recovery after massive stroke

[aunt juju]

My 59 year old (otherwise healthy) mother had a right side brain stroke two weeks ago. The DR. said it was prety massive on most of the right side, leaving her unable to move her left side.  She is able to talk, eat, drink, and able to answer any question. (still not completely normal in thinking and talking, but really close.)

She started a live-in rehab last thursday (3 days ago) and now can move her left leg some.  Stil no movement of the arm.  She does have the neglect of the left side. my question(s)

1.  How long does the brain swelling take to go completely away?

2.  Well the neglect she has get better?

3.  Well she be able to walk and move her arm, and if so how long with rehab will that take?

[vja]

I am not a doctor.  I only know what I have been told in regards to my mother who had a massive stroke.  All strokes are different, all recoveries are different and depend on several factors.  I know this does not help much, but it is true.  The brain swelling depends on the size of the stroke and I believe it takes a few weeks, but best to ask the Dr. on that one.  Regarding the neglect, you can help this situation by making people approach her from her left side..also place her bed so she has to look to her left to see people enter the room..hold her left hand, tap on her left arm...try to make her aware of that side.  Re arm movement coming back...I have been told that the arm and hand movement is one of the last things to come back, due to the fact that it takes so much "brain power" for hand movements...she will probably walk first.  I hope these posts help you, it is very hard for the family and the stroke victim. Vicki

[amber0987]

My father had a similar sounding stroke on Dec. 8, 2006.  He seemed pretty alert, spoke well, could swallow, etc.  His major problems were left side paralysis and double vision.
After about three weeks, he took his first steps and within 2 weeks of that was walking 40 feet with a walker.  He was not able to start moving his left hand until about 4 weeks in.  At that point, he could move all fingers and make a loose fist.

[aunt juju]

My mom is doing better.  She has been in a live-in rehab for 2 weeks.  She is walking with a hemiwalker and a Physical therapist about 20 feet now.  She can move her shoulder a little and the muscle in her upper arm are tighting.  She can push her arm out and pull it back on a table with OT.  Her leg is able to move her upper part and today she flexed her foot some (a little) With your father was the progress soooo slow?  And has anyone seen the paralysised arm move when the person yawed?  Her arm well raise up when she yawns....  Bad or good?  anyone know?

[Tressa999]

Very common.  Neither bad nor good, just reflexive.

[caregiver222]

You have to be very careful about having a bowel obstruction. The aides have to maintain both a daily hydration log and provide a daily bowel report. Abscence of a bowel movement for three consecutive days is grounds to go to general quarters. The biggest offender is cheese (unfortunately a favorite of my little 102 year old pal) and of the cheese offenders the inexpensive Kraft macaroni and cheese is the worst. It contains a chemical that causes it to harden, and it continues to harden in the gut and will not negotiate the turns in the intestine. In addition, stroke patients often have peristaltic and motility problems. These are the sequential muscular waves that drive waste through the passageways down to the rectum. She has a good chance of great improvement, proving the initial problem that caused the stroke is stabilized. Never give up hope.

[Dina907]

My husband is 62 years old and had a massive stroke on Tuesday.  They were able to give him the medication within 3 hours.  He has been lucid from the begining,aware where he is, etc.  He also asks me about household things, like is this working, did you remember to do this, I am taking that as a good sign.  His sense of humor is back but his focus is unfocused when he looks at you.  Do they ever come back to who they were?  His left arm has no movement but his left leg does. His right side is okay, I guess I am asking, what am I in for, is this how he is going to be for the rest of his life, we have a 14 year old daughter, and it's breaking my heart to see her so upset about her dad. dina

[PamRam228]

Dina907, your husband was very fortunate to have reached the hospital when he did so the doctors could administer the tpa drug (if that's what they did).  It is so early in his recovery and you, your husband and your daughter have a lot to look forward to.  Although your husband isn't a spring chicken he's not all that old, either, and that will help his recovery.  You will be amazed at how he bounces back.  My husband (56 at the time) had a stroke last July and he has problems with his eyes. He has developed double vision. He, at first, was paralyzed on his left side but all that came back.  He's almost back to his old self.  

So, chin up and smile.  Although, no one knows the extent that your husband will recover you can be assured that he's on his way.  Make sure you find out what kind of stroke he's had (bleed or clot) and ask about deficits...what part of the brain was affected.

Keep posting about his recovery!

[Hope111975]

Dina,

My 65 year old father had a massive right sided stroke 7 weeks ago.  He too had total left sides paralysis, but all his mental faculties remained intact, save for slurred speech which improved in a few days.  He missed the 3 hour window for the TPA, unfortunately.

He is now 7-8 weeks out and just came home a week ago following 5.5 weeks in acute inpatient rehab and 4 days in the hospital.  He has PT, OT, and VNA coming into the house, my mother and 2 siblings (brother, 28, and sister, 21) live at home and are helping him.  He is now doing some walking with a hemi walker and assistance, but he is very unsteady and he fatigues quickly.  He needs help getting out of the chair and the bed to a standing position.  He is able to feed himself and use the urinal, but needs assistance and a walker to the commode for moving his bowels.
On a positive side, he can speak, is 100% mentally and cognitively, and is right handed and so write and feed himself.

He initially had no use of his left leg and some of that is coming back (when he walks he swings from his hip to bring his left leg out, and he wears a brace to prevent foot drop on his left lower leg), and he is just now this week slowly getting some function back in his left arm- though it's very limited.  He can move his left thumb a bit, and very gently squeeze my hand, and he can pull his arm back towards his body when it is moved away from his body.

His PT said that the flexor tone (muscles which pull the arm towards the core of his body, curl his fingers and wrist) come back before the extensor tone does (muscles that extend the fingers, and move the arm away from the body.)  It's important to do passive range of motion on his neglected arm to prevent the muscles from locking into painful contractures.  My father also wears a brace at night to keep his forearm and wrist in an extended position so it won't lock up flexed.  He wears a shoulder strap/sling to protect his left shoulder from the weight of the dead arm as well, as those shoulder muscles are fragile and not repairable if damaged.

At present my mother is having a wheelchair ramp built going into their house and has had a bed rail made for him and grab bars in the bedroom and bathroom, and the home health aide is supposed to come this week with OT and help get him into the shower.  It's a long process, and we still don't know how much function will come back.  His doctor said to expect a good 9 months before we start to get an idea.

You and your family are in my thoughts, I hope you will come back and up date us.

[Dr_Aparna]

Hi,
Stroke rehabilitation, or, in more optimistic terms, stroke recovery, is the process by which patients with disabling strokes undergo treatment to help them return to normal life as much as possible by regaining and relearning the skills of everyday living. It is multidisciplinary in that it involves a team with different skills working together to help the patient. These include nursing staff, physiotherapy, occupational therapy, speech and language therapy and usually a physician trained in rehabilitation medicine.
For most stroke patients, the rehabilitation process includes nursing, occupational therapy (OT), physical therapy (PT), therapeutic recreation (TR) and speech therapy (or speech language therapy, SLP). OT involves exercise