Stroke rehabilitation: A brain scientist and stroke survivor advice to stroke victims and caregivers
Posted Oct 23 2008 6:33pm
Stroke, also referred to as brain stroke or in medical terms, cerebrovascular accident (CVA), is a life-threatening event in which part of the brain is deprived of blood flow, thus of adequate oxygen. There are two types of strokes. An ischemic stroke is when the blood supply to the brain is interrupted, usually by a blood clot. The second kind of stroke is a hemorrhagic stroke, which occurs when there is bleeding into or around the brain. When deprived of oxygen, the brain nerve cells will start to die. This will lead to various symptoms, depending on which part of the brain is affected.
Among various symptoms of a stroke are
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden numbness or weakness of face, arm or leg, especially on one side of the body
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause
nausea or vomiting
Consequences of a stroke
Stroke is a very serious, life-threatening event which can lead to death or physical and mental disabilities which depend on which part of the brain is affected and how fast one gets help. If you experience any of the symptoms, you should get to the hospital as soon as possible.
People who survive a stroke should begin stroke rehabilitation (stroke recovery) as soon as possible to regain as many lost functions (e.g., lack of coordination, strength) as possible. Most recovery occurs during the first few months following a stroke. However, new intensive rehabilitation techniques are offering new hope for recovery even a year or so following a stroke. A neuroanatomist, Dr. Jill Bolte Taylor even said that she took 8 years to fully recover from her stroke (see below).
The experience of a stroke victim, Jill Bolte Taylor who is a brain scientist
10 years ago, Dr. Jill Bolte Taylor, then working as a neuroanatomist (brain scientist) at Harvard, suffered a rare form of stroke. A congenital malformation of the blood vessels in her brain exploded, and she observed for 4 hours how her brain deteriorated not only through the eyes of stroke victim, but also through the eyes of a curious brain scientist.
When she awoke later, she was shocked to find that she couldn't talk, couldn't understand language, lost all recollection of her life and lost all perception of her physical presence. The stroke had affected her brain's left hemisphere, and her right hemisphere became dominant. She shifted away from a typical type-A personality focused on achievement and academics to become more humane and compassionate. Her values shifted towards helping those in society who need help.
She could not sing in tune before her stroke. After her stroke, she could sing better as the sound that she hears when she sings now matches the sound that others hear. She is now in fact known as the "singing scientist". She said many neurologists have the opinion that the brain has only six months to recover following from a stroke. However, Taylor believes the brain is an amazing, resilient organ, much of which still remains a mystery to science. In her stroke recovery, she watched her brain grow, change and recover for eight years before she thought she was fully recovered.
Jill Bolte Taylor has resumed activities before she had her stroke. She resumed teaching at Indiana University and the Midwest Proton Radiotherapy Institute. She travel the country "singing for brains" on behalf of the Harvard Brain Bank, asking people to donate their brains after they die so that vital mental health research can be conducted. In her travel, she added a few songs to lighten the mood of what otherwise would be a frightening pitch (I want your brain, but don't worry, I'm in no hurry).
She now see more beauty, more colors, curves and textures and has become more creative with a new-found artistic talent. She now makes anatomically correct stained-glass brains. She takes time to appreciate the present moment and is not in such a hurry.
Taylor said that when her language center in her left brain became hushed after the stroke, she felt a great sense of deep inner peace. She has written a book My Stroke of Insight: A Brain Scientist's Personal Journey offering tips for stroke victims how to quiet the left hemisphere to achieve their right hemisphere experience of deep inner peace.
Jill Bolte Taylor questioned how many brain scientists have been able to study the brain from the inside out? She said she has gotten as much out of this experience of losing my left brain as she had in her entire academic career. She describe her stroke as a delightful experience. The stroke shifted her out of her left hemisphere, which thinks in language and focuses on the past and future, to the consciousness of her right hemisphere, which thinks in pictures and exists in the present moment. She said she love being in the present because that is where joy exists. Joy is a right here and right now experience."
Taylor said the stroke gave her the opportunity to lose a lifetime of emotional baggage. While recovering, she said she paid very close attention to the pieces of her past mind that began to resurface, and when negative experiences wanted to resurface, she said she was able to persuade her brain that she was not interested in reengaging with that neurocircuitry. She said people should pay attention to their thoughts, because thoughts are based upon the neural circuits underlying those thoughts. According to Taylor, people have a lot more control over what's going on inside our brains than anyone was ever taught. The thoughts that one focus on become more dominant. According to her, if there are thoughts you don't want to think about anymore, then you can teach yourself to consciously choose to activate new thought patterns by coming back to the present moment. Those who subscribe to Napoleon Hill's "thoughts are things" will readily concur with her. (Napoleon Hill is the author of " Think and Grow Rich!").
Give the brain time recover. The brain is constantly changing because it has a plasticity that lets its cells make new connections. Sleep has healing power. With a brain trauma, every moment is filled with millions of bits of information. Sleep, said Taylor, is when the brain organizes and files away this information, leaving people refreshed and ready to learn when they awake.
Advice for stroke survivor caregivers
Break every action down into little steps to avoid discouraging the recovering victim from failure. To illustrate, Taylor took sitting up as an example. Don't expecting someone who recovered from a stroke to sit up right away. Begin with rocking, and celebrate when he/she can rock. When the survivor can rock with enthusiasm, begin working on a roll and celebrate when he/she can do the roll. Continue this in tiny steps until eventually the person can progress to sitting up.
Taylor was not aware of her past, of what she could and what she couldn't do and any tiny progress is an achievement worthy of praise. So constantly remind the survivor how far they have progressed.
Advice for those who come into contact with the stroke survivor
Remember that the survivor is wounded, not stupid, and treat him/her with respect. When talking with them, go close to them and speak slowly and clearly. There is no need to speak loudly though. Be as patient with the survivor on the 20th time you teach him/her something as if it was the first time.