Life After a Stroke: What You Should Know

May 21, 2024

A stroke affects the brain’s arteries and occurs when a blood vessel that brings blood to the brain gets blocked or ruptures. The area of the brain that is supplied with blood by the blocked or ruptured blood vessel doesn’t get the oxygen and nutrients it needs, and without oxygen, nerve cells are unable to function. Since the brain controls one’s ability to move, feel, and think, a stroke can cause injury to the brain that could affect any or all of these functions.

Everyone should know the signs of a stroke and seek immediate medical attention if you think you or someone around you is having a stroke. If you or someone you love has recently had a stroke, then it’s important to understand what happens next.

Know the Symptoms of a Stroke and act FAST

The longer the brain is left untreated during a stroke, the more likely it is that someone will have irreversible brain damage. The acronym FAST can help everyone recognize the four main signs that someone may be having a stroke and remember to act fast in seeking medical treatment. That means calling 9-1-1 immediately, as emergency response workers can treat someone on arrival if they think that person is having a stroke.

FAST stands for Facial drooping, Arm weakness, Speech difficulties, and most importantly, Time. If one side of a person’s face is drooping, if the person cannot lift both arms or one arm is drifting downward, and if the person’s speech is slurred or they cannot repeat a simple sentence, then they may be having a stroke. Not all of these signs need to be present to signal a stroke. Just one or two of these symptoms is enough to call 9-1-1, because time is of the essence in the event of a stroke.

Stroke Treatment Begins With Emergency Response Workers

Calling for an ambulance means that the emergency response workers can start life-saving treatment on the way to the hospital. Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly than people who wait to drive themselves. The emergency workers may also know best where to take someone, such as to a specialized stroke center to ensure that they receive the quickest possible treatment. The emergency workers can also collect valuable information for the hospital medical staff before the patient even gets to the emergency room, alerting staff of your arrival and allowing time to prepare. All of what the ambulance team can provide saves time in the treatment of stroke, and in the event of a stroke, time is of the essence.

Ischemic Stroke or Hemorrhagic Stroke?

There are two different kinds of stroke, ischemic or hemorrhagic. A medical team will need to determine which kind of stroke the patient is having in order to direct treatment. An ischemic stroke accounts for 87% of all strokes and happens when a blood clot blocks a vessel supplying blood to the brain. Hemorrhagic stroke happens when a blood vessel ruptures and bleeds within or around the brain.

Fifty percent of strokes present with a clot in a large vessel in the brain, and these don’t respond very well to the old treatment, the IV clot busting medicine,” says M.D. and director of the Sparrow Comprehensive Stroke Center Anmar Razak. “And so nowadays, we do surgery, and what we do is we rush them into the hospital, into the cath lab. We quickly get access through the blood vessels and get up to where the clot is and pull it out.”

With ischemic stroke, the treatment goal is to dissolve or remove the clot. A medication called alteplase or tPA is often administered and works to dissolve the clot and enable blood flow. Alteplase saves lives and reduces the long-term effects of a stroke but must be given to the patient within three hours of the start of a stroke. Then, a procedure called mechanical thrombectomy removes the clot and must happen within six to 24 hours of stroke symptom onset.

For hemorrhagic stroke, the treatment goal is to stop the bleeding. There is a less-invasive endovascular procedure involving a catheter being threaded through a major artery in an arm or leg toward the area of the bleeding in the brain where a mechanism is inserted to prevent further rupture. In some cases, surgery is required to secure the blood vessel that has ruptured at the base of the bleeding.

Rehabilitation After a Stroke

Perhaps the most important part of stroke treatment is determining why it happened or the underlying causes of the stroke. Stroke risk factors include high blood pressure, which weakens arteries over time, smoking, diabetes, high cholesterol, physical inactivity, being overweight, heart disease including atrial fibrillation or aFib, excessive alcohol intake or illegal drug use, and sleep apnea. By making the right lifestyle choices and having a good medical management plan moving forward, the risk of another stroke can be greatly reduced.

That’s because if you have had a stroke, you are at high risk for having another one. One in four stroke survivors have another within five years, while the risk of stroke within 90 days of transient ischemic attack or TIA is as high as 17% with the greatest risk during the first week. This is why it becomes so important to determine the underlying causes of the initial stroke. Your doctor may give you medications to manage a condition, such as high blood pressure, and then recommend lifestyle changes, including a different diet and regular exercise.

Rehabilitation after a stroke begins in the hospital, often within only a day or 2 after the stroke. “There are so many things that patients need to fall into place to be functional and independent again after a stroke,” said Razak. “And they always come down to speed and time.” Rehabilitation can help with the transition from the hospital to home and can help prevent another stroke. Recovery time after a stroke is different for everyone and can take weeks, months, or even years. Some people may recover fully, while others may have long-term or lifelong disabilities. Stroke rehabilitation should be thought of as a balance between full recovery and learning how to live most effectively with some deficits that may not be recovered.

What to Expect After a Stroke

Difficulties from a stroke range from paralysis or weakness on one or both sides of the body, fatigue, trouble with cognitive functioning such as thinking and memory, seizures, and mental health issues like depression or anxiety from the fear of having another stroke. Everyone’s rehabilitation will look different based on their difficulties after a stroke but may include speech, physical, and occupational therapy. Speech therapy helps when someone is having problems producing or understanding speech, physical therapy uses exercises that help someone relearn movement and coordination skills, and occupational therapy focuses on improving daily activities, such as eating, dressing, and bathing. Joining a patient support group may help people adjust to life after a stroke, while support from family and friends can also help relieve the depression and anxiety following a stroke. It’s important for stroke patients to let their medical team and loved ones know how they’re feeling throughout their recovery and what they may need help with.

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Stroke rehabilitation can be hard work, but just as in the initial treatment of a stroke, time matters in the possibility of a full recovery. Many survivors will tell you that rehabilitation is worth it and recommend using motivators to achieve recovery goals, such as wanting to see a child’s graduation or returning to working in the garden. With Insureyouknow.org, caretakers may keep track of medical treatments and rehabilitation plans in one easy-to-review place so that they may focus on caring for their loved one during the period of recovery from stroke.

May is American Stroke Month which aims to raise awareness of the second leading cause of death.

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Gardening for Mental Well-Being

May 15, 2024

Interest in gardening has increased since the pandemic, as more and more people are searching for ways to disconnect from stressful times and reconnect to nature. It turns out that immersing ourselves in green spaces and caring for plants is a form of caring for ourselves. Time spent in nature has been found to improve mental health so much so that gardening has been prescribed by the National Health Service in Great Britain since 2019. But while scientists are just beginning to pay attention to nature’s overall effect on our health, humans have known about the power of gardening for a very long time. 

Historic Gardens and Horticultural Therapy

Ancient and modern gardens all over the world, including Persian pleasure gardens, Islamic paradise gardens, Chinese courtyard gardens and Japanese rock gardens, nurture a sense of separation from the chaotic world and provide a place for inward reflection. In addition to sources of food, the Roman Empire treated gardens as a place to cultivate mindfulness. As extensions of the home, Roman gardens were the first outdoor rooms. They served as spaces to rest and marvel at nature’s wonder. By the Middle Ages, hospital gardens modeled after these Roman gardens were seen as integral parts of the hospital, not just to feed patients and grow medicines but to offer patients time outside. But as efficiency and technology took over medical treatment, these spaces went extinct.

Still, the benefits of gardens were not forgotten. In the 1800s, early American psychiatrists began noting links between horticulture and mental health. Born in 1933, the famous neurologist Dr. Oliver Sacks believed that gardens and nature were more powerful than any medication. As the scientific evidence of spending time in green spaces leading to better health grew, many hospitals began incorporating gardens into their facilities again and horticultural therapy was developed as a therapeutic practice in the 1970s.

Horticultural therapy involves taking care of plants with specific goals for the patient in mind. For instance, tending to a garden and watching it thrive can help people build self-esteem and feel a sense of accomplishment. Gardening can also lead to life lessons, such as when a plant dies, the person can ask themselves, “What could I have done differently?” Connecting the garden to themself can lead them to think that maybe they can do a little more to take care of themself, too. “It’s really the plants that are the therapists,” says Laura Rumpf, a horticultural therapist who treats patients with dementia through gardening. “Even if somebody can’t necessarily name what it is they’re smelling, the body somehow remembers.” For those with dementia for instance, plants can help them to reminisce which leads to telling stories and sharing memories, an important part of connecting to others and validating their identity.

The Scientific Proof of Nature’s Benefits

Gardening involves exercise, which we know is beneficial to our health, and since people tend to breathe more deeply when they’re outside, outdoor activities can clear the lungs, aid digestion, and improve immune responses. Sunlight also lowers blood pressure and increases vitamin D levels, but the benefits of outdoor gardening extend beyond these physical benefits.

A recent study conducted by scientists at the University of Florida found that gardening lowered stress, anxiety and depression in healthy women who attended a gardening class twice a week. “Past studies have shown that gardening can help improve the mental health of people who have existing medical conditions or challenges,” said the principal investigator of the study Charles Guy. “Our study shows that healthy people can also experience a boost in mental well-being through gardening.” In addition to improved mental well-being, interacting with nature has proven cognitive benefits. A 2019 study by University of Chicago psychologist Marc Berman showed that green spaces near schools promote cognitive development in children, while adults assigned to public housing in green neighborhoods exhibited better attentional functioning than those assigned to units with less access to green spaces.

Scientists have a few ideas as to why nature is so good for our mental health. One hypothesis is that since our ancestors evolved in the wild and relied on their environment for survival, we have an innate drive to connect with nature. As a species, we may be attracted to plants because we depend on them for food and shelter. Another hypothesis is that spending time in nature triggers a physiological response that lowers stress levels. Throughout human history, trees and water have been an oasis and signaled relaxation. There is an implicit trust in nature that calms our parasympathetic nervous system. Yet a third hypothesis is that nature replenishes cognitive functioning, which restores the ability to concentrate and pay attention. The truth probably lies in a combination of all of these theories.

Gardening Against Loneliness

Perhaps one of the most overlooked yet obvious benefits of gardening is that it can make people feel less alone in the world. While gardening can bring people together through community gardens, one doesn’t even need to be around other people while spending time in nature in order to feel more connected to others. “Nature can be a way to induce awe,” said psychology professor John Zelenski. “One of the things that may come from awe is the feeling that the individual is part of a much bigger whole.”

Gardening can bring people together through a sense of community, as people who garden are rich with expertise that they are willing to share with other gardeners. Master gardeners and local volunteers dedicate their time to empowering other people in the community who are interested in growing their own plants. Simply sharing a gardening blunder is just one way to connect with a fellow gardener. Social connections are important for our mental well-being because they help lower stress, improve resilience, and provide support, while a strong sense of belonging has been shown to lower one’s risk of depression and anxiety.    

Community gardens are a great place to connect with others as they offer room for talking during uncomplicated and repetitive tasks. Since gardening can bring together all kinds of people, time in the garden with others can also remind us that we are more alike than not. “Gardens are a great point of connection,” said the director of a London community garden Sarah Alun-Jones. “We often find ourselves talking about where we grew up, our childhood gardens, food we like to grow and cook… and we learn lots along the way.”

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If you’re thinking of incorporating gardening into your routine, it doesn’t need to be intimidating. Simply starting by potting indoor plants or taking walks in green spaces during your lunch break are just two simple ways to connect with nature now. At Insureyouknow.org, you may store all of your gardening plans and records, so that you can become the researcher of your own gardening benefits.

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