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Early Recovery
Your Body’s Initial Response
At the stroke site, where a blood vessel has burst or been blocked, a localised reaction occurs which leads to swelling.
This swelling can interfere with the function of some cells in the area.
As this swelling gradually settles down, some affected cells recover their function.
This initial healing can take several weeks but during this time you may notice a marked improvement in some of the effects of your stroke.
It is not until the initial improvement slows down that it becomes clearer what longer-term effects are going to be as a result of permanent damage.
Some brain cells, deprived of oxygen and nutrients will die and their function will be lost. Other brain cells may be able to take over some of these functions but this takes time.
This is why organised or ‘formal’ rehabilitation may not commence straightaway but recovery and initial care in the early days begins immediately.
The Severity Of Your Stroke
The severity of your stroke may be described in terms such as ‘minor/slight’ or ‘major’.
This description depends on:
- which part of your brain was damaged -location
- how severe your stroke was
- your age and general health before your stroke
In the first few days people who have had a stroke are likely to
- be very tired and sleepy
- may find it hard to understand what is going on around them
- may find it difficult to remember information that has been given to them
Immediate Care
It is accepted that where possible it is best to go to hospital initially at least. It is difficult to be precise about how every stroke will be dealt with as there are so many variables.
The severity of the stroke determines how much looking after you will need, initially and longer term
- those with very disabling strokes, such as difficulty swallowing, poor conscious level and paralysis require nursing care as well as therapy and need to be admitted to hospital. Problems with continence, skin care, constipation and pain, require monitoring and intervention to avoid complications.
- people with less severe strokes may be able to remain at home with the following options:
- have tests and investigations done at a local hospital clinic
- be referred to a stroke specialist and other therapists as required
- be referred to a specialist stroke clinic to have tests including a scan in the same visit
- in the longer term, rehabilitation can be accessed in various ways such as admission to a stroke rehabilitation unit, out patient clinic or day hospital or by community therapists visiting at home
Taking Care Of Personal Needs
If you are admitted to hospital nursing staff will provide help to ensure that all your needs are attended to, depending on how much you are able to do for yourself.
You may need help with everyday tasks such as getting washed and dressed, cleaning teeth, transferring from bed to chair, and going to the toilet.
- Mouthcare After A Stroke F11 [3.03M PDF]
Early Mobilisation
It is very important to avoid prolonged time in bed even in the early days. This is called early mobilisation and has been identified as important for many reasons
- it helps prevent the limbs becoming sore and stiff from lack of movement
- helps to recover sense of posture, balance and movement by being upright
- makes it easier to eat and drink
- reduces the risk of blood clots in the legs
- reduces the risk of developing a chest infection
Rest
This is not to say that you will not need adequate rest. Most people after a stroke find they are overwhelmingly tired and want to sleep a lot. Ideally activity should be paced throughout the day, allowing rest and various therapy and activity periods to take place at different times of the day, not one after the other.
Avoid Damage
It is very important to listen to the advice of the physiotherapist and nurses about what will help movement to return and the positioning of affected arm or leg. Sometimes repetitive movements can cause spasm and damage.
Careful positioning is also vital in protecting the affected arm or leg from being damaged. Get advice and don’t rely on ‘old wives tales’.
- Positioning F16 [137K PDF]
Routine Monitoring
Blood pressure, temperature, pulse will be checked regularly. Blood sugar, blood oxygen and fluid intake will also be monitored. A higher blood pressure is likely after a stroke but is not necessarily actively lowered. Blood pressure usually settles back to normal for each individual reasonably quickly. Longer term monitoring of blood pressure is important to ensure a sustained high blood pressure is treated if necessary.
Communication Problems
The left side of the brain normally controls reading, writing, speaking and understanding. It also controls the right side of your body. So you are more likely to have communication problems if the stroke affects the right side of your body. Read more under Communication Problems…
Tiredness
During the initial recovery period most people feel very tired and sleepy. This is because the brain is recovering. Many people also have difficulty concentrating and retaining information.
Confusion
In the early stages after a stroke many people experience confusion. This usually passes quickly as the damaged area of the brain starts to settle down. Confusion can also be caused by additional problems such as infection or imbalances in the blood.
Swallowing Problems
Some people have problems swallowing after a stroke and this is why most people are not allowed to eat or drink straight away.
Once swallowing has been assessed it can be decided what form of eating and drinking is safe. Swallowing Problems often improve quite quickly and thickened fluids, soft diet and then normal diet can follow. However it may be necessary to be given fluids by a drip (intravenous infusion) to avoid dehydration.
In some cases swallowing does not return or remains impaired and other methods have to be used to maintain nutrition such as tube feeding. In all these situations a speech and language therapist and the dietician are likely to be involved in your care.
- Swallowing Problems After Stroke F29 [48K PDF]
Family Issues
Coping when a family member has a stroke can be difficult. Life’s daily routines and commitments are upset and it is a worrying time. For sources of help and information see Information For Carers. Other members of the family and friends may not understand what’s happened, and feel uncomfortable and embarrassed. Explain to them what’s happened and what they can do to help. If you have any particular concerns about finances, transport or family commitments ask to speak to a social worker.
How You Can Help
Your help is important to the recovery process, particularly with support issues
- the person affected by stroke will need a lot of verbal and physical reassurance
- it is important to be aware of and sensitive to the effects of the stroke and be patient (particularly if speech has been affected)
- the person will tire easily so keep visits short but frequent
- try to avoid too many people visiting at one time
- remember to keep the person up to date with what’s been happening at home and with the family
- think about things to take into hospital to do and share
- speak to members of the staff team for more ideas on how to help or if you would like to be more involved
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