The Journey From Stroke to Recovery
Recovering After a Stroke
If there’s one thing true about strokes, it’s that they don’t discriminate. Strokes can happen to anyone at any time, regardless of age, sex or health status. According to the American Stroke Association, 800,000 Americans have a stroke every year. It’s the fifth leading cause of death in the U.S. and the number one leading cause of adult disability. This is precisely why it’s so important for everyone to understand the signs of stroke. The faster a stroke is identified and treated, the better chance a patient has of making a full recovery.
But first, it’s important to understand exactly what a stroke is. A stroke is basically a brain attack.
During a stroke, blood flow is cut off to particular areas of the brain, resulting in loss of oxygen to these areas. Individuals may subsequently experience loss or change of function to the areas affected.
“The location of the stroke in the brain, severity of the stroke, and whether an individual receives initial treatment determine the types of deficits,” says Mahesh Ramachandran, MD, chief medical officer, medical director of the stroke program and physiatrist at Northwestern Medicine Marianjoy Rehabilitation Hospital. These deficits may include muscle weakness or paralysis, sensory loss, and changes in swallowing, speech, language and/or cognition.
Types of Stroke
There are two kinds of stroke: hemorrhagic and ischemic. Hemorrhagic strokes make up only 13% of strokes but are responsible for about 40% of all stroke deaths. This type of stroke happens when a brain aneurysm bursts or when a weakened blood vessel leaks. Blood spills into or around the brain and creates swelling and pressure, damaging cells and tissue in the brain.
An ischemic stroke happens when a blood vessel carrying blood to the brain is blocked by a blood clot. This makes it impossible for blood to reach the brain, resulting in stroke.
Although ischemic and hemorrhagic strokes differ in cause, they both require an individual to do some type of rehabilitation to regain as much function as possible. “Our goal is for patients to progress to the best of their abilities,” says Dr. Ramachandran. “We also want them to return home to their original settings.” To accomplish this, a multidisciplinary team approach can target specific areas, such as the ability to walk and talk, or cognitive functions.
The Road to Rehabilitation
“When a patient who has had a stroke first comes to Marianjoy Rehabilitation Hospital, they have just experienced a life-altering event. They don’t know what the future holds,” says Dr. Ramachandran. “As the team starts working with them, one of the most important things they can give is hope — and returning them to the highest level of function.”
Stroke rehabilitation includes a mix of many different therapies, including physical, occupational and speech therapies. The charge is led by a team of physicians, surgeons, nurses, case managers, therapists, speech pathologists, registered dietitians and psychologists who work together to develop a care plan.
The care plan is influenced by factors such as the patient’s current level of function, overall health and the goals of both the patient and the patient’s family.
Stroke rehabilitation helps individuals recover or compensate for functions lost as the result of a stroke. Therapists help patients perform increasingly difficult tasks in an effort to retrain the brain and regain function.
For some patients, rehabilitation includes both inpatient and outpatient therapy, and it always includes nutrition and stroke prevention education. The amount of time it takes a patient to recover is unique to the individual.
Dr. Ramachandran adds that as patients start to improve on a day-to-day basis, they can see their teams' initial predictions come to fruition. “With help from a dedicated therapy team, the results and functional outcomes can be incredible, and that’s what we strive for with each patient.”
Although some individuals recover function immediately, others slowly regain function over time. This is why a strong support system is important in a patient's recovery after stroke.
A Family Affair
Following the stroke, family members may need to assume the patient’s responsibilities for a period of time, including taking care of the finances, grocery shopping, laundry and other household tasks. They may find themselves in more of a caregiver role.
For this reason, the rehabilitation team works closely with families to keep them involved throughout the entire journey. “Education for the families is equally paramount,” says Dr. Ramachandran. “This gives them a knowledge base to understand the needs of the patient. They also have an opportunity to ask questions and have hands-on training.”
It’s important to remember stroke recovery doesn’t only happen during the first couple months of rehabilitation. Recovery can be a lifelong process and often requires the loving care and support of family and friends.
“Stroke recovery doesn’t just happen in a hospital or a rehabilitation setting,” explains Dr. Ramachandran. “It’s a lifetime of continued care.” He notes that outpatient programs, the Aphasia Center and clinics are essential in order to help maximize a patient's functional potential.
Recovering individuals may develop depression, anxiety or other psychological disorders. Therefore, it’s also important to connect them with professional help to find coping strategies, such as meditation.
Eighty percent of strokes are preventable. Some risk factors you cannot control, such as heredity and sex: Women are more likely to experience stroke than men. However, taking small steps toward improving your health and learning the warning signs can go a long way in preventing stroke and improving recovery.