7 South. Rehabilitation is an important part of your recovery and it will be based on your personal needs. During rehabilitation you will work on many things such as: • getting in and out of bed safely • walking or moving around • talking • thinking • eating • bathing • dressing Your Stroke Care Binder – Welcome to 7 South Rehabilitation cannot cure the damage caused to the brain by the stroke but can help you to re-learn how to do the things you Taking part in your treatment is an important part of your recovery. • You will be closely watched by the health care team. • The health care team will do physical and medical • Tests such as a CT/MRI scan, ECG, Holter monitor and blood work may be ordered by the doctor. • monitor your bowel and bladder function. • check your blood sugars. • The pharmacist will review the medications you take at • The physiotherapist and occupational therapist will assess your level of activity and cognitive abilities. • The speech language therapist will assess you for • The dietitian will help you meet your nutritional needs. Your Stroke Care Binder – Welcome to 7 South • The social worker will meet with you and your family to address concerns, discuss the stroke program and book • All health care professionals will begin planning your discharge with you and your family during this time. • Family members can bring in hearing aids, glasses, As you progress on 7 South:
• The health care team will work with you and your • A family meeting will be held to discuss the results of your assessment including the type of stroke, your deficits and Your family meeting:
Date: _____________________ Time:___________
• After you have had your family meeting, you will move to the next location of care that is based on your personal needs. Your Stroke Care Binder – Welcome to 7 South Other information about 7 South
Meals
Meals are served at approximately 8:00 am, 12:00 noon,
Laundry
Bedding will be changed as needed. Personal clothing will
Services available at the Hamilton General Hospital
• a number of vending machines throughout the hospital • the Market Place Cafeteria on the 1st level • a coffee shop on the main level of the hospital • a gift shop on the main level We understand…
This may be a stressful time for you. We recognize that your family or significant others are an important part of your care. The health care team will work with you in a respectful and caring manner. It is important that you and your family act in a respectful manner to the health care Your Stroke Care Binder – Tests you may have on 7 South Tests you may have on 7 South
Type of test
Purpose of test
How the test is done
your body and these pads have sensors, which detects the electrical activity of your heart. The information is printed out. monitors your heart rhythm for a longer period of time. The monitor is worn on your body. rotating device through the area of interest. The computer makes a 3 dimensional picture of the area. Your Stroke Care Binder – Tests you may have on 7 South Type of test
Purpose of test
How the test is done
pictures of the blood vessels. You are required to lay still in a scanner. produce a 3 dimensional image of the brain. You are required to lay still in a scanner. done by inserting a tube into in the esophagus (food pipe). You are sedated. Your Stroke Care Binder – Tests you may have on 7 South Your Stroke Care Binder – About Stroke About stroke
What is a stroke?
A stroke is a sudden loss of brain function. It is caused by the blockage of blood flow to the brain or the rupture of blood vessels in the brain. Each stroke is different. The effects of the stroke depend on where the brain was injured and how much of the How well you recover from a stroke depends upon many factors including how much and what parts of your brain were damaged Your Stroke Care Binder – About Stroke Types of stroke
Ischemic stroke
This type of stroke is caused by a blood clot or a blockage
within an artery leading to the brain. This affects the blood flow There are two causes of ischemic stroke: Embolic stroke – It is a result of a blood clot that was
formed somewhere other than in the brain. The blood clot travels in the bloodstream until it becomes lodged in the Thrombotic stroke – This is the result of diseased or
damaged arteries in the brain. The artery becomes blocked by the formation of a blood clot within the brain. Common terms that your health care team may use if you have • Ischemic – When the blood flow in the brain is cut off by a
• Atherosclerosis – The inside of an artery is blocked off
by the build up of a thick plaque inside the artery walls. • Atherothrombosis – The build up of a clot over the
Your Stroke Care Binder – About Stroke Hemorrhagic stroke
This stroke is caused when a diseased vessel bursts in the
brain allowing blood to leak inside the brain causing damage. Common terms that your health care team may use if you have • Aneurysm – The wall of the artery becomes weak and
balloons out. If the aneurysm bursts or leaks blood out it • Intracerebral Hemorrhage – When an artery in the brain
Effects of a stroke
Stroke in the cerebrum
The cerebrum is the largest part of the brain. It controls your
speech, thinking, reasoning, memory, sexual function and your emotions. It also controls the movements in other parts of the body. The cerebrum is divided into two parts; the right and the left side. The effects from your stroke depend on which side Your Stroke Care Binder – About Stroke Right side of the brain
If your stroke occurs in the right side of the brain, then the left side of your body will be affected. You may have: • problems distinguishing distance, depth, between up and down, or between front and back. This can make it hard to pick up objects, button a shirt, or tie your shoes. • problems with short-term memory. You may be able to remember something that happened several years ago, but not something you did a few minutes ago. • forgetting or ignoring objects or people on your left side. This is called neglect. You may even ignore your own left • difficulty in judgment such as acting impulsively or not Your Stroke Care Binder – About Stroke Left side of the brain
If your stroke occurs in the left side of the brain, then the right side of your body will be affected. You may have: • weakness or paralysis. • trouble reading, talking, thinking or doing math. • behaviour to become more slow and cautious than usual. • trouble learning or remembering new information. • the need for frequent instructions and feedback to Your Stroke Care Binder – About Stroke Stroke in the brain stem
The brain stem is the area at the very base of the brain,
If you have had a stroke in the brain stem, this can cause:
• weakness or paralysis of your arms and legs on both sides
• problems breathing and heart problems. • difficulty in controlling your body temperature. • problems in balance and coordination. • problems chewing, swallowing and speaking. • problems seeing. Stroke in the cerebellum
Although strokes are less common in the cerebellum, the effects
If you have a stroke in the cerebellum, you can have
problems with:
• walking, coordination and balance – this is called ataxia • dizziness • headache • nausea and vomiting Your Stroke Care Binder – About Stroke TIA
TIA is short for transient ischemic attack. Transient means
short term, ischemic means lack of blood supply. Therefore TIA means a short term, lack of blood supply to the brain. This is a temporary problem, which occurs when the brain does not get enough blood supply. TIA’s usually last from 30 seconds to 10 minutes however some can last up to 24 hours. Most short term TIA’s do not leave noticeable deficits even though some Minor damage to brain cells may go unnoticed as the other healthy brain cells continue to do the work of the normal TIA’s are often referred to as “mini-strokes” and are considered to be a serious sign of an increased risk of stroke. The short term problems that may occur with a TIA are: • weakness • vision problems • trouble speaking • dizziness • headache Your Stroke Care Binder – About Stroke Your Stroke Care Binder – What are the risk factors for a stroke? What are the risk factors for
a stroke?
Risk factors you can do something about:
Risk factors you cannot control:
history of stroke or Transient Ischemic Attack (TIA) Your Stroke Care Binder – What are the risk factors for a stroke? Your Stroke Care Binder – Stroke medications Stroke medications
What medications help?
Medications are used for many reasons. You will have your own medication plan to follow based on your condition. You may need medication to: help your heart beat more slowly and strongly It is important that you take your medications as prescribed. Never take anyone else’s medications. Do not share your medications with other people. What are the common medications?
The chart on the next few pages lists the common medications used to prevent stroke and treat heart disease. Medication names are listed by their generic name first and then some of the common trade names in brackets. As many companies can make the same medication, not all names are listed. New medications often come on the market that may not be listed. If you have any questions, please ask your doctor, nurse or pharmacist. Your Stroke Care Binder – Stroke medications Generic and Trade Names
What medication does
(generic names are listed 1st with no capital letters) Type of medication
Angiotensin-Converting Enzymes
(ACE) Inhibitors:
lisinopril (Prinivil®, Zestril®) quinapril (Accupril®) perindopril (Coversyl®) ramipril (Altace®) Angiotensin Receptor Blockers (ARB)
Beta Blockers
carvedilol (Coreg®) metoprolol (Lopressor®) Calcium Channel Blockers
Heart rate controlling:
Cardizem®CD, Tiazac®) verapamil (Isoptin®, Isoptin SR®) Your Stroke Care Binder – Stroke medications Generic and Trade Names
What medication does
(generic names are listed 1st with no capital letters) Type of medication
Non-heart rate controlling:
Diuretics
Lipid Lowering Agents - Statins:
• lowers your total cholesterol and your Lipid Lowering Agents - Fibrates:
bezafibrate (Bezalip®) fenofibrate (Lipidil Micro®) gemfibrozil (Lopid®) Lipid Lowering Agents - Others:
ezetimibe (Ezetrol®) nicotinic acid (Niacin) Platelet Inhibitors and
Anticoagulant Medications
• helps to reduce the chance of stroke clopidogrel (Plavix®) ticlopidine (Ticlid®) warfarin (Coumadin®) Your Stroke Care Binder – Stroke medications What are the side effects of my medications?
Each medication has its own side effects. You can learn more about the side effects of any medication you take by reading the medication information handouts provided by your hospital or pharmacist. These handouts tell you about the side effects you may notice and when to contact your doctor. In general, contact your doctor or go to the nearest hospital if you have: Call your doctor, nurse or pharmacist if you have any questions about your medication. Carry an up-to-date list of your medications
and dosages with you all the time.
Your Stroke Care Binder – Stroke medications What do I need to know about my medications
before I leave the hospital?
You, your family members and partner need to know: the correct name and dose of your medications the possible side effects of your medications Your nurse, doctor and pharmacist will help you learn this information about your medications while you are at the hospital. Your community pharmacist will review this information with you each time you refill your prescription as well. Hamilton Health Sciences, 2011 PD 7392 – 02/2011 dpc/pted/StrokeBinder-StrokeCareCoreInfo-trh.doc dt/February 24, 2011

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