The other day, my wife and I were talking about my stroke recovery. It has been remarkable even though I am not patient. I want “me” to be back to like I was. That will never happen, but I do agree that I consistently make progress.
My
wife commented that when I had my strokes, I cried all of the time. I was startled. I do remember crying often
for a few days. However, when my wife said that I was emotional for months after the strokes, I did not remember that.
I started to think about
my emotions during those awful days and months.
I
now realized that I was very emotional. I now remember crying and sobbing a
lot.
One Saturday afternoon when I was in St. Alphonsus Hospital on the rehab
floor, I remember sobbing quietly to myself. The nurse asked if she could do
anything for me, and I said through my tears, “I really want to be alone.” She closed
the door softly, and I cried thinking my life was over.
Even now, two years and nine months later, I still get too emotional.
When
my wife told me about my crying, I started to research stroke and emotional
response.
I
found a website of the Burlington Chapter of Stroke Recovery Canada. It is very helpful explaining “Emotional and Behavioral
Changes After Stroke.” Here is a detailed excerpt that kind of explaining “ME!”
Emotional Factors in
Recovery
Following a stroke, the
patient's anxiety, fear, and frustration are enormous. Many stroke survivors
initially suffer confusion that makes it impossible to do the simplest mental
tasks. They often feel helpless and dependent, and their sense of self-worth is
diminished. It is important to understand the survivor's limitations and allow
an appropriate time for recovery. Self-worth, confidence and enjoyment of life
will gradually return.
Encouragement is an
extremely important motivating factor for stroke survivors. Caregivers should
avoid being critical. While inappropriate behavior should be pointed out, nagging tends to upset and anger stroke survivors, and discourages rather than
encourages effort.
Determination is essential
in overcoming the effects of a stroke. Patients must be willing to adapt to the
disability and be convinced that by therapy they will improve. It has to be
stressed that the will to recover does pay off. Nothing helps raise the body
and spirit of the survivor of a recent stroke like seeing how their own hard
work helps their recovery.
On a survivors return home,
the following guidelines will encourage a positive recovery.
- Set attainable goals the road to recovery is built of simple achievements.
- Involve the survivor in daily activities and routines.
- Encourage independent activities, while recognizing the survivor's limitations.
- Try to maintain social contacts within the family and community.
The Effects of Stroke
Different sides of the
brain deal with different areas of human intellectual functioning. Generally
speaking, brain damage due to a stroke causes the kinds of problems noted
below. However, it is important to note that brain injury in left-handed
individuals results in effects that are exactly the opposite of those explained
below.
Left Brain Injury
(right-sided weakness (hemiplegia)
Those with left brain
injury and a paralyzed right side are more likely to have problems with speech
and language. Apart from language problems, these individuals tend to be
cautious, hesitant, anxious and disorganized when faced with an unfamiliar
problem. Many of those with right hemiplegia need frequent assurance that they
are doing okay, with lots of immediate positive feedback. Breaking tasks down
into steps and practicing often will aid learning.
One-side neglect
Many stroke survivors have
visual field defects - up to half their visual field (what they can see with
both eyes) is, in simplest terms, not there. This is usually compensated for by
turning the head. However, some individuals, usually those with left hemiplegia,
have what ranges from a reduced to no sense that their left side exists, or
that anything or anybody approaching from that side exists. This is called
neglect, and is potentially isolating for these individuals.
Depression
Depression resulting from a
stroke is one of the most difficult factors for a spouse and family to deal
with. A certain amount of crying, though upsetting to the family, may be a
natural and normal emotional response to the stroke survivor's greatly changed
circumstances. However, chemical changes caused by stroke may result in deeper
depression and apathy, with the survivor appearing passive and detached, a
state that will usually improve with time.
Emotional Lability
Often, excessive crying
seems to have little relationship to sadness or what is happening around the
survivor. This loss of emotional control due to brain injury is called
emotional lability. Someone who is emotionally labile may not be sad when
crying, happy when laughing, or angry when appearing hostile. If possible,
interrupting the emotional behavior of such a person (by clapping hands or
snapping fingers) is usually a good idea, saving them embarrassment and
fatigue.
Change in Personality
Changes in personality and
emotional response are common after a stroke. The type, size and location of a
stroke, as well as the individual's previous personality all have a bearing on
what these changes will be. The stroke survivor may seem a different person,
showing feelings of anger, caution or anxiety that are completely out of
character. The affected individual may also feel this-and feel less of a
person.
Memory Deficits
Almost any brain injury,
however slight, may cause memory problems, contributing to language,
spatial-perceptual and retention span difficulties. For most stroke survivors,
remembering old information (from before the stroke) remains easy, while new
learning is difficult.
Generalization
Some stroke survivors are
capable of learning new information, but are unable to apply that learning to
other similar situations (generalization). For instance, they may make safe
transfers to and from a wheelchair while in the hospital, but are unable to
once at home. They may become very sensitive to and often fearful of changes in
their environment, and will thus benefit from, and be comforted by, an
effectively established routine.
Sensory deprivation and
over-stimulation
Many recent stroke
survivors are overwhelmed by too much stimulation. When visiting, go singly or
in small, quiet groups, and speak one at a time.
Conversely, some stroke
survivors may have diminished sensations of touch, pressure, sight or pain,
causing them to suffer a constant level of sensory deprivation, leading to
psychological stress. The quiet of night may compound this-a radio playing
softly or a soft light left on may help.
Quality Control
Even minor brain damage
affects a memory related area of behavior called quality control. This refers
to how well individuals check and control their own behaviour. A previously
fastidious person may fail to bathe or zip his fly, or a formerly polite person
may become rude and profane. Caregivers need to be aware of these deficits, and
praise appropriate efforts to compensate for them.
The
good news, I am still learning about my strokes. The “bad news?” I am still
learning about my strokes.
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