The Aftermath of a Stroke
What to Expect
All stroke sufferers are different. There is really no way for doctors to be able to tell you the exact damage that was endured during the stroke at first. The truth is, only time will tell. Within the first few days of a stroke, patients may not respond a great deal. During this time, it is quite difficult to learn the side effects. Doctors can often tell how severe the stroke was, which area the stroke affected, and what could be expected. They will come in each day, and prepare you for the worst. But it is important to note that each stroke patient recovers differently. The brain is the most miraculous and complex organ in the body. So it is important to have faith in your loved one. He/she must fight for their recovery.
Essentially, you must mentally prepare yourself for what's ahead. This will not be easy, but it is important for you to provide all the love and support necessary to help the recovery along. Remember to never, ever give up. This will be a long process and though it may seem scary or hopeless at times, it must be remembered that many stroke patients make close to (or even) a full recovery with time.
Your loved one may not be able to eat, speak, or have mobility. He/she may not be able to form words or sentences, and may have difficulty following the simplest of commands. Vision or hearing may be affected, and coordination will most likely be impaired. But these things may improve with time, assistance, and perseverance. It is essential to note each aspect of your loved one's progression, no matter how small it may be.
Recovery, Rehab, and Therapy
First and foremost the stroke sufferer must be well enough to begin therapy. All medical issues must be at bay first. Survivors will attend medical rehab, in-patient acute rehab, in-patient sub-acute rehab, or outpatient acute or sub-acute rehab. Depending on the health of your loved one and the severity of the stroke, you will determine which type of therapy is best for him/her.
Secondly, you must throw out whatever rules you have learned about the recovery time being only within the first year and after that the effects are permanent. I know firsthand that this is simply untrue. Recovery time will vary widely among people and can last months to many years!
My dad suffered a stroke almost two years ago. It was considered a moderate stroke, with the left side of his brain being impaired. This caused his entire right side of his body to be limp. He had no feeling whatsoever in his right side when he awoke in the hospital. He was unable to speak. He was unable to eat or drink, and a feeding tube was given to him. We were also told he may never be able to walk, talk, or eat again. But after a few days, he moved his toes, and after a week, his foot. After a few weeks he moved his fingers the slightest bit and it was the happiest day of our lives. He spent the first month of recovery (after three weeks in the hospital) at a medical rehab, and then a regular rehab for the next few months. He came home for the first time three months after the stroke but only to go back into the hospital and rehab centers 6- 7 more times before he finally came home for good in December, ten long months after his stroke. Since then his medical issues have improved and he has been able to participate in more rigorous therapy sessions. This has helped his speech immensely, and his strength has doubled. It has been almost two years, and he is STILL improving every single day. He is now able to walk, he eats like a champ, his speech is slowly but steadily improving week after week, and he has some mobility in his arm (and it is getting stronger) which is truly miraculous.
Perhaps the greatest and most drastic improvements come within the first 6 months to a year, but this does not mean that the recovery ends here. Many patients will slowly get feeling back in their limbs, and make some progression towards their speech within the first few months. It is so important to continue to go to therapy each and every time, because even the slightest improvements are essential toward the entire recovery. They may need physical, occupational, and speech therapy. It will be long and tiring for them. It will take time to adjust to the new lifestyle, and it is very common for stroke patients to become irate or irrationally angry, sad, or even depressed. It is expected and difficult to deal with everything that is going on in their world now. As their loved ones, it is our job to assist them in any way possible--to try to calm their nerves, lend a hand, and make things easier for them. It is quite frustrating for one not to be able to remember how to do even the simplest tasks that we sometimes take for granted. So be sure to help them out, but to promote independence whenever necessary as well.
Therapy is a long and difficult process. But never give up. It can sometimes take years for recovery. However, each day it gets a little bit easier--both for the sufferer and his/her loved ones. Day by day small improvements can be reached, even if it is not visible to you at the time. It might be something as simple as being able to say the word "dog" for the first time, or even being able to follow one or two-step directions.
Therapists will do an evaluation during the first session. This will determine whether or not they are ready to participate in therapy at all. Physical therapists will focus on their strengths and weaknesses in their limbs, their ability to walk or raise their heads and bodies, and their general mobility. Occupational therapists will focus on their limitations, such as an arm or leg that has been affected. They will determine how much mobility they do have in the affected area, and focus on both what they can do and what they can improve on. They will stretch their arms and legs and do short exercises with them to determine their degree of movement. This evaluation will be done periodically to measure improvement. Speech therapists will ask simple questions to determine the severity of the impairment. They may ask the survivor to repeat after them, point to pictures, ask what specific items are used for, repeat sounds, etc. This will all be done to focus on what type of therapy they should focus their future sessions on. Do not worry if your loved one is unable to complete these initial tasks. It just means they must focus on these types of exercises in therapy to regain this awareness.
Dealing with a stroke is difficult. It is not something that will change overnight, and certainly isn't easy. But there is help and there is hope. Your loved one can get better. Your loved one can fight, can be strong, and can recover. It is up to you to be there for them every step of the way, and to never give up.