Recovering from stroke varies with each individual because every stroke is different. One of the questions I had when Steve had a stroke was, “How long will it take for him to recover?” The answer was always, “I don’t know.” I thought the doctors, nurses and therapists were trying to hide something from me because they were being so evasive. But then I met other stroke survivors, and although there were some similarities in the way the stroke affected them, there were differences in each one of them, which resulted in variables in their recovery process too. According to the American Stroke Association, over 780,000 Americans suffer a stroke annually, and there could be 780,000 variations of stroke.
Steve made very good progress in the beginning when he was recovering from stroke. In fact, he made the most progress in the last two days before he was discharged from the hospital where he was a patient for 6 weeks in the rehabilitation unit. He started out by not being able to sit by himself without falling over. The stroke affected his core balance, and it was like teaching a baby how to sit up by himself. It took four therapists to help him stand up in this video of his first therapy session a few days after the stroke. You can see that he still has a feeding tube in because his swallowing reflex was greatly affected. His swallowing improved as time went on, but while he was in the hospital he was given pureed food until that reflex improved. By the time Steve left the hospital, he was eating a normal, but low-salt diet.
He was extremely tired while recovering from his stroke. This is quite common in stroke survivors, and you should not be alarmed if your loved one is experiencing the same thing. Their injured brain needs sleep to heal. Sometimes Steve slept so much that he had difficulty making it through his therapy sessions.
For several weeks his therapists worked on his balance and on the muscles in his arm and leg that weren’t responding. They didn’t want them to freeze up, so they were stretched every day as he lay in bed. His leg wasn’t completely paralyzed as his arm was, but it was very, very weak, and he couldn’t move his foot or toes at all. After his core balance was reestablished, he learned how to walk again. That was about 3-4 weeks into his stroke recovery.
Steve’s case was complicated by a broken ankle that he broke three weeks before the stroke. It was on the weak, left leg, so that made it more painful to stand on. It could have been worse. He could have broken the right ankle instead, then he wouldn’t be able to stand at all. But as a result of the broken ankle, he had to wear a heavy air cast which made walking more difficult. That was changed later to a brace to correct foot drop. These things hindered him from recovering from stroke at a faster pace.
When Steve left the hospital, he was admitted to a nursing home for two months to continue his stroke recovery. However, the therapists there were not as aggressive, nor as skilled in treating patients recovering from stroke. When he left there, he was able to come home. He learned to climb steps, grasp the fingers of his left hand and move his arm, get in and out of bed, and use the bathroom by himself. He continued with home health care and outpatient therapy for several months. From there we went to the Cerebral Palsy Aquatic Center for water therapy.
He’s had many setbacks with different things hindering him recovering from stroke. They included ankle pain, cellulitis in his eyes contracted while he was in the hospital; shoulder subluxation; flu while he was in the nursing home; pneumonia from ingesting a small peel of a nectarine into his lung; three seizures; depression and lack of motivation; congestive heart failure, atrial fibrillation, among other ailments.
At this writing, two years after the stroke, Steve is progressing, but at a slower rate. He is discouraged by the slow progress and wants to give up at times. Pain seems to be a constant companion, mostly in his left shoulder, leg and ankle. The seizures have affected his motivation and drive to get better, so he needs constant encouragement and hope.
In most cases people do get better. The effects of a stroke are greatest immediately after the stroke occurs. From then on, the speed and pace for recovering from stroke depends on the extent of the brain injury, the success of rehabilitation and the determination of the stroke survivor. The most improvement in recovery is made within 18-24 months after the stroke, so time is of the essence. However, even though the recovery process may slow down, good progress can be made for many years with continued efforts as the brain rewires itself.
Finding a Good Therapist
Good therapy will greatly help in stroke recovery, but not all therapists are the same. Try to find a rehab center which specializes in stroke therapy. We once had a physical therapist fill in for our regular home health therapist, and within 5 minutes we could tell that she had the expertise we needed. She referred us to the correct facility.
If your therapist is just so-so, keep looking, keep asking questions, talk to other stroke survivors, consult with your doctor, call other agencies, go to a cerebral palsy center and ask for referrals. Did you know that cerebral palsy is often caused by a stroke at birth or in the womb? Your local CP center will be a great source of information for you. Don’t give up and don’t settle for anything less than the best. The most improvement in recovery is made within 18-24 months after the stroke, so time is of the essence. However, even though the recovery process may slow down, good progress can be made for many years with continued efforts as the brain rewires itself.
The American Physical Therapy Association represents more than 73,000 physical therapists nationwide. Its goal is to foster advancements in physical therapist education, practice and research. You can access “Find a PT” to find a physical therapist in your area at www.apta.org/consumer