Stroke Rehabilitation: What Is a Stroke?
What is a stroke?
A stroke, also called a "brain attack," occurs when an interruption of blood, oxygen, or sugar supply to the brain results in damage to a portion of the brain. A steady flow of blood to the brain is needed to supply the oxygen and nutrition needed for the brain to function properly. Damage to the brain occurs when something happens to interfere with that flow. The problems experienced by a person who has had a stroke depend on what part of the brain is damaged. Loss of movement on one side of the body, loss of feeling on one side of the body, difficulty with communication, difficulty swallowing, loss of bladder or bowel control, difficulty with coordination, impaired vision, neglect of one side of the body and depression are some of the more common physical problems associated with stroke. However, each stroke is different, and your stroke rehabilitation team will help you understand which of these problems are affecting you or your family member.
Most people who survive a stroke have some degree of function recovery. Some return almost completely to normal, while others have only partial return. The emphasis of stroke rehabilitation should be on doing things without the help of another person, even if that means learning a new way of doing them.
What are the emotional effects of stroke?
Emotionally, strokes can have a profound effect on both persons who have experienced a stroke and their families. After a stroke, you or a loved one may experience fear, anxiety, guilt, anger, resentment and overwhelming feelings of grief. There may be a loss of self-esteem and concerns about sexuality. Family members most often experience extreme anxiety about what the future will bring. There is also a fair amount of grieving that takes place when a family member suffers a stroke, as there is sometimes a significant amount of function loss involved.
What are the three types of stroke?
A thrombotic stroke occurs when an artery is blocked by a clot forming on a deposit (plaque) on the wall of the artery. This can be caused by arteriosclerosis (hardening of the arteries).
An embolic stroke occurs when a piece of clot or one of these plaques breaks off and gets stuck in a smaller part of the artery, cutting off blood flow beyond that point. If the piece is small, the flow of blood may resume and the problem is solved in less than 24 hours. This "mini-stroke" is known as a TIA (transient ischemic attack) and is an early warning sign that medication or surgery may be needed to prevent a more serious stroke.
A hemorrhagic stroke occurs when there is a rupture of a diseased artery in the brain. These ruptures are often caused by high blood pressure, but in some cases an aneurysm (a ballooning or weakening of the wall of the artery) may be involved. Any damage to the brain from a hemorrhagic stroke is caused by a combination of an interruption to the blood supply and a release of neurochemicals that contributes to swelling and the scarring of brain tissue following bleed.
Will I become my "old self" again?
After a stroke, your body does change in ways that will make you different. This is because a stroke is a "brain attack" and the brain controls how you feel, think and move during your daily activities.
How long will it take for me to regain control of daily functions?
During the first six months after a stroke, your physician will be able to determine what "brain function" has been restored. However, you can continue to improve your functional abilities as you become active in daily living skills. Even the most basic functions such as dressing, bathing or eating help increase independence and enhance recovery.
Why do I need stroke rehabilitation?
Rehabilitation is similar to education. It is a process whereby you work with nurses and therapists to regain living skills. These skills will only improve as you continue to practice the techniques and strategies you have learned in rehabilitation. In essence, rehabilitation becomes a model for living.
How long will my rehabilitation last?
Rehabilitation is an ongoing process of life-changing behavior. The compensatory techniques, strategies, and therapeutic programs learned in rehab are intended as life-long behavior modifications to advance or maintain functional levels. Rehabilitation can take place in many settings including in a hospital as an inpatient, in your home or on an outpatient basis at a clinic or hospital.
Why do I need to see so many therapists?
Since the brain controls how we think, feel, move and speak, a stroke can cause changes in any or all of these functions. Some people will have more difficulty moving, standing or walking while others may have more difficulty speaking or understanding. Good Shepherd's stroke rehabilitation team will help you determine what changes have occurred since your stroke and will design a personalized plan. Your stroke rehab team will work with you to assess the deficits caused by your stroke, establish goals in a rehabilitation program and help you reach those goals.
My husband had a stroke and has had a personality change. Is this normal?
It's common for patients to experience some personality changes as a result of a stroke. Therefore, they may react differently to things that happen. For example, people may cry very easily, which may not have been part of their personality before. This can be very upsetting to family members who do not know how to cope with these behaviors.
Changes in function and ability can affect a wide variety of social roles (parent, wage earner, drivers, etc.) and alter relationships within the family. Effective rehabilitation also addresses these issues as they evolve over time. Good Shepherd's experience and research on stroke outcomes has shown that issues of psychological and social adjustment after stroke are often the most important factors in determining level of function and quality of life.