OT: Stroke experience with parents

[Hey Adrien!]

Hi Boneyarders,

I've learned last night that my 72 year old father had a left-brain stroke. Luckily, he survived and his girlfriend said that he was talking (albeit slurred) soon after it happened, but I haven't seen him and won't see him until he has a few days to recover at the hospital.

Obviously, this has been a huge shock to me and I have yet to fully process the news. I have zero experience with stroke in my family and I'm curious if any people here can help educate me on the recovery process and how it may or may not affect my dad in the immediate and long-term future.

Thanks.

 

[buddy]

There are two types of strokes, one caused by lack of blood flow by clot and there are hemorrhagic strokes caused by brain bleed. Those are usually much more damaging. There is a "golden" period where if one can get to a hospital within a couple hours the stroke can sometimes be treated with drugs to bust the clot. It is possible for partial recovery once the swelling in the brain around the area effected reduces, as the brain reorganizes. Some of the damaged neurons may also recover over time, which can be months to years. Sometimes symptoms slowly resolve. Other times the defect is permanent. With physical therapy, there can be retraining and alternate muscles can sometimes take over jobs effected muscles used to be able to do. I would consult with rehab specialist asap.

 

[jibsey]

My brother-in-law 81 had a stroke that he mostly recovered from, unfortunately it was followed by several more and he is now not in good shape. Lifetime of high blood pressure which was treated but maybe not good enough. I wish you well and hope he has a complete recovery, because care of stroke patients if they are severely debilitated is a challenging thing, lots of help is needed.

 

[NatiHuskiFan]

Be sure he has a speech pathologist in to see him. I imagine that would be an automatic thing in a hospital but figured I’d say it anyways. 98% of population has language control within the left side of brain and the better recovery is associated with starting speech therapy as soon as possible. Swallowing is also something that may need to be looked at if there is any noticeable coughing with drinking fluids. Motor control for swallowing is very slow to same area of brain as speech and language

 

[Rocktheworld]

I’m a speech therapist who works in hospital and acute rehab. If you want to PM me we can talk; long story short, every stroke, every patient, and every recovery is different.

This is completely irrecognizable from a fall and a broken bone. The first few days should be, besides at least an initial evaluation of his current swallow and mobility statuses, a wait-and-see period

 

[Offhegoes]

Every CVA prognosis is dependent on location, type, if TPA was administered etc. When stable, working with OT, PT, and speech therapy is crucial for optimal functional recovery and safe discharge planning from the hospital.

 

[Swflhusky]

Hi Boneyarders,

I've learned last night that my 72 year old father had a left-brain stroke. Luckily, he survived and his girlfriend said that he was talking (albeit slurred) soon after it happened, but I haven't seen him and won't see him until he has a few days to recover at the hospital.

Obviously, this has been a huge shock to me and I have yet to fully process the news. I have zero experience with stroke in my family and I'm curious if any people here can help educate me on the recovery process and how it may or may not affect my dad in the immediate and long-term future.

Thanks.

 

[Swflhusky]

He will receive therapy in the hospital. Physical, speech, & occupational. If he can’t say words, called aphasia, get him a chalk board or something similar where he can write things down.
When he is able to return home he can receive therapy at home. Also could go to rehab center when ready to be discharged from hospital.
I’m a retired home care nurse & worked for a VNA in SECT.

 

[Kathy]

My husband had a massive right sided stroke at the age of 53. He recovered more than they thought he would, but was still wheelchair bound. Make sure he goes to a good rehab hospital if that is the plan, I was not happy with the one they sent him to - made some medication mistakes treating his diabetes that slowed his rehab. The rehab in the first 6-8 weeks is crucial.

 

[joober jones]

It's tough to know - aphasia almost always is a part of the picture to some degree, but it's not always permanent. Even when it is, as other posters pointed out, therapy can help a lot and big improvements can be made. I don't know what part of CT you live in (of if you do live in CT) but Gaylord Hospital in Wallingford has worked wonders for some stroke patients. I wish you and your famlily all the best and will keep you in my thoughts and prayers.

 

[Purple Stein]

My dad had a stroke 4 years ago (he was 79 at the time). My son had just been born and I was bringing him over to meet my parents. I found my dad, sitting in the dark, with half of his face drooped. He refused medical care, insisted it was Bells Palsy, told me he had an appointment with his eye doctor the next week who would look at it.

Long story short, we eventually got him to a doctor (I'm talking a couple of weeks later), who ordered imaging, and who, after the imaging was done, told him to go to the ER immediately because his scan showed he had just had another "small" stroke. The ER doctor rightly chewed him out, and the rest of us out, for not forcing him to go to the doctor sooner.

4 years later, his mobility is impaired but not entirely lost and his speech is much improved. It's really remarkable how he's recovered. The nurses, doctors, and rehab folks who cared for him and who continue to care for him have made a remarkable difference in all of our lives.

I'm not going to lie, @Hey Adrien! -- rehab was really hard. There were a lot of frustrations and doubts and tears. Depending on severity, your dad may be facing a much taller or shorter climb. I'm a pretty cynical person, but I got through it all by focusing on gratitude -- being grateful for the time with my dad and for the people who provided such remarkable care. Good luck to you and your dad.

 

[Kitaman]

I was home alone and felt dizzy, saw stars, lips numbed and my fingers tingly. I sat down and it went away, Got up and 10 minutes later it returned. Not feeling right I went to the medical clinic. Didn't come back home for 4 days. Diagnosed with a stroke.

To this day they still haven't pinpointed the cause but I am now on HBP meds. Think it was a lack of blood to the brain (clogged vessel). I can't speak for the OP as each situation is different, however a full recovery is certainly possible, but expect long term or permanent issues.

My friends (who have had a stroke) and I have these two issues many minor:

Memory loss (forgetting names, places, etc.)
Forgetfulness (not closing doors, misplaced items

If there is a loss of movement (arm, hand, legs even balance) then therapy can help recover strength. Victims can do all the things they used to do but periodically will show mental signs of the stroke. Should be no worries. Hopefully if diet or weight loss changes are recommended the victim adheres to the doctor's orders.

Again this is the minor stroke situation, the major stroke is much more problematic and life changing.

This is not a professional opinion but a personal experience one.

 

[Rocktheworld]

My husband had a massive right sided stroke at the age of 53. He recovered more than they thought he would, but was still wheelchair bound. Make sure he goes to a good rehab hospital if that is the plan, I was not happy with the one they sent him to - made some medication mistakes treating his diabetes that slowed his rehab. The rehab in the first 6-8 weeks is crucial.

Yes @Hey Adrien! if you can, depending on how things go over the next few days, I would try to get dad in acute rehab. If a doctor or case manager just says “rehab”, ask them to specify “acute rehab” or “skilled nursing facility”. Those two terms are often —sometimes ingenuously, but not always— used interchangeably; but the quality, frequency, and intensity of the therapy will be worlds better in acute rehab. With skilled nursing, “epidemic” doesn’t do justic the level of shady therapy practices that go on. The nursing care is often less attentive. And further, the therapy minutes will be lower, and the frequency will be diminished.

@Kathy said that the first 6-8 weeks of therapy is crucial. We don’t know where your dad is right now, and won’t really know for a couple days. However impaired he is now, it can’t hurt to have him get as intense of therapy as possible to capitalize on a general stroke phenomenon called “spontaneous recovery”. This is a period of 6-18 months starting from the day after the stroke where, even without therapy, the brain will in a sense “re-wire” itself and there will be some appreciable recovery of function. The intense therapy will make the most dramatic gains.

I would appeal for acute rehab over home health if you can, if the care team is kind of on the fence on home vs rehab. If, for example, your dad is just a minimal assist or something (these terms will make sense as you interact with the therapies) and they say he could potentially go straight home, I would still go the rehab route so they can get him as close to modified independent as possible. Then go outpatient to clean up whatever is left to work on.

I would not do home health. Vast majority of home health therapy is a joke from what I’ve been told

 

[Hey Adrien!]

Thanks everyone for responding. Getting support from family and friends has been key, but also getting support from people whom I don't personally know is super helpful too.

The bad news from yesterday is that my father had a hemorrhage and a stroke, so the bleeding needed to be drained and stopped, so coagulates were out of the picture. He was still awake, responsive and even cracking a few jokes and between the 8 AM and 4 PM CAT scan only minimal additional blood was detected. If much more was detected, the outlook would look bad and he would have likely died there in the hospital.

I spent the night in Pennsylvania and on my way to the hospital to get the results of today's CAT scan...hoping for no more additional blood in the brain. All avenues of outcomes are still possible, but the worse case scenario probability has decreased by a lot from 24 hours ago. Hopefully that decreases even more once we get the results in about an hour or two.

 

[Kitaman]

I would like to affirm the therapy mandate. Therapy in a rehab is crucial. The added benefit is the victim can possibly meet other victims and gain knowledge, confidence, hope, guage their recovery vs others and be challenged. A good therapist can be a motivational help, especially on days when not feeling it's working or fear/depression rises. Home therapy does not provide those benefits.

My therapy consisted of basic gym work (weight resistance) and motor skills (moving/stacking plastic cups). Seemed redundant since I had a gym membership, and moving cups around seemed mundaned, but I am not qualified to determine how important it meant or it's long term value.

Apparently it worked because no one can believe I had a stroke.

 

[Rocktheworld]

Thanks everyone for responding. Getting support from family and friends has been key, but also getting support from people whom I don't personally know is super helpful too.

The bad news from yesterday is that my father had a hemorrhage and a stroke, so the bleeding needed to be drained and stopped, so coagulates were out of the picture. He was still awake, responsive and even cracking a few jokes and between the 8 AM and 4 PM CAT scan only minimal additional blood was detected. If much more was detected, the outlook would look bad and he would have likely died there in the hospital.

I spent the night in Pennsylvania and on my way to the hospital to get the results of today's CAT scan...hoping for no more additional blood in the brain. All avenues of outcomes are still possible, but the worse case scenario probability has decreased by a lot from 24 hours ago. Hopefully that decreases even more once we get the results in about an hour or two.

He’s in hospital now under incredibly close watch, with neurosurgery ready to intervene in a moments notice. I imagine they are doing neuro checks at least every 2 hours.

They are doing everything they can to manage the bleed and to not allow it to progress. Glad to hear it was a small one, and seemingly, one that was relatively easy to get to and drain. I would take it as an encouraging that dad was joking with blood on the brain; we more often see/expect confusion and agitation/aggression.

 

[NJHusky]

My only experience is seeing stroke patients in rehab while I was rehabbing a major knee injury. People I saw day one that couldn't stand alone were almost fully function after months of PT. So I would agree with the posters that are pushing PT...as soon and as much as possible.

Good luck

 

[Dean Wormer]

All of the above on the great responses.
My uncle suffered 2 strokes, first one he recovered fully, 2nd left him partially paralyzed on his left side.
My sister had a stroke 4yrs ago and she still hasn’t made it all the way back. Memory loss and some motor skills lacking as well as relearning speech, etc
As others have said, the biggest factor right now is making sure they don’t rush your Dad back home without taking advantage of the inpatient PT available in a facility. We literally had to fight the bean counters to make sure our loved ones were taken care of.
Good luck to you and your family @Hey Adrien!