Therapy Sessions
Please remember to bring:

• Glasses
• Hearing aids
• Comfortable day clothes (trousers/skirts with elastic waists are often useful)
• Walking aids
• Supportive footwear

Visiting
Sleep plays a vital part in patient recovery in the early stages after a stroke, and visitors can be very tiring for a patient. 

For this reason, we ask visitors to visit only during the designated visiting hours. We also ask that each patient has a maximum of 2 visitors at a time. A crowded bed space can make it difficult for a nurse to carry out essential duties. Visiting is welcome in the lounge or balcony area.

We have a rest period from 12.45pm – 2.00pm. At this time we turn the lights out and encourage patients to participate in bed rest.

Family and friends can visit the ward out of visiting hours to attend prearranged meetings or treatment sessions.

Meals
You are given menus to fill out for the following day. Your relatives or a nurse can help you complete it. If you require a pureed, minced or soft diet, as a result of swallowing difficulties you might have less choice from the menu. If you are ‘nil by mouth’ you might require your food via a feeding tube. Halal and Kosher meals are available upon request. You might be advised to have a special diet such as high protein or low sugar.

We encourage as much independence at mealtimes as possible. Heath Care Assistants will assist you to eat your meal if required. Individual arrangements can be made if a patient requires help from a relative or regular carer to eat their meal.

Visitors are welcome to bring in snacks and drinks. Please ask us what is recommended. We are not allowed to re-heat food or keep items in the fridge for more than 24 hours.

Meals and drinks are served at the following times:

• Breakfast 8am
• Morning tea 10.30am
• Lunch 12.00pm
• Afternoon tea 3pm
• Evening meal 6pm

Doctors
Consultant Stroke Physicians look after each ward.  Each Consultant has a weekly ward round. Both wards have a team of ward doctors including a Medical Registrar, Senior House Officer and House Officers. If you wish to meet with a Consultant, please ask the ward receptionist or nurse to make an appointment.

Nursing Staff
Nursing staff work in teams. A qualified nurse is responsible for coordinating patients’ daily care. Health Care Assistants support the nurses and provide personal care. Nurses & Health Care Assistants work in shifts. There is always a Nurse in Charge on each ward. He/she wears a yellow badge.

Administration Assistant
The administration assistant on HASU/ASU may contact your family to arrange progress meetings. She can be contacted on HASU/ASU.

Advanced Nurse Practitioners for Stroke (ANP) / Stroke Nurse Practitioners(SNP)                                                                                                                                                                                                                                                                                                                                 They are nurses who have undergone further study and training to be able to see, diagnose and treat patients independently. They assess acute stroke patients presenting to the Emergency Department, facilitating early imaging, assessment, diagnosis and treatment and ensure a smooth patient journey from ED to the Acute stroke unit. They offer information, advice and support. Transfer of regional thrombectomy patients is also co-ordinated by them, ensuring that patients receive the necessary assessments, checks and investigations prior and post procedure in a time critical fashion. ANPs review patients presenting to TIA clinic. As well as clinical work they are also involved in audit, teaching programmes – including running in-house and regional Simulation workshops - and research.

Social Worker
The social worker works with the stroke team in planning your discharge. They will arrange to see you/your family if you are in need of support after hospital.  This might be:

• Arranging packages of care to help people at home.
• Arranging care homes for people who are unable to manage in their own home.
• Support for families who are providing care.
• Making contact with other services, for example benefits advice, support groups, luncheon clubs, transport schemes.
• Applications for re-housing.

Occupational Therapy
Occupational Therapist identify any difficulties you may have with everyday tasks such as feeding yourself, getting washed and dressed or simple kitchen activities.

Problems in these areas may be due to:

• Muscle weakness
• Poor balance
• Memory changes
• Difficulty with concentration
• Altered understanding

The Occupational Therapist will work with you to improve your skills and confidence. This may include:

• Practice of a task
• Advice on new ways of doing things to increase your independence and safety
• Provision of equipment such as handrails, commode etc
• Looking at how you will manage in your own home and what help you will need if you are ready to be discharged
• Advice on returning to work or leisure activities

Physiotherapy
The aim of physiotherapy is to help you regain mobility and relearn the movements required to be able perform activities such as standing up, walking or reaching for objects following a stroke.

The Physiotherapists assess how the stroke has affected the way you move when you are first admitted to the unit.

During Physiotherapy sessions we work with you to improve:

• Moving around in bed
• Moving from bed to chair
• Sit to stand
• Balance
• Muscle strength
• How to improve arm movement
• Walking

The Physiotherapists and Occupational Therapists also assess positioning to ensure that you are comfortable when you are in bed or in a chair and that your affected arm is well supported.

Speech and Language Therapy
If you are having communication difficulties (talking, understanding, reading or writing), a Speech and Language Therapist will see you. They will assess the level of your problems and find ways for you and your family to make communication easier.

If you have swallowing difficulties, a Speech and Language Therapist will also see you. They will advise the stroke team how to make sure you swallow safely (i.e. ensure food and drink do not go down the wrong way into your windpipe and lungs). This may mean having a special consistency diet that is easier and safer for you.
If you cannot swallow safely at all, you will be unable to eat and drink. You will be ‘nil by mouth’ and may have a feeding tube passed via your nose directly to your stomach. This will be fully explained to you.

Dieticians
If you have a poor appetite or are unable to eat a normal diet due to swallowing difficulties, the dietician will see you.  They will discuss with you the best way to keep you well nourished, which may include a special diets, supplements or feeding using a tube. Some medical conditions require special diets, recommended by the dietitian. Please ask to see a dietician if you have any dietary issues.

Psychology
Stroke can affect you emotionally as well as physically. It is normal to experience a variety of psychological responses as you adjust to the changes in your life. For example, mood, concentration and memory may be affected. The Psychologist can help you and your family to adjust to what has happened to you.

Pharmacy
A Pharmacist comes to the ward every weekday and will check the medications you are taking. You can ask them any questions you have.

Carotid Doppler Test
Carotid doppler ultrasound is a non-invasive test that uses sound waves to measure the flow of blood through the large carotid arteries that supply blood to the brain. These arteries can become narrowed due to atherosclerosis (furring up) or other causes, and this can lead to transient ischemic attack (mini-stroke) or stroke. The carotid doppler test can help doctors determine stroke risk and the need for preventive measures.
A carotid doppler test may be performed if you are considered to be at risk of having a stroke due to decreased blood flow in the carotid arteries.
It is a non-invasive procedure, and no special preparations are necessary. The ultrasound technician will apply a jelly-like substance to both sides of your neck, where the carotid arteries are located. This helps lubricate the skin and allow the ultrasound sensor to move more freely. The sensor is moved back and forth over the neck and generates sound waves that bounce off the arteries. The echo that bounces back is measured, and the changes in frequency can measure the flow of blood. The flow will be different in areas that are narrowed.
This test takes an average of 15 to 30 minutes for most people, though it can vary. Once the test is completed, you will be free to resume normal activities with no restrictions.

Echocardiogram
An echocardiogram is a test that uses sound waves to create a moving picture of the heart. It allows doctors to see the heart beating, and to see many of the structures of the heart in a noninvasive way. A trained sonographer performs the test. You will be asked to remove your clothes from the waist up and lie on an examination table on your back. A gel will be spread on your chest and then an instrument called a transducer that transmits high-frequency sound waves is applied. The transducer picks up the echoes of the sound waves and transmits them as electrical impulses. The echocardiography machine converts these impulses into moving pictures of the heart. The probe records the motion of the blood through the heart.
An echocardiogram can help to identify heart problems that may cause blood clots to form.

ECG
ECG (electrocardiogram) is a test that measures the electrical activity of the heart. Your chest area is cleaned with alcohol and electrodes are stuck on. The electrical impulses made while the heart is beating are recorded and shown on a piece of paper. Any problems with the heart's rhythm can be identified, to enable the correct treatment.
24 Hour Tape ECG Monitoring
Some problems, like palpitations, are difficult to identify during routine heart examinations as they only happen now and then. 24 Hour Tape Monitoring is a test carried out to monitor your heart during your normal daily activities, over a 24 hour period. You will not be required to stay in hospital for the monitoring. Your chest area is cleaned with alcohol and electrodes are stuck on. Wires from the electrodes connect to a small tape recorder on a belt worn around your waist. You can carry out normal activities and you keep the monitor on all day and night. You will be asked to return to the hospital the next day to return the monitor and its recordings.

CT scan
A CT (computerised tomography) scanner is a special kind of X-ray machine. CT scans are far more detailed than ordinary X-rays and give multiple cross-section pictures through the body. The scanner is particularly good at testing for bleeding in the brain so it will identify what kind of stroke you have had.

Magnetic Resonance Imaging (MRI) scan
MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body.

Diffusion Weighted MRI (DWI MRI)
Is a type of scan used to identify areas of an organ, such as the brain, which have recently been damaged. The MRI machine is set to detect small restrictions in the movement of water molecules inside the injured areas. These small changes are detected by the MRI machine and appear as bright spots on the screen.

Consultant Colorectal Surgeons
Miss Anne Pullyblank
Miss Caroline Burt
Miss Kathryn McCarthy
Miss Ann Lyons
Mr Andrew Smith
Mr Haytham Sumrien

MacMillan Colorectal Specialist Nurses
Sarah John
Annie Reilly

Consultant Radiologists
Dr Paul McCoubie
Dr Shoba Philip
Dr Adrian Pollentine

Colorectal MDT Co-ordinator
Madaline Manning

The aim of the Enhanced Recovery Programme is to get you back to full health as quickly as possible after your operation.

Research indicates that after surgery, the earlier we get you out of bed, exercising, eating and drinking, your recovery will be quicker and it will be less likely that complications will develop.

Some of the benefits include:

• A quicker return of normal bowel function.
• Reduced chest infections.
• A quicker return to usual mobility.
• Decreased fatigue.
• Reduced risk of developing blood clots after surgery.

There may be circumstances where the programme will not be appropriate for some patients and if this is the case, you will be fully informed of the alternatives.

GMC Number: 4423780

Year of first qualification: 1997, University of Southampton

Specialty: Neonatal Medicine

Secretary: Julie Deady

Telephone: 0117 414 6815

Dr Claire Rose has been a consultant in neonatology since 2008.

GMC Number: 4220688

Year & location of first qualification: 1995, London

Specialty: Trauma & Orthopaedics

Clinical interest: Arthroscopic ("Key-hole") Surgery, Anterior Cruciate Ligament reconstruction Meniscus repair and transplant Treatment of early arthritis Partial Knee replacement

Secretary: Rona Webster

Telephone: 0117 414 1612

ESSKA (European Society of Sports Traumatology, Knee Surgery and Arthroscopy) Arthroscopy Committee ESSKA Collateral ligaments working group ISAKOS (International  Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine) - member BASK (British Association for Surgery of the Knee) - member ACL (Anterior Cruciate Ligament) Study Group - member UK National Ligament Registry - Steering Committee member

GMC Number: 5188512

Year of first qualification: 1996

Specialty: Renal

Clinical interest: Transplantation

Secretary: Sue Emery/Eleanor Hucker

Telephone: 0117 414 7699

Specialty: Anaesthetics

Telephone: 0117 414 0879

GMC Number: 4186102

Year of first qualification: 1995, University of Bristol

Specialty: General surgery

Clinical interest:  Vascular, Renal transplantation and Renal access surgery 

Secretary: Natasha Brown

Telephone: 0117 414 0798

Mr William Neary trained comprehensively and has a full time commitment in General, Vascular and Renal Transplantation Surgery and to undergraduate medical education. 

He is a member of the Vascular Society, Association of Surgeons of Great Britain and Ireland and the British Transplantation society. 

Mr William Neary's MD is in the identification and reduction of operative risk.