Therapy, active lifestyle keys to recovery from stroke
HOWLAND — Ken Miller doesn’t recall much about the morning of Nov. 24.
“I got out of bed and my legs were weak,” he said. “All I remember is hitting the floor.”
Miller, 72, of Brookfield, was flown by medical helicopter from Sharon Regional Medical Center to a Cleveland hospital, where he stayed for 11 days for treatment of an ischemic stroke, which is a clot in the brain.
The other major stroke type is hemorrhagic, caused by brain bleeds. Miller said his two brain bleeds were caused from hitting his head on something while collapsing from the stroke.
Strokes are the fifth-leading cause of death in the United States, behind heart disease, cancer, COVID-19 and accidents, according to the National Center for Health Statistics. About 795,000 Americans experience strokes annually.
Strokes can affect speech, memory, balance and function. Recovery from a stroke can take months and the patient may never fully regain everything.
Therapy at Hillside Rehabilitation Hospital has helped Miller regain quite a bit since his stroke. Movements of his left leg and left hand still are hampered. He’s moved from wheelchair to a walker or cane. He continues to experience some difficulties with speech, balance and memory.
“There are things I did before that I can’t do now. I did woodwork in my garage. If I go in my garage (now) and start doing something and it doesn’t go right, it goes flying across the garage,” the retired steel mill overhead crane operator said. “It’s frustrating.”
These days, when he puts away the clean dishes, “it might be one-handed and it might take a while, but at least that’s something I can do.”
Miller tried to see if he could drive, but flunked that test. His foot won’t move fast enough. He said he’d rather not drive than cause a potentially fatal accident because his limbs won’t work right.
“I’m back on my lawn mower,” he confessed. “I know I shouldn’t be but I got to prove to myself I can do it. I hit a couple of things (but I did OK).
“It’s hard,” Miller said. “Take your time; listen to your therapist. Listen to your doctor. Take your medication like you’re supposed to. Just use your head a little bit.”
Karen Hartman, a physical therapist at Hillside Rehab Hospital, said, “Most recovery is made in the first four to six months. You can improve for a year after that. It’s amazing when we see people come back and they’re much better than we expected. So don’t give up.”
In-patient therapy is three hours per day and is divided over physical, occupational and speech therapies. Families are included in the care to make sure exercises and activities continue at home when the patient is discharged, typically after three weeks of in-patient therapy. It’s important the patient and caregivers know what to expect and what to do.
“When you first start to do something you were unable to do after a stroke, make sure you have someone to keep you safe,” Hartman said. Certain activities should be cleared with a doctor first.
“Take your time and do a little bit more each day and see how you feel after that,” Hartman said. “Get the input of a therapist. If it’s something you can’t do like you did before, you might have to find a new way to do it.”
Patients may have setbacks and may need refresher therapy sessions, she said.
Stroke patient Ronald Blackburn, 59, of Salem, said that it’s also important to keep moving. The effects of the stroke won’t simply disappear.
“I know a guy who had a stroke. He sat around bummed out and now he can’t move well,” Blackburn said. “People sit around and get lazy. They think it’s going to go away. It won’t go away.”
Blackburn said that his own doctor told him that he probably won’t regain 100 percent of his movement, “but I will get better. It’s up to me.”
When it hit him, the former newspaper pressman didn’t realize he was having a stroke.
“I woke up one morning (in February) and was feeling a little numb around my right leg. I had been hit by a car in October and had surgery on that leg. The doctor said it might be numb. I thought it was that — then it traveled up my right arm and I couldn’t grip anything.”
Then a friend told him that his speech was slurring. “He said, ‘Dude, you had a stroke.’ I said, ‘I’m too young to have a stroke.’ He said, ‘No, no, go check that out.’ The doctor said, ‘You had a stroke and two others before that.'”
The stroke was diagnosed as a transient ischemic attack — TIA or “mini-stroke” — which is caused by a temporary disruption in the blood supply to part of the brain.
“It was scary,” Blackburn said. “I was scared.”
Besides the slurred speech, Blackburn couldn’t grip items or make a fist, and his balance was off. He was discharged from Salem Regional Medical Center to Hillside. He rolled through the doors in a wheelchair for 21 days of therapy and exercises.
“I got better,” he said. “They helped a lot. I don’t use my walker as much. Now I use a cane. I can walk up and down steps. I don’t feel pain. My memory is OK. My speech is a little off at times. Therapy is taking care of that. I can’t really write yet. I have to use my left hand.”
He continues outpatient therapy at Salem Regional and works on ways to adapt.
“I found myself shortcuts to do what I do,” he said. “I have a different routine now. I like to play cards. I couldn’t. I’d drop the cards on the floor. Now I can hold them with my right hand and pick out a card with my left hand, because of therapy.
“It does get frustrating, but you got to keep doing it,” he said. “There’s a little drag in my right foot. I can’t help that.
“I tried to make pancakes. I couldn’t mix the pancakes. I couldn’t reach for things,” Blackburn said. “I can’t do 100 percent but now when I wash my face, I can reach the soap. At the beginning, I couldn’t even put on my shirt. Now I can dress easier.”
“Therapy gave me some Play-Doh with marbles in it. I play with it while watching TV. When watching TV, I will raise my arms above my head,” he said. “Keep moving. You’ve got to keep moving. If you don’t feel like doing it — do it.”
F.A.S.T. WARNING SIGNS OF STROKE
Use the acronym F.A.S.T. to spot a stroke:
F: Face drooping — Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
A: Arm weakness — Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S: Speech difficulty — Is speech slurred?
T: Time to call 911
OTHER STROKE SYMPTOMS
Watch for sudden:
* Numbness or weakness of face, arm, or leg especially on one side of the body;
* Confusion, trouble speaking or understanding speech;
* Trouble seeing in one or both eyes;
* Trouble walking, dizziness, loss of balance or coordination;
* Severe headache with no known cause.
Modifiable stroke risk factors
* High blood pressure;
* Heart disease;
* Oral contraceptives;
* Physical inactivity;
* High cholesterol;
* Excessive alcohol use.
Nonmodifiable risk factors
* Older age — the likelihood of having a stroke increases with age for both males and females;
* Family history
* Race — African-Americans are at a higher risk;
* Gender — Women are at higher risk;
* Prior stroke, TIA or heart attack.
TYPES OF STROKES
* Ischemic — Most strokes are ischemic, which occurs when blood clots or other particles block the blood vessels to the brain. Fatty plaque deposits also can cause blockages by building up in the blood vessels.
* Hemorrhagic — A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures. The leaked blood puts too much pressure on brain cells, which damages them. High blood pressure and aneurysms are examples of conditions that cause a hemorrhagic stroke.
* Transient ischemic attack (TIA or “mini-stroke,” sometimes known as a “warning stroke.”)
A TIA is a warning sign of a future stroke. It is a medical emergency, just like a major stroke, and requires emergency care. There is no way to know in the beginning whether symptoms are from a TIA or from a major type of stroke. Like ischemic strokes, blood clots often cause TIAs. More than a third of people who have a TIA but don’t get treatment have a major stroke within a year. Recognizing and treating TIAs can lower the risk of a major stroke.
SOURCE: Hillside Rehabilitation Hospital