Stroke Survival Guide

Having a stroke can change your life, but thankfully almost all stroke survivors recover to some extent and go on to lead normal, meaningful lives.  The support from those around you is crucial in helping you make the best possible recovery.  By Erika Ketterer, registered dietician at the Heart and Stroke Foundation South Africa

Suffering a stroke can be a shock that leaves you reeling.  One of the first steps to recovery is accepting that it might be a long road.

Rehabilitation is an important part of that recovery and can help you adapt to your new physical limitations.  The goal of rehabilitation should be for you to regain independence and become productive as soon as possible – although this might not mean that your capabilities will return to exactly the same level as before the stroke.

It is difficult to predict how long stroke rehabilitation will take.  The extent and rate at which people recover varies greatly, but most progress takes place in the first 18 months after the stroke.  Some people will find that their symptoms improve considerably in the early weeks after their stroke, while recovery in the subsequent months may be more gradual.

You may receive rehabilitation in the same hospital where you were initially treated for your stroke, in a special rehabilitation facility as an out-patient, or from a rehabilitation specialist who may come to your home.  The rehabilitation team may include at doctor, nurse, physiotherapist, occupational therapist, dietician, speech therapist, psychologist or social worker.


Common effects of a stroke

Paralysis or weakness of one side of the body  is one of the most common effects of stroke.  Rehabilitation will help you to regain as much motion and control as possible.  If you are having difficulty moving around, getting your balance or coordinating your movements, you can be helped by a physiotherapist.  They will teach you exercises and techniques to improve muscle control, balance, mobility and walking.  An occupational therapist can help you learn practical skills to cope in everyday life and perform daily tasks on your own.  They can help you achieve your goals and make the best use of your physical and mental abilities.

Vision problems  are fairly common after a stroke.  You may lose part of your vision in one or both eyes, so you may only see the food on one side of your plate, or be able to read only one side of a written page.  Your caregiver can help you by putting objects on your ‘good’ side, where it is easier for you to see them.  Turning your head will also allow you to see more on your ‘bad’ side where it is easier for you to see them.  If you have had a stroke in the brain stem, you may have double vision, and may need special glasses.

Aphasia  refers  to difficulty in speaking, reading, writing or understanding language  caused by damage to the parts of the brain that control your ability to communicate.  It can be very frustrating for you.  The severity of the aphasia varies from person to person – it may be temporary and improve quickly after the stroke.  Other stroke survivors may be left with permanent language problems.  Speech therapy can help you recover the use of language or learn new ways of communicating.


Dysphagia  can occur if the stroke affected the muscles of your moth, tongue and throat.  As a result, you may have trouble swallowing.  Dysphagia may be temporary or permanent and is usually diagnosed and treated by a speech therapist.  If not treated the swallowing problems can result in choking or inhaling food (aspiration) that can lead to pneumonia, malnutrition, or dehydration.  During the early stages of your recovery, your dietician may order meals that are soft and easy for you to swallow.  The dietician can help you plan healthy meals to help with weight control, cholesterol levels or any problems you might have with swallowing or eating.

Incontinence  refers to trouble controlling your bowels or bladder and many stroke survivors suffer from incontinence after their stroke.  Nurses work closely with you during the initial stages following a stroke.  Until you can do more for yourself, nurses will help you with daily care such as taking medications, bathing and dressing.

Depression  is commonly experienced by stroke survivors, who feel sad or overwhelmed by the changes in their lives.  You may have emotional responses that are exaggerated or inappropriate, which include outbursts of anger or crying uncontrollably for little or no reason.  This can affect your relationships with others.   If you are having emotional issues or are having problems with thinking or memory skills – a psychologist can help you.  A social worker can also help you and your family deal with feelings of anger, sadness, depression, confusion and anxiety that are common after a stroke.  Social workers can also help with arranging community services, family finances, work and discharge plans.

HELPING  HAND

For a list of rehabilitation units at Life Healthcare Hospitals contact Janet Young at email This e-mail address is being protected from spambots. You need JavaScript enabled to view it or fax 0865007535.

To find out about stroke support groups in your area, contact the Heart Mark Diet Line or 0860223222, email This e-mail address is being protected from spambots. You need JavaScript enabled to view it or go to www.heartfoundation.co.za

CAREGIVERS

Other important parts of your rehabilitation team are your caregiver, family and friends – they can provide important emotional support.  They can also help you continue you rehabilitation at home.

Being a stroke caregiver is a demanding, but rewarding responsibility.  They are crucial in maintaining the comfort, safety, dignity and self-esteem of the stroke survivor.

At times the caregiver may feel overwhelmed by the responsibilities and it may be helpful to learn to delegate.  Think about what family members, friends or outside resources can do to lighten your load.  Talk with your social worker, doctor, church, hospital, stroke team or local community centre about caregiver support services in your area.  This could include services such as Meals on Wheels, respite Care so you can have a break or Stroke Support Groups.

Caregivers may sometimes feel burnt-out, frustrated, helpless and depressed – these feelings are normal and understandable.  Enlist the help of family and friends, take care of your physical health, eat a healthy diet and try to be physically active on most days of the week.