Recovering from stroke
Recovery time after a stroke is different for everyone—it can take weeks, months, or even years. Some people recover fully, but others have long-term or lifelong disabilities. Rehabilitation or in short rehab often begins in the hospital, within a day or two after the stroke. Rehab helps to ease the transition from hospital to home and can help prevent the occurrence of another stroke.
About stroke
Generally, a stroke happens when the blood vessel in the brain is blocked causing insufficient blood flow to the brain cells. When the brain cells do not receive enough nutrients and oxygen, they die off. There are 3 types of stroke:
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Ischemic stroke
Ischemic stroke is the most common type of stroke which is likely caused by high blood cholesterol levels. A cholesterol plaque is formed inside the blood vessels supplying the brain. Over time, the plaque gets bigger and the blood supply to the brain gets clogged or cut off completely.
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Hemorrhagic stroke
Commonly caused by uncontrollably high blood pressure. The blood vessel breaks open and starts bleeding into or around the brain tissues. This can lead to increased pressure buildup within the enclosed skull space, causing damage to the brain. Also, blood surrounding the brain tissue can be a source of irritants can causing the tissues to swell.
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Mini stroke—transient ischemic attack
It happens when the blood flow to the brain is blocked temporarily. It is a milder version of a stroke that does not damage the brain and the symptoms only last for a short amount of time. With that being said, people who experience TIA must receive medical attention as they are at higher risk for future ischemic stroke. Medical treatment should be initiated to prevent a future stroke from happening.
Symptoms of stroke
The common symptoms would be:
Read about First Aid for Stroke.
What to expect after a stroke?
If you have had a stroke, you can make great progress in regaining your independence. However, some problems may continue:
- Paralysis (inability to move some parts of the body), weakness, on one or both sides of the body
- Trouble with cognition, awareness, attention, learning, judgment, and memory
- Problems understanding or forming speech
- Trouble controlling or expressing emotions
- Numbness or strange sensations
- Pain in the hands and feet that worsens with movement and temperature changes
- Trouble with chewing and swallowing
- Problems with bladder and bowel control
- Depression
Medicines after stroke
It will be a great mistake to regard stroke as a one-off event. If you have had a stroke, you are at high risk for another stroke. That’s why it is important to treat the causes of stroke, which includes
- Heart disease
- High blood pressure
- Atrial fibrillation (fast, irregular heartbeat)
- High cholesterol
- Diabetes
Different types of stroke are treated differently.
Treatment for ischemic stroke
Many people who have had a stroke or TIA take 3 medicines or more. That might seem like a lot, but each of them does a different job.
- Blood thinner - reduce the chance of blood clot formation.
- Medicines that lower blood pressure - help prevent the damage to blood vessels caused by high blood pressure. These medicines also help make sure the brain gets all the blood it needs.
- Medicines that lower bad cholesterol levels – reduce the chance of cholesterol plaque formation.
Treatment for hemorrhagic stroke
If the CT scan or MRI shows a hemorrhagic stroke, your doctor might:
- Stop any medicines such as blood thinners or medication that delay clotting.
- Give you medications and/or treatments that reduce brain damage caused by the bleeding.
- Give you medications to lower your blood pressure, if your blood pressure is too high.
- Carry out further tests to figure out the cause of the bleeding.
- Monitor the pressure in your brain to make sure that it doesn't get too high.
Some people are also treated with surgery, depending on the severity of the symptoms and other factors such as other underlying medical conditions. Doctors can do surgery to:
- Remove a collection of blood, if it is pressing down on the brain or causing the brain to swell.
- Stop the bleeding in the brain and fix the blood vessel that is bleeding.
In the long run, physiotherapy is also provided to stroke survivors to help them regain mobility, increase muscle strength and prevent muscle wasting.
Here are just a few examples of how rehabilitation services could help you:
- If you can no longer walk very well, a physical therapist (exercise expert) can show you ways to improve the way you walk. They can also recommend braces, canes, and other devices that might make it easier and more confident for you to walk.
- If you can no longer swallow well, a speech and language therapist can teach you to do exercises that might improve how you swallow. They can also offer tips on how to cope with swallowing problems. For instance, the therapist might suggest you add powders or other ingredients to the liquids you drink, so that they are thick and less likely to go down the wrong way.
- If you can no longer hold your toothbrush to brush your teeth, an occupational therapist can show you new ways of holding your brush, so that you can use it.
- If you are depressed because you had a stroke, a psychiatrist (a doctor who specializes in mental health) can prescribe medicines to treat depression. They can also talk to you about the way you feel about the stroke.
What are the chances of full recovery after a stroke?
The chances of making a full recovery depend on a lot of factors, such as:
- How large was the impact of the stroke
- Which part of the brain was damaged by the stroke
- Age of the person (younger people tend to recover better than older people)
- What other medical problems a person has (such as heart failure or cancer)
- Whether the person was sick before the stroke happened
- How soon was the person treated following the stroke
Scientists used to think that when a part of the brain was damaged, there was no way to recover what was lost. It turns out that is not true. The brain can adapt and recover some functions. The most important thing you can do to help make this happen is to stick with rehab and do all the exercises and therapies your healthcare team recommends. Also, be patient. It takes time to heal and learn new ways to cope, but hard work and patience will pay off.
How can I prevent another stroke?
Other than taking medicines as instructed by your doctor, it is also important to adopt healthy lifestyle habits.
- Have a low salt diet. WHO recommends less than 5 grams (1 teaspoon) of salts per day.
- Lose that extra weight. Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke.
- Stay physically active. Exercise at a moderate intensity at least five days a week. This can be as effortless as taking a walk around your neighbourhood or taking the stairs instead of an elevator.
- Drink alcohol moderately. Strive to have no more than one glass of alcohol a day.
- Quit smoking if you are a smoker. Smoking accelerates clot formation in a couple of different ways.
All in all
Stroke is a serious health issue, and recovery can take a lot of time, effort, and patience. You must take whatever medications are prescribed to you by your doctor, exactly as directed. Do not forget to adopt and maintain good lifestyle habits, as they greatly decrease the risk of getting another stroke.
Medically reviewed by Ashwini Nair, MB BCh BAO.
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References:
- Patient education: Stroke symptoms and diagnosis (Beyond the Basics) - UpToDate. Accessed April 27, 2022. https://www.uptodate.com/contents/stroke-symptoms-and-diagnosis-beyond-the-basics?search=patient%20education%20stroke&source=search_result&selectedTitle=7~150&usage_type=default&display_rank=7
- Patient education: Hemorrhagic stroke (The Basics) - UpToDate. Accessed April 27, 2022. https://www.uptodate.com/contents/hemorrhagic-stroke-the-basics?search=patient%20education%20stroke&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
- Overview of secondary prevention of ischemic stroke - UpToDate. Accessed April 27, 2022. https://www.uptodate.com/contents/overview-of-secondary-prevention-of-ischemic-stroke?search=overview%20of%20secondary%20prevention%20of%20ischemic%20rtoke&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
- 7 things you can do to prevent a stroke. Harvard Health. Published June 1, 2013. Accessed April 27, 2022. https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke
- Patient education: Recovery after stroke (The Basics) - UpToDate. Accessed April 27, 2022. https://www.uptodate.com/contents/recovery-after-stroke-the-basics?search=patient%20education%20stroke&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3#H6591102
- CDC. Treat and Recover from Stroke | cdc.gov. Centres for Disease Control and Prevention. Published April 5, 2022. Accessed April 26, 2022. https://www.cdc.gov/stroke/treatments.htm
