A stroke is an emergency, and it is best to start treatment as soon as possible. However, what occurs over the days, weeks, and months following a stroke?
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Gaining an understanding of the stroke recovery timeline may be beneficial, even if everyone’s road to recovery is unique. This will help you and your loved ones be prepared for what comes next after a stroke.
Day 1: First Course of Therapy
In order to stabilize your health and identify the type of stroke you have, you will probably be admitted to an emergency room at the beginning of the stroke. If you receive treatment for your ischemic stroke in a timely manner, clot-busting medicine may help lessen its long-term consequences.
You might need to stay in acute care or intensive care for a while, depending on how severe the stroke was.
According to Raghavan, “the key to stroke recovery is initiating rehabilitation as soon as possible after the cause of the stroke is treated.” “Rehabilitation at Johns Hopkins begins about 24 hours following a stroke.”
Speech-language pathologists, nurses, physiatrists, neurologists, physical and occupational therapists, and others make up the rehabilitation team. They have daily meetings to talk about the patient’s health, and during the first day or two, treatment sessions can take place up to once an hour.
The Initial Weeks Following a Stroke
After a stroke, a patient typically stays in the hospital for five to seven days. The rehabilitation strategy will be decided upon by the stroke care team once they have assessed the stroke’s consequences.
Depending on the extent of the stroke and the part of the brain damaged, each person will have different long-term repercussions. Some examples of these impacts include:
cognitive symptoms, such as difficulties speaking and remembering
Physical signs such paralysis, weakness, and trouble swallowing
emotional manifestations such as impulsivity and depression
extreme exhaustion and difficulty sleeping
Physical and occupational therapy can assist in identifying the brain regions that are impacted by helping a patient do different activities, such as walking or combing their hair. For individuals who have swallowing difficulties as a result of a stroke or the aftereffects of a breathing tube, speech-language therapy is crucial.
While the patient is in the hospital, therapy sessions can last up to six times a day, which aids in assessing the extent of the stroke’s damage and expediting the healing process.
Priorities for Stroke Rehabilitation
Following a stroke, the focus of rehabilitation shifts to activities of daily living (ADL). ADLs usually involve things like taking a shower or making meals. To help you define your recovery objectives, you should also discuss with your care team the things that are important to you, such engaging in a hobby or using a skill that is connected to your line of work. Even while treatment is essential, practicing alone is just as necessary.
A stroke can seriously impair a patient’s and caregiver’s cognitive and emotional functioning in addition to impacting ADL. Neuropsychologists and rehabilitation psychologists can assess for these sorts of issues and devise a strategy to strengthen cognitive function and build resilience against potentially irreversible lifestyle changes.
Releasing a Stroke Victim from the Hospital
The discharge plan that your care team creates will be based on how much functional impairment you have. Following your hospital stay, you may carry out further rehabilitation:
If you can benefit from medical supervision and can endure three hours of therapy each day, you may be able to get treatment in an inpatient rehabilitation unit or independent rehabilitation center.
If you need a slower rehabilitation course with one to two hours of treatment each day, you can receive it at a subacute rehabilitation center.
at home with sporadic trips to an outpatient rehabilitation facility
After a stroke, “you don’t have to be at 100% health to return home,” adds Raghavan. “You can return home if you are able to complete the majority of your everyday tasks in your home setting and/or if your family is there to help with these tasks.”
1-3 Months After a Stroke
According to Raghavan, “patients will see the most improvement and recovery during the first three months following a stroke.” Most patients will either start and finish an inpatient rehabilitation program at this period, or they will continue to improve in their outpatient therapy sessions.
Restoring function to pre-stroke levels or creating compensatory techniques to get around a functional impairment are the two main objectives of rehabilitation. Learning how to hold a toothpaste tube so the strong hand can unscrew the cap is an example of a compensating approach.
Intelligent Recuperation
A patient may encounter a phenomena known as spontaneous recovery in the first three months following a stroke; this is when a skill or ability that appeared to be gone due to the stroke reappears out of nowhere as the brain discovers new methods to carry out activities.
Preparing for Obstacles
In the months following a stroke, some individuals may encounter complications such as pneumonia, a heart attack, or another stroke. These difficulties may have major psychological, emotional, and physical implications, necessitating a delay in rehabilitation. When there are setbacks in your recovery, it’s critical to collaborate with your care team to modify your goals.
Investigating Novel Therapies
Although speech, occupational, and physical therapy continue to be the mainstays of stroke rehabilitation, scientists are constantly developing innovative strategies to improve or augment existing therapies. Noninvasive brain stimulation (NIBS), which employs mild electrical currents to activate brain regions linked to certain functions like speech or movement, is one cutting-edge method. This stimulation may enhance the therapeutic benefits. Using an injectable enzyme, a novel therapy for spasticity and muscular stiffness that does not result in muscle weakening is another advance. Furthermore, technology-assisted therapy can increase recovery by engagingly focusing on particular behaviors or procedures.
The Halfway Point and Up
Although significantly slower, gains are still possible after six months. At this phase, the majority of stroke patients achieve a rather stable condition. This entails a full recovery for some. Some will experience persistent disability, commonly known as chronic stroke illness. The degree of the stroke, the speed at which the first therapy was administered, and the kind and extent of rehabilitation all affect the likelihood of a full recovery.
It is essential to maintain following up with members of your care team even while recovery does slow down. This includes:
Your primary care physician, who can assist you with managing any post-stroke health issues and taking preventative measures against more strokes
A physiatrist (rehabilitation doctor) who can help plan the many components of your recovery and continue to see you for as long as you require assistance, for as little as a few years or as long as the rest of your life
Physical, occupational, and speech therapists can assist you with regaining as much function as you can in daily tasks while concentrating on your individual objectives.
A neurologist, who is knowledgeable with the processes behind brain damage caused by stroke and who can recommend specialized therapies that specifically target the damaged brain region
A rehabilitation psychologist can support an individual’s recovery by assisting with their cognitive, emotional, and behavioral functioning as well as their reintegration into the society.
Physiatrist Raghavan adds, “I try to support patients any way I can” during examinations. “We’ll make a plan if there’s any way I can help them minimize fall risk, build muscle tone, improve sleep patterns, get back to work, or address psychological needs.”
Months or years down the road, more growth might be facilitated by a coordinated effort across professionals. Even though some patients may need more time to improve, even modest progress is still possible. According to Raghavan, “I think it’s important to paint a picture of hope in stroke.” “For the patient, every time they require less help to complete a task, that is a milestone.”