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Pikeville Medical Center’s Primary Stroke Center is among the top stroke treatment centers in KY. Our goal is to deliver the most effective care with cutting edge technology. Our Stroke Center aligns with the mission of PMC to provide world-class health care in a Christian environment.

Dr. Naveed Ahmed, a Board-Certified Neurologist and Stroke Specialist, is Medical Director of PMC’s Primary Stroke Center. The hospital’s neurology staff also includes Neurologist Dr. Ryan Owens, and Neurosurgeons Dr. Norman Mayer and Dr. George M. Ghobrial. In addition, Physiatrists (physical medicine specialists) Dr. Milton Calima and Dr. Sankar Chirumamilla help stroke patients recover through physical rehabilitation.

To provide patients with quality care, PMC works with Emergency Medical Service providers from across the region to ensure acute stroke care starts from the moment of patient contact.

PMC’s Emergency Department is highly trained for immediate identification of early stroke symptoms and equipped to provide intervention. The hospital has assembled a Stroke Team which has been trained to respond to stroke emergencies and provide expert neurological care.


PMC awarded Advanced Certification for Primary Stroke Centers

PIKEVILLE — Pikeville Medical Center (PMC) announced that it has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Centers. The Gold Seal of Approval® and the Heart-Check mark represent symbols of quality from their respective organizations. PMC has received this honor for eight consecutive years.

The hospital recently underwent a rigorous onsite review during which experts from The Joint Commission evaluated compliance with stroke-related standards and requirements. This included program management, the delivery of care and performance improvement.

“Pikeville Medical Center has thoroughly demonstrated the greatest level of commitment to the care of stroke patients through its Advanced Certification for Primary Stroke Centers,” said Wendi J. Roberts, RN, executive director, Certification Programs, The Joint Commission. “We commend Pikeville Medical Center for becoming a leader in stroke care, potentially providing a higher standard of service for stroke patients in its community.”

“We congratulate Pikeville Medical Center for achieving this designation,” said Nancy Brown, CEO of the American Heart Association/American Stroke Association. “By adhering to this very specific set of treatment guidelines, Pikeville Medical Center has clearly made it a priority to deliver high quality care to all patients affected by stroke.”

PMC officials were pleased to once again receive Advanced Certification for Primary Stroke Centers.

“Pikeville Medical Center is pleased to receive advanced certification from The Joint Commission and the American Heart Association/American Stroke Association,” said Dr. Naveed Ahmed, PMC neurologist and medical director of the Primary Stroke Center. “This award is a great honor and is only possible thanks to the dedication of our stroke team and continued support of PMC’s administration.”

Established in 2003, Advanced Certification for Primary Stroke Centers is awarded for a two-year period to Joint Commission-accredited acute care hospitals. The certification was derived from the Brain Attack Coalition’s “Recommendations for the Establishment of Primary Stroke Centers” (JAMA, 2000) and the “Revised and Updated Recommendations for the Establishment of Primary Stroke Centers” (Stroke, 2011).

On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year.

What is a Stroke?

what_is_a_strokeStroke is a disease that affects the arteries of the brain. A stroke occurs when a blood vessel bringing blood and oxygen to the brain becomes blocked or ruptured and brain cells don’t receive the blood needed. Deprived if oxygen, nerve cells can’t function and die within minutes. The part of the body those cells control can’t function either.

The devastating effects of stroke are often permanent since dead brain cells can’t be replaced. The degree of disability depends on the size of the stroke and location in the brain.

Types of Strokes


Most strokes are ischemic, caused by a lack of blood supply to part of the brain.


A hemorrhagic stroke occurs when the brain ruptures an artery. Brain cells beyond the rupture are also deprived of blood and damaged. High blood pressure is the most common cause of hemorrhagic stroke. The constant force of high blood pressure can weaken blood vessel walls, resulting in bleeding in the brain or brain hemorrhage.

Transient Ischemic Attack (TIA)

  • A Transient Ischemic Attack (TIA) is a temporary interruption of blood flow to part of the brain.
  • The symptoms for a TIA are the same as for a stroke, but appear for a shorter period of time (several minutes to 24 hours) and then disappear.
  • A TIA indicates a serious underlying rick that a stroke may follow.
  • About one-third of all people who have suffered a stroke have experienced a TIA previously.
  • Medical attention and evaluation are needed immediately.

After the underlying cause of the TIA are determined, medication, surgery or lifestyle changes may reduce the risk of having a fatal or disabling stroke.

Risk factors for stroke

Brain graphicKnowing your risk factors is the key to prevention. You can learn about your risk factors by having regular medical checkups. Some rick factors can be changed or treated. It is critical for those who have experienced a stroke or TIA to manage risk factors and be compliant with prescribed medications. The rick of a stroke is 10 times greater in patients who have already had a stroke or TIA than it is in those who have never experienced one.

What risk factors can I change or treat?

  • High blood pressure
  • Tobacco use
  • Diabetes mellitus
  • Carotid or other artery disease
  • TIAs
  • Atrial fibrillation or other heart disease
  • Certain blood disorders
  • High blood cholesterol
  • Physical inactivity and obesity
  • Excessive alcohol intake
  • Illegal drug use

What are the risk factors I can’t control?

  • Increasing age
  • Gender
  • Heredity
  • Race
  • Prior Stroke

What can I do to control my risk factors?

  • Lower blood pressure
  • Quit smoking
  • Control diabetes
  • Be physically active
  • Ask your physician about narrowing of the carotid artery (asymptomatic)
  • Reduce alcohol use
  • Do not use illegal drugs
  • Manage stress
  • Monitor heart disease with your physician
  • Fight obesity
  • Avoid high cholesterol

To lower your cholesterol you should:

  • Eat a low-fat, low cholesterol diet
  • Eat more fruits, vegetables and grains
  • Eliminate or reduce meat intake, particularly red meat
  • Eat only lean cuts of red meat
  • Limit whole eggs to no more than two to three times a week
  • Choose dairy products made with skim milk or low-fat milk substitute
  • Reduce your saturated fat intake
  • Use monounsaturated oils (such as canola, olive or peanut) or polyunsaturated oils (such as corn, sunflower or soybean) instead of saturated fat (butter and lard)
  • Avoid hydrogenated oils
  • Exercise regularly

If your blood cholesterol level does not improve with lifestyle changes alone, your physician may prescribe cholesterol-lowering medication.

ACT F.A.S.T. to increase recognition and response to stroke symptoms


FACE: Ask the person to smile.
Does one side of the face droop?

ARM: Ask the person to raise both arms.
Does one arm drift downward?

SPEECH: Ask the person to repeat a simple sentence.
Does the speech sound slurred of strange?

TIME: If you observe any of these signs, it is time to call 911.
Go to the nearest emergency department immediately for treatment.



Effects of a Stroke

  • Uncontrolled crying and/or laughing
  • Slow adjustment to new things
  • Bowel & bladder control problems
  • Sexual concerns
  • Intermittent distress
  • Major depression
  • Grief
  • Fatigue
  • Difficulty swallowing
  • Disturbed sleep or appetite

Severity of Physical Effects depends on the following:

  • Type of Stroke
  • The extent and location of the damaged brain cells
  • How well the body repairs the blood supply to the brain
  • How quickly other areas of the brain tissue take over the work of the damaged cells

When a stroke occurs, it usually takes place in a single area in one hemisphere.


A stroke in the left hemisphere affects the right side of the body and a stroke in the right hemisphere affects the left side of the body.

To diagnose a stroke, information on the type of stroke, source of the stroke and location of the brain injury is needed.

Once in the emergency room, your doctor or stroke emergency team may do the following:

  • Inquire about your medical history
  • Perform a physical and neurological exam
  • Conduct laboratory (blood) tests
  • Perform imaging tests on your brain


Where can I learn more?

Mayo Clinic > Diseases & Conditions > Stroke

American Stroke Association’s “Warmline”: 1-888-4-STROKE (1-888-478-7865)

Strokes of Support:

Stroke support groups in Pike County: 430-7580

For a free publication for stroke survivors and caregivers:

Stroke Connection Magazine: 1-888-478-7653

Stroke Smart Magazine: 1-800-787-6537

CDC Stroke Education:

Types of Stroke

Stroke Conditions

Stroke Signs and Symptoms

Stroke Facts

Stroke Awareness

    • APRIL 30, 2021
    May Is Stroke Awareness Month

    May Is Stroke Awareness Month

    Many patients in Eastern Kentucky experience unexplained symptoms that can often be treated by a neurologist. These specialized physicians treat disorders that affect the nervous system, which includes the brain, spinal cord and nerves. Signs can be subtle and often blamed on other problems, and as a result, go untreated.  These can include muscle weakness,

    Read more
    • APRIL 30, 2021
    PMC Neurologists Bring Awareness to Unseen Problems

    PMC Neurologists Bring Awareness to Unseen Problems

    Stroke is a leading cause of death in the United States and is one of the primary causes of disability among adults, according to the CDC. Each year, an estimated 795,000 people in the U.S. have a stroke, with about 610,000 of these being first or new strokes. The good news is that strokes are

    Read more
    • OCTOBER 9, 2020
    PMC First in Region to Use Advanced Software to Identify Stroke

    PMC First in Region to Use Advanced Software to Identify Stroke

    Pikeville Medical Center (PMC) is the first hospital in Eastern Kentucky to use new, advanced software powered by artificial intelligence to help identify certain types of strokes even quicker than before. The software, powered by, is linked directly to PMC’s CT scanner, which uses rotating x-ray machines to create detailed images of the inside

    Read more
    • SEPTEMBER 3, 2019
    Watchman Procedure Reducing Stroke Risk for Afib Patients

    Watchman Procedure Reducing Stroke Risk for Afib Patients

    According to the American Heart Association, at least 2.7 million Americans are living with atrial fibrillation (AFib). AFib is a quivering of the heart, or irregular heartbeat that can lead to blood clots. People with AFib are at a significantly increased risk of stroke due to clot formation within the heart.   The Pikeville Medical

    Read more
    • JUNE 10, 2019
    Patient Credits Faith and PMC for Helping Him Walk Again

    Patient Credits Faith and PMC for Helping Him Walk Again

    Stroke is the leading cause of disability in the U.S. and the fifth leading cause of death, according to the American Heart/American Stroke Association. However, about 80 percent of strokes are preventable. Unmanaged high blood pressure and high cholesterol are risk factors that can lead to stroke. Last February, Gilford Hall, 56 of Wheelwright Ky,

    Read more
    • MAY 8, 2019
    PMC Awarded at Stroke Conference

    PMC Awarded at Stroke Conference

    Pikeville Medical Center (PMC) Primary Stroke Center Medical Director Naveed Ahmed, MD, accepted the Outstanding Achievement Award at the International Stroke Conference in Hawaii, on behalf of the hospital. Together, with American Heart/American Stroke Association Quality and Systems Improvement Director Cynthia Keely, they presented the award to CEO Donovan Blackburn and the PMC Board of

    Read more
    • OCTOBER 17, 2018
    PMC Awarded Advanced Certification for Primary Stroke Centers

    PMC Awarded Advanced Certification for Primary Stroke Centers

    Pikeville Medical Center (PMC) announced that it has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Center. The Gold Seal of Approval® and the Heart-Check mark represent symbols of quality from their respective organizations. The hospital has held this prestigious

    Read more
    • AUGUST 31, 2018
    Record-Breaking Stroke Symposium

    Record-Breaking Stroke Symposium

    The Pikeville Medical Primary Stroke Center has added many feathers to its cap over the years. But this year, the Stroke Center has come full circle by appointing Trauma Director, Sandy Tackett, RN, as the interim Stroke Program Coordinator. Tackett has been with the hospital for over 20 years. Her experience includes serving as Stroke

    Read more

I would like to take this time to welcome you to PMC’s Stroke Support Group page. According to the Centers for Disease Control and Prevention, stroke is the leading cause of serious long-term disability, affecting someone in the United States every 40 seconds. This means, on average, 788,400 Americans will suffer from a stroke in one year alone.

Our goal for this group is to provide support for patients, family, friends, and caregivers who are dealing with the after-effects of a stroke and stroke recovery. Stroke affects more than just the patients, and we here at PMC would like to extend a helping hand to those who may need us, despite their role. To me, this is much more than a profession, but rather a work of heart stepping into the lives of my patients, watching them recover and thrive.


Latest Support Group Posts:

April 2023

April is commonly known as Autism Awareness Month.  However, it is also Stress Awareness Month.

Stroke survivors and stroke caregivers are often dealing with stress.  There is the stress of the diagnosis itself.  There is the stress of finances.  There can also be the stress of dealing with weakness even after discharge from the hospital.

Stress is known to affect the body in multiple ways. Stress can obviously increase blood pressure, but it can also create the urge to put things into your body, such as tobacco or alcohol, that are detrimental to your brain health, especially post-stroke diagnosis.

Ways to decrease stress look different to different people.  Some like to play video games. Others enjoy going for a walk or gardening.  After a diagnosis of stroke, the previous ways that were used to decrease stress might have to be changed, due to weakness or disability left after a stroke.

Stress-relieving activities can be amended based on the person’s ability to perform them. The important thing is to try different activities if one isn’t working.  Reading, crossword puzzles, exercise if possible, cooking, etc. are all things that can be attempted to relieve stress. If those things aren’t satisfactory, try something else. There is no right or wrong answer, there is only the answer that is correct for you.


March 2023

March is Disability Awareness Month.

Stroke is one of the top causes of disability in the United States.

This support group is for stroke survivors and caregivers, to be a place of education and assistance.

Strokes can cause not only emotional and mental disability, but physical disability. Both are equally detrimental to a person, and both require support following a stroke.

PMC is available for support in any way that we can following a stroke, but there are also additional resources available if needed.

If financial support is needed, reach out to an attorney who provides free consultations for disability benefits. Some strokes can cause temporary disability which is eased by therapy and strength training. Some stroke can cause permanent disability which impedes the ability to work and provide.  An attorney could assist you in determining whether disability benefits are a possibility for you or your stroke survivor.

Another option is to speak with your primary care provider.  Primary care doctors have resources they can use to find help not only financially but with other types of assistance. You can speak to your PCP about options for assistance with home care.

If additional assistance is needed, or you’re having trouble finding assistance after discharge from the hospital, don’t hesitate to reach out to PMC Stroke Program at 6064307580.  We can work with the different departments and try to find ways to help.


February 2023

February is recognized as American Heart Health Month.

Heart health and strokes are very closely related.  As a stroke survivor, I’m sure you have heard ways that improving your cardiovascular health can decrease your risk for another stroke event in the future.

Some cardiovascular risk factors are modifiable.  Examples of non-modifiable risk factors include age, sex, and race.  Examples of modifiable risk factors include hypertension, smoking, obesity, diet, physical inactivity, high cholesterol, diabetes, and increased alcohol use.

Ways you can reduce your risk for another stroke event in the future involves making lifestyle changes.  If you smoke, stop smoking. If your cholesterol is elevated, talk to your primary care provider (PCP) about medications that can decrease your cholesterol.  If you have hypertension, check your blood pressure at least once per day, and adhere to your blood pressure medication schedule.  Just the same with diabetes, check your blood sugar and adhere to your medications to control your diabetes.  Have your A1C level checked.  Speak with your PCP about all your stroke risk factors, and, together, create a plan to reduce your risk.

Atrial fibrillation (a-fib) is technically a non-modifiable risk factor for stroke because a lifestyle change will not fix it, but there are treatments for a-fib that can reduce your risk for ischemic stroke.  Anticoagulants have been used for many years to treat a-fib.  Many people are hesitant to take anticoagulants due to the increased chance of bleeding, the diet restrictions that some anticoagulants required, and the routine blood work that had to be done to make sure your dose was therapeutic.  There are new anticoagulants (NOAC’s) that are FDA approved and used widely now that do not require frequent blood work, and don’t require any diet modifications.  Always ask your PCP if you could benefit from a NOAC.

January 2023

New year, new resolutions!

Typically, with the change of a new year, people set goals for themselves.  These often include weight loss goals, or self-improvement goals. For stroke survivors, new years resolutions may look different.  Stroke survivors may find the need to focus on things like flexibility, pain-relief, or secondary stroke prevention.

Suffering from a stroke can be devastating. For a piano player, losing dexterity in one hand can be life changing. For a construction worker, one-sided weakness can alter their daily activities.

Resolutions, while the idea is innocent, can be overwhelming if a lot of changes are being made at once.  Take small steps. Focus on one goal at a time. Instead of one huge goal that can seem daunting, break it up into more manageable tasks.

For example, if your goal is to prevent a limb from contracting, do one set of stretches or exercises a day. They say it takes 21 days to make something a habit.  Do this one exercise for at least 21 days, or until it becomes a habit.  Once you’re used to this, work on another goal.

If your resolution involves speech; find a word, phrase, or sound that is difficult since your stroke, and practice every day.  Don’t become frustrated if you don’t see immediate results.  Your brain takes time to heal.  A positive attitude will go a long way in your recovery.

As a caregiver, encourage your survivor to set small goals that can be easily obtained, and provide motivation to work up to larger goals as they show improvement.

Maintain a positive attitude and focus on yourself and your health this year.

December 2022

The holidays are a time where family join to socialize, spend time together, and (at least in my family) eat.

Diet control is often pushed to the side during the holidays.  However, as a stroke survivor, maintaining a healthy diet is one thing that, if possible, should be regulated.  Moderation is key. Keep in mind that even during holidays, controlling your individual risk factors for stroke can still be done.

Below is a detailed plan for diet modification from the American Heart Association.  Enjoy the holidays, enjoy your families, but remember to maintain a modified diet for your health.

Daily Goals For good health, people need to eat foods from a variety of food groups.  As you plan meals, think about how they meet daily goals for healthy eating.

Fruits and Vegetables: Have at least 3 portions of vegetables and 2 portions of fruit each day. Good choices include dark-green, yellow, and orange vegetables, as well as citrus fruit.  One portion is usually equal to: • ½ cup cooked vegetables • ½ cup canned fruit • ½ cup juice • 1 cup raw fruit

Meat and Other Protein Foods: Make lean protein a part of at least 2 meals each day. Eat 5 to 6 ounces per day.  Good choices include: • Skinless poultry • Lean beef, pork, or veal • Fish o Fatty fish (such as salmon, tuna, mackerel, or sardines) are especially healthy. Have them twice a week. o Canned and smoked fish are usually high in sodium. Choose fresh or frozen fish instead, or have low-sodium canned types. • Dried beans and peas (¼ cup cooked = 1 ounce) • Soy foods or other foods made with vegetarian protein • Egg whites or egg substitutes 1 Daily Goal

Grains and Other Starches: Grains and starches (such as potatoes) can be good sources of fiber and other healthy nutrients.  For fiber, the best choices are:  • Whole grain products • Foods that have at least 2 grams of fiber in each serving (read the food label to find out how many grams of dietary fiber are in a serving)

Milk and Dairy Foods: Milk and dairy foods have calcium and potassium and other healthy nutrients. However, whole milk and foods made with whole milk or cream (such as ice cream or half-and-half) are high in unhealthy fats. To avoid these fats, choose fat-free or low-fat milk or yogurt.  If you eat cheese, pick types that are low in both fat and sodium.

Fats: Select fats wisely. In general, limit the calories that you get from fats to no more than 25% to 35% of your total daily calories. For someone who eats 2,000 calories per day, that’s 50 to 75 grams of fat. Some fats are healthier than others. As you plan meals: • Choose unsaturated fats. These are found in nuts and avocado, as well as many vegetable oils (such as olive, canola, sunflower, and safflower oils). • Avoid saturated and trans fats. Saturated fat is found in fatty meat, poultry skin, whole milk and cream, butter, and other fats from animals. It is also in tropical oils (such as palm, palm kernel, or coconut oil).   Trans fat is in stick margarine and solid vegetable shortening. It is also in all foods made with hydrogenated oil. (Look for this oil in the ingredients list on food labels.)

Beverages: Drink plenty of healthy beverages, such as water, fruit juice, and nonfat (skim) or low-fat milk. These are better choices than sodas and flavored drinks made with sugar.  Sugary drinks are high in calories but low in healthy nutrients. Drink them rarely or not at all.

October 2022

World Stroke Day 2022 is Saturday, October 29

The main focus for World Stroke Day this year, is focusing on stroke symptoms and how to seek help.

Previous stroke support group posts have highlighted symptoms of a stroke. To make it easier to remember, think BE FAST.  A sudden change in balance or vision can be a sign of a stroke.  Facial droop, weakness or tingling on one side of the body and changes in speech, can also be a sign that a stroke is occurring.  The “T” stands for time.  Time is of the essence in stroke care. Time is brain when it comes to treating strokes.  The longer one waits for treatment, the more permanent damage is done to the brain.  It is better to be safe, rather than sorry when it comes to stroke symptoms.  Always seek help in an emergency room when stroke symptoms occur.

Strokes can happen to people of all ages. The affects of a stroke can be a wide range. A TIA, or mini stroke, is often a warning sign, of an impending stroke. Do not ignore these symptoms.  Seek treatment.  Have the proper examination and testing completed.  Make lifestyle changes as indicated. And seek support from others.

Visit the following link at any time for more information regarding effects of a stroke, and helpful resources.

September 2022

Post Stroke Pain:

Post Stroke Pain is often misunderstood or believed to be related to another issue. Often, it is not reported, therefore, not treated.  The issue with the misunderstanding of post stroke pain is that stroke survivors will postpone or prematurely end therapy due to pain.  Post stroke pain can include headaches, muscle and/or joint pain.

Symptoms and risk factors of post stroke pain:

Indications can include numbness, tingling, burning, and decrease in range of motion.

Risk factors can include ischemic strokes, especially in older women, post-stroke spasticity, and depression

Diagnosis should be completed by an evaluation by your healthcare provider, including an extensive assessment with subjective and objective data.


Ways to decrease post stroke pain:

Exercise, especially low-impact exercise, such as swimming or walking.

Strength and flexibility exercises.  Lifting light weights and stretching can decrease post stroke pain.

Weight loss, if indicated.  Even losing 5-10 pounds can decrease the amount of stress on the joints.  Enhancing your diet and light exercise can help achieve this goal.

For further help, physical and occupational therapies can allow the stroke survivor to be monitored in their progress and be taught new personalized exercise regimens to obtain the maximum range of motion without pain.

Importantly, keep your follow up appointments with your providers, make it clear that your pain began after the stroke occurred, and follow the recommendations for treatment.

August 2022

Post Stroke Spasticity

After someone experiences a stroke, the effects can last longer than the initial injury.  Sometimes, signals from the brain which allow muscles to relax are blocked, causing the muscles on the affected side to tighten and spasm.  This can lead to contracture, where muscles shorten, and joints become stuck.  About 25%-43% of stroke survivors will experience spasticity in the year after their stroke, with the onset ranging from weeks to months after the stroke.

Spasticity can range from mild to severe. Mild symptoms of spasticity include some slight muscle stiffness.  Severe symptoms include painful spasms. Symptoms and effects of spasticity:

  • Rigid muscles
  • Muscle spasms, like a charley horse
  • Arms folded against chest
  • Pointed foot
  • Fist in closed position
  • Bent elbow

Complications due to spasticity can arise, which include:

  • Difficulty in activities of daily living such as bathing and hygiene
  • Skin irritation and breakdown in some cases
  • Abnormal posture
  • Permanent contractures
  • Social isolation or depression, due to the negative impacts on ability to do activities

If you or a loved one are experiencing symptoms or complications from post-stroke spasticity, ask your primary care provider for a referral to a rehabilitation physician (also known as a physiatrist).  PMC has two rehab physicians who see post-stroke patients in the clinic, as well as treat patients who are admitted to the Inpatient Rehab Unit.

There is no cure for spasticity, but there are multiple ways to lessen the symptoms.  Some of these consist of:

  • Botox injections can reduce tightness in the affected muscles
  • Oral medications that increase muscle relaxation
  • Range-of-motion exercises and stretching of tight muscles
  • Combination of medication and physical therapy

How to cope with post-stroke spasticity?

First, get a proper diagnosis and begin treatment.  Other ways to cope with spasticity:

  • Home modifications and assistive aids (ramps, grab bars, shower chair, braces, walkers, etc)
  • Schedule breaks for regular stretching throughout the day, especially in the morning
  • Set goals and celebrate when they are met

July 2022

This month is all about caregivers.

Stroke survivors sometimes leave the hospital independent and without disabilities.  However, others need 24-hour care and compassion that is typically given by a family member who steps up and takes on the role of caregiver.

Being a 24-hour caregiver is rewarding at times when your loved one shows signs of improvement.  Being a stroke survivor caregiver also requires a lot of strength, the ability to put someone else’s needs above your own, and resilience.

I recently joined a group on Facebook specifically for stroke caregivers, called “Stroke Caregivers Support Group”.  From the past few weeks of just observing the posts and comments, I have learned that the best thing that you as a caregiver can do for yourself, is take time off from your caregiving duties.

Taking a break, while it may seem selfish at first, is necessary for the caregiver to “recharge their batteries”.  As the saying goes, “you can’t pour from an empty cup”.  Self-care needs to be a priority before the job of caregiving becomes a burden that you can sometimes resent.

Some examples of how to recharge as a caregiver:

Reach out to family members, friends, church family, or neighbors, to help for a few hours once or twice a week.  Many people are often willing to help, they just are not sure how to approach the topic.  They may feel like they are prying or crossing a boundary.

Consider hiring an aide to assist during daytime (or nighttime) hours, if feasible. There are resources in the community for affordable assistance.  Caregivers can contact a hospital social worker to inquire about more information.

If the above are not options, consider contacting the stroke survivors’ insurance company.  Case managers who work for the insurance company can assist with obtaining respite care at times. If your stroke survivor is a hospice patient, respite services are offered through the hospice company, as well.

Caregiving is not for the weak, but caregiving should not make you weak. Take care of yourself as a caregiver.  Search for resources that are out there and available.  Ask for help.

June 2022

On June 1st, Pikeville Medical Center went live with the new medical record system, Epic.  Epic is a well-known and loved system that incorporates all aspects of healthcare in one domain.  It also allows the patient to view their records quickly and efficiently.

MyChart is an app, powered by Epic, which can be downloaded to a smartphone.  After the patient’s first visit to PMC, an email is sent to complete the log in portion of the app.  Once log in is established, the patient can view upcoming appointments, lab results, and medication list.  Also, the patient has the ability to send messages to their providers and hospital staff.  The message section is intended to be used for NON-emergency questions.  The patient can choose to send a message in regards to medical inquiries, or other questions about billing, insurance, etc. Since the providers and staff are handling other patient situations in the hospital, these questions will be answered as soon as possible, but not immediately.

MyChart is a great tool for post-stroke patients and caregivers.  It will notify you of upcoming appointments and notify you of lab results immediately. You are viewing your results just as quickly as the provider, which can sometimes help ease anxiety.  Also, by using the library, you can view thousands of articles about stroke care and recovery.

Additional perks to MyChart include a symptom checker (not to be replaced by a diagnosis).  One can schedule an appointment with a provider, you can oversee your own preventative care by obtaining reminders of things like vaccines and screenings, share your medical record with other systems that use epic.  Possibly my favorite part of MyChart is the Health Reference Library.  Patients and caregivers can search medical conditions, medications, tests, etc. to become better educated all-around with their medical care.

If you or someone you know need help accessing their MyChart, feel free to contact PMC.


April 2022

The past two years have been hard for everyone. Whether or not you had Covid, were exposed to Covid, or know or cared for someone with Covid, we have all been affected by the pandemic in some way. Recently, case numbers have been dropping, and more businesses and organizations are opening back up to in-person opportunities.  This “post-Covid” period can be strange getting back into your routine that you have not done in two years.  While Covid caused mild symptoms for some, and was unfortunately deadly for others, the American Heart Association has revealed that complications due to Covid, may reveal themselves long after one recovers from the virus.  It is important for people who did recover from Covid, to be aware of the following complications that could arise.


Regardless to whether or not someone suffered from a mild or severe case of Covid, studies are showing potential heart, lung, and brain problems.  These have been found to be a possible complication of Covid up to one year after the infection.  Not only physical symptoms, but mental and behavioral problems could arise as well. Although it is not rare to experience long-term issues from Covid, the percentage of possibly experiencing these are about 10% to 20%; this is according to the World Health Organization.  10% to 20% does not sound like many, but hundreds of millions of people around the world have been affected by Covid.  In the United States alone, approximately 80 million people have previously been infected since the pandemic began.

It is very difficult to be able to determine who is at a higher risk for post-Covid complications, and even how long they may last, but experts who have researched the topic have encouraged everyone who is post-Covid to keep an eye out for the possible symptoms which include:


-Heart disease and Stroke.  Neither heart disease nor stroke are insignificant issues and need to be treated to prevent so many other problems. Some instances have shown cases of irregular heart rhythm, heart failure, coronary disease, heart attacks, and POTS.  Also, the risk of suffering from a stroke within one year post-Covid increased to 52%.


-Brain issues.  This would include feelings of brain fog.  Brain fog is comparable to the inability to multitask and difficulty learning new things.  A study also showed an increase in brain shrinkage in post-Covid patients compared to those who did not have Covid.


-Mental Health. Along with the physical issues.  There are some reports of mental issues, as well. An increased risk of anxiety disorders and depression were also shown to be higher. Although mental health is not considered a “physical” symptom, it can absolutely affect one’s physical health. It is specifically related to cardiovascular health. Mental health can prevent a person from exercising, maintaining a proper diet, keeping a healthy sleep cycle, or taking care of themselves. All those things can affect one’s physical health in addition to mental health.


All of this sounds distressing.  However, there are ways to be proactive against post-Covid complications.

  1. Take care of yourself! Make one small change that could increase your cardiovascular health.  Once that change becomes a habit, make another small change.  One small change could be drinking more water.  You could go to sleep one hour earlier.  Cut out one dessert per week.  Don’t create a change for yourself that is so drastic that it is impossible to adapt to.
  2. Set goals. If weight loss is a goal, do not try to lose 50 pounds in one month. Instead, set small, realistic goals.  Go for a walk, see how far you can go. Then next time, go a little farther, then a little farther than that. Eventually you will see yourself doing more than you ever thought you would be able to do.  Small goals means you will obtain them more often, which leads to that feeling of satisfaction more often.  That feeling is what will motivate you to create more goals, beat those goals, etc.
  3. Pay attention to your body.  Do not ignore symptoms.  If they have been present longer than six weeks, it’s time to be evaluated by a healthcare provider.
  4. Stay informed. Research is still going on about Covid, and likely will for some time. For trustworthy, evidence-based information, the Centers for Disease Control and Prevention has a website you can visit.  Remember, the CDC does recommend getting vaccinated against Covid.


March 2022

Stroke recovery is not the easiest thing to have to go through. Especially alone. The support of friends, family, colleagues, etc. is vital when recovering from a stroke.  We have previously discussed this in earlier months. However, this month I wanted to provide a few resources for additional assistance during you or your loved ones stroke recovery.

Pikeville Medical Center does offer a Stroke Support Group meeting once per month.  It is usually the last Wednesday of each month at noon, however, since Covid has come about and we are no longer able to meet in person, we created this webpage to provide information, resources, and support. My name is Chelsea Kinney, BSN, RN, and I am the stroke program manager at PMC.  My contact information is: Office: 6064307580, Cell: 6067945715, Email:  My colleague is Katlin Runyon, BSN, RN. Her contact information is Office (same as above), Cell: 6062130631, Email:  We are both available to provide any type of assistance that we possibly can, even after discharge. If we are unable to assist you, we can definitely point you in the right direction of someone who can.  Covid has created some hard times for all of us, but we are doing our best to continue to offer support needed for stroke recovery.

The American Heart Association website also provides stroke support resources.

But the one that was new to me, and could be very beneficial, is the Stroke Family Warmline. It is used to connect stroke survivors, caregivers, families, friends, etc. with an American Stroke Association member who can provide not only support, but information and even just a listening ear. The Stroke Family Warmline number is 1-888-4-STROKE (1-888-478-7653).

While our ultimate goal is to be able to meet back in person soon, we want all of you to know we are here for you anytime you need us. Please don’t hesitate to reach out.

February 2021

Life After Stroke.  Many people discuss the symptoms of a stroke, or how to prevent a stroke, but sometimes it is uncommon to hear the effects that a stroke can have on your life after you have gone home.

The American Heart Association and American Stroke Association work closely together to help patients and their families with every aspect possible in regards to stroke care and education.

The Guide in the link below is a great tool for such.  The guide begins with the definition of a stroke, different types of strokes.  Different types of strokes can affect people in different ways. It discusses how a stroke is diagnosed, and how it is treated. There are different types of affects that can happen after a stroke.  You can have physical changes. Weakness to one side, numbness, difficulty with grip strength, etc.  You can have communication changes. Difficulty speaking as in slurred speech, or difficulty speaking as in you are unable to get the appropriate words out. You can also have emotional or personality changes after a stroke.  Since the brain controls the entire body, so much can be affected when the brain is injured.  This can be frustrating.  Especially without the right support.

The guide also discusses the types of rehabilitation that one could need after a stroke, where to go for this, and why it is important. It is essential to create goals for yourself or your loved one to strive towards when it comes to rehabilitation after a stroke.

Please use this guide to educate yourself or your loved one. Share it as you wish.


December 2021

Life after suffering a stroke is challenging not only physically, but also mentally. A stroke can leave one with deficits that can make the smallest tasks seem daunting. Post-stroke conditions such as arm or leg weakness, numbness to an affected body part, trouble with speech and vision changes can cause one to have to learn different ways to complete some tasks.

Tasks like dressing, cooking, and taking care of one’s self can prove to be challenging when dealing with the residual effects from a stroke.  It is important to be patient with yourself or your loved one.  As the stroke survivor, always be patient with yourself as you relearn tasks that you were able to do so easily without assistance before.  As a caregiver, have patient with your loved one and offer help, but allow them to perform tasks as independently as safely possible.

Just as learning to care for yourself took time, so will relearning how to perform activities of daily living after a stroke. You may need to take rest breaks more often, and that’s okay.

The American Stroke Association has several videos which highlight safe stroke recovery, and how to create a safe home environment post-stroke, in order to prevent accidents and injuries.

Please take the time to watch some or all, and please reach out if you have any questions.


November 2021

Stroke Survivors with Diabetes 

In the United States, 65% of deaths caused by diabetes are attributed to heart disease or stroke. Up to 23% of adults in the U.S. do not know that they currently have diabetes.  Whether prior to your hospitalization or during your hospitalization for a stroke, you may have learned that you have diabetes.  Diabetes is a risk factor for stroke due to several reasons.  Those can be that diabetes creates hardened arteries and decreased elasticity in the arteries compared to those without diabetes. During a stroke, your body may naturally create more glucose due to stress it is experiencing.  High blood sugar has been shown to make the effects on the brain during a stroke even worse.  This can cause additional damage to the brain, leading to increased risk for long-term disability, or even death.

Maintaining a normal glucose level post-stroke is important, as well. The typical treatment for maintaining adequate blood glucose levels during the first 24 hours, especially, after a stroke is the use of insulin.  Normalizing blood glucose during the post-stroke phase has benefits. If you or your family member has not done so already, make a plan to discuss blood glucose control with your primary care provider or nurse.

In conclusion, the risks of hyperglycemia, or high blood glucose, in acute stroke patients have been determined to be increased risk of death, long-term disability and the re-occurrence of another stroke. Be proactive against diabetes and know your A1C level, and what your blood glucose normally runs in order to prevent either the development of diabetes, or future heart disease or stroke. If you do not know your levels, speak to your provider about obtaining these levels in order to become knowledgeable and work towards a better health.  There is always room for improvement.


October 2021

After a stroke, you may realize that a lot of your lifestyle habits may need to change in order to decrease your risk for another stroke.  It can be easy to become overwhelmed by all the changes and you find yourself giving up.  Instead of trying to change everything at once.  Take one thing at a time.  After a stroke, your doctor or nurse may mention to you the need to improve your diet.  While that sounds easy enough, once you delve into nutrition information like fats and carbohydrates and sugars, it can easily become overwhelming.  A couple risk factors for stroke are high cholesterol and high blood pressure.  Diet has been proven to play a role in controlling these two things.  A low-fat, low-salt diet can greatly improve not only your overall health, but your risk for future stroke, as well.  This video simply breaks down everything you need to know about how to maintain a healthy diet to prevent a future stroke.



September 2021

This story is about a neurologist who woke up in her own hospital, after having a stroke.  The most important thing to remember after having a stroke and beginning therapy in order to recover is that there is no expiration date to your stroke recovery. Each person’s recovery is individual and its vital to recognize that the more you put into your stroke recovery, the more you will get out of it in the long run.


August 2021

This month our topic of discussion will be Transient Ischemic Attacks, or TIA’s. TIA’s are also known as “mini-strokes”.  TIA’s are still an emergency, and one should go to the ER to be evaluated quickly. Ischemia can cause damage to the brain, but the goal is to prevent an infarct, which causes irreversible damage. TIA’s can sometimes progress into an ischemic stroke, and are a warning sign for future stroke. Please view the following educational video regarding TIA’s and how to prevent one.



July 2021

The topic for this month’s Stroke Support Group post is risk factors.  There are two types of risk factors for stroke. There are those that are uncontrolled, or cannot be changed, and manageable risk factors, those that can be modified with medications, lifestyle changes, diet, etc.

Uncontrolled risk factors include:

  • Age
  • Race
  • Gender
  • Family History


Manageable risk factors include:

  • High blood pressure
  • Atrial Fibrillation (A-fib)
  • High cholesterol
  • Smoking
  • Diabetes
  • Poor circulation
  • Lack of physical activity or sedentary lifestyle
  • Obesity

By making a commitment to decrease your risk for stroke, you can also improve your overall health and decrease your risk for other diseases such as heart disease, blood clots, etc.  Increased exercise and improved diet are a good way to start making changes.  Make it a point to talk to your healthcare provider to find out how you can decrease your risk factor for stroke.



June 2021

Symptoms of a stroke are sudden.  They should not be ignored.  It is better to overreact to stroke symptoms, than to ignore them.  The best thing you can do for yourself or your loved one is to get them to the hospital immediately.  BE FAST is an easy way to remember signs of a stroke. Any of these signs could mean a STROKE has happened.

B: Balance. Watch for sudden loss of balance. This can indicate a stroke has occurred.

E: Eyes. Check for sudden vision loss or blurriness in one or both eyes.

F: Face.  Assess for an uneven smile, or facial “droop”. Ask them to smile and see if only one side of the mouth goes up.

A: Arm.  Look to see if one arm is weaker than the other. Are they able to hold it up, or does it “drift”, or fall down?

S: Speech.  Listen for slurred speech, or the sudden inability to speak.

T: Time. Begin transport to the hospital right away.


BE FAST, Call 911!


May 2021

As a stroke survivor it is common to feel isolated and alone. One must try to remember that strokes occur every day, every minute, so there are numerous survivors.  Having support is so important to recovery.  Every stroke is different, so everyone’s recovery is different.  Some strokes leave people unable to walk, or even move.  With hard work and determination survivors can improve to have enhanced quality of life.  Recovery is never promised to be easy, but it will be worth it.


Watch Jim’s story about his stroke recovery with the use of technology.


April 2021

Welcome back to PMC’s Online Stroke Support Group! Aphasia is defined as the loss of ability to understand or express speech.  Aphasia is a common symptom and result of a stroke.  This month we will show you what it’s like to live with and take care of someone who suffers from aphasia. Aphasia is a common symptom of stroke that can sometimes last for days, weeks, months, or years.  Please watch this informative video regarding aphasia and how to live with it.

Chelsea Kinney
Stroke Program Manager
Cell: 606-794-5715


March 2021

Today, I want to recommend to you a couple of books I’ve read regarding actual stroke patients sharing their stories of impact and recovery. These books have given me an insight to what my patients are going through. I wanted to show these to you, so those watching may read (or listen to) these, and grasp a better understanding of how a stroke affects the patient.

1. My Stroke of Insight by Jill Bolte Taylor, Ph.D. This book is written by the stroke survivor herself. She explains her stroke, her struggles with her identity after her stroke and her long recovery.

2. Healing the Broken Brain by Dr. Mike Dow and David Dow with Megan Sutton, CCC-SLP. This book answers 100 questions asked about strokes and recovery, and the author tells the story of his brother who had a stroke at a young age.

Thank you so much for joining us today! These will be posted monthly to this page for viewing. If you have any questions or recommendations for our next Stroke Support group, please feel free to let us know!

Chelsea Kinney
Stroke Program Manager
Cell: 606-794-5715

Pikeville Medical Center