Self-care during COVID-19

• A stroke is a medical emergency. Dial 9-1-1 immediately if you are experiencing stroke symptoms. Do not delay.
• The data and evidence about COVID-19 and stroke is very new and evolving every day so there are many things we just do not know yet.
• Currently, having a history of stroke does not seem to make people more likely to get COVID-19; everybody is at risk of potentially contracting the virus.
• However, some risk factors or conditions could put people with these conditions at a higher risk of more serious complications of COVID-19, should they be exposed to the virus.
• Almost 15-20% of strokes are preceded by a transient ischemic attack (TIA), or mini stroke. If you think you may have had a TIA, you need to be assessed by your health care team without delay as this may be a warning sign that a more serious stroke may happen.

  • View Heart & Stroke’s TIA Factsheet here.

• Prevention is more important now than ever. Dr. Swartz recommends the following health promoting behaviours, especially during COVID-19:

  • Medications: Continue to take all your medications as prescribed. Ensure you have enough supply for a month. Do not stockpile medications. If you are having trouble affording medications during this time, speak to your health care team or your local pharmacist about options.

  • Smoking cessation and trying to quit. Smoking has many health implications such as increasing risk for stroke and heart disease. It may also increase the likelihood of having more serious complications from a COVID-19 infection.

  • Stay active and eat healthy. With public health measures like physical distancing, more people are cooking at home and eating as a family.

• Know how to access medical care and support, should you need it. Know how to contact your primary care physicians and what alternatives are available to you. If their office is not open at this time, you may need referrals to other clinics or telehealth/ virtual care.

  • If you need to know how to access community, social, government and health services and organizations you can dial 2-1-1 on your phone or search online in your province. 2-1-1 is a repository of information on community services. *This service may vary from province to province.

• Dr. Swartz notes the importance of checking in with your healthcare team to determine which medical appointments can be adapted to virtual, and which ones are required in-person. Do not skip medical appointments, or assume they are not occurring due to COVID-19. Check with your healthcare team first.
• You should also check with your healthcare team about any blood work or other tests you may require, and which are needed, and which ones can be postponed.
• Remember to virtually check in on care supporters or people you know who are caring for someone with a chronic condition. These individuals are providing unpaid care every day for those living with heart, stroke and VCI and this is a big job in a very stressful time.

Dr. Richard Swartz is a neurologist at Sunnybrook Health Sciences Centre in Toronto.

• COVID-19 is a respiratory virus, and it’s transmitted through droplets and contact; it is not airborne. Coughing, sneezing, and surfaces are ways and places that you could contract the virus.
• If you are experiencing signs of a heart attack, dial 9-1-1. An emergency is still an emergency, regardless of a pandemic.

  • Hospital staff and health care teams are taking all the necessary precautions to ensure the safety of you, your loved ones, hospital staff and any hospital visitors during COVID-19.

  • Discharge planning may look a little different during COVID-19, but your health care team will work with you and your family to provide you the best options so that you are not left at risk in the hospital, and certainly not left at risk of being discharged too soon.

• Maintain healthy behaviours and stay active (consult with your health team on what’s right for you). Manage your stress levels and stay connected to others to help avoid social isolation during physical distancing and continue to follow the advice of Public Health.
• Continue to take your medications. If you are concerned about your medications, please speak with your health care provider or pharmacist before making any changes.
• There is a lot of information circulating about COVID and heart conditions. Speak with your healthcare providers to get accurate information.

Dr. Gurmeet Singh is medical director of the Adult ECMO Program in Edmonton.

During COVID-19, it’s okay if you are anxious — this is normal.

There are two parts of our brain that explain why we may be feeling this way:

1. The first part is what Dr. Lee-Baggley refers to as our “caveman brain.” This part of the brain was developed for times of survival; it is also responsible for things like emotions, thoughts, memories, learning. Anxiety stems from this part of the brain.
2. The frontal lobe controls behaviour. This part of our brain operates like a battery; during COVID-19, a lot of its power is being used up and we need to ensure it gets recharged.

Dr. Lee-Baggley suggests that we recharge our battery in the following ways:

• Build a routine. Put structure into your day. Get up at the same time, eat healthy meals, continue to incorporate movement, and socialize with friends on a schedule.
• Connect virtually with family and friends. People are social creatures and the best way to recharge your battery is to use the technology available to you and stay connected.
• Limit media exposure. Catch up on reliable information and news, only a couple times a day. Listening to or reading the news all day can maintain levels of stress or anxiety.
• Focus on what you can control. Follow public health recommendations and try to maintain healthy behaviours. For example, it can be frustrating when other people aren't following the physical distancing recommendations but focus on what you are doing instead.
• Try to be in the present moment. It can be overwhelming to problem-solve too many steps ahead. There are too many unknowns—especially during COVID-19, so you end up problem-solving things that might not happen.
• Be kind to yourself and others. COVID-19 is impacting everyone in some way. We will make it through if we cooperate, reach out to others, and be kind.

Dr. Dayna Lee-Baggley is a clinical psychologist with the Nova Scotia Health Authority.