Stroke is one of the most common diseases that is caused by the interruption of blood supply to the brain. The pathophysiology of stroke was already discussed in detail in the previous article. Early management for stroke can minimize the damages and complications caused by stroke. Unfortunately, most people tend to be unfamiliar with the immediate responses to a sudden stroke as well as post-discharge management. This article meant to let you know what you might go throught and what to expect when you first meet stroke.
Treatment for stroke begins in a hospital with "acute care." This first step includes helping the patient survive, preventing another stroke, and taking care of any other medical problems.
Once the patient is discharged from the hospital, there are a few things to take note of so that family members/caregivers are aware of the complications after a stroke.
Depending on the damages caused by the stroke, patients may be presented with:
• Muscle weakness/ hemiparesis
Depending on the location of blood flow interruption in the brain, the patient may lose function and muscle control on one side of the body. For instance, cerebrovascular attacks on the left side of the brain causes muscle weakness to be presented on the right side of the body.
• Impact balance and coordination
This may cause the patient to develop fear of moving or changing positionssuch as sit to stand, standing unsupported, walking etc.
• Problems using language/ aphasia/ dysarthria
A patient with aphasia may have difficulties in speech or writing. The patientmay understand but is not able to express via words. Dysarthria refers to a person who knows the words but has difficult expressing it correctly.
• Being unaware of or ignoring things on one side of the body/ hemineglect
Hemineglect refers to a person neglecting one side of the body. This can be observed when the patient only finishes half his plate of food or utilizes only one side of their limbs and turns mainly towards the unaffected side.
• Pain, numbness, or odd sensations
Altered sensation in the joints and skin affects the prognosis of rehabilitation for the patient.
• Problems with memory, thinking, attention, or learning/ cognitive problems
Patients suffering from a stroke may experience memory loss (long term or short term), difficulties in understanding instructions and problems with orientation.
• Trouble swallowing / dysphagia
Muscle atrophy of the swallowing muscles can be dangerous for the patient as it may cause choking.
• Loss of bowel or bladder control
Bedpans, portable urinals and diapers are necessarily for the patient who has bladder and bowel incontinence. Always check on the skin layer covered with diapers to prevent skin diseases.
• Getting tired very quickly
Cardiovascular and fitness levels are affected greatly after a stroke, thus having rests in between exercises or any form of activity is crucial.
• Sudden bursts of emotion, such as laughing, crying, or anger
Family members/caregivers need to be prepared as these symptoms tend to happen in a stroke survivor. Apart from being understanding and providing emotional support, participating in community activities as well as interacting with other people prove helpful in managing this fluctuation of emotions.
What is needed after a stroke?
Rehabilitation. It is a term that involves a multidisciplinary team such as physical therapy, occupational therapy, speech therapy, recreational therapy, group activities, and patient and family education aid to improve recovery.
A physiotherapist evaluates the problem and current mobility status of the patient and implements a rehabilitation program for the stroke survivor. They provide treatment that is aimed to improve balance, mobility, muscle strength as well as one’s independency level. For example, important functional movements such as bed to wheelchair (vice versa) transfer and bed mobility are emphasized during the beginning of rehabilitation to allow more independency in a stroke survivor.
Reference:
Reviews and Notes: Neurology: Recovering at Home after a Stroke: A Practical Guide for You & Your Family. (1995). Annals of Internal Medicine, 122(8), p.639.