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Lack of Energy Following Stroke
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Lack of Energy Following Stroke

I am 50 years old and I had a stroke on 2/19/07.  I was lucky and got to the hospital in time for the doctors to administer tPA, and the paralysis in my arm and leg were 99% reversed.  My question is that I am wondering why I still have no energy and want to sleep all of the time two weeks later.  If the stroke was reversed, why am I still so tired?  And how long will it be before I can expect to regain my energy?  All answers and opinions will be greatly appreciated.  Many thanks.
Tags: Stroke, brain
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Avatar_n_tn
     You lack energy bcs your body, particularly brain, has withstood an enormous assault.  So what to do about it?
     Do you have to go to work yet?  If not, there's a fine line between wisely giving yourself a chance to heal and contributing to your own lethargy.  I'd recommend you get up early and get out in the sun for 20 min. as early in the day as you can.  Do regular chores on a regular-ish schedule.  Plan some interesting activities so you won't be tired as a result of boredom.  But rest before you become exhausted.  A couple of naps a day are not too many, only two weeks post stroke.  
     And don't kid yourself.  tPA did not cause the stroke not to have happened, it only dissolved your clot.  You were still hit in the head with a baseball bat, even though you were lucky enough to recover well from the blow.
     Good luck to you, and take it easy.  
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Avatar_n_tn
How is your husband doing... Haven't heard from you in a while.. My dad is getting a little stronger, but still not walking on his own.  His short term memory is still pretty bad, but overall he is doing much better....
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144586_tn?1284669764
This is a complex question. The lack of energy and the excessive sleepiness of many post stroke survivors are related issues. Unfortunately, there is not a lot that we know about the human brain. Both sleepiness and tiredness are related, and these are generally hormonally related. And related to the circardian cycle. Hormones are signaling substances, generally polypeptides. For example a hormone called TRH makes the pituitary gland produce thyrotropin. But you can investigate the hormone system in your own without me boring you to tears. Strokes often distrupt temporal rhythyms. The good news is that the study of these problems is called chronobiology and it has become a new medical specialty. It has been less than two decades since Dr. Harvey Moldofsky established a center to study such disorders at the University of Toronto. Now there are many excellent physicians and centers, including one at Mount Sinai New York. In the short term sleepiness and tireness is to be expected after a stroke, however if this continues a consult with an M.D. who specializes in chronobiology is indicated.
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Avatar_n_tn
Oh, lahinva my unknown friend, it's so sad.  My husband & I came to India to work under Dr. Vasa bcs he began to resent my constantly telling him what to do.  He was slowly but surely making significant, important gains and I was very glad we had come.  Then a bit over two weeks ago he fell in bath and hit his head.  No loss of consciousness, and according to two CT scans no brain bleed, but as he was pulled up from floor he began speaking gibberish, with occasional intelligible word or phrase mixed in, and he his speech has not recovered.  I keep reminding myself that it could have happened anywhere, but we're so sad.
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Avatar_n_tn
Thank you, Tressa, for your response.  I think I do forget the fact that my brain has been assaulted, since the tPA did reverse the damage, but yes, I was "hit on the head with a baseball bat," and because I look the same and have no paralysis, I somehow felt that I should be back to normal.  Your answer has made me realize that I am expecting too much from myself only two weeks out.  I am lucky, I do not have to go back to work yet.  Your advice is excellent, I know I do feel better when I at least get an early shower and get dressed and putter around the house and do some "fun" things rather than just the dull ones, i.e. laundry, which I really haven't done much of yet anyway.  I am glad to hear you say a couple of naps a day are normal, because it seems that after three or four hours of being awake, I just MUST lie down.  Yes, I was very lucky to have been treated with the tPA within that magic three-hour window.  Thank you for your kind words, and your response.  I am taking it easy, truly because I have no choice, but also because I know I have to.  I read your post to Lahinva, and I am sorry that your husband has struggled so and that you are both sad.  He is lucky to have you in his life, I can see that.  
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Avatar_n_tn
I am so sorry to hear about your husband... You have to remember that you are **** so much to help him and hopefully his speech will return soon...I will keep you both in my thoughts and prayers...
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Avatar_n_tn
Thank you, caregiver, for your response to my question.  I am just learning about this wonderful organ we possess called the "brain," and how it works.  I  have read online about how common tiredness and sleepiness are following a stroke, but, as I posted to Tressa, I look the same and feel the same (thanks to tPA), and I guess I don't understand why I can't seem to do much of anything or stay awake!  I know I have to be patient. You mentioned the circadian rhythms, it's funny but I seem to be wide awake from late afternoon until sometimes the middle of the night, and have slept some days until 5 p.m.  Perhaps the stroke mixed up my days and nights.  And when I am awake at those odd hours, I still have no energy to do much but sit at the computer or watch TV.  It is a mystery, for sure.  Oh, I am a very inquisitive person, and your post will lead me once again off to google to research these subjects.  Thank you for your good advice about following up with a doctor.  I have an excellent primary care physician, and I will be following up with him on a regular basis.  He told me that I should feel better week-to-week rather than day-to-day, and I hope that is true.  It is just so frustrating to have no energy and fall asleep at the drop of a hat, but yes, I know, I am a very lucky lady. Thanks again for your good advice.  
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144586_tn?1284669764
It is impossible to diagnose or provide reliable medical advice on the net without proper personal evaluation and input from and M.D. That being said, and you being an inquisitive person, look into the role of the suprachaismatic nuclei, the master body clock, consisting of two clusters of 50,000 or so neurons, one on each side of the brain. And the use of light therapy to reset the circadian cycles. One of the reasons for "tiredness" can be abnornal glucose utilization syndromes, which can generally be identified by what is called the "Insulin Clamp Test". Ask your physician about it. It is often states that diabetes and insulin syndrome can cause strokes, but there is also evidence that strokes can exacerbate or induce such syndromes. (1) Kawiak W, Stelmaskiaksi: Investigations on glucose metabolism in patients with cerebrovascular accidents Polish Med J. 6: 942-949 1967 (2) Hallpike Jr., Claveria LW, Cohen NM et al: Glucose tolerancde and plasma insulin levels in subarachroid hemorrhage. Brain 94 251-164, 1971.
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Avatar_n_tn
Iam 68 and had my stroke fivemonthsago. My energy level is low nd I can exhaust myself overthe simplest task. My neurologist said itcouldbe years before I'm back to normal. I walk a lot especially
an slight up hill course so that helps.
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Avatar_n_tn
Iam 68 and had my stroke fivemonthsago. My energy level is low nd I can exhaust myself overthe simplest task. My neurologist said itcouldbe years before I'm back to normal. I walk a lot especially
an slight up hill course so that helps.
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Avatar_f_tn
After my stroke in 11/07, I too was so exhausted that I could barely get out of bed.  I have a 2 and 4 year old kids so staying in bed is not an option.  After talking things over with my doc, I started going to the gym and walking on the treadmill (really slow) and doing light weight lifting (5 lbs) and it took about a month and my energy has increased.  i think laying around can make you more tired.  I was like you with my stroke and had tPA and the MERCI retriever done on me and made an immediate come back and didn't need rehab.  But like the earlier posts, we still were hit in the head with a bat.  Another thing is your meds.  Sometimes meds can make you tired.  Definitely talk to your doc about this.
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Avatar_m_tn
Thank you for your posts. I am going through this tiredness phase and I find your words very encouraging.I am a diabetic as well and I'm sure that doesn't help. Thank you especially for your interest in helping others navigate these very troubled waters,
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