James Weimer, assistant professor of computer science and noted medical-device entrepreneur, has received a National Science Foundation CAREER Award to improve the safety and efficacy of systems that use advanced machine learning and artificial intelligence techniques.

Learning-enabled medical cyber-physical systems (LE-MCPS) are smart medical systems that provide actionable feedback to caregivers. They use machine learning and AI to enhance their functionality and decision-making capabilities.

One example is a stroke detection device in hospitals that processes accelerometer data to not only alert nurses when a stroke is suspected, but also personalize it to the patient such that a maximum number of false alarms is guaranteed. Another example is a postpartum hemorrhage predictor that provides timely insight into the risk of hemorrhage for a woman prior to childbirth, such that clinical care teams can plan ahead and be prepared to take prompt action after delivery.

However, LE-MCPS rely heavily on experimentation to generate data for design and assurance, which can lead to inefficiencies and increased patient risk. Weimer and his team plan to use the more than $570,000 grant to develop technology that will improve efficiency and reduce the possibility of errors.

The CAREER Award project will leverage Weimer’s expertise—specifically his co-founding of companies Neuralert and Vasowatch—to study the LE-MCPS problem in the context of stroke detection and postpartum hemorrhage prediction.

“We’re addressing foundational technical challenges I’ve identified through my experience in building real-world medical devices,” says Weimer, who is also faculty affiliate of the Vanderbilt Institute for Surgery and Engineering (VISE) and the Institute for Software Integrated Systems (ISIS).

In 2022, Weimer was one of two Vanderbilt faculty who received the distinction of Best Invention by Time magazine editors. He created Neuralert, a lightweight, noninvasive wristband device that automates stroke detection and alerting. Neuralert’s stroke detection device can identify the onset of asymmetric movement in as little as 15 minutes, even if the wearer is asleep. In 2021, the FDA named Neuralert a Breakthrough Device.

Avoid another stroke

In order to avoid another stroke, you may need to make lifestyle changes and take medications to correct the factors that brought on your stroke. About 25% of strokes are repeat strokes, but you don’t have to be a statistic.

Common factors that contribute to stroke risk are cardiovascular disease, high blood pressure, elevated cholesterol, smoking and substance abuse, a sedentary lifestyle, obesity, stress, and poor diet. With the help of your doctor, evaluate what lifestyle changes you need to make to reduce or eliminate these factors, such as: 

• Eating a healthy diet, low in simple carbohydrates and added sugar, and eliminating trans fats and partially hydrogenated vegetable oils
• Developing an exercise regimen for daily movement
• Getting plenty of sleep; if you have a sleep disorder, get professional help
• Quitting smoking, excessive drinking, or the use of controlled substances (drugs)
• Losing weight 

Your doctor may have some additional suggestions for your particular case. Medication alone won’t prevent another stroke. It is critical to make lifestyle changes to overcome the factors that led to the first stroke and may lead to another. 

Consider adding a Neuralert stroke detection monitor to your stroke-recovery plan, at least during the period in which you are still at a high risk for stroke. Our monitor looks like a smartwatch and is connected to a state-of-the-art algorithm that can detect signs of a possible stroke within minutes and transmit a warning to your medical provider to quickly evaluate your condition. Fast action saves lives and minimizes long-term damage. The Neuralert stroke detection wristbands may provide you with the peace of mind you need while building back from your stroke.

Continue healing

In the first months after a stroke, intensive rehabilitation and treatments will focus on returning function to damaged areas of the brain to regain mobility, communication, and self-care skills. These treatments will begin in the hospital, within hours after the stroke.

However, many people stop rehab or exercise when they hit a plateau, thinking they have reached the extent of their improvement. But don’t stop. Your brain has an amazing power known as neuroplasticity, the ability to make new connections and use new areas of the brain for new purposes. As long as you start exercising your brain quickly after a stroke and you don’t stop, your brain will continue to respond to the demands that are placed on it. Improvement may be slower after the first few months, and you may have to compare your progress from month to month, or even year to year, but improvement should continue, as long as you keep at it.

Maintain a positive outlook

In order to have the motivation to continue to stick to your lifestyle changes, struggle through communication problems, and maintain activity to regain function, you need a positive attitude. People with post-stroke anxiety or post-stroke depression experience poor recovery of physical function and have a higher post-stroke mortality rate than those who do not experience depression or anxiety.

It is understandable to feel sad, angry, or worried about the future after having a stroke. But you must work to overcome those feelings to overcome the effects of stroke. In some cases, the emotions may actually be caused by damage to a certain part of the brain. This may make it more difficult to overcome, but at the same time, it may give you a sense of purpose – to try harder to heal your brain to conquer unwelcome emotions. 

Each person is different, but there are a number of steps you should take in order to develop and maintain a healthy, positive attitude:

• Set goals: short-term, mid-term, and long-term. They should be realistic so that you can achieve them, but challenging enough that you must work to reach them. Remind yourself of them daily.
• Commit to maintaining lifestyle changes for life. Don’t go back to pizza and beer or pick up smoking again after a while. To return to old patterns is to return to stroke risk.
• Continue to take prescriptions as needed. Visit your doctor regularly to adjust medications as necessary as your condition improves.
• Maintain friendships and family ties. Isolation and loneliness bring on depression and bad habits.
• Make new friends. Join support groups or clubs associated with a hobby, such as a garden club, chess club, or walking club. Stimulate your brain, body, and communication skills at the same time, while making human connections that are so important for us to thrive.
• Develop an attitude of gratitude. Be thankful for each new day and find blessings all around you.
• Find meaning. Many people find that practicing religious faith, praying, and/or performing works of service provide meaning to their lives.

Recovering and thriving after a stroke is possible. It takes effort and the help of support people as you travel your journey, but many people find their lives meaningful and happy after a stroke by taking these important steps. 

Determining the cause of stroke

The immediate cause of a stroke is what actually happened in your body to cause the stroke: an ischemic stroke is caused by a blood clot that completely prevents the flow of blood to some part of the brain; a hemorrhagic stroke is caused by a leak or rupture in an artery in the neck, brain, or around the brain; a transient ischemic attack (TIA) is often called a mini-stroke and is caused by a temporary blockage of blood flow. A TIA should be treated as seriously as a major stroke, since about one-third of people who experience a TIA subsequently have a stroke, sometimes within days. 

The question the doctors must then answer is what brought about the conditions to cause the blood clots or blood vessel rupture. While age and genetics are factors beyond the patient’s control, fortunately, most other factors are controllable, either by proper medication or by lifestyle changes, and often both. The most common risk factors include:

• High blood pressure
• Cardiovascular disease, including irregular heartbeat or AFib
• Diabetes, Type 2 diabetes, or pre-diabetes
• Elevated cholesterol, especially triglycerides
• Smoking or substance abuse
• Unhealthy diet, such as processed foods
• Obesity or being overweight
• Sedentary lifestyle, limited exercise
• Living alone
• Stress, anxiety, depression
• Poor sleep habits, sleep apnea, snoring, and other sleep disorders 

There are also social determinants and environmental conditions which, while theoretically controllable, are not easy to control in reality. Such factors include living in an area with a poor healthcare system or in an environment that has high exposure to pollutants. If you have environmental or socio-economic factors that you cannot change, it is even more important to follow the doctor’s orders to decrease your risk of another stroke.

Addressing risk factors with medication

High blood pressure, or hypertension, is a top cause of both ischemic and hemorrhagic stroke. If your doctor determines that this is one of the causes of your stroke, you will be prescribed medications to bring your blood pressure into a healthy range. These may include diuretics to help you flush retained fluids, ACE inhibitors and calcium channel blockers to widen your blood vessels, or beta blockers to help control your heartbeat.

If you’ve had an ischemic stroke, you will probably be prescribed anticoagulants or antiplatelets to help prevent blood clots. If your cholesterol is elevated, your doctor may prescribe statins to bring your cholesterol down to a healthy level. And certainly, if you have diabetes, you must take your diabetic medications, including insulin. Type 2 diabetes and pre-diabetes should be monitored and lifestyle changes made to prevent developing diabetes. 

Making lifestyle changes

Lifestyle changes can help with virtually all the risk factors, and your doctor will probably recommend some along with the prescriptions. Do not depend solely on prescriptions, and unless your condition is mild, do not depend entirely on lifestyle changes. Both should be used in conjunction. Some of these changes include:

• Quit smoking and avoid secondhand smoke as much as possible
• Limit alcohol consumption, and certainly do not engage in other substance use such as recreational drugs
• Lose weight, if necessary
• Eat a healthy diet, low in added sugars and simple carbs; eliminate trans fats and vegetable oils such as corn oil and canola oil
• Move your body every day, and exercise at least several times a week, beginning with walking and stretching exercises if you are not used to exercising
• Get healthy sleep; address sleep disorders with the help of a medical professional, if necessary 

Remaining consistent for the long run

Remember, avoiding another stroke is not a short-term action that you can stop doing once you’re “in the clear.” While some of your conditions may improve over time, check with your doctor about changes to your medication rather than deciding on your own to stop taking them. The lifestyle changes are permanent – for life! Don’t go back to smoking or eating junk or being sedentary. Stay active and healthy. 

Make regular appointments with your doctor and keep them. While you are still at a high risk of stroke and until you can get your risk factors under control, consider using a Neuralert stroke detection monitor. Our state-of-the-art system looks like a smartwatch but is connected to an algorithm that can determine within minutes if there are signs of another stroke and can immediately alert your healthcare provider to rush medical help. Time is critical, because the quicker a stroke is caught, the better the chances of limiting long-term effects. Talk to your healthcare provider about adding Neuralert to your post-stroke health program.

People with diabetes who have strokes are less likely to fully recover and have an increased risk of death from the stroke.

Certain ethnic groups in the U.S. have a greater occurrence of diabetes: American Indians, Alaska Natives, African Americans, and Hispanics/Latinos. These populations also have higher rates of stroke.

Diabetes is a very dangerous condition that must be controlled. According to the American Heart Association, 16% of adults over age 65 with diabetes die of stroke and 68% die of some form of heart disease.

About diabetes

Diabetes is a condition in which the body is inefficient in managing blood glucose levels – sugar in the bloodstream. Many foods are turned into glucose by the body and used as energy in the cells. The hormone insulin, produced by the pancreas, is critical in getting the glucose into the cells. With diabetes, the pancreas does not make enough insulin to help the body convert all the glucose you consume into energy.

Many people with diabetes have comorbidities that are also stroke risk factors: high blood pressure, high cholesterol, obesity, and circulation problems. Fluctuating blood glucose levels can also damage the cardiovascular system.

How diabetes can lead to stroke

Over time, excess sugar in the blood can lead to atherosclerosis – the buildup of clots or fat deposits in blood vessels. This can cause a narrowing of the passage in the blood vessels, thus increasing the risk of bursting blood vessels or developing a clot that completely blocks the flow of blood. Either event can cause a loss of blood to the brain, which is called a stroke. A stroke caused by blockage is called an ischemic stroke; one caused by a burst or leaking blood vessel in or around the brain or neck is called a hemorrhagic stroke. 

Loss of blood flow, and thus a loss of oxygen, causes brain cells to quickly begin to die. Time is critical after a stroke, because the more quickly blood flow can be restored to the brain, the less long-term damage may be done.

Controlling diabetes and reducing the risk of stroke

Lifestyle changes can do a great deal to alleviate diabetes and the many risk factors of stroke that often accompany diabetes. Avoiding sugar and simple carbohydrates that convert quickly into sugar can significantly decrease your blood sugar load and help the pancreas stay on top of the amount of glucose you’re putting into your body.

Regular exercise and healthy sleep habits are important for overall health. If you smoke, stop smoking. Drink alcohol in moderation, if at all. These two changes will have a powerful effect on your blood pressure, helping to bring it into a healthier balance. If you are overweight, it’s important to lose weight to help control most of the health conditions mentioned.

Your doctor may prescribe medications that can help keep your blood sugar levels under control, alleviating some of the symptoms of diabetes and lessening your risk of stroke. You may also want to talk to your doctor about adding Neuralert’s stroke detection monitor to your stroke risk reduction program. At Neuralert, we are dedicated to reducing the devastating damage that can be caused by stroke. Our stroke detection monitor looks like a smartwatch and is connected to state-of-the-art AI programming that has been proven to pick up signs of most strokes within minutes, sending a message to your healthcare provider that immediate evaluation and care are needed.

By adjusting your lifestyle, taking appropriate medications, and wearing our stroke monitor wristbands, you will dramatically decrease your risk of stroke and speed medical care your way if you do have a stroke, thus decreasing the risk of long-term damage. Talk to your doctor about Neuralert.

Effects on recovery

A recent study looked at the effect of depression and anxiety on recovery. The study found that each condition affects post-stroke patients differently, with the worst outcomes in those who experience both conditions.

Post-stroke anxiety (PSA) was associated with poor self-control, immobility, and fatigue. People with post-stroke depression (PSD) had a 3.4- to 7-times higher mortality rate than those without PSD. These patients also experienced poor recovery of physical function, daily living skills, and cognitive recovery, including memory and problem-solving. Having anxiety along with depression deepened the depressive symptoms and worsened the recovery. 

Many factors impact the presence or severity of anxiety and/or depression, including the severity of the stroke and the part of the brain impacted, because some mood changes are physiological rather than purely emotional. Various psychosocial factors were associated with the increased risk of depression, such as previous psychiatric history in the individual and in the family; living alone or having little social contact; and being younger than age 59. Women also have a higher risk than men.

Overcoming Depression and Anxiety

If you or a loved one has experienced a stroke, your medical team should thoroughly educate you on the signs and symptoms of depression and anxiety, as well as other mood disorders, such as uncontrolled emotions (laughing, crying, or shouting for unclear reasons), apathy, anger, or impulsivity. The doctors should be able to explain what emotional changes to expect due to the physiological damage to the brain, as well as what emotions to expect during the recovery process.

Your health team should also be providing emotional and psychological support right from the start, in order to avoid or lessen the onset of depression and anxiety. It is natural to experience a certain grief and sense of loss after a stroke, concern about the recovery that lies ahead, and a sense of uncertainty about the final outcome. By addressing those feelings head-on, right from the outset, you can create a positive mental outlook that can dramatically improve your chance of recovery.

Constructive integrative psychosocial interventions (CIPI) have been found to significantly decrease feelings of depression and anxiety, most dramatically in the first month post-stroke, but continuing to show benefits into the sixth month. These CIPI treatments include:

• Psychological education, so patients know what to expect, including cognitive, emotional, and physical changes, as well as prognosis, rehabilitation, and recovery
• Sharing narratives of difficult experiences in the past and how they were overcome, creating a sense of resilience in the patient
• Nurturing a sense of self-management and problem-solving in the stroke patient, creating a sense of empowerment and control over aspects of the situation
• Identifying resources that are available in the case of necessity, creating confidence that help is available if needed
• Engagement in at least three activities per day

To these common-sense approaches, you may choose to add some other methods that are known to support mood health, such as mindfulness, coping strategies, and relaxation techniques.

Taking care of caregivers

Caregivers can also feel anxious or depressed, both from seeing their loved one struggling and from feeling overwhelmed by their new responsibilities and the changes in their lives. If you are a caregiver of a stroke survivor, you also need to take care of your emotional health.

Take breaks so that you can recharge and revitalize through doing things you love, resting, worshiping, or spending time with others. You may want to join a support group for caregivers. Always get plenty of sleep, eat well, and exercise so you can enjoy your own life while also supporting your loved one in need.

One of the most common sources of anxiety, for both the stroke survivor and loved ones, is the risk of another stroke. Unfortunately, 25% of strokes are repeat strokes. Neuralert is committed to decreasing the devastating effects of stroke with our stroke detection monitor, combining a unique, non-invasive wristband technology with a state-of-the-art patented algorithm that detects signs of a possible stroke and alerts medical personnel and caregivers, speeding up treatment before valuable time is lost. Ask your healthcare team about adding Neuralert to the stroke prevention plan.

Be prepared

Preparation is key to successfully caring for your loved one who has experienced a stroke. Start by becoming well-educated on the subject. Ask questions of the medical team, both doctors and therapists, about stroke and about your loved one’s particular stroke. Ask about limitations as well as mood and behavior changes you can expect. 

Attend rehab sessions to know what the therapists are doing and to learn how to do it at home. Many therapies will require a lot of repetition at home with the help and guidance of a caregiver. Therapists are also excellent sources of information about what to expect and how best to help in recovery.

Meet with the social worker or case manager for your loved one. This person can help you find local and governmental resources to offer elder care services, counseling, and financial help. Be sure to contact your insurance company and any state or federal agencies that may help with your financial needs. 

Once you have a clear sense of what the stroke patient will need, look realistically at the situation and determine what you can do yourself and where you will need help. For instance, maybe you can provide meals, medication management, and help with at-home therapy practice, but you will need someone to help with bathing, dressing, or lifting your loved one. Types of services that can help include:

• Cleaning service
• Home health aide
• Transportation service
• Meal delivery service
• Adult daycare
• Bookkeeping
• Counseling – for yourself or your loved one 

Tap into family, friends, and the resources offered by the case manager to set up your support team. The U.S. Administration on Aging offers an eldercare locator through their Administration for Community Living. The website is eldercare.acl.gov. Be careful when searching the internet for elder care, because there are scammers who specialize in scamming the elderly. 

Make whatever home modifications the therapists or doctors recommend. You could request a home visit to get an expert’s opinion on any potentially dangerous situations that you might not see. You may also request that your loved one be brought for a “test run” visit with a nurse or therapist, so the stroke patient can see how he or she will be able to maneuver in the home. This can relieve some anxiety about how different things will be, hopefully reassuring the patient that “there is no place like home” and all will be well. 

The American Stroke Association offers a very helpful Caregiver Guide to Stroke, which goes over the effects of a stroke, medical management, legal and financial help resources, and emotional support. Be sure to review this very helpful guide.

Support recovery

If you have thoroughly prepared yourself, you should be able to implement the plan and successfully support your loved one in recovery. A few things to remember:

• Do with, not for. As hard as it is to watch a loved one suffer, he or she needs to work to relearn how to do things. This effort engages the neuroplasticity of the brain, rebuilding the injured areas. Encourage your loved one with this fact whenever he or she may feel discouraged.
• Schedule the day, and show your loved one in a manner in which he or she can understand. For instance, if the stroke has taken away the ability to read, use pictures to list out the activities of the day. Plan time for eating, exercise, therapy practice, resting, and leisure activities.
• Organize the medications. Containers with days of the week and times of the day are particularly helpful, but be sure to have it all written down so other people will know the schedule, as well.
• Watch for signs of depression, which can occur in 30-50% of stroke patients. Discuss with the stroke management team what to look for and what to do if you see any signs.
• Watch for deterioration of physical health, which may indicate a problem with medication or a second stroke onset. Unfortunately, 25% of strokes are second strokes. Neuralert has created a non-invasive, wristband technology that can recognize possible signs of a stroke within minutes, sending a message to designated people – caregivers and health team – to get immediate help. Quick treatment can lessen or even prevent long-term harm from a stroke.
• Arrange for a regular change of pace, such as outings or trips to the adult day care. This can be rejuvenating for both of you and can help your loved one feel like part of the world again.
• Encourage the stroke victim when improvement in condition slows, as it always does. Keep in mind that studies have shown that consistent therapy, even two years later, shows continued improvement in health. “Slow and steady wins the race!”

Maintain your equilibrium

Most caregivers continue their former roles in the family while adding the significant burden of full-time caregiver to an injured person. This is a recipe for overload if you don’t plan for your own health as well as that of your loved one. 

First, be sure to eat a healthy diet, exercise, and maintain good sleep habits. These are essential for a healthy life, but especially when caring for another person. 

Learn how to avoid injury, especially from bending or lifting. A physical therapist can teach you the proper way to lift or bend to protect your spine and limbs. If you can’t do it safely, arrange for home health aides or family members to help.

Protect your emotional health by giving yourself frequent breaks, engaging in religious or spiritual functions that fuel you spiritually, participating in a hobby or other relaxing activity, and spending time with family and friends without the need to provide care. 

Learn how to ask for help and to say “yes” when it is offered. You do not have to do this alone. Consider joining a support group or talking to a counselor to help you maintain a positive attitude. 

Taking care of yourself will help you take care of your loved one. Adding Neuralert to the stroke recovery plan will also give you and the medical team peace of mind that you will receive a warning should another stroke occur, allowing your loved one to get help right away. Ask the medical team about adding Neuralert’s stroke detection wristbands to your loved one’s stroke recovery program.

The relationship between sleep disorders, vascular risk factors, and stroke is well-documented, though not well understood. Consequences of untreated sleep disorders include decreased cognitive dysfunction, altered mood, and daytime fatigue, which can influence stroke occurrence, recurrence, and recovery.

One-third of American adults report getting less than seven hours of sleep each night, and 50-70 million have a sleep disorder. Habitual snoring affects up to 40% of the adult population in the United States and is associated with increased stroke risk. Breathing pauses while sleeping caused by obstructive sleep apnea (OSA) are believed to increase stroke risk in several ways:

• Changes in airway pressure
• Low oxygen levels in the blood
• Heart working harder to pump blood because of decreased oxygen level
• Blood vessels in the heart constricting in response to heart trouble 

These physiological responses increase the risk of both stroke and heart attack, especially at night.

Signs that you have OSA or other sleep disorder

If you have insomnia, you probably know it. You may have trouble falling asleep, wake up too early, or awaken multiple times during the night. But you may not know if you have OSA or snoring.

Signs that you have a sleep disorder include dozing off while sitting and reading, riding in a car, watching television, or even while talking to someone. Other signs may include memory loss or poor concentration; mental fog; irritability or weepiness; or short-lasting morning headaches. You may be told that you snore, stop breathing during the night, or sound like you’re choking at night.

Obesity, diabetes, high blood pressure, and age are all factors that contribute to a higher risk of sleep apnea, and they are also risks of stroke. 

Excessive sleep can also be a risk factor for stroke, as well as for dementia and cardiovascular disease. A study published in the journal Neurology followed nearly 32,000 participants for 6 years, an average age of 62 at the beginning of the study, with no history of stroke or serious health conditions. Compared to people who slept 7-8 hours per day, those who slept 9 or more hours per night had a 23% greater risk of stroke, while those who slept 9 or more hours and also napped during the day had an 85% greater risk of stroke. Those who had poor sleep quality were also at a greater risk of stroke. 

Prevention and management of sleep disorders

If you recognize any of the symptoms described, start with some lifestyle changes. First, turn off technology at least an hour before going to bed. The blue light emitted from cell phones and computers hinders healthy sleep by inhibiting the production of melatonin. The content you are consuming may also cause you stress that will not be easy to release right before bed.

Avoid alcohol at least three hours before bed and caffeine at least six hours before bed.  

Develop relaxation techniques, such as journaling, meditating, engaging in a relaxing activity such as knitting, or spending pleasant time with family and friends. Some people find a warm bath or shower very relaxing.

Go to bed at the same time and get up at the same time every day in order to train your body into a healthy rhythm of wake time and sleep time. Daily exercise and time outside in the sun, as well as turning the lights low before bed, can stimulate sleep hormones and help create a healthy sleep rhythm. 

If sleep problems persist, particularly OSA or snoring, which are not easily corrected by lifestyle changes, talk to your doctor about ways to manage your sleep issues. A good night’s sleep is critical for overall health, and a lack of healthy sleep can also hamper your body’s ability to properly heal itself and recover from illness or injury. 

If you are at high risk of stroke, ask your doctor about the Neuralert stroke detection system, a non-invasive wristband technology that can detect possible signs of stroke within minutes and send an alert to your medical team, hastening treatment and decreasing the risk of serious damage from a stroke.

Simple and quick changes

While some home remodeling may be necessary, many changes are quick and easy and will immediately improve accessibility and safety, depending on your limitations. These include:

• Access to a phone or emergency service at all times, regardless of the room you are in
• Door Knob extenders, which are fitted over a round knob to provide a handle for easy opening
• Non-slip bath mat and tub transfer bench which sits inside and outside the tub, so you can shift across the bench rather than step in or out of the tub
• Shower hose, which allows you to hold the shower head and move it around your body
• Grab bars and rails near the toilet and in the tub – these should be professionally installed, so that they securely attach to the wall and will not give way when weight is repeatedly applied to them, but this is an important addition to any bathroom
• Raised toilet seat or bedside commode
• Clear walkways, which may require moving furniture and removing rugs that are not wall-to-wall to eliminate trip hazards
• Cord covers to keep all cords and cables against the wall, eliminating a fall risk
• Night lights in each room, preferably near the ground where you will walk, especially toward the bathroom at night 

Bathroom remodeling

There are a variety of bathroom modifications that can help stroke patients feel much more independent and may be more attractive than temporary adaptations, such as a toilet lift or tub bench. These may include:

• Walk-in shower with seat and handheld shower head, with doors that swing wide for walker and keep the water in, no matter what direction the shower head is pointed
• Handrails mounted wherever you would like one (certainly in the tub and near the toilet)
• Single lever faucets and soap pumps for easy function with only one hand
• Higher toilet seat
• Open cabinets for easy access to bathroom items like towels and toiletries
• Proper lighting and temperature control so that you feel comfortable and safe

Bedroom remodeling

You may find your bed is too high. Risers or a step added along your side of the bed will help you step in or out of bed comfortably. Also consider handrails, properly installed, along the wall toward the bathroom or the closet. Rather than keeping clothes in drawers, consider remodeling the closet to keep clothes on shelves or easy-to-reach clothes racks. 

Kitchen modifications

Many adaptations in the kitchen can help you reclaim a sense of independence. Many kitchen utensils are available that have been designed specifically with stroke patients in mind, whether that be eating utensils, knives, plates with suction bottoms and high sides, handy one-hand cutting boards, and more.

Other modifications may require some remodeling, based on your particular needs, for instance:

• Cooking appliances should be lowered for easy access and safety. The stove or oven should have front knobs to avoid reaching across hot burners. Consider replacing a stove and oven with a microwave, crockpot, Instapot, and/or toaster oven. Keep a fire extinguisher that you can operate close by.
• Install pull-out shelves or lazy susans for easy access to shelves and cabinets. Upper cabinets can even be installed with lifts that allow you to lower them to counter level and raise them again. Some lifts can be easily installed in existing cabinets, which lower the shelves without having to open the doors.
• Countertops can be lowered to a more comfortable level, or an island at a comfortable height can be installed.
•  Clear pathways that fit a walker or wheelchair should be created or maintained, with no obstacles in the way. 

Home access

A temporary ramp may be immediately installed to improve access, but if long-term limitations to mobility remain, permanent ramps and a clear, easy-to-navigate pathway to the home should be maintained. For safety, there should be at least two exit points from the home. 

Portable ramps can be purchased or rented, or permanent ramps can be built. You will want a comfortable angle for the operation of a wheelchair or walker on the ramp. A physical therapist can advise on the appropriate angle, which would affect the length of the ramp. If you will have a ramp built, be sure to have it installed professionally so you know it will be safe and sturdy, with railings on both sides. 

Ongoing protection

While you modify your home for safety, be sure to follow all the advice of your medical team whose job it is to help you recover as much independence as possible and prevent another stroke. Unfortunately, 25% of strokes are repeat strokes within the first five years after a stroke. It is important to make any lifestyle changes to decrease that risk, and it’s equally important to catch any signs of a second stroke as soon as possible to limit or prevent any additional harm. 

At Neuralert, we are committed to decreasing the devastating effects of stroke with our wearable stroke detection monitor, which looks like a smartwatch and is equipped with a state-of-the-art AI algorithm designed to detect the first signs of stroke and send a message within minutes to the medical team and caregivers that you designate. Fast action reduces the risk of long-term damage from stroke. Talk to your doctor about adding Neuralert to your stroke-prevention plan.

Defining terms

In the U.S., a standard definition for “a drink” is considered a 12oz can of beer, a 5oz glass of wine, or a 1.5oz shot of hard liquor. Drink levels are generally defined as:

• Never or infrequent drinking: less than 1 drink per week
• Light drinking: 1-3 drinks per week
• Moderate drinking: 1 drink per day for women, 2 for men
• Heavy drinking: 2-3 drinks per day for women, 3-4 for men
• Very heavy drinking: Over 3 drinks per day
• Binge drinking: 4+ drinks within 2 hours for women, 5+ for men 

Although many of us have heard that a glass of red wine per day is good for cardiovascular health, particularly due to the resveratrol and other antioxidants in red wine, most studies have been done with the antioxidants themselves in laboratory tests rather than on humans who drink red wine exclusively.

Although there is still some evidence that a glass of red wine per day may decrease the risk of cardiovascular disease, broader studies of actual drinkers in recent years have shown different results.

Drinking and blood pressure

While drinking heavily has always been recognized as a risk factor for cardiovascular disease, high blood pressure, and stroke, recent evidence suggests that even moderate drinking, one drink per day, is associated with increased risks. A 2023 analysis of data from seven studies with 19,548 participants from the U.S., Korea, and Japan who were followed for 4-12 years found that even moderate drinking was associated with increased blood pressure as compared to those who did not drink at all. While the increase in blood pressure for moderate drinkers was not very high, it was considered significant. Overall, the average systolic measure increased 1.25 mmHg for moderate drinkers and 4.9mmHg for heavy drinkers. 

While this positive association between drinking and blood pressure levels may seem like a small number, this is an average. Thus, drinking could significantly impact a person’s blood pressure depending on other factors, and therefore, it is best to be cautious when it comes to consuming alcohol. 

As a case in point, another study of 600,000 people demonstrated that those drinking 7-14 drinks per week could expect on average a 6-month shorter life expectancy, as of age 40. Those drinking 14-25 drinks per week could expect a 1-2 year shorter lifespan, and heavier drinkers a 4-5 year shorter lifespan. 

Potential good news

Becoming a teetotaler is not quite necessary, however, according to a study reported in 2018. Following nearly 100,000 adults aged 55-74 years who participated in the PLCO Cancer Screening Trial, those in the light drinking category (1-3 drinks per week) had the lowest risk of overall mortality, cardiovascular-related mortality, and combined risk of death or cancer, even lower than those among never-or-infrequent drinkers. As expected, hazard ratios of these outcomes increased as the frequency of alcoholic consumption increased.

This study suggests that a drink or two over the weekend may be healthier for you than not drinking at all. But virtually all evidence points to the negative health effects of frequent alcohol consumption.

Strokes are the #1 cause of long-term disability in the United States and the 4^th-leading cause of death. Neuralert is committed to decreasing the devastating effects of stroke with its innovative, non-invasive stroke detection system that looks like a smartwatch. Its patented AI algorithm accurately warns of signs of a stroke within minutes and sends an alert to the designated medical personnel or caregivers. 

Early stroke treatment saves lives and can often prevent or limit long-term side effects. Ask your healthcare providers about adding Neuralert stroke detection wristbands to your or a loved one’s overall stroke prevention plan. 

Effects of stroke

Cognitive functions, such as memory and decision-making, can be impaired by stroke. Communication may be impaired in a variety of ways: speech, comprehension, reading, and/or writing. Social skills are often impacted by personality changes, inappropriate behavior or speech, or emotional problems such as depression, mood swings, anger, or anxiety.

Senses and perceptions can be damaged by a stroke: depth perception, which can lead to balance problems and falls, blurred vision, changes to taste and smell, impaired touch sensation, and hearing loss. Automatic functions such as body temperature control, regular breathing, or heartbeat may also be affected. 

Damage to nerves and muscle control can cause a host of problems. Weakness or paralysis of throat, tongue, or mouth muscles may cause difficulty eating and swallowing, increasing the risk of choking. Incontinence and reduced sexual function are not uncommon. Impaired hand-eye coordination can cause difficulty with personal hygiene, feeding oneself, or picking up objects. Nerve damage can cause ghost pains or twitches, cause muscles to contract, or send no signals to extremities, leading to loss of feeling and inability to move those muscles.

Limiting damage

The more quickly a stroke patient receives medical treatment, the greater the likelihood that severe, long-term damage can be averted. Not only quick medical care is needed. Therapy must also be immediate, beginning, if possible, within hours of restoring blood flow to all parts of the brain. Because of the brain’s amazing ability to heal itself, known as neuroplasticity, quick treatment followed by quick therapy can help the brain rebuild and restore former functions. 

Since a stroke can be so devastating, it is critically important to take steps to eliminate as many stroke factors as possible to reduce the risk of stroke, including AFib, CHF, hypertension, elevated cholesterol, diabetes, obesity, and smoking. Prior stroke is also a risk factor, as is a hospital stay; 25% of all strokes are repeat strokes, and 17% of strokes occur in patients who are already in the hospital for other reasons. 

Neuralert is dedicated to decreasing the devastating effects of stroke by detecting a potential stroke within minutes, speeding treatment to the patient as soon as possible. Our non-invasive stroke detection monitor looks like a smartwatch and has been proven to detect strokes in as little as 15 minutes, with a near-zero false alarm rate. 

The Neuralert stroke detection system can be used both in the hospital as well as in an outpatient setting for patients at risk of stroke. Talk to your doctor about using our stroke detection wristbands to provide the quick response you need to decrease your risk of damage from stroke.