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recovery after massive stroke

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?
184 Responses
Avatar universal
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
Avatar universal
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.
Avatar universal
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?
Avatar universal
Very common.  Neither bad nor good, just reflexive.
144586 tn?1284669764
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.
Avatar universal
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
338899 tn?1195795569
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!
Avatar universal

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.
Avatar universal
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 and training to help the stroke patient relearn everyday activities, sometimes called the Activities of daily living (ADLs), such as eating and drinking, dressing, bathing, cooking, reading and writing, and toileting. Therapeutic recreation works on several areas including problem solving, improving movement and re-entry into the community through familiar, new, and adaptive leisure skills.
Stroke rehabilitation can last from a few days up to several months. Most return of function is seen in the first few days and weeks.
Hope you find this information useful.
Avatar universal
My husband (43) had a massive stroke on his left side 19 months ago. And he is walking with a cane and a walk gate now. But his fingers are not opening at all.

I'm afraid that he wont be able to ever move his fingers again. Do anyone out there seen stroke victims move their finger and open and close them after 19 months?

I also heard that what ever you get back after 2 years is what your left with?

We got the Saeboflex for the hand but no results yet on any finger movements.

Please tell me what might happen in the next 6 months.

Avatar universal
My 62 year old mother had a right-sided massive stroke on May 9.  She will be getting out of rehab on June 20, only because insurance will not pay for anymore rehad.  My dad has talked to the insurance company about any extentions, but of course, they do not care that she will need probably another good 6 months of rehab.  Does anyone have any ideas of things my dad can apply for (besides disability) to help pay for additional rehab?  Thank you so much for your help!
Avatar universal
I don't know what state you're in, but looks like medicaid should step in and help.  Also, you might be surprised at the help that is available through an "elder" attorney.  We recently found that my Mom is due veteran's benefits after her stroke due to my father's time in the service.
Avatar universal
On June 22, 2008 my mother had a massive stroke, due to high blood pressure. She was awake and talking when she arrived to the hospital, now she is in a coma. Doctors are currently draining fluid from here brain, I was told this is a slow process and could take several days if not weeks. She responds to pain and at times responds to commands of myself and doctors. Has anyone had a similar experience, if so any advice will be truely appreciated. I am a only chid.
338899 tn?1195795569
Hello.  I went through the same thing you did last year.  My husband had a stroke that happened because of uncontrolled blood pressure.  You can read all my posts to get the full story.  He was half comatosed when I got him to the hospital.  He had started stroking about 4 hours before I realized something was very wrong.  To make a long story short he came out of it with very little deficits.  His healing was truly a miracle.  He was in the hospital a total of 4 weeks and in rehab for 3 weeks.  He is now driving, taking care of himself and doing very well.  He is on total disability because he now has double vision.  Although, people that have hemorraghic strokes have a higher mortality rate than those that have clots, they often heal much better.  I can try to help you with many of your questions by sharing my experiences with you.  I know how you feel.  You're going to go through an array of emotions and you're going to get frustrated with doctors.  Just realize that if the doctor says "we don't know" they're right.  No one knows the extent that your mom will heal.  A lot of times they paint a glim picture but it may not be all that bad.  Keep in touch and let us know how she is progressing.  
Avatar universal
My grandma, age 82, had a major stroke on her right brain, leaving her somewhat paralyzed on her left side. She stayed at the hospital for 1 week then was transferred to an acute rehab facility for 3 wks before she was discharged.  She currently can move her left leg but her left arm is still pretty weak but gradually getting better. Although she can move her leg she still is unable to stand straight (tend to lean her body to the left) and needs assistance with the hemi-walker and to the commode. My family and I are devastated to see her like this but we pray for her speedy recovery.  I just wanted to express my deepest sympathy to everyone with loved ones who are going through the same experience.  Just be supportive and shower them with love.  Believe in the power of miracles.  And never stop fighting.  
Avatar universal
I keep reading about left sided paralyze but how about a right sided.  My mom was 60 years old when she suffered a massive stroke in 2001. She is not able to move her right arm and she drags her right foot when walking using a quad walker.  She can sing and say names when we ask her to, but not on her own.  Her memory is great but she can't talk. I am her only daughter and the youngest with seven brothers.  You can't imagine what I have to go through taking care of my mom.  In our culture, daughters have to care for their mom if she is disabled.  Sometimes I wish I wasn't born.  Any help will be great!
338899 tn?1195795569
She is hurting now and she doesn't need you telling her what a bad daughter you think she is.  Look at it from her point of view...she is the youngest, she is an only daughter and she has 7 older brothers, so she was probably overprotected or maybe after 7 years she's a bit burned out.  Some people, such as yourself, may be stronger than others but it's no reason to belittle them. She may not have the financial means to quit her job like you did or even hire a full time nurse to take care of her mom.  You don't know her situation so it's really unfair for you to judge her. I really think you owe her an apology.  I know this is none of my business but it is an open forum and I just had to comment.  

Judi, I keep wishing I could turn back the clock to a time before my husbands stroke but I can't.  You just have to make the best of it and do what you can to make your mom comfortable.  None of us wanted this to happen to our loved ones.  Many of us have a life that's very different now because of a stroke.  Don't give up.  Like they say, when you're thrown a lemon, make lemonade.  You are not alone.  I miss the way my life used to be before my husbands stroke but at least he is still here with me.  He's different and most of the time I feel like a caregiver instead of his wife.  When I start feeling sorry for myself I remind myself that it could be worse.  My husband could be a vegetable or even dead.  He is doing much better than some whose stroke wasn't as bad as his.  Your mom is walking and her memory is intact.  Those are blessings.  You must look on the positive side or the situation you're in can eat straight to your soul.  One thing laaz said that I do agree with is that your mom didn't ask for this and  I'm sure she wouldn't want you to have to take care of her.

Keep your chin up and I hope things get easier for you.  I really hope your mom will show more improvement.  It still is possible even after 7 years.

Avatar universal
On March 20, 2008, I suffered a bleeding massive stroke which led me into a coma and on life support with left-sided paralization. On the same day and time, I lost my Mother. Today, I am walking with assistance with the care of my daughter and boyfriend.  I believe they are tired as well and they let me know, but I thank God for them and my sons as well, they'll come if called.

Jud670, don't ever wish you weren't born.  I cared for my grandmother and my mom and I have 5 brothers.  Have you asked one of your brothers for assistance.  Some times boys/men want you to ask, instead of just volunteering.  If you believe in the power of prayer;  Pray for strength.

For myself, things are coming together and I would like to know if anyone has any knowledge on arm spasms of a frozen shoulder.  This is the main problem I am having at this time and my therapists can't figure it out.  I had to go over what happened when I had the stroke repeatedly for the information they received was incorrect, now it's corrected.  I've been told, they are unsure of how to treat me, because, I was suppose to be dead.  I'm getting use to this statement.  If anyone has information they would like to share, it would be greatly appreciated.
Avatar universal
My husband's cousin is 42 years old she had a massive stroke she is nonresponsive, she seems like she may be developing pneumonia, they are telling us they have a schedule to suction her, what could be the prognosis, she has always had problems with her high blood pressure and she never stopped smoking.
Avatar universal
All these posts left me speechless!  Take a breather everyone!  Lighten up!  All of our lives are HARD or we wouldn't be on this board!
597239 tn?1223782370
hi, I'm an occupational therapist, I was working on a research on CVA patients in acute phase recently. about your questions I should say:
- in most patients I saw, the swelling was absorbed till 5 months but it is not a standard duration may it take more times for your mother because as u said she had a massive stroke
- the neglect is a common disorder in right hemisphere disorder which can not said to be completely solved but I think it can be improved in your case as the edema absorbs by the time but rehabilitation can take a great measure in this context by sensory stimulation.
- I have not seen your mum but I'm optimistic about her walking. physical therapy is really effective for gait training and most patients can walk again.
the points which u should pay attention are :
1- your mum is not so old. so the power of neuroplasticity  in the brain is high, specially if you stimulate it by practice
2- the first 6 months after stroke is the golden time for rehabilitation so do rehabilitation every day and regularly. it doesn't mean that after there is no result for rehabilitation, but this period is more important
3- don't forget that practice all the day I don't know how many houres do you practice a day but I always tell to my patients, the more practice, more result.
4- occupational therapy works on upper extrimity and their work on upper limb usually has more effects and the other point is that usually arm improves more slower than leg!
Avatar universal
I am 43 years old and had a massive stroke on Oct1 2004. I also have seemingly uncrontrolled high blood pressure.No matter what meds I am on my reading is always high. My stroke almost unheard of came from my blood pressure and the stomach flu.I became very ill at work and a supervisor needed to drive me home. The stroke occurred from weakened caratod arteries from the high blood pressure with massive vomiting from the flu/bug. While vomiting hard it felt like I ruptured a tonsil. Then loss of vision, severe headache and crying from the pain. By the grace of god my spouse came home early and found me. He gave me 4 advil (and I don't get headaches) and stayed with me till I slept. When I woke I realized my right arm felt fine but was not working. I am a smoker and I burnt myself. Also vision was not right. I had white dots like someone just took a picrure with a flash. I could walk and was lucid mentally but when I tried to talk,what I wanted to say came out as jumbled spiratic words. He looked at me like I was nuts. Anyway I waited the wholw weekend and saw my Dr. Monday. Sent right for an MRI which immediately I was told to get to ER I had three blood clots on my brain. I didn't get the thre hour meds. But I recovered fairly quickly because of my age. The hand thing is always last to recover. I know this from my therapy and a very good friend who does home nursing. It is the last thing to come back. Never give up. Always encourage. Anything is possible. Where this is a will there is a way.
Avatar universal
My mother is 80 and just had a stroke 5 days ago.  Unfortunately the dr. did not recognize her signs so she was not given any drugs for her stroke.  She walked into the hospital and now has no ability to move her left side.  She could move her right side after the stroke but the last couple of days she is saying her ability to do so is decreasing.  We are at a small hospital.  Do we get her out of here?  Is this in any way "normal"?  She has not really made any gains in the past five days.  She is also VERY tired constantly.  She can hardly stay awake for therapy.  Prior to her stroke she was very active and still working.  Can anyone help me?
Avatar universal
Hi mountaingirl;
very glad to hear your recovery seems to be going well - it gives us all hope.  In your post, you commented that you recovered "fairly quickly" due to your age - may I ask about your recovery?  About how long and how much have you recovered?  My brother had massive left side ischemic stroke 2 mos ago and is recovering slowly but surely. Was too late for tpa but he's in a rehab hospital getting lots of therapy and is due to be discharged in 2 weeks.   He also has age on his side (49 yrs old) but I'm curious to know the experiences of younger stroke survivors.   I hope you continue to get stronger and stronger. It sounds like your spirits are good and that is wonderful.
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