Life After Stroke: What to Expect

If you or a loved one has experienced a stroke, you know what an eye-opening experience it can be. While your recovery in the first few days will be focused on getting you back on your feet to be discharged from the hospital, you may be wondering what life outside the hospital is going to look like now.

Every year, more than 795,000 people in the United States have a stroke, according to the American Heart Association. More than 75% of these strokes are first or new strokes, but nearly 1 in 4 people will have another stroke, so your goal after leaving the hospital will be preventing another from occurring.

“In the first few weeks, your care teams are evaluating and trying to find the underlying cause for the stroke, then coming up with a treatment plan and determining rehabilitation,” says Yamini Chennu, M.D., a neurologist and physician on the medical staff at Texas Health Fort Worth.

Common physical, cognitive and emotional changes someone can anticipate after stroke include:

  • Memory problems, poor attention, difficulty solving problems
  • Visual disturbance
  • Speech difficulties including understanding speech, difficulties with reading, writing and saying what they want to say
  • Weakness, paralysis and problems with balance or coordination
  • Pain, numbness or burning and tingling sensations
  • Swallowing difficulties
  • Inattention to one side of the body, difficulty recognizing their own deficits, difficulty recognizing limitations caused by stroke
  • Fatigue
  • Bowel and bladder incontinence
  • Falls
  • Depression
  • Impaired sexual function

 

Road to Recovery

The first three months after a stroke are the most important for recovery and are also when you will see the most improvement. During this period, most patients enter and complete what is referred to as stroke and brain rehabilitation, since stroke is considered a brain injury.

Therapy for stroke and brain injury is performed by a multi-disciplinary team that consists of physical, occupational and speech therapists. These specialists work in a one-on-one setting to address functional, cognitive and physical deficits. Treatments may include balance and strength training, use of new adaptive equipment, cognitive, language or swallowing training along with education to minimize the risk of future stroke and brain injury. Everything is geared toward the goal of regaining independence in both the home and community setting.

However, many stroke survivors still struggle with adjusting to their “new normal” even with rehabilitation.

“Positive social support can have a significant impact on the physical and physiological wellbeing of patients with stroke,” says Chennu. “Family members, particularly spouses, can provide important social support. Family acceptance and support can help issues related to self-esteem and self-image after disability, and positive attitudes and reinforcement from loved ones often help stroke survivors work toward recovery.

“Family participation, flexibility and open communication can overcome any barriers associated with disability,” Chennu continues.

Although the brain has suffered injury due to stroke and life may look quite different, the changes experienced after one can improve with rehabilitation and time. Additionally, medication, counseling or a combination of the two may be most effective in battling depression, anxiety and other mood changes after a stroke, according to the National Stroke Association (NSA).

The NSA recommends tackling behavioral and emotional changes as soon as possible after the stroke, working with the patient’s care team. It also suggests the following practical tips:

  • Try to remain active and stay involved in hobbies and social activities as much as possible.
  • Visit with family and friends regularly, be open and honest about your progress and don’t be afraid to ask for their help!
  • Set daily, weekly, monthly and long-term goals to give you a sense of accomplishment and concrete things to work toward.
  • Do things that make you happy and give you a sense of purpose.
  • Get involved with your local stroke association and join a survivor support group to meet people who have had similar experiences to discuss challenges and share victories.

 

Preventing Future Stroke

While a survivor should indeed focus on strengthening their emotional well-being as much as possible, Chennu notes that it’s also important to prevent additional strokes with continued medical attention.

“There are modifiable risk factors that we can address to help prevent a future stroke, such as high blood pressure, atrial fibrillation or an irregular rapid heart rate, smoking, heart disease, diabetes, high cholesterol, and the excessive consumption of alcohol and/or drugs,” Chennu explains.

Diet and exercise cannot be overlooked either. Be sure to eat plenty of fresh fruits and vegetables. Aiming for foods that are low in saturated fats, trans fat, and cholesterol but high in fiber can help prevent high cholesterol and lower your risk of another stroke. Limiting salt (sodium) in your diet can also lower your blood pressure.

Physical activity can help you stay at a healthy weight and lower your cholesterol and blood pressure levels. The Department of Health & Human Services (DHHS) recommends adults aim for a minimum of 150 minutes of moderate-intensity aerobic exercise — or 75 minutes of vigorous-intensity aerobic exercise — weekly.

Chennu also reminds that you should comply with any prescribed medications, especially blood thinners, and continue working closely with your neurologist.

 

The Takeaway

Because there no set rules or timelines for recovery after stroke, Chennu says it’s common for a stroke survivor to feel uneasy about their future, but there is hope that recovery is possible.

“The road to recovery after a stroke is full of uncertainty and stroke survivors have several challenges to face, including physical, cognitive and emotional challenges. But with some hard work, practice, and family support, you can face these challenges and conquer them,” she says. “However, you should know that recovery is a process and is not going to happen in one day. I know that can be frustrating but setting realistic and reasonable expectations, along with recognizing your own accomplishments and connecting with survivors can make a world of difference, and you can see every day as an opportunity to improve.”

 

Think F.A.S.T in an Emergency

Early action is important for stroke. Know the warning signs and symptoms of stroke so that you can act fast if you or someone you know might be having a stroke. The chances of survival are greater when emergency treatment begins quickly.

To help you remember what to do if you suspect you or someone is experiencing a stroke, just remember F.A.S.T.:

F – Face: If there is a droop on the face, think stroke

A – Arm: If 1 arm drift downwards, think stroke

S – Speech: If a person is having trouble speaking, slurring their words or having difficulties understanding speech, think stroke

T – Time to call 911 services

Remember, stroke is always an emergency.

To find a neurologist with Texas Health Resources who can help you manage your vascular health following a stroke, visit TexasHealth.org/provider.

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