A stroke or a transient ischemic attack (TIA), which is sometimes called a "mini-stroke," can change your life. These episodes of cerebrovascular disease, which block blood flow to the brain, are a major cause of death and disability. If you want to avoid having a first stroke or a second one, the key to success is to work closely with your primary care doctor all the time. Direct Primary Care (DPC) is a type of healthcare that is made to help you have this kind of ongoing, complete, and personalized relationship to keep your brain healthy.
Cerebrovascular disease is a term for a group of diseases that hurt the brain's blood vessels and make it harder for blood to flow through the brain. The two most common things that happen are:
Ischemic Stroke: This happens when a blood clot blocks an artery, stopping blood from flowing to a part of the brain. This is the type of stroke that happens the most.
A transient ischemic attack (TIA), also known as a "mini-stroke," is when blood flow to the brain is temporarily blocked and symptoms that look like a stroke go away on their own. A TIA is a very important sign that a major stroke might happen soon.
The Goal: Avoiding, avoiding, avoiding
Primary Prevention: The goal is to keep people who are at risk from having their first stroke.
Secondary Prevention: After a stroke or TIA, the goal is to aggressively manage risk factors to stop another event from happening, which is often worse. This is the most important part of long-term care.
Things that are very risky that you need to keep an eye on: High cholesterol, high blood pressure, diabetes, smoking, and atrial fibrillation are all problems.
Direct Primary Care (DPC) is a membership-based system that lets patients see their doctor whenever they want. The DPC model's emphasis on time, prevention, and partnership is a big plus when it comes to managing cerebrovascular risk.
Here's why DPC is so important for your brain health:
Aggressive control of risk factors based on guidelines: This is the most important thing that primary care can do to stop strokes. A DPC doctor has the time to do more than just basic care to really improve your health.
Careful Medication Management: They check in with you often to help you reach the strict goals set by the American Heart Association and American Stroke Association for your blood pressure, cholesterol (often with high-intensity statins), and blood sugar.
Robust Lifestyle Partnership: They offer ongoing, in-depth counseling to help people quit smoking, plan their meals, and make a long-term exercise plan.
Expert supervision of antithrombotic therapy, like aspirin or other blood thinners, to make sure you are taking the right medicine at the right dose.
Full care after a stroke or TIA: Recovery after an event involves more than just taking medicine. The fact that DPC is still going on is great for dealing with what happened.
Checking for Hidden Problems: Your DPC doctor will actively look for common but often missed problems that can happen after a stroke, such as depression, memory problems, and a higher risk of falling.
Putting together rehabilitation: They are your main hub, making sure that you can easily talk to and work with your physical, occupational, and speech therapists.
Getting everyone in your support system, like family and caregivers, involved to make sure you have a solid base for recovery at home.
A medical home that is easy to reach and responsive: Having a doctor who responds quickly is very important for a stroke survivor's safety.
Fast Access for New Symptoms: You can get checked out right away if you have any new or worrisome neurological symptoms, which will keep your care from being delayed.
A Reliable Advocate: Your DPC doctor knows everything about your health and can speak up for you in every part of the healthcare system.
Case 1 (Secondary Prevention): James, who is 68 years old, sees his DPC doctor the day after he leaves the hospital after having a TIA. The doctor makes a strong secondary prevention plan by scheduling weekly visits for the first month to fine-tune his blood pressure medication and statin dose. The doctor also checks James for depression and puts him in touch with a local support group. This is all part of his care plan to greatly lower his risk of having a major stroke.
Case 2 (Primary Prevention): Maria, who is 62 years old, has a number of risk factors for stroke, such as diabetes and high blood pressure. Her DPC doctor sees her every three months for 30 minutes. Together, they get her A1c and blood pressure to where they should be, which makes a plan that greatly lowers her risk of having a stroke and gives her the tools she needs to live a healthier life.
Q: I had a TIA, but I'm fine now. Why do I need to follow up so closely? A: A TIA is a very bad sign. In the weeks and months right after a TIA, your risk of having a major, permanently disabling stroke is highest. The best way to change that outcome during this time is to get aggressive medical care. DPC gives you the close follow-up you need to do this right.
Q: After a stroke, does my DPC doctor take the place of my neurologist? A: After a stroke, a neurologist will be one of the most important people on your specialty team. Your DPC doctor is the "captain" of your care and works closely with your neurologist. Your DPC doctor is in charge of all of your health and manages all of your risk factors. The neurologist gives you specialized advice.
Q: What is the most important thing I can do to stop a stroke? A: For most people, the best thing you can do is to keep your blood pressure under control. A DPC doctor who can help you reach and keep your blood pressure goal through both lifestyle changes and medication is an important part of modern stroke prevention.
DPC is clearly better for anyone who wants to avoid or recover from a stroke because it:
Following the Guidelines-Recommended Prevention: The DPC model is set up perfectly to give the long-term, intensive risk factor control that has been shown to stop strokes.
Giving full care after a stroke: Taking care of not only the medications, but also the common problems that happen after a stroke, like depression and memory loss, that lower the quality of life.
Making a real partnership with the patient: Encouraging the learning, involvement, and joint decision-making that will help you take an active part in your own recovery and long-term brain health.
A proactive partner can help keep your brain safe. A stroke or TIA changes your life, but it also gives you a strong reason to act. To stop another one from happening, you need a partner who is dedicated and proactive. Direct Primary Care gives you the ongoing, all-around, and personalized care you need to keep your brain safe and invest in a healthier future.
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