Stroke = Dog Tired

As many as 70% of stroke survivors complain about fatigue. Many stroke survivors think that fatigue is the worst thing caused by their stroke. 

Stroke survivors should be four times as tired as everyone else, and I can prove it. Research shows that, when you compare survivors to age-matched “couch potatoes," the stroke survivors are in half as good cardiovascular health. Research also shows that most everything (i.e. walking, dressing, bathing etc.) takes twice as much energy after a stroke. Mathematically… 

(Twice as much energy needed) 
x (half as much energy available) 
= (I need a nap)

The best thing you can do is stay in good cardiovascular and muscular shape. This means resistance training and cardio work. It may be counter-intuitive, but exercise increases energy. Other things that will help increase energy levels include 

• Eating well 

• drinking plenty of water 

• sleeping well

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What do doctors know?

Show me a neurologist or physiatrist who does not know that recovery can continue after a year and I'll show you someone who should lose their license.

In some ways doctors are forced by the Hippocratic Oath to lowball any estimate of recovery. If a doctor says you won't recover, and then you do, they can say “Great!” If a doctor says, "You can expect a great recovery” and you don't, they have done you harm.

In terms of having a doctor understand rehabilitation per se, it's probably not going to happen. The responsibility for rehabilitation is offloaded to therapists. The one exception to this may be physiatrists. However, although they may be very aware of various recovery options, they are not trained in rehabilitation techniques.

Of course, MDs can be a driving force towards recovery. Each clinician (MD, therapist) has a unique role to play. Some MDs are not very well versed in all things recovery. If you want to find aggressive MDs and therapists, click this link >>> 

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Reading to Recover

Ever want trip up a therapist? Ask this question: What's the latest stroke recovery research say? The answers will be, politely, inconsistent. Some therapists actually know a lot. Others haven't read their professional journals, ever. Look for facilities and therapists that are "evidence-based" (basing treatment on the best available scientific evidence). Being evidence-based is sort of like having a GPS.

Imagine you have two people; one person has an absolutely stellar sense of direction. They never seem to get lost. The other person has no sense direction at all. They get lost in their own neighborhood. Let's say the “neighborhood looser” buys a GPS. Now who has a better sense of direction?

Imagine you have two therapists; one therapist is very smart, intuitive, conscientious, and caring. Everyone says they are a great therapist. The other therapist is sloppy, snotty and disorganized. Let's say snotty therapist reads a lot of stroke recovery research and implements what he reads. Now who is the better therapist?


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Simple. Brain. Recovery. Game.

Stroke recovery involves neuroplasticity. You can slice it and you can dice it but the bottom line always comes back to stroke as brain injury -- and how to overcome it. If you can't get the brain to reorganize around the injury, recovery is toast.

• Spasticity: caused by brain damage.

• Inability to feel the movement: caused by brain damage.

• Unilateral neglect (decreased attention to the “bad” side): caused by brain damage.

• Lack of control over the affected arm and leg: caused by brain damage.

• Aphasia: caused by brain damage

• Vision problems: caused by brain damage

• And much more!: caused by brain damage

So the answer to the question “… how might movement problems be overcome?” is simple: Rewire your brain.

And it is good that it is simple because only the stroke survivor can do it. A therapist could have a double major physical and occupational therapist PhD from Harvard school of Super Duper Rehab summa cum laude with postdoctoral training as a Rhodes Scholar and they still can't do it for you. You know the old Smokey the Bear poster: "Only you can prevent forest fires"? For stroke survivors the poster should say: "Only you can drive neuroplastic change". Fortunately, the rules for rewiring your brain are very, very simple. Unfortunately, rewiring takes a tremendous amount of hard work.

And what does it take? Repetitive practice.

Repetitive practice is boring.
So try spicing up with a video game yay!

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