November 17, 2017

Stroke, A Helpful Bit of Information

Recognize the Signs of A Stroke

What is a stroke?

 A Stroke is a disease that affects the arteries leading to and within the brain. 

It is the  No. 5 cause of death and a leading cause of disability in the United States.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). 

When that happens , part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die.

What happens during a stroke?

Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). A TIA (transient ischemic attack), or "mini stroke", is caused by a temporary clot.

What is after care of a stroke?

When discharged from the hospital, if you are sufficiently recovered and have family members who can help you rest and recover at home, you may be able to go directly home.

If your home wasn’t designed to accommodate a stroke survivor, it may need some modifications.  Furniture may need to be moved — or in some cases even removed — so that you have a clear pathway from room to room and even within a room, particularly if you’re using a wheelchair or a walker. Bathrooms and showers may need to be refitted with grab bars on the wall so that you can more easily get up and stand. One study showed that nearly 40% of stroke survivors suffered a serious fall within a year after their strokes occurred.

Your treatment will continue at home.  A physical therapist or other health care professional may come one or more times a week to treat you and to assess your progress.

If your health team determines that your condition still requires extensive therapy, and that home is not a good option at this time, your doctor may send you to a specialized rehabilitation facility where you can continue your recovery until you are sufficiently independent to go home.

Some stroke survivors are so afflicted that they need ongoing nursing care, on a low level basis or even 24/7 so those patients may go from the hospital directly to a nursing home.

Therapies (occupational, speech, physical, more)

Your care team, both in and post hospital may include a Physical Therapist (PT) who helps stroke survivors with problems in moving and balance; suggests exercises to strengthen muscles for walking, standing and other activities.

 An Occupational Therapist (OT) helps stroke survivors learn strategies to manage daily activities such as eating, bathing, dressing, writing or cooking.

 A Speech Therapist (ST) help the stroke patient with the process of speaking more clearly and helping them to be more understood vocally and help the patient get the words that are in the brain to come out the mouth the correct way. 

There may also be a Dietitian who will help with correcting dietary issues and nutrition needs. 

The link above will take you to a workbook that you can print out to help your loved one recover. 

What is Aphasia?

 Aphasia is a communication disorder that results from damage to the parts of the brain that contain language (typically in the left half of the brain). Aphasia is most often caused by stroke. However, any disease or damage to the parts of the brain that control language can cause aphasia. These include brain tumors, traumatic brain injury, and progressive neurological disorders. 

The specific symptoms and severity of aphasia vary depending on the location and extent of brain damage. Individuals with damage to the front part of the brain may have "choppy" or non-fluent speech.

 However, they can typically understand what people say fairly well. Those with damage to the posterior regions of the brain often have fluent speech—that is, the rate and rhythm of speech may sound normal. However, their speech may contain the wrong words or made-up words. They also typically have difficulty understanding what is spoken.

Additionally, all individuals with aphasia may also have one or more of the following problems:
  • Difficulty producing language:
    • Experience difficulty coming up with the words they want to say
    • Substitute the intended word with another word that may be related in meaning to the target (e.g., "chicken" for "fish") or unrelated (e.g., "radio" for "ball")
    • Switch sounds within words (e.g., "wish dasher" for "dishwasher")
    • Use made-up words (e.g., "frigilin" for "hamburger")
    • Have difficulty putting words together to form sentences
    • String together made-up words and real words fluently but without making sense
  • Difficulty understanding language:

    • Misunderstand what others say, especially when they speak fast (e.g., radio or television news) or in long sentences
    • Find it hard to understand speech in background noise or in group situations
    • Misinterpret jokes and take the literal meaning of figurative speech (e.g., "it's raining cats and dogs")
  • Difficulty reading and writing:

    • Difficulty reading forms, pamphlets, books, and other written material
    • Problems spelling and putting words together to write sentences
    • Difficulty understanding number concepts (e.g., telling time, counting money, adding/subtracting)
  1. Get the person's attention before you start speaking.
  2. Maintain eye contact and watch the person’s body language and use of gesture.
  3. Minimize or eliminate background noise (TV, radio, other people).
  4. Keep your voice at a normal level. Do not speak loudly unless the person asks you to do so.
  5. Keep communication simple, but adult. Don't "talk down" to the person with aphasia.
  6. Simplify your sentence structure and emphasize key words. 
  7. Reduce your rate of speech.
  8. Give the individual time to speak. Resist the urge to finish sentences or offer words.
  9. Communicate with drawings, gestures, writing, and facial expressions in addition to speech.
  10. Encourage the person to use drawings, gestures, and writing.
  11. Use "yes" and "no" questions rather than open-ended questions.
  12. Praise all attempts to speak and downplay any errors. Avoid insisting that that each word be produced perfectly.
  13. Engage in normal activities whenever possible. 
  14. Encourage independence and avoid being overprotective.

There is no instant cure or recovery for the stroke patient. It is a long recovery depending on the type of stoke and how the patient was effected. It could be months to years before recovery is done. They may never fully recover. 

To the wife, husband, girlfriend, boyfriend, child, friend of the patient: Please remember you are not alone! There are many of us out here who have had to watch a loved one go through this process. It is hard and you will feel helpless and maybe worthless as you watch them try and try and fail. You may feel powerless. But you are not. You have the power to help them by standing with them and letting them know they are not alone in the recovery process. You can reach out to your loved ones care team and they can help you find a support group or a therapist who can help you through your emotional journey as you help your loved one through theirs. You are not alone.

My Story:

This July someone I love I had a massive seizure and spent 3 weeks in the ICU. After being home for a week he suffered a stroke. He spent another week in ICU in a specialized unit. He was sent home. 6 days later he was readmitted to the hospital for a second stroke and a medication mistake. He has had a long journey and his isnt over. He is still recovering and I am still by his side. It is hard but the days are getting easier as he gets better.