Life After a Stroke

Getting your life back after having a stroke can be hard work and a slow process. But it's important to know that in most cases, you can do it. Your attitude, the skills you learn, and the steps you take may have a lot to do with your recovery.

Stroke, or "brain attack," is the third-leading cause of death in the United States after heart disease and cancer. It occurs when blood flow is interrupted to an area of the brain because of a blocked artery or blood vessel, or a broken blood vessel. When the flow of blood is cut off, brain cells in the affected area die, and a person loses control of abilities once controlled by that area.

A serious stroke can cause muscles on one side of the body to be weak or paralyzed, or the person can have difficulty seeing, speaking, or thinking. Stroke can affect the ability to walk, dress, or groom, or to engage in other normal, everyday activities.

Yet most people see improvements in the weeks and months after a stroke. For some, the effects all but disappear. Many others have lingering impairments but can learn ways to compensate so they can function again.

Setting high goals

Although you may think that stroke happens only to older adults, middle-aged and younger people—even those younger than 45—can have a stroke, says Richard L. Harvey, M.D., a stroke rehabilitation specialist in Chicago. "The focus of treatment ...is on helping people regain the full measure of their lives, including those who previously led youthful, active lifestyles," he says.

What factors affect success? Much depends on the area of the brain affected by the stroke. Another important factor in stroke recovery is depression. Many people who suffer a stroke become depressed.

The drive to succeed may overcome many obstacles to recovery. As an example, Dr. Harvey describes one of his patients who, until her stroke, had a successful career and regularly exercised. She was hospitalized, underwent extensive rehabilitation, and eventually was able to return to work part-time.

But she was not satisfied with her progress because of ongoing fatigue, muscle weakness, pain, and stiffness. Rather than getting discouraged with her physical therapy routine and giving up on it, as some people might do, she applied herself even more to it.

"She wants very much to get back to full-time work. She will do nothing less than what she needs to in order to get there," says Dr. Harvey. "That's the kind of person who does really well. It has to do with the willingness to shoot too high rather than too low."

Keeping up the therapy

Physical therapy exercises not only improve muscle strength, but when practiced intensely, they also appear to essentially "rewire" the brain, enabling a person to regain some real control.

"There is a very important balance between working on getting back your control and compensating for lack of control," says Dr. Harvey. "You need to be open to both."

Repetitively exercising weak muscles through physical therapy is an important part of recovery, no matter how severe your stroke. At the same time, occupational therapy can help you learn how to approach normal daily tasks in a new way, such as using one hand to dress yourself, walking with a cane or using special devices to help you eat or bathe. In addition, speech language pathology teaches methods for coping with problems related to speech, language, memory and thought.

Preventing a second stroke

Soon after a stroke, most people receive a full diagnostic evaluation and a plan for avoiding a second attack, because as many as 40 percent of stroke survivors have a second one within five years. They may undergo surgery to reopen blocked arteries, or be prescribed medications such as aspirin or warfarin to prevent new blockages.

In addition, a person can dramatically reduce the risk for a first or second stroke by making healthy lifestyle changes such as exercising regularly, according to a health care provider's advice; making healthy dietary changes; managing blood pressure and cholesterol levels; and controlling weight.