Recovery after a stroke
Concentrating on a card with the number "four" on it, the patient thinks very hard about her answer before saying, "six." You see, the patient knows that the number is four. She can pick it out on a clock or in a list of numbers. But she is struggling with aphasia (trouble using language) after having a stroke, and she just can't seem to find the right word to describe the number verbally.
"The brain controls how people speak, comprehend, feel, think, behave and move, so when a stroke occurs, all of these abilities may be affected," states
Mitchell Rubin, MD, board-certified neurologist and director of Virtua's Stroke Centers.
Get to a stroke center
Rehabilitation begins right in the hospital
Taking recovery one day at a time
A comprehensive plan
Seeking support throughout recovery
Signs of a stroke
Get to a stroke center
The decrease or loss of abilities depends on how quickly the stroke is treated, its severity and where it occurred in the brain. That's why it's vital to seek medical treatment at an established stroke center as soon as symptoms occur.
When admitted to one of the Virtua Stroke Centers, which were established according to the guidelines of the National Institutes of Health (NIH), a patient is first stablized. Then the stroke team, which includes neurologists, emergency room physicians, radiologists and nurses, completes a battery of tests to make a diagnosis. This may include a medical history, physical and neurological exam, blood tests, a CT scan and other diagnostic tests.
Rehabilitation begins right in the hospital
According to Kathleen Lee, MA, CCC/SLP, director of the Virtua Rehabilitation Network: "A patient is evaluated within 24 hours of the stroke by a multi-specialty rehabilitation team, which includes physical (PT), occupational (OT) and speech therapists, nutritionists, and other specialists. The team works with patients to see if they can independently get out of bed, bathe, eat, take medication and perform other mental and physical tasks. If they can't, the staff works them each day to help them re-learn these skills. " This team also helps determine where patients would receive the most suitable care after leaving the hospital
"Some patients go home and receive home care or outpatient rehabilitation, but others need more intensive rehabilitation," states Jamie Strause, MSN, CRNP, director of the neuroscience program of excellence at Virtua. For these patients, Virtua offers long-term rehabilitation programs at the Virtua Health and Rehabilitation Centers in Berlin and Mount Holly. At these centers, patients receive at least three hours of rehabilitation each day to improve strength, endurance and other skills.
Taking recovery one day at a time
Patients who participate in Virtua's outpatient rehabilitation program may be seen as many as two to three times a week by a staff member from PT, OT and/or speech therapy. Using everything from stretchy bands and huge, bouncy balls to weight machines and treadmills, physical therapists work with patients to help them improve mobility, flexibility, balance and strength.
Occupational therapists help patients re-learn functions such as dressing, bathing, and grooming, as well as telling time, counting money and other functions. Patients who have problems with speech or swallowing work with a speech therapist who identifies and treats strengths and weaknesses, and sets up a plan for communicating with family and friends.
A comprehensive plan
Together with the patient and family, the team creates one comprehensive plan and sets realistic goals. "For some, the goal may be to get around the house or to cook independently, while for others it may be to garden, bike, or keep up with grandchildren," states Maria Franchio, physical therapist and manager of Virtua's outpatient rehabilitation services. "We want to help manage their expectations, while still encouraging them to work hard toward their goals."
Seeking support throughout recovery
The team also provides emotional support for patients who have a hard time coping with the effects of the stroke. "We try to help patients through the emotional ups and downs so they can focus on gaining back their lives and independence," states Franchio. Virtua also provides stroke support groups that meet once a month both at Virtua Health and Rehabilitation Center at Mt. Holly and Virtua Voorhees.
"A stroke is a traumatic, life-changing event that happens in an instant, yet recovery can take months," states Dr. Rubin. "My best advice is to be patient but diligent throughout rehabilitation and to accept the support of family and friends."
The Virtua Stroke Centers offer comprehensive stroke diagnosis, treatment and follow-up care, as well as stroke-risk assessment, prevention and rehabilitation. For information on these services or a free fact sheet about stroke, call 1-888-Virtua-3.