Let's say you're a chronic stroke survivor. You know "chronic" – it's the time after your plateau. Typically the chronic phase goes from 3 months to the end of the stroke survivors life. Do you still have a chance to get better during the chronic phase?
Yes.
Seriously?
Yes.
There's actually good scientific reason to believe that you can get better after the plateau – once you are chronic.
And here it is…
Typically survivors are forced through rehab as soon as possible. Facilities are expensive and home is cheap, so off you go! The problem is that to get the survivor out the door, compensatory strategies are implemented. Things like AFOs and using the good arm to get everything done. It makes sense, these things do get people out of the system. The problem is those same strategies also hurt the survivors brain.
In fact, if compensation is taught during the first 10 days after stroke it hurts future function of the "bad" side.
OK, but how does this all help the chronic survivor? It sounds like it would hurt recovery.
Here's why: Since the survivor is encouraged to use the "good" side, the "bad" side of the brain sits fallow- doing nothing. The upshot is that many survivors have a huge portion of the brain, usually adjacent to the area damaged by the stroke, that is on vacation. You've heard of 'use it or lose it'? Well, they've lost it. BUT, it can be regained. How?
Here & here & here & here are some ideas.
OK, but how does this all help the chronic survivor? It sounds like it would hurt recovery.
Here's why: Since the survivor is encouraged to use the "good" side, the "bad" side of the brain sits fallow- doing nothing. The upshot is that many survivors have a huge portion of the brain, usually adjacent to the area damaged by the stroke, that is on vacation. You've heard of 'use it or lose it'? Well, they've lost it. BUT, it can be regained. How?Here & here & here & here are some ideas.
9 comments:
As a 5 1/2 year stroke survivor, here is my conclusion in a nutshell regarding recovery of physical abilities.
Whatever the stroke leaves you with can be improved upon over time, but slowly and with a hell of a lot of work. Unless, like me, spasticity enters the picture to drag you back to the starting point and make sure you stay there.
I wanted to eventually go back to work after my stroke. After I completed acute care rehab and outpatient rehab, I was not ready to go back to work due to issues with fatigue, processing speed and executive function among other things. My doctor recommended the Center for Transitional NeuroRehab here in Phoenix. They have an intensive day program that helps people with brain injuries return to work, school or the community. The program was not covered by my insurance. I applied at the State DES program to get Vocational Rehab funding, but apparently you have to be below the poverty level to get funding. So I managed my own rehab, but I know I didn't challenge myself as hard as I would have been challenged if I had gone through the Center's program. Now it is four years later, and I still am not back at work. I believe that a program with intensive cognitive (brain) rehab, as well as intensive physical rehab, would have helped speed up my recovery.
The first 3 months were too shocking and stressful for me, to even start working on my rehab. So much emotional stress from being downgraded so quickly to an invalid, all I could do was hide. I think stress is the biggest obstacle for us survivors. Financial stress or esthetical stress like in my case is al the same to the body, it keeps you stuck in fight or flight. And with all those stress hormones flooding your body, your body can't heal itself.
Can you get better? YES, YES, YES!!! Don't give up, I'm 5 years and keep getting better. Anyone who gives you doom and gloom, drop them asap! Work hard and stop recovering when you want. When you stop, its over, but only by ur choice!
This may have an obvious answer. just wondering what happens to the dead brain scar tissue after many years/decades? does it get cleaned out? you end up with a hole in your brain? or no idea?
John, That area cavitates and fill;s with cerebral spinal fluid (which is a good thing, otherwise other brain tissue would collapse into the empty part).
I thought at first I would never play video games on a console again, but decided to keep at it for however long it was going to take, and it wasn't even three months before my hand stopped the spasms that would happen almost the instant I tried using the controller. Soon after I was able to finish Grand Theft Auto V and didn't even have to lower the difficulty. Some controllers give my hand a hard time, but many of the smaller ones are quite manageable.
I thought I wouldn't be able to use a rower or a total gym, my hand would lose grip after a short while. All it took was practice, I work out with both machines often now, and have not been in this good shape and level of fitness since my early twenties. The total gym or equivalent brand x machine is ideal for someone with my condition, when the tendons in one arm have shortened a bit.
Don't yield, don't quit, never give up.
My experience with rehab in the US health care system is exactly as described. About 3 years ago, I had a stroke caused by a rare bacterial infection called Whipple's. No damage to cognition, memory, or speech, but did cause a 2.5 cm x 4.0 cm wedge shaped lesion in upper motor sensory area on right side leaving my left side completely paralyzed & no sensation. I came home in wheelchair after 56 days in hospital. Now I can walk with a cane & AFO, move my arm, but do not have functional use of my hand. Working hard to recover and I spend a good part of my day doing rehab and I am still getting better everyday s-l-o-w-l-y.
I have a lot of learned non-use, muscle shortening, and spasticity to overcome. I am currently struggling with the choice of doubling my rehab efforts for another year or two, or just accept my condition and find some part time work and go on with life best I can.
I know it takes a huge # of repetition with intention to rewire the brain, but I am very frustrated the health care system does not recognize the need for methods & devices to help with this. Insurance will not pay for anything not proven and it is very hard to prove any aspect of stroke because there are too many variables and not industry standard of measurement. An old business saying is "If you can't measure it, you can't manage it."
Hey, very nice site. I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment. Thanks for sharing.
Wrist and Forearm Splint Right-Left
Keep Posting:)
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