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Effects of a stroke

How a stroke may affect you

It is important to understand that no two people are affected by stroke in the same way. Some people have only mild effects which improve in a short time. Others may suffer more serious and long term effects. The effect of a stroke on a person depends on which part of the brain has been affected and how much damage has been caused.

About the brain

The brain has two sides. Messages (nerve signals) cross over at the base of the brain. So a stroke on the left side of your brain affects the right side of your body and a stroke on the right side of your brain affects the left side of your body.

Some of the most common effects of a stroke are listed here. You can click on the ones that apply to you.

Emotional Changes

• sadness (feelings of loss)
• anger (questioning “why did this happen, why me”)
• anxiety (fear and worry)
• self-consciousness
• frustration
• low mood
• apathy and low motivation

Depression

Depression is a feeling of sadness, loss or emptiness that goes on for a long period of time, and gets in the way of the person leading their life. Symptoms include feeling tired, changed sleep patterns, loss of interest, loss of appetite and libido (sex drive), and gloomy or negative thoughts. Someone who is depressed may withdraw from other people, activities or interests. If you think you may be suffering from depression, tell a member of your team or your GP as there are treatments that can help.

Mood Swings

It is very common to have emotional swings after a stroke – for example, laughing one minute then crying the next. In certain cases, where a specific part of the brain has been affected, emotions can get confused and the person cries when they don’t feel particularly sad, and laughs when they don’t feel particularly happy. This can be very confusing and upsetting for relatives.Top tips for handling emotions:
•tell others how you feel – family, friends or if necessary health professionals
• keep as active as possible and take part in exercise – ask a health professional for advice
• do something rewarding and/or enjoyable every day
• set yourself goals to work towards
• pace your activities – plan what you are going to do, do little and often, take regular rests and use the appropriate help and/or equipment for the job and build up gradually
• fight negative or gloomy thoughts
• socialise and engage in hobbies and interests
• enjoy the moment as it is happening – the simple things in life are important
• spend some time everyday thinking about the positive things that have happened in the day
• remember your skills, personal qualities and strengths – including any newly discovered ones
• spend some time re-evaluating your life and appreciating the positives
• learn relaxation skills and practise daily (see below)

Relaxation Skills

These relaxation skills should help you unwind:
• take a few minutes, somewhere warm and comfortable, where you will not be disturbed
• breathe deeply and slowly
• let the muscles relax and loosen
• think relaxing thoughts like ‘let your muscles become loose’ or ‘let your body sink into the bed’, ‘imagine you are floating on a cloud’ – choose whatever works for you
• imagine being somewhere like a lovely beach, a place in the countryside, a favourite room
• listen to music or a relaxation CD (or ask one of your carers/health professionals to help you with this)

Sleep problems

Sleep problems are common after a stroke. This may be due to emotional upset, changed routine, feeling physically uncomfortable or a combination of all of these.The following tips should help:
• be mentally and physically active throughout the day
• avoid caffeine and heavy meals before going to bed
• make the place where you sleep comfortable and relaxing
• have a regular time to go to bed. If you struggle to get to sleep, try going to bed later
• turn the clock face away so you cannot ‘clock watch’
• have a ‘wind down’ routine – for example drawing the curtains, getting changed into nightclothes, and having a warm milky drink
• use relaxation techniques
• have a regular morning routine – get up at a similar time everyday
• do not try to make up for lost sleep by getting up late as this can make it more difficult to sleep at night

Relationships and Sex

Many people find that the stroke has affected their relationship with their partner, or their sexual feelings.
• talk about the changes in your relationship
• discuss ways to get close again
• discuss any concerns you have about sex (for example, anxiety or self-consciousness)
• think about different ways of having sex that allow for the problems caused by the stroke, for example different positions that you may find more comfortable
• discuss your concerns with a health professional. They will try to help you find ways to address the problem
• you and your partner may find that you are content with the changes in your relationship and accept that it has evolved into something equally as satisfying without the sexual element
• read the advice leaflet ‘Sex after Stroke’ available on the Stroke Association website

Difficulty making sense of your surroundings

This can include:
• concentration
• attention
• memory – short term, long term, planning
• recognising colours, objects
• awareness of own body
• altered sensation
• vision
• using everyday objects (comb, knife)
• planning, multi-tasking
Communication disorders can include:

Slurred speech

This is called dysarthia. Your speech can become slurred because the muscles used to make sounds to form words can be weak, stiff or uncoordinated which can result in poor speech control. This can affect your breath control, the production of sound, the speed of speech, and the tone of your voice.

Difficulty finding the right words and understanding

This is called dysarthia. A range of communication processes can be affected when you have a stroke and in different ways including: difficulty talking, putting thoughts into words, listening and understanding speech, reading and writing and using numbers.

Difficulty swallowing

Your ability to swallow food and drink safely can be affected following a stroke. Food and fluids can become stuck in the mouth, throat, and stomach. Your ability to swallow safely will be assessed when you come into hospital by a member of your team. It may be necessary to change the texture of your food/drink, or you may be advised that you are ‘nil by mouth’ for a while. This is because there is a risk that food or drink may go down the wrong way getting into the windpipe and so into the lungs. If this happens there is an increased risk of a chest infection or pneumonia developing. It is important you follow instructions about safe swallowing and have good mouth hygiene.

Washing and dressing

You may find that washing and dressing become difficult following your stroke due to paralysis, difficulty planning, visual problems, judgment and awareness. Your therapist will work with you to look at alternative ways in which to complete the difficult tasks. Sometimes equipment may be ordered or you may need someone to help with these tasks.

Physical Effects of a Stroke

These can include:
• weakness/ paralysis of one side of the body
• inability to control posture
• altered muscle tone
• reduced balance
• impaired co-ordination

Difficulty with senses

You may experience any of the following difficulties with your senses:
• vision – double vision, blurred vision, partial blindness, difficulty seeing anything on the right or left, this can lead to problems with balance, co-ordination and recognising familiar things or people
• smell
• hearing
• taste
• altered sensation to touch, pain or temperature – such as unpleasant feelings of hot or cold and tingling like pins and needles

Continence

It is quite common to find that you are unable to control your bladder and/or bowel movements and can also cause constipation. The most common types of bladder continence problems include:
• urgency – a desperate need to pass urine
• frequency – needing to pass urine very often
• urge incontinence – not managing to get to the toilet in time
• involuntary passage of urine – passing urine without realising you have done so
• loss of feeling – difficulty emptying the bladder completely
• retention – not able to pass urine
Some people may need a catheter to help with these problems. This is where a tube is passed into your bladder to allow it to drain. Constipation may also be a problem. This can be caused by weakness of abdominal and pelvic muscles caused by lying for long periods, not eating or drinking as much as usual or some medications. Constipation can also lead to leakage of faeces and make emptying your bladder worse when hard stools press on the bladder. The nursing staff will discuss with you the best way of how to manage your constipation. Most people regain control in a few weeks.

Pain

For some people pain can be a problem after their stroke. This may be due to:
• the muscles becoming stiff
• the muscles become tight and it is difficult to straighten them out
• some patients do have pain after a stroke but the exact cause is unknown. This is called central post stroke pain and is usually in the side effected by the stroke.
Your nurse, doctor and physiotherapist will discuss the options for your treatment. After you have had a stroke, it is important that you learn to position and move your limbs correctly. Techniques including shoulder care of the affected side are important to help reduce, prevent and manage pain. Other issues which you may find after a stroke are:
• medication – you may already be taking medication before your hospital admission. This may be changed and you may start new medication. You will receive an explanation of the reason for any changes or need for medication
• tiredness – is very common and can have a significant impact on your recovery after a stroke
• lifestyle change – changes in lifestyle such as: smoking cessation, exercise, alcohol reduction and diet are important to reduce identified risk factors
• change of role – at home, in the workplace, or in the community.

 

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