Lilian Tsi Stielstra's Why

Lilian Tsi Stielstra was a couch potato. But at age 46, that changed.

Waking on a Saturday in 2010 in her San Francisco home, she recalls feeling tired. She brushed it off as stress from her demanding bank sales job.

Walking up the stairs, she felt “pins and needles” in her left leg. A few minutes later, her left arm had the same sensation. Then the left side of her face felt numb.

“I realized it was a stroke because it was all on one side,” Lilian said.

Her husband, Scott Stielstra, a firefighter and paramedic, bundled Lilian into the car and drove about three blocks to UCSF Medical Center. The American Heart Association recommends people experiencing stroke symptoms, such as face drooping, arm weakness or speech difficulty, call 911 immediately.

Lilian’s stroke came six months after she was diagnosed with high blood pressure, a leading risk factor for strokes and heart attacks. Tests after the stroke showed that she also had high cholesterol and high triglycerides, other risk factors for heart disease and stroke.

Being an overweight woman with a stressful, sedentary lifestyle also increased her risk of stroke.

Although Lilian, now 53, has no residual effects from the stroke, her neurologist recommended that she walk for 30 minutes a day.

“My excuse for many years was that I didn’t have time to exercise,” said Lilian, who was interviewed for this article while she walked through Golden Gate Park. She made time.

Lilian with son Peter at the Bay to Breakers race in San Francisco.

A neighbor volunteered to walk with her every day at 6 a.m., keeping her accountable. Within two years of her stroke, she was jogging and pledged to run by age 50 the local 7.5-mile Bay to Breakers race — known for runners dressed in costumes. She did, with her then-13-year-old son Peter. She was a tiger mom, complete with a tail.

Now, Lilian runs about 4 miles a day, farther on weekends. She also started swimming two years ago and is trying strength training.

She changed her diet, eating more vegetables and grains, and less sugar. She substitutes Greek yogurt for ice cream.

Lilian also stopped working 15-hour days at her job, where she often was the top salesperson. In 2016, she was No. 7 out of 35 people.

“I just learned to live with that,” Lilian said. “I decided I cannot afford my health to go bad again.”

Those changes led to weight loss: about 25 pounds. They also reduced Lilian’s risk of another stroke.

“It takes a lot of willpower,” said Scott, who made similar changes. He and Lilian later this year plan to walk the 500-mile Camino de Santiago, an ancient European pilgrim route to the tomb of St. James in Santiago de Compostela, Spain.

Lilian, who grew up in Singapore, said heart health was never discussed in her family, even though her father died from a heart attack at 81 and experienced mild strokes. Now, she makes sure Peter and her 22-year-old daughter, Audrey, understand why the family has made certain changes.

Lilian’s educational efforts extend beyond family. Fluent in Cantonese, she volunteers with the Chinese Community Cardiac Council in San Francisco. As a national Go Red For Women spokeswoman, she encourages other women to learn about their family health history and make healthier choices.

“You have to make a conscious choice to change your lifestyle and have cooperation from your family,” Lilian said. “I want to have a healthy heart so I can be alive for my children’s weddings and my potential grandchildren.”

Everyone has a reason to live a longer and healthier life.

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Stroke Rehabilitation

Making the Best Decisions at Discharge After Stroke

The type of rehabilitation and support systems a survivor receives at discharge can strongly influence health outcomes and recovery. In this, the first part of a two-part series on stroke rehab, we offer guidance for the decision-making process required when it’s time to leave the hospital.

What to Expect from Outpatient Rehab

After stroke, about two-thirds of survivors receive some type of rehabilitation. Outpatient therapy may consist of Several types of therapy. Whether a patient is referred to inpatient or outpatient therapy depends on the level of medical care required.

What to Expect in Stroke Rehab

Following a stroke, about two-thirds of survivors receive some type rehabilitation. In this second of our two-part series, we want to alleviate some of the mystery, fear and anxiety around the inpatient rehab part of the stroke recovery journey.
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AHA-ASA Resources

The Support Network

When faced with challenges recovering from heart disease or stroke, it’s important to have emotional support. That is why we created a network to connect patients and loved ones with others during their journey.

Caregiver Guide to Stroke

The Caregiver Guide to Stroke is meant to help caregivers better navigate the recovery process and the financial and social implications of a stroke.

Stroke Support Group Finder

To find a group near you, simply enter your ZIP code and a mile radius. If your initial search does not pull up any groups, try

Tips for Daily Living Library

This volunteer-powered library gathers tips and ideas from stroke survivors, caregivers and healthcare professionals all over the country who’ve created or discovered adaptive and often innovative ways to get things done!

Stroke Family Warmline

The Warmline connects stroke survivors and their families with an ASA team member who can provide support, helpful information or just a listening ear.

Let's Talk About Stroke Patient Information Sheets

Let's Talk About Stroke is a series of downloadable patient information sheets, created by the American Stroke Association, that presents information in a question-and-answer format that's brief, easy to follow and easy to read.

Request Free Stroke Information Packets

Fill out this online form to request free information about a variety of post-stroke topics.
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Stroke & Parts of the Brain

When Stroke Affects the Occipital Lobe

Our occipital lobe, the smallest of the four lobes of the cerebral cortex, controls how we visually interpret our world.

When Stroke Affects the Cerebellum

The cerebellum contains 80 percent of our neurons. Its job seems to be to make things better. We talked with neuroscientist Jeremy Schmahmann about how stroke affects the “little brain.”

When Stroke Affects the Parietal Lobe

The parietal lobe helps us make sense of sensory information, like where our bodies and body parts are in space, our sense of touch, and the part of our vision that deals with the location of objects.

When Stroke Affects the Frontal Lobe

Of the four lobes that make up the cerebral cortex, the frontal lobe is the largest. It plays a huge role in many of the functions that make us human — memory, language, movement, judgment, abstract thinking.

When Stroke Affects the Temporal Lobe

The temporal lobe has several functions, mainly involved with memory, perception and language.

When Stroke Affects the Brain Stem

The brain stem serves as a bridge in the nervous system. It sits at the top of the spinal column in the center of the brain. When a stroke happens there, it can cause a few different deficits and, in the most severe cases, can lead to locked-in syndrome.

When Stroke Affects the Thalamus

The thalamus can be thought of as a "relay station," receiving signals from the brain’s outer regions (cerebral cortex), interpreting them, then sending them to other areas of the brain to complete their job.
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Simple Cooking

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Helping Others Understand

Stroke affects people differently and many of the effects of stroke can be complicated. Helping friends and family understand how a stroke is affecting a survivor can help everyone involved.

Support Showcase

Our new department highlighting the good work being done by stroke support groups from around the nation. If you are part of a successful support group we should consider featuring, let us know!