Stroke Treatment and Rehabilitation
Immediate Treatment for Strokes
Getting immediate treatment for a stroke is essential. If you get to the hospital within 3 hours of the stroke you may be a candidate for the tissue plasminogen activator (TPA), a clot-busting drug which actually breaks up clots and helps to restore the damaged area. These drugs can only be used for the ischemic type of strokes as they would cause more bleeding with a hemorrhagic stroke. Other treatments include;
Blood thinners such a warfarin (Coumadin), aspirin, and clogidogrel (Plavix) for ischemic strokes.
Medication will be given for high blood pressure and pain medicine for the headaches. In appropriate cases a special stroke team and skilled radiologist may use angiography to open the clogged artery.
For hemorrhage strokes it is often necessary to evacuate the excess blood from the brain and to repair damaged blood vessels. Surgery on the carotid artery is also quite common, which is called a carotid endarectomy. Sometimes they will do an angioplasty and place a stent in the artery but the surgery if more common.
Stroke Risk Factors
- Positive family history of stroke, heart attack or TIA’s
- Being age 55 or over
- High Blood Pressure, (a systolic over 140 m, Hg or higher and a diastolicpressureof 90 mm Hg or higher
- Cigarette smoking
- Obesity (a body mass index of 30 or higher
- Cardiovascular disease, including heart failure, a heart defect, heart infection or abnormal heart rhythm
- Previous stroke or TIA
- High levels of homocysteine, an amino acid, in the blood
- Use of birth control pills or other hormone therapy
- In some cases, binge drinking or use of illicit drugs
Men and women have strokes at about the same rate, women die more often then men. Blacks are more likely to have strokes than other races
Stroke Recovery Video
Complications of Strokes
Paralysis or loss of muscle movement typically limited to one side of the body. Physical therapy is most important to improve chances of recovery
Difficulty talking or swallowing may occur because the stroke effects the way the muscles in the mouth move making talking difficult, plus swallowing and eating may be a problem. Sometimes the stroke cause aphasia which means the person has difficulty expressing thoughts through language. This is very frustrating to the patients. Speech and language pathologists can greatly improve this disability
Memory loss or trouble understanding can be a problem and also may improve with therapy
Pain – Some have pain, numbness and strange sensations in parts of their body affected by the stroke. For instances, if you have lost feeling in your left arm you may have an uncomfortable tingling sensation in that arm. You also may be very sensitive to temperature changes, especially cold. This phenomenon is called central stroke pain or central pain syndrome. Since this pain is caused by problems in the brain, there are very few medications that treat the discomfort.
Every person's stroke recovery is different. Depending on what complications you might have, the team of people to help you in your recovery could include:
Rehabilitation of Elderly Patient
Psychologist or psychiatrist
The goal for rehabilitation is to recover as much of the patient's independence and functioning as possible. Much of stroke rehabilitation involves relearning skills you may have lost, such as walking or communicating
Recovering from a stroke can be mentally exhausting. In addition to the various physical side effects, feelings of helplessness, frustration, depression and apathy aren't unusual. Diminished sex drive and mood changes also are common. Patients that go home to a healthy spouse or other companion are more likely to become independent. Patients require a lot of emotional support as their lives are usually forever changed. They have to learn to live within the limits of their abilities, and this is very difficult for some people to accept. It really depends on the individual and the degree of complications. Often they are very emotional, as suddenly they can’t work anymore, or maybe they can’t walk at all. Living with disabilities isn’t easy when it changes your whole lifestyle.
If someone close to you has had a stroke give emotional support by staying in touch, keep your conversation at an adult level because you want to treat them the same way as you did before they had the stroke. Use your normal tone of voice, speaking at a comfortable pace allowing time for your words to be processed. Reduce distractions and talk one-on-one as the stroke survivor may understand you better than they might in a group of people. Always keep caregivers in mind as they need support and friendship as well. Although stroke disabilities may be permanent, many live an active full life.
Prevention of Strokes
Controlling high blood pressure is essential. Take you prescribed medicine. It is good to have a blood pressure machine and write down your blood pressure each day.
Lower your cholesterol and saturated fat intake. This will help reduce the fat deposits in your arteries. Many patients are placed on cholesterol lowering medicine.
If you have diabetes, it is essential to keep it in control by following the appropriated diet, checking your blood sugar level and taking your prescribed medicine.
Maintain a healthy weight. Being obese causes many other risk factors to get out of control.
Exercise regularly to the best of your capabilities. Aerobic exercise is wonderful to reduce your risk factors. It will increase your good cholesterol also.
Manage stress. Stress can cause a temporary hike in your blood pressure and increase the tendency for blood clots. Use relaxation techniques and simplify your life as much as possible.
Drink alcohol in moderation if at all. Alcohol can be a risk factor and also a preventive measure for strokes. Binge drinking obviously isn’t healthy. On the other hand, drinking a small to moderate amount can increase your HDL (good cholesterol), and decrease your blood clotting tendencies and it is also relaxing.
Don’t use illicit drugs, particularly cocaine or crack cocaine as they have been linked to TIA’s and strokes.
Many people take a baby aspirin each day to prevent blood clots or if you have more extensive disease your doctor may prescribe other anti-platelet drugs.
My Husband's Stroke
My husband had a stroke at the age of 59 about 4 years ago. He was a lifetime smoker until about 3 years before the stroke. He had normal blood pressure, is not a diabetic, but he had high cholesterol and a stressful job which are all risk factors. One day he came home from work and said he was really tired and seemed a little unsteady on his feet for a few minutes, which I now know was the only TIA he ever had. He said he felt better in a few minutes and got in the shower while I finished cooking dinner. We ate, watched a little TV and went to bed.
At 1 AM I heard him call my name, and he was on the floor totally paralyzed on the left side. I called 911, made my husband as comfortable as possible and awoke up my elderly mother to let her know what happened. She lives with us and as she had one leg amputated the year before. She has a prosthesis and walks fairly well. I quickly dressed and before the ambulance arrived my mother was fully dressed and determined to go with me. I think she is the fastest one legged woman I know! When we arrived at the hospital we found out my husband could not receive the clot buster drug because we really didn’t know what time the stroke occurred since he was asleep. They put him on a Heparin drip (which is a strong blood thinner) and in the next 24 hours he could move his left side although it was very weak. We learned his right carotid article was almost completely blocked which caused the stroke and he eventually had the surgery.
He can walk but he has left sided weakness particularly in his arm, plus the stroke permanently affected his balance. He has fallen numerous times, cracking his ribs on one occasion in the first year. He is much more careful and isn’t falling very often now. Rehabilitation helped tremendously. He also has some visual disturbance but that has improved over time.
He will never be able to work again and certainly didn’t plan on retiring at age 59. It has been difficult for him to accept some of his limitations and not too easy for me either. We have adjusted as well as we can and live each day to the best of our ability. After all, his limitations could have been much worse and we’re grateful that we have become comfortable with life as it is. Trusting God and acceptance is the key to living a peaceful life.
In conclusion, the obvious best thing to do is to prevent a stroke. The prevention methods listed will also help prevent diabetes and heart disease. Remember the signs of a stroke as you may be with a friend or loved one when a stroke happens.
© 2010 Pamela Oglesby
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