In most cases, symptoms do improve after a stroke. The speed and level of your recovery depends on the extent of the brain injury and your ability to respond to rehabilitation. Your brain controls how you move, feel, think and act and a brain injury from a stroke may affect some of these abilities. Your doctor's highest priorities after a stroke are to prevent complications from the present stroke and to prevent another stroke. This means that all complications must be treated and under control before rehabilitation can begin.
Some of the physical effects and complications of a stroke can include:
- hemiparesis - weakness on one side of the body
- hemiplegia - paralysis on one side of the body
- aphasia - difficulty getting your words out or understanding what is being said
- dysphagia - trouble swallowing which can lead to breathing problems and pneumonia if not treated
- dysarthria - difficulty speaking or slurred speech
- vision - decreased field of vision and trouble with visual perception
- deep venous thrombosis - blood clots form in veins of the legs because of immobility from stroke
- brain edema - swelling of the brain after a stroke
In addition to physical changes and complications, people often experience emotional and behavioral changes. Damages from a stroke may make a person forgetful, careless, irritable or confused. Stroke survivors may also feel anxiety, anger or depression. After a stroke, behavior depends on where and how badly the brain is injured. Many disabilities resulting from stroke improve with time. Behavior changes and emotional health can also improve.
After a stroke, almost all patients feel tired at some point. Recovering from a stroke may require working harder to compensate for the loss of normal functions (such as being unable to use an arm or hand). You'll start to feel less tired as your recovery continues and strength is regained. It's important to pinpoint what's causing you to be tired so you can take action to manage it. You may feel tired after a stroke for four major reasons:
- Less energy - you may have less energy than before because of sleeping poorly, not getting enough exercise, poor nutrition or the side effects of your post-stroke medication
- Using energy differently - you might have as much energy as before, but you're using it differently. Because of the effects of your stroke, many things, like dressing, talking or walking, take a lot more effort. Changes in thinking and memory take more concentration. You have to stay "on alert" all the time - and this takes energy.
- Emotional changes - you also may feel more tired due to emotional changes. Coping with frustration, anxiety, anger and sadness can be draining. Often, loss of energy, interest or enthusiasm occurs along with a depressed mood.
- Clinical depression - is a treatable illness that happens to many. Symptoms include significant lack of energy, lack of motivation, and problems concentrating or finding enjoyment in anything. Talk to your doctor about an evaluation for clinical depression if tiredness continues.
Loss of speech, language or swallowing abilities
Stroke can trigger a loss of ability to communicate by affecting the strength of the muscles that control the tongue and lips (dysarthria) or by disrupting the motor patterns sent by the brain to the tongue and lips (dyspraxia). Both disorders impact our ability to form the basic movements that allow us to speak.
Aphasia (ah-FAY-ze-ah) is a loss of language function that can impact your ability to understand what others are saying, as well as interfere with your ability to express yourself. After stroke, you may struggle to find the words you want to use to form sentences for conversation. Since we communicate in many ways, people with aphasia may have difficulty reading, writing or using numbers, as well.
People with aphasia are often frustrated because they cannot speak as well or understand things the way they did before their stroke. It may be helpful for family members to:
- be open about the problem so other people can better understand the situation
- check the patient's understanding with "yes" or "no" questions
- use sentences that are short and to the point
- keep the noise level down and stand where the patient can see you
- remember to treat the stroke survivor as you normally would and include them in conversations and decision making
- be patient and give them the time they need to speak and get their point across
You use your tongue, lips and throat muscles primarily for swallowing. Stroke may also affect this function causing dysphagia or difficulty swallowing.
All of these conditions are treatable and can me markedly improved through speech, language and swallowing rehabilitation. Evaluation and treatment will begin with your Beaumont speech and language pathologist as soon as you are admitted to the hospital, and will continue throughout each phase of your hospitalization. Our extensive outpatient speech and language rehabilitation programs have changed many lives for the better, providing family education, daily treatment and support groups so patients and families can find the skills they need for healthy and productive daily living.