So the universe's roll of the dice gave you a stroke. To be fair, many of us are aware of the omissions, commissions and habits that resulted in our strokes. You may also be one of the unfortunate few (2 in 10 actually) that got a cryptogenic stroke, i.e. a stroke caused by an undetermined origin due to two or more causes being identified, negative evaluation, or incomplete evaluation.
Well, regardless of the what caused the stroke, you are here probably because you already had a stroke or know and are or intend to help someone who has a stroke (God bless your soul). Here are some essentials to know and act upon after a stroke. In the Malaysian context, I hope that you will find the information in this post, Having A Game Plan, extremely helpful as well.
Where Did The Stroke Occur
Ask your doctor about the location of your stroke. The location of your stroke will have a significant impact on your side effects and recovery process.
Typically, right-side strokes result in very different side effects than left-side strokes. Understanding which part of the brain was affected by stroke can help you anticipate and make sense of the side effects that you experience. (For example, if you had a left-side stroke and your language center was damaged, it may result in a language disorder known as aphasia.)How Large Was The Stroke
The size of your stroke has a significant impact on you recovery.
Strokes happen in a wide spectrum of sizes. Some stroke patients sustain TIA’s, which are ‘mini strokes’ and often result in mild/moderate side effects. Some patients recover in 6 months or a few years.
Other stroke patients sustain massive strokes, which result in severe side effects that require intensive rehabilitation to treat. Some patients take decades to recover from massive stroke. By asking your doctor the size and location of your stroke, you’ll have a good sense of what to expect on the road to recovery.Everybody's Side Effect Is Different
Every stroke is different because stroke can happen in different areas of the brain. Since each part of the brain controls a different function, each stroke can cause different impairments.
Unfortunately, this can make it difficult for medical professionals to provide or prescribe the ‘perfect’ rehab treatment because there are so many different variables – known and unknown – to consider for each patients.
That’s why it’s important to avoid comparing your recovery to someone else’s. You might heal faster than some and slower than others. Try not to bog yourself down with comparison and instead focus on the next step in front of you.Recovery Is Always Possible - Even Decades Later
There is plenty of evidence, both anecdotal and research based, that shows that recovery is possible even years after a stroke. Neuroplasticity doesn't just activate during traumatic brain injury (TBI) like a stroke, although it may be more active immediately after a TBI, but remains active throughout our lives.Repetition Is Our Friend
Repetition is the #1 driver of success during stroke recovery because repetition helps activate neuroplasticity, the mechanism that your brain uses to rewire itself and form new connections. The more you practice something, the stronger the connections in your brain become.Being Consistent
While there is no magic pill (although there has been some promising results with the off label use of Perispinal Etanercept) for stroke recovery, you can speed up your results by being consistent with your rehabilitation.
When the brain has consistent stimulation daily practice (or practice every other day), you will reinforce and strengthen the new connections in your brain faster, which will help you see faster results.Use It Or Lose It
During stroke recovery, the phrase “use it or lose it” is commonly used by therapists to describe the clinical condition of learned non-use. Learned non-use occurs when you completely stop using your affected limb, and after a while your brain literally forgets how to use it.
The best way to avoid learned non-use is to move your affected limbs at least a little bit every day. Even passive range of motion (assisting your affected muscles through their full range of motion) helps.
You also need to address the root cause of muscle spasticity, which is brain-muscle communication. When stroke disrupts your brain’s ability to communicate with your muscles, they tense up in order to protect themselves.
Therefore, the way to permanently treat spasticity is by reconnecting your mind to your muscles with rehab exercise. By activating neuroplasticity, your brain will regain control over your spastic muscles – and they will relax.Plateaus = Double Down
During stroke recovery, you will experience the fastest results during the first few months of recovery when your brain is in a heightened state of plasticity (meaning, your brain is trying really hard to recover). But after the first 3 months, your progress starts to slow down.
This is considered a plateau, and it is not a sign that you should give up. Rather, it’s a sign that you need to double down. Recovery won’t stop as long as you don’t stop.Exercising Too Much?
Exercising after stroke in order to regain movement is all well and good and highly encouraged. But don’t over-do it.
You know your body best, and if you feel like you’re pushing too hard, then ease up. Take a day o . Get some sleep. Then get back at it.Sleep - Lots Of It
While making up only a small fraction of our total body mass, the brain represents the largest source of energy consumption—accounting for over 20% of total oxygen metabolism. Of this, it is estimated that neurons consume 75%–80% of energy produced in the brain (Hyder et al., 2013)
A lot of stroke patients are startled by how much sleep they crave after stroke. Rest assured that sleeping a lot after stroke is perfectly normal.
Your brain is hard at work healing itself right now, and that sucks up a lot of energy.
Plus, everyday activities might take up more energy than normal, so you need to allow yourself to get extra rest to re-energize and heal.Become An Advocate
Apart from changing your expectations and learning how to empower a stroke survivor or learning to assert and empower yourself if you are the survivor, start reading and researching all things stroke recovery so that you know what’s in your own best interest.
Your doctors and therapists can only take you so far. Once you’re discharged or cut o insurance, your recovery is in your hands. You’ve got this!
To quote Tracy Chan, the chief physiotherapist at the National Stroke Association of Malaysia,
'If we can empower stroke survivors to have a voice, they can become the most powerful advocates of stroke prevention. These stroke survivors can raise their voices in advocating for better healthcare, rehabilitation and prevention. Raising awareness about stroke can help in better management of stroke in Malaysia and facilitate the goals of universal healthcare for all."