Stroke Survivors: Living And Thriving After A Stroke

A stroke is a brain injury that occurs when the brain tissue is deprived of oxygen and nutrients due to interrupted blood flow to the brain. This can be caused by blood clots or broken blood vessels. The effects of a stroke vary from person to person and can range from physical, such as weakness or paralysis, to mental, like memory problems and depression, and emotional, such as anxiety and mood swings. The recovery process is different for everyone and can take anywhere from days to years. It involves rehabilitation to improve or restore speech, cognitive, motor, and sensory skills. The first three months after a stroke are the most crucial for recovery, and patients may experience setbacks or spontaneous recovery during this time.

Can a stroke patient recover?

The impact of a stroke varies from person to person, and the road to recovery is different for everyone. However, with the right treatment and rehabilitation, it is possible for stroke patients to recover and regain their independence.

The Recovery Timeline

The recovery process should begin as early as possible after a stroke to increase the chances of regaining lost functions. The first three months are critical, with most improvements occurring during this period as the brain actively tries to repair itself. The patient may experience spontaneous recovery, where lost skills suddenly return as the brain finds new ways to perform tasks. However, it's important to note that some people may never fully recover, and the recovery process can take weeks, months, or even years.

Factors Affecting Recovery

The severity of the stroke, the area of the brain affected, the patient's age, and their overall health before the stroke are all factors that influence recovery. Additionally, the quality and quantity of rehabilitation, caregiver support, and the patient's motivation can impact the recovery process.

Rehabilitation Options

Rehabilitation typically focuses on improving Activities of Daily Living (ADL), such as bathing and preparing food. Physical and occupational therapy can help determine the affected areas of the brain and address physical symptoms like weakness, paralysis, and difficulty with movement and coordination. Speech-language therapy is crucial for patients with speech and swallowing difficulties. Cognitive behavioural therapy (CBT) can address anxiety, depression, and tiredness, while cognitive rehabilitation helps improve memory, concentration, thinking, and mood.

Post-Stroke Challenges

Post-stroke depression is common, affecting 30-50% of stroke survivors. It's important to monitor changes in attitude and behaviour and seek professional help if needed. Additionally, survivors are at high risk of having another stroke, so maintaining a healthy lifestyle, taking prescribed medications, and regular check-ups with a healthcare provider are crucial.

What are the risk factors for another stroke?

There are several risk factors for another stroke, some of which are controllable, and some are not. Uncontrollable risk factors include age, family history and genetics, and race and ethnicity. The risk of stroke increases as people grow older, especially for adults over 65, and babies under 1. If a parent or other family member has had a stroke, your risk is higher, especially if they were young. Certain genes also affect stroke risk, including those that determine blood type—people with blood type AB have a higher risk. In the United States, stroke occurs more frequently in Black, Alaska Native, American Indian, and Hispanic adults than in white adults.

Controllable risk factors include lifestyle, environment, and other medical conditions. Unhealthy lifestyle habits that increase the risk of stroke include drinking too much alcohol, getting too much sleep (more than 9 hours), and using illegal drugs such as cocaine. Living or working in areas with air pollution can also increase the risk of stroke. Other medical conditions that increase the risk of stroke include sleep apnea, kidney disease, and migraine headaches.

High blood pressure (hypertension) is a major risk factor for stroke, as it can lead to a blocked blood vessel or bleeding in the brain. High cholesterol (hyperlipidemia) and Type 2 diabetes are also risk factors, as they can contribute to blocked blood vessels. Ischemic strokes, caused by blocked blood vessels, are the most common type, accounting for about 80% of all strokes.

Anxiety, depression, and high stress levels can also increase the risk of stroke, as can a lack of social connection and long working hours. It is important to manage these risk factors and make healthy lifestyle choices to lower the risk of stroke.

What are the signs of a stroke?

A stroke is a life-threatening medical emergency that requires immediate attention. It occurs when there is an issue with blood flow to the brain, such as blocked blood vessels or bleeding in the brain. Knowing the signs of a stroke is crucial as it can help prevent permanent damage or even death.

One of the most well-known methods for identifying a stroke is the BE FAST method:

• Balance: Be watchful for a sudden loss of balance.
• Eyes: Look out for a sudden loss of vision or double vision in one or both eyes.
• Face: Ask the person to smile and look for a droop on one or both sides of their face, indicating muscle weakness or paralysis.
• Arms: Ask the person to raise their arms. If they have one-sided weakness, one arm will stay higher while the other will sag.
• Speech: Strokes often cause difficulty in speaking, such as slurred speech or trouble choosing the right words.
• Time: Time is critical. If you observe any of the above signs, immediately call emergency services and note the time the symptoms started, as this information will help healthcare providers determine the best treatment options.

In addition to the BE FAST method, other signs and symptoms of a stroke may include:

• Weakness or numbness, usually on one side of the body.
• Problems with movement or walking.
• Dizziness or vertigo.
• Loss of coordination or clumsiness (ataxia).
• Nausea and vomiting.
• Emotional instability and personality changes.
• Confusion or agitation.
• Memory loss.
• Severe headaches, especially if sudden.
• Fainting or loss of consciousness.
• Seizures.
• Brief loss or change of consciousness, such as confusion, coma, or transient ischemic attack (TIA), also known as a "mini-stroke."

If you or someone you know is exhibiting any of these signs, it is crucial to act quickly and seek medical attention immediately.

How is a stroke treated?

Stroke treatment depends on the type of stroke and how soon the patient receives treatment. Immediate medical attention is critical to prevent permanent damage or death. Calling emergency services is the first step in getting treatment for a stroke.

Ischemic Stroke Treatment

Ischemic strokes are caused by blocked blood vessels in the brain, cutting off blood flow. Treatment for this type of stroke focuses on restoring circulation to the affected areas of the brain. This can be done through medication, such as thrombolytics, or a catheterization procedure called a thrombectomy. Thrombolytics, or "clot-busting" drugs, must be administered within three to four and a half hours of the onset of symptoms to be effective and improve the chances of recovery.

Hemorrhagic Stroke Treatment

Hemorrhagic strokes are caused by bleeding in or around the brain due to a ruptured or leaking blood vessel. Treatment for this type of stroke depends on the location and severity of the bleeding. Reducing blood pressure is often a priority to limit bleeding and allow clotting to seal the damaged blood vessel. Surgery may be necessary to relieve pressure on the brain from accumulated blood and stop the bleeding. Endovascular procedures can help repair weak spots or breaks in blood vessels.

Long-term Treatments

Long-term treatments for stroke occur in the days and months following emergency treatment. These may include blood pressure management, medication or surgery to reduce pressure inside the skull, and rehabilitation to help the patient recover or adapt to changes in their brain. Rehabilitation can include speech therapy, physical therapy, occupational therapy, and cognitive therapy.

What are the complications of having a stroke?

A stroke can cause permanent loss of function. The complications of a stroke depend on the size and location of the stroke, as well as which part of the brain was affected and by how much. A stroke can result in physical and neurological complications that may be minor or major, temporary or permanent.

A small stroke may cause weakness in your arm or leg. Larger strokes can cause paralysis, loss of speech, or even death. Many people who have a stroke are left with paralysis of one arm and have trouble with simple math, such as adding or subtracting.

The most common types of disability after a stroke are changes to speech, learning and understanding, and weakness or paralysis on one side of the body. Other physical changes after a stroke include difficulty with gripping or holding things, fatigue or tiredness, incontinence, pain, restricted physical abilities, and weakness or paralysis of limbs.

Emotional and personality changes are also common after a stroke. Depression is common in the first year, especially in people with aphasia, and anxiety may occur either on its own or with depression. Personality and behavioural changes can include irritability, aggressiveness, apathy, repetitive behaviour, disinhibition, and impulsiveness.

Cognitive changes after a stroke can include changes to thinking, memory, and perception. This may affect how you feel about yourself, your family, and your friends. Changes to perception can include how you see, hear, and feel the world, and can cause you to bump into things.

Other complications of a stroke include urinary tract infections, bowel and bladder problems, mobility problems, difficulty swallowing, difficulty breathing, motor control problems, locked-in syndrome, brain edema, pneumonia, bedsores, limb contractures, shoulder pain, deep vein thrombosis, aphasia, and headaches.

Frequently asked questions