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Suffered a stroke in 2004 (migrainous infarction). Became half blind. Rested for a good year. Became a photographer for 8 years, then switched back again to software development. From then on, the limits were: WFH only, limit stress, run away from job if things go bad again. Nap if brain feels exhausted. Sleep, more and better. 20 years later (53yo), I'd say I'm doing great! Also fitness helps remind me to take care of the body...
Tech has built literal industries of people trying to stress you out, and they mostly don't have actual tech skills or the empathy that comes with them so back it up.

For me, I usually try to avoid anything where the working practices are strongly defined. Agile has long been a bad word.

I'm glad you're doing well now.

> WFH only, limit stress, run away from job if things go bad again

I’m facing a similar set of health-based restrictions, it’s edifying and impressive how you’ve pushed through. I’m curious: how do you broach this with potential employers and shape your job search/career path around it?

Applying for pure remote positions puts one in direct competition with younger people who can pull obscene hours with no accommodation needs. Leading with disability/accommodation needs feels like the opposite of the ‘best foot forward’ honeymoon phase salesmanship associated with new jobs, and kinda soul crushing regurgitating the circumstances for chronic illness while hoping for a job. And uncontrollable management changes can eliminate medical protections and acceptable working environments, leading to an enhanced need to be able to hop jobs (exacerbating both the previous situations).

I’m fortunate my primary skills are amenable to straightforward accommodations, but you gotta get the job to do the job…

Whats your stack? (Software). Very impressive after 8 years to come back
I'd be interested in how you managed the impact to your vision, any particular technology improvements you made? My dad had a stroked over the summer and lost vision on his right side - he's older but still works at a computer and is pretty particular about workflows so I don't want to muddle with what works for him too much.
Did you work with something else during your rest period?

I don't think most people wouldn't be able to, financially.

> Became half blind. ... Became a photographer

Impressive.

As a migraine sufferer this sounds scary and only today I have learned about it. What was it like? If I may ask. Is there a way to prevent it? I googled it and it seems to appear rather arbitrarily and suddenly.
My dad's suffering with aphasia from a large half brain stroke too.

You give me some hope things will get better for him.

> WFH only, limit stress, run away from job if things go bad again

Sounds like senior management

Had a stroke 2 months ago at 55, after an entire life (professionally since I'm 16) as a dev. I mostly followed these rules apart from when I got dragged into a project that was sufficiently interesting that I started overworking. 12-14h days.

Just don't do that. I used to do that just fine and that's why I thought I was OK. I mean, I USED to go on in huge coding benders, did'nt I ? Well apparently not at 55, when the pressure has been on for months instead of weeks.

Other things to watch -- diet! With the work came less free time, put on weight etc and all the good habits I had built for years, disappeared.

And the worst bit you can think of is "Oh but I'm so CLOSE to being done, I'll just fix it up later when I can relax". Just don't.

I lost all sensation on the right side. It is coming back slowly. I can still work, didn't lose speech or mobility or strength, I consider myself super-mega-lucky in that.

Strikes close to home. 8 years ago I was in a bike accident that took me out for 4 months. I instantly felt dumber. The headaches became a fact of life, and the need to get out of the house early in the day to avoid brain fog creeping in became a routine.

It... sucks. I've still progressed my career and made significant strides, and come to appreciate things that I never would have noticed if I kept on my previous trajectory, and while I don't think about it much anymore, for years it ate at me.

For those in workplaces that treat you well. One suggestion that is not in OP: Tell others, explain, expand, give presentations on what you went through. Not only will it help your environment understand WHAT you are doing, they then are also able to understand the WHY. I've had my share of colleagues with afflictions. Your environment must know to understand! Otherwise, you are only allowing them to react to resulting situations, without understanding of the why. Second order benefit is that if people would do this more, general kindness towards how personal situations influence business situations would rise. We need more kindness, from understanding each other. (I understand this is an advice that does not work for those workplaces where HR is the enemy, the boss is their to get you, co-workers are in a free for all for bonuses and promotions. I hope most of us are not in that kind of work situations.)
Interesting to see all the people in this thread who had a stroke. I had a mild and then moderate cerebellar stroke within a 7 day span about two years ago. I remember being on the stroke neurology floor of the hospital with a lot of bed ridden people who had also suffered them. I know because, within 24 hours, I was doing hourly walking laps with my nurses because I was bored. In other words, I was one of the lucky ones. Within a week I was back at work — not because I felt pressured to by them, they were completely understanding, but because I had no more symptoms that were experienced simply because I was sitting down to work.

I also see some advice about listening to your body after the fact, which I fully agree with. In my case, without going into too much detail, the stroke might not have happened if I had listened to my body beforehand, as it was caused by an injury I could have prevented.

So if I could give any advice from this place of experience it would be to listen to your body, and try to hear it when your fears and ego are shouting.

I had a stroke roughly eleven years ago. When the stroke started, I got really creeped out. I was in an elevator and I thought a stranger was reaching around me from behind to grab me. It was my right arm. I cracked a joke about it, I didn't know it, but I wasn't soeaking. Just mumbling and making creepy gutteral noises when I thought I was laughing. Then the face droop. Followed by my right hand becoming locked in a fist. It took months on rehab to get it open. And it lost a lot of function.
> HEADPHONES, blinders, and 'No'. Eliminate unwanted inputs at the earliest point of entry.

Open-floor offices, non-stop emails and chat messages, several meetings scattered throughout the week and the day.

This kills productivity and increases stress and fatigue for people that need to concentrate to work on complex stuff. There's also the time you need to properly switch contexts.

I haven't had a stroke but I did get a nasty tropical mono when I was young. You never quite recover from that one. I've got ibs since. My stomach just gets tired and stops. My mental focus feels the same. I sleep 9 hours a night, often 10 and I'm still tired.

I feel I always have less stamina than other people.

So this list is close to what I have always preached.

Time as in energy is my most precious resource.

Don't let processes suck the life out of you. They're there to serve the people not the other way around.

I think these are also good strategies for anyone who suffers from mental illness/burnout.
I have not had a stroke, but a few years ago I noticed my eyesight was getting strange. There were many other things including a very fuzzy brain, and wanting to stay in bed for weeks. I thought I was just sad until the eyesight issue.

It turned out I had Advanced Neurological Lyme disease. It took a couple years to recover from it. I also have Cluster Headaches, one of the most painful medical conditions known to science. Losing my the ability to think clearly, was worse.

As someone who uses my brain for work, the depression that arose from losing my mental faculties was very significant. I searched TFA for depression and did not see a mention. If anyone is dealing with a neurological issue like this, I would imagine that second order effects like depression are common, correct?

Most of the advice is good for pre-stroke persons too. Might even avoid having one.
Thank you for sharing.

Reading this, I'm reminded of the idea that we should all care about accessibility, because barring death or radical advances in restorative medical technology, we will all rely on accessibility tech in some way eventually.

Besides what is listed here, have you observed anything that your coworkers or managers can do to help accommodate you? i.e. Is there a version of this for folks working with stroke-surviving software engineers?

How strange to come across someone whose medical stuff so mirrors my own. I was just a decade older and don’t have epilepsy symptoms with meds. I can get behind all the advice here. Running out of “juice” and needing a break is very much thing. Before too but more so now. And taking a lot of semi stream of consciousness notes to help my more limited memory is too.
Good advice. I had one young too; I worked long days and had no life outside my company; it was in an economic downturn so I was also burning out (hindsight). I figured out what was important to me and that all changed everything.
All excellent advice even if you haven't suffered some health issue like stroke.
Good advice. I didn’t have a stroke but a couple months ago I developed blindness in my left eye. It came down to my optic nerve being inflamed. I was later diagnosed with a rare autoimmune condition called MOGAD which “attacks” the optic nerve. Thankfully my vision is approx 95% recovered by now. But I still can’t read, eg code on my laptop, which is scary (my right eye is basically making up for it). And I’m scared of another attack happening. So I’ve been really looking after my health and trying not to do the 12+ hr coding benders I used to do. I appreciate these tips!
Going through several panic attacks with stroke-level blood pressure elevation had a similar impact on my worldview and approach to work.

Slow down. Prioritize your own health and well-being. Focus on the essentials and cut out everything else.

If you are in pain, see a doctor before you end up in urgent care like I did.

OP thank you for this generous text. I would add that these tips are amazing for people with post-covid/long-covid/brain-fog too
Some of these apply to other neurodivergents like myself.

One thing I struggle with is that the only time I seem to really get in the flow is when no one is around and no one else is working. Some form of stimulant is needed, but no stimulant I can use gets me to the point where I can get into more flow than I can when no one is around. I sometimes dream of how much I could do if I just lived at my office alone. This is sad and frustrating, because I don’t want that life where I cannot have a life of my own and where I cannot interact with people at work or it disables my ability to get things done.

Nutrition and some form of exercise are also incredibly important, especially as you get older. Not everyone needs the same things, so don’t let others tell you what is the “right thing for everyone”- there’s no such thing.

It's very depressing how the article says "you don't have to do it alone! use AI"

ah this age where "not alone" means "AI"...

How about, enjoy good connections with nice people. Both in personal and work. Maybe those people can even see the warning signs and tell you to stop before you have a stroke.

This was a very good to-the-point post! Applies to everyone, and you only truly seem to wake up to care for your health when you lost it first.
Could honestly change the title to "Tips for stroke-surviving software engineers (or anyone trying to avoid one)". All of us need these fresh little reminders that our brains are very different than the tech we regularly interact with every now and then. Recognize and respect your organic hardware!
Wow, this article resonated so much more than I expected when I clicked on it. Mostly because I have epilepsy without the stroke, and after decades of it being stable, around 2021 it got a bit harder to control and started to interfere with my daily living for the first time.

A couple points I'd add/double down on:

1. Find yourself a team of really good folks to work with who treat you as a human - At the peak of my epilepsy acutely interfering with my life, I was at a startup that, after being devastated by lockdowns, decided to scale down from 100 employees to 6 and start over. When I told the founder I'd need a month off twice within the span of 4 months for some very invasive surgeries, I fully expected him to let me go, as he was legally permitted. He told me to take all the time I needed, and for that I'll forever be indebted.

2. Avoid the urge to "other" yourself - the only brain we're exposed to 24/7 is our own. That makes it easy to lose track of what's baseline and easy to assume every time you forget something or otherwise "glitch," it's a sign you are flawed in ways others aren't. That's not true, everyone forgets things.

3. It takes time to recover emotionally - This week marks 3 years since my last big surgery, and I'm just past 2 since things started to really stabilize. Only in the last few months have I stopped walking around constantly viewing myself through the lens of a condition and with a sense of self-doubt and "othering". So be kind and patient with yourself. It takes time.

4. Reddit has some very supportive communities to help answer questions and remind you that you're not alone (including r/epilepsy). But don't get overly involved in them for too long, because then it becomes easy to define yourself and your tribe through your medical condition.

5. If epilepsy or some other condition prevents you from getting a driver's license, there's a lot to say for living in NYC or SF. Two of the only places in America where it's completely normal to live without a car and you wont stand out or feel excluded.

Question to the OP or anyone else that has experienced something similar. Have you tried grey area or Peptide space medications like Dihexa, P-21, Semax, etc to see if there are any benefits there?

Very much self experimentation but they do work in mouse models as well as Russian medicine. I'm not encouraging anyone to experiment, just interested to see if anyone that has undergone experiences like OP's has experimented.

I have not experienced a stroke or similar but I just started a 6 - 8 week Dihexa course, low dose to test tolerance and I find I am experiencing benefits such as improved recall. I am learning guitar as my test suite. Something I have attempted multiple times before and given up on relatively quickly. 2 weeks in so far.

My intention is to drop the Dihexa at week 8 and then switch to Semax. The theory being that Dihexa improves synaptogenesis but inhibits pruning. Semax allows for pruning but optimizes the efficiency of existing used synapses. Dihexa is an experimental Alzheimer's medication and Semax is a Russian post stroke drug

Hey folks, my wife is a speech language pathologist who specializes in stroke rehab, I sent her this post and this comment section and she sent me this to share:

As a stroke/neuro rehab speech-language pathologist that is married to a web dev/engineering manager (that obviously sent me this blogpost), everyone reading needs to listen to this author's sound advice for prevention of CVA as well as for post-stroke management. We are seeing younger age strokes more frequently, especially those with jobs that are high stress and low physicality (read: you folks!). Thank you to the writer for spreading this info and awareness… I can confirm it is not as niche as one might think and for best outcomes you have to respond FAST (look at Face, Arm weakness, Speech difficulty, Time to call 911). PSA of the day!

DMSO can allegedly help some people improve after stroke, if applied soon enough.

https://www.midwesterndoctor.com/p/dmso-could-save-millions-...

This is applicable to far more than stroke victims. Any manner of brain interference should have the same ruleset. Reading through the comments, this ruleset should apply to everyone regardless of their medical situation. Chiming in with a +1 to fitness, and diet. It helps, massively.
I'm terrified by the possibility of a stroke that would disable me, not in a way that would let me write here about my experience with it, but leaving me dependent on the care of others. I'd prefer to shuffle off of this mortal coil, but such a sudden event may not allow that choice. So I fantasize about writing a suicide program that would take care of business if I fail to pass a bespoke Turing (delichon) test. But I doubt my ability to write that with enough nines of reliability to be willing to deploy it. I tried to implant that algorithm into my brother, but he declines to go to prison for me, the jerk. If I live long enough maybe AI tech will become reliable enough for this application, but I doubt it will be soon.
Thank you for sharing this. Keep up the good work and healing, OP! It's incredible that you've continued to be polite and to do as much as you can through your health struggle. Setting and enforcing boundaries can be difficult for some, especially when you're feeling hazy and not operating at 100%. I like that you pointed out being polite can be expensive sometimes.

This is excellent advice for anyone with knowledge based work though. Distractions, messages, pop-ups, asks, meetings, etc. are the leading reason I don't get as much done as I could. Some of your items could definitely help here.

> Let it hold state so your brain can judge rather than store and needlessly cogitate on stuff.

Isn’t that needless cogitation something that helps creating new links in your brain and helps against cognitive decline in later ages?

This is good advice for non brain damaged engineers too (or maybe I am?)
Oh gosh, even with the laws that should provide cover, the pushback you’ll encounter in academia from so many individuals with limited life experience who are trained only to rigidly follow blanket policies.

But if you feel like you won’t speak up because it’s not that bad, remember the next person who will come after you. When you have the capacity to push systems to do better, it’s better for everyone if you exercise it.

This advice could be translated 1:1 to ADHD (at least in my experience). You have to be very mindful with your attention and energy levels.

I'm wondering if some underlying mechanism in the brain is similar between having ADHD and having suffered a stroke. Or maybe it's just the conscious effort how to handle the symptoms that's similar.

Good tips. Not a stroke survivor but I developed epilepsy as a young adult… Not sure if work/stress had anything to do with it, but stress certainly triggers it!

I’m still able to work as a software engineer, and my career has progressed, but the condition has held me back in a lot of ways.

Are there types of disability insurance you can buy that would cover you as a software engineer in case something like this happens and you're not able to go back to work or not work as effectively in this field? Does anyone have experiences with this?
I haven't had a stroke (yet) but I find all that to be generally good advice. Good read!
Good read. Recovery takes time, and steady small steps help rebuild skill and focus.
https://stroke.jonasr.app/dates/

Quite a recovery. No it's not me, just a dev that works in the same field.

Isn't it better to prevent than remediate it? It's not rocket science. Mediterranean diet, daily nattokinase, absolutely no alcohol at any time, exercise
I don't get it, why is this mentioning "anti-discrimination legislation". Is being part of a minority prerequisite for personal health care?