Medical Issues

Many people feel sad after a stroke. This feeling is not surprising, since a stroke is a very serious medical event that can be life altering. It is normal to feel sad, upset or angry as the stroke survivor discovers the extent of his or her challenges throughout the recovery process. These feelings may gradually start to fade away as function improves, but a period of grief is normal. In some situations, these sad feelings don't go away and the person becomes depressed. This can happen months or years after a stroke. It is important for friends and family of stroke survivors to be aware of signs of depression, such as changes in sleep patterns, appetite, weight or feeling sad all the time. Individuals with a prior or family history of depression and those with significant communication difficulties are particularly at risk for depression after stroke. Many stroke survivors find antidepressant medications and/or professional counseling to be helpful in improving depression. Survivors should be urged to address their feelings of depression and get the necessary help. If left untreated, depression can significantly slow down the recovery process.

Because of the imbalance in muscle strength between the stronger and weaker sides of the body, many stroke survivors have difficulty maintaining their balance when sitting, standing or walking. Changes in vision, perception and sensation can further complicate balance problems. For example, some stroke survivors can't feel their weaker leg or foot as well as the stronger side, which can make walking more unstable. Difficulties with balance can make stroke survivors at risk for falls or further injury. For this reason, balance work is an important part of the rehabilitation program. Once the stroke survivor is able to attain balance while sitting and standing, they are able to complete tasks more safely and efficiently. Improving balance also helps to make mobility easier.

Some strokes cause significant visual changes. Some people can not see things on the left or right. This is called hemianopsia and is caused by the damage to the brain. Individuals with hemianopsia may bump into things, ignore people or objects on one side, or have trouble reading. There are exercises that can help compensate for these visual changes. Other strokes cause double vision, or diplopia. This type of visual change is often helped with special glasses or an eye patch.

In some situations, visual changes cause stroke survivors to have difficulty recognizing faces. They may see well, but have difficulty recognizing faces or objects. This difficulty may occur even with family members and close friends. Unfortunately, glasses do not help in most of these situations, since the problem is in the brain and not in the eyes. A neuro-opthalmologist can help to diagnose these visual changes and recommend treatment options.

Some people have difficulty using the bathroom after a stroke. There are many different reasons for this problem. Changes in the brain may make it difficult to control the bladder and bowels. Physical problems can impede survivors getting to the bathroom quickly, since moving takes more effort and time. Stroke survivors with communication problems may have difficulty requesting the help that they need to get to the restroom. Stroke survivors having difficulty with continence should discuss their concerns with their doctor and therapists. Dietary changes and adaptive equipment may help with some continence issues.

Damage to the brain causes some stroke survivors to have seizures which can happen long after a stroke. The damaged brain tissue causes increased electrical activity, which results in a seizure. A person may feel confused, tired or frightened after a seizure. Talking may be more difficult. It is important to make sure that seizures are reported to the stroke survivor's doctor. Medication (called anti-convulsants) is used to prevent additional seizures. It may take a while to find the right medication and the right dosage to control seizures, and the medications may have unpleasant side effects (such as fatigue). Individuals who have had seizures should check with the Department of Motor Vehicles to learn about the driving laws, since seizures may prevent a person from driving. While seizures can be very scary medical events, they can usually be controlled.