Stroke Rehabilitation

What is a stroke?
Most strokes happen when blood can't reach a part of your brain. When blood flow to the brain stops, brain cells in that part of the brain may die. Your brain controls how you move, feel, think and behave. A stroke may damage any of these functions.

What are some of the effects of a stroke?
The following are the most common effects of stroke:

• Weakness or paralysis on one side of the body
• Problems with speech and language
• Poor balance or clumsy movement
• Not knowing what happens on one side of the body
• Trouble swallowing
• Problems with bladder or bowel control
• Problems with memory, thinking or problem solving
• Poor vision and/or changes in vision
• Numbness
• Problems getting around and caring for yourself
  

What is stroke rehabilitation?
Stroke rehabilitation is a very important part of recovery for many people who have had a stroke. It helps build your strength, coordination, endurance and confidence. In stroke rehabilitation, you may learn how to move, talk, think and care for yourself. The goal of stroke rehabilitation is to help you learn how to do things that you did before the stroke.
Your doctor will be able to determine whether you need stroke rehabilitation and, if so, what kind of rehabilitation would help you. Most people who have had a stroke do get better. How fast and how much you improve depends on how severe your stroke was. Rehabilitation can begin right after the stroke is over and your condition is stable. Some improvements occur by themselves as the brain is healing.

After I have had a stroke, am I more likely to have another one?
Yes. People who have had a stroke are at increased risk of having another stroke, especially during the first year after the first stroke.

What can be done to reduce my risk of another stroke?
Your risk of having another stroke is higher if you are older, if you smoke cigarettes or if you drink a lot of alcohol. The risk is also increased if you have high blood pressure, high cholesterol, diabetes or are obese. Your risk is also increased if you have heart failure or a transient ischemic
attack (sometimes called a TIA or a mini-stroke) .

Ways to reduce your risk of having another stroke:

• Have regular check-ups. Your doctor can work with you to improve your health.
• If you are a smoker, stop smoking.
• Reduce the amount of alcohol you drink.
• Control your blood pressure.
• Control your cholesterol levels
• If you have diabetes, control your blood sugar level.
• Enjoy regular physical activity.
  

What about depression after a stroke?
Emotional changes may occur from stroke because of brain injury and loss of function. After a stroke, your moods may go up and down more quickly than before, or you may become depressed. You may suddenly start crying and then quickly stop, or you may start laughing for no reason.
Soon after the stroke, you may find it difficult to control your emotions. Usually this gets better over time. It is understandable if you feel depressed, sad or frustrated. These feelings are a part of getting used to the changes brought on by the stroke. Emotional reactions and depression are
common after a stroke, but they can be treated. Talk to your doctor about being depressed and sad.

What about driving a car again after a stroke?
Driving gives a feeling of independence, and you may want to drive after your stroke. However, a stroke can affect your mobility, vision, thinking and communication skills. Your reaction time may also be slowed. Think carefully about how these changes may affect your own safety and the safety of others. Your doctor can help you decide when and if it is safe for you to drive after the stroke.
Call your state department of motor vehicles and ask what rules apply to people who have had a stroke. You may receive a driver assessment, classroom instruction and suggestions for modifying your vehicle. Driver training programs are often available through rehabilitation centers.
If you can't drive, try to take comfort in the fact that you have made the responsible choice for your safety and the safety of others. There are other forms of transportation, including public transportation, specialized vans, taxis and rides from friends and family. Check on community resources, such as senior citizen groups and local volunteer agencies.

What can relatives do to help their loved one recover from a stroke?
If you are a relative of someone who has had a stroke, you should encourage and support him or her. Visit your loved one in the hospital or rehabilitation center. If he or she has trouble talking, ask the speech therapist how you can help. You can relax with your family member by playing cards, watching television, listening to the radio or playing a board game together.
Some places offer classes for stroke survivors and their families. Ask if you can go to some rehabilitation sessions. This is a good way to learn how rehabilitation works and how to help your loved one get better. Encourage and help your family member practice the skills learned in
rehabilitation. Make sure that the rehabilitation staff suggest activities that fit your loved one's needs and interests. Find out what he or she can do alone, what he or she can do with help, and what he or she can't do at all. Avoid doing things for your family member that he or she is able to do alone. Confidence will grow with each task he or she does without help. Ask your loved one's doctor and the rehabilitation staff to meet with you and your family so that everyone can ask questions and find out how your loved one is doing. In addition, take care of yourself by eating well, getting enough rest and taking time to do things that you enjoy.
(AAFP)