Strokes are sudden, often unpredictable, and dramatic in their impact. Not only do they steal from a person some or many of their normal basic functions and abilities, but they greatly affect their daily life and well-being, and have significant effects on their families and caregivers.
Fortunately, after decades of research and progress, our treatments can limit, reverse and, in some cases, almost reverse the disability caused by stroke soon after it occurs. Similar advances could prevent strokes in those most at risk, particularly those who have already had a stroke or a transient ischemic attack (TIA).
Unfortunately, once a stroke and the resulting brain damage has occurred, treating or improving the neurological deficit is difficult. Until future breakthroughs come, we have many ways to understand, overcome, and alleviate the pain and suffering of stroke.
Here are nine common complications of stroke and how to deal with them.
1. Effects of stroke on the brain
Most people have some residual neurological deficiencies after a stroke, which can range from inconvenience to severe disability. After a stroke, time to think and process information may be slower, concentration may be impaired, and some basic acquired skills may be lost, slowed down, or impaired.
The functions the brain uses to process information include:
- spatial awareness
- Routine skills
Rehabilitation can help overcome some of these deficiencies, through focus, exercise, repetition, and training. Unfortunately, large and multiple strokes may eventually lead to vascular dementia.
2. Will speech return after a stroke?
Speech problems are common after a stroke, including:
- Speech impairment caused by weakness or coordination (dysarthria or slurred speech)
- Impaired speech interpretation or production (aphasia)
These deficiencies may also affect your ability to write or understand what is written. Rehabilitation with a speech pathologist is very helpful in identifying problems and learning exercises to overcome them.
3. Vision loss or eye problems
When the areas of the brain responsible for processing vision are damaged by a stroke, there may be vision loss on one side or the other, or in rare cases, total blindness. Vision loss may affect routine activities, such as driving or walking. After a stroke, we determine the extent of vision problems to avoid affected activities and use rehabilitation to safely overcome these limitations.
4. How to walk after a stroke
More than half of people after a stroke have some degree of weakness, usually on one side. Others may only have balance and coordination problems that can be isolated or additive to the weakness. These disabilities can partially or significantly affect their ability to walk or move within their homes. Some will, unfortunately, be limited to living in a skilled nursing facility.
Rehabilitation can be helped by significant muscle strengthening and balance, along with the use of equipment or supportive equipment.
5. Swallowing and eating after a stroke
Strokes can interfere with muscle coordination and eating movements. Dysphagia occurs when the mouth and esophagus allow food to enter the windpipe and lungs. The resulting irritation and inflammation (pneumonia) can be devastating.
Rehabilitation with a speech pathologist can help examine these limitations, improve them through techniques, and identify those who are significantly impaired should not eat or drink through their mouths. Until a full evaluation is done, you may initially have a feeding tube through the nose. If necessary, a percutaneous gastrostomy or PEG is placed to allow safe feeding. This is often reversed and stopped once swallowing abilities have been restored over time.
Swallowing problems after a stroke may lead to nutritional deficiencies. A healthy diet provides the nutrients needed to rebuild muscles, joints, tissues, and the brain.
A diet similar to the Mediterranean and rich in fruits, vegetables, nuts, olive oil, and seafood is the best logical recommendation.
- Eat fresh fruits and vegetables to get essential vitamins and minerals
- Reduce salt in your diet to lower blood pressure, especially if you have high blood pressure
- Increase complex carbohydrates to manage diabetes and prediabetes (and reduce simple carbohydrates)
- Reducing fats, especially saturated ones, to reduce the possibility of atherosclerosis or narrowing of the arteries.
6. Back to having sex
Having a stroke doesn’t mean you should forget about sex. Many intimate stroke survivors fear that they will have another stroke.
Some men may develop erectile dysfunction, which medications can treat. Likewise, omitting some medications may reverse the loss of libido (reduced sex drive).
Everyone is different, and the way each stroke affects a person is unique. Be open about your concerns and concerns with your doctor or provider – they can help you get an objective view and decide how to move forward.
7. Driving after a stroke
Leadership is very beneficial for independence and participation in social activities. After a stroke, many people are eager to get back to driving as soon as possible.
However, driving with a weakened nervous system puts the driver and other drivers on the road at risk of accidents that can be fatal or disabling. Before returning to driving, your physician should perform a formal evaluation of visual, cognitive, and reflex impairment.
8. Seamless or leakage
The extent and location of the stroke can affect the brain’s control of the bladder and intestines, causing incontinence. This can be embarrassing for patients and their families and isolate them. Fortunately, incontinence can be treated with medication, exercise, and incontinence products.
9. Emotions and mental health
Strokes can cause or make anxiety and fear worse. About 20% to 30% of stroke survivors have depression, which is routinely screened and treated. It is often transient over the next two years. Rarely, other psychiatric conditions may occur or be detected with a stroke. In addition to medication and therapy, the support of family and friends is essential for mental health.
The emotional health of caregivers is also important. Caring for patients with stroke and significant disability can be challenging and stressful for a caregiver’s patience, endurance, and emotions. Avoiding frustration, fatigue, and anger while managing one’s own feelings and well-being helps not only the caregiver, but the patient as well.
How to prevent another stroke
Patients who have had a stroke or TIA are most likely to have another stroke. Initiating a stroke prevention strategy soon after the first stroke is critical to preventing additional disability. Fortunately, we have many ways to control the risk factors for high blood pressure, diabetes, and high cholesterol, as well as using medications to thin the blood gently or forcefully. Surgery or interventions can also help some at-risk patients. We tailor treatments to each individual’s needs and ensure that treatment goals are achieved through close follow-up.
How long does it take to recover from a stroke?
How much recovery is expected and how long it will take are difficult questions to answer. Because strokes affect different parts of the brain, recovery depends on the nature and extent of the disability, age, pre-stroke baseline, and other medical conditions.
The general rule is that the fastest and greatest recovery will occur during the first three months, then slow down a bit over the next six months, and become more subtle and slower after that, although it may continue over the next year or two or more. Early, more thoughtful, robust and comprehensive rehabilitation is essential to identify defects and disabilities and help improve and speed up early recovery.
After a stroke, family and social support is critical in helping a patient navigate the post-stroke cycle, overcome deficiencies and disabilities, break isolation, and return to their environment.