Paralysis 24 hours after Stroke -- Can it improve? (arms, doctor, heart)

[Hopes]

I'm researching this, but I thought I would post here in case someone knows the answer.

If someone has a stroke and has complete paralysis on one side of the body 24 hours after stroke, can the paralysis improve over time? I'm not talking full recovery. I'm just wondering if there is hope for some type of quality functioning.

[Woof]

I've heard stroke victims say that their paralysis improved over time. I suppose it depends on many variables - her doctor should be able to discuss the case, as long as you are family (otherwise I think confidentiality laws would prevent discussion if you are not.)

[Hopes]

I'm daughter's friend's father had a stroke. She came to me for guidance on financial issues and such. She's only 21, and she is entirely responsible for the entire family right now. This is going to have a tremendous impact on the entire family because he is the only parent and only financial support of the family. I'm providing her with guidance and emotional support. She will hear more from the doctor tomorrow. I'm just trying to learn as much as I can so I'm prepared. I know they are in for a long haul over the next 12 months at least. She's super smart and very responsible. She is and will continue to rise to the occasion. I'm just hoping like hell that he can regain some quality of functioning for basic living---bathing, eating, walking, etc.

[SouthernBelleInUtah]

Rehab will help a lot! If he is still in hospital, he's getting PT, OT, and maybe Speech therapy. Once released, whether to home or a rehab center, the rehab therapies should continue. He can most likely improve.

[Fancy-Schmancy]

Yes, people can and do recover from this. Depends on different factors, of course, like exactly where in the brain the damage occurred. But with proper treatment and diligent PT, much of the loss can be made up.

My FIL had a severe stroke a number of years ago -- paralysis on one side, unable to speak. Within 6 months, he had 95% function restored and could both speak and write understandably.

[Hopes]

His stroke was in the top left side of the brain that is responsible for motor function, language and emotion. I'm happy to report that slow progress is being made. He is talking better---still very basic talking and can't comprehend concepts that aren't basic. Parts of his personality are shining through. Still paralyzed, but they are able to get a reaction from his foot when poking and tickling it. He is in physical therapy at the hospital and will soon be transferred to another hospital for more physical therapy. She's okay financially. We were able to track down the disability insurance and all of the other assets. There is plenty of money to provide him with excellent care and continue to support the household without depleting any savings or investments. So now we can focus completely on worrying about his recovery. It's a big job for a 21 year old, but she is up for the challenge. She's a smart, strong girl and she's making everyone proud of her.

[CraigCreek]

Your daughter's friend is fortunate to have caring friends. How old is her father? Younger people tend to recover faster - and can continue to make progress for at least two years.

I am the adult child of an elderly stroke survivor who suffered a very similar and very severe stroke, so what I am posting is mostly based on that experience. I was my parent's primary caregiver. I cannot stress enough that your ongoing friendship, support and compassion for this young woman are precious gifts. Please continue your kindness to her in the difficult months ahead - she will need caring friends such as you and your daughter.

Here are some suggestions.

Since speech is affected, encourage this gentleman to sing - anything - as singing is a right-brain function. Usually people who have left-brain strokes are still able to pronounce words easily - as long as they are sung. Listening to music - whatever kind he likes - may also be helpful in assisting the brain to rewire the damaged areas.

It's more common for legs to recover than arms and hands. The therapists - physical, speech, and occupational - can be an enormous help in recovery, and also in making the best use of remaining abilities.

Suggest that your young friend obtain free materials from the National Stroke Association - they also have a good website, and may have a local chapter for stroke survivors and their families. The local public library may also have helpful material - just make sure it's up to date, as much progress has been made in treating stroke in recent years. Encourage her to learn as much as she can, and to continue to be a strong advocate for her father, especially when he is in rehab.

The stroke survivor is likely to need to sleep and rest a great deal more than before - a stroke is a "brain attack", and it should be viewed similarly to a heart attack when it comes to the need for rest to allow the brain to recover.

There are adaptive devices which can help with self-feeding - plates with a raised edge, eating utensils with handles which are easy to grasp, plastic glasses which are cut down on the side above the mouth. Your friend's father may need to have his food pureed for a while, since the mouth and swallowing are usually affected by this type of stroke. He may also need to have liquids thickened - the speech therapist can assess this. Things like mashed potatoes, apple sauce, scrambled eggs, and oatmeal can usually be swallowed without difficulty.

Some of the seeming mental confusion may be due to damage to the receptive speech centers of the brain rather than to cognitive damage. This is likely to improve with time - meanwhile, it's best to give him time to speak and to use short, direct sentences when talking with him, and to speak fairly slowly. Often people with this difficulty will do word-substitution - rhyming words or nouns which are not synonymous, but which have qualities in common - "bedspread" for "curtains", "pickle" for "fiddle", etc. Usually they can be understood fairly easily through context. Opposites can be traded as well - "up" for "down", and so on. This should improve with time.

Similar confusion may occur with reading - words which resemble one another physically may be misread _ "glasses/gypsies", though their meanings are completely different. Grammar may survive intact, and pronunciation can be expected to improve with time (singing helps!).

All of these examples are from my parent's experience. Though within a month of the stroke, they were speaking clearly in complex sentences of up to seventeen words, word-substitution and serious difficulties with reading remained. These problems lessened with time - but again, clarity of speech returned very rapidly, greatly helping with communication.

Emotional control may be erratic, with unexpected tears that puzzle everyone, the stroke survivor included. If this is distressing to him, a mild antidepressant can help. This, too, should lessen with time.

Seizures may be an overlooked problem, if they are petit mal and happen when the nurse or other attendant is out of the room. Make sure everyone is on the lookout for them - medication can control them, if necessary.

When your friend's father is ready to start dressing himself again, pullover tops are easiest, as are slip-on shoes that are supportive. That sort of shoe may not be best for walking, however, so a flat shoe that ties and offers good support might be best initially. Pants with elastic waists are also easy to wear.

If the plan is for your young friend's father to return home eventually, make sure a good social worker presents a workable plan. Meals on Wheels can provide special diets and can be extremely helpful. Therapists can continue to visit in the home as long as progress is noted - this can be tough with stroke survivors, who tend to plateau for a while before making further progress. Your young friend may need to take a hard line and be insistent - good documentation of her father's progress will help here. Also, she should try to arrange for the therapists to visit whenever her father's energy and alertness are at their best. She may be able to obtain visiting nurses or home health aides to assist with bathing, dressing, and checking vital signs. It's likely she will need to hire additional assistants - weekends are the toughest to cover.

If there is any extended family - aunts? uncles? cousins? - who can lend a hand and be emotionally supportive to this young lady, do what you can to involve them. She will need them. Even if they live far away, encourage them to call and write her - just make sure they don't all call, one after another, when she gets home from the hospital after visits. Setting up a phone chain is a good idea, or perhaps she might like to set up a Caring Bridge online site so she doesn't have to spend precious time and energy repeating herself over and over to various good folks who just don't realize...Also, if some of the extended family and/or friends live in different time zones, make sure they don't call her at midnight, thinking it's 10:00 p.m., as happened to me.

If extended family and/or friends want to come help out, it's generally best that they make hotel reservations rather than expecting to stay at this young lady's home. She already has her hands full and doesn't need houseguests, though if they are able to fit into existing family routines, do laundry, cooking, cleaning, and yard work while they are there, staying with her may be a good thing.

Any out-of-town visitors should clear it with her first and give ample warning, not call at 8:30 a.m. to tell her they're arriving at noon with a friend unknown to her and expect to stay with her. This happened to me, on a day I had to work, and it was very stressful, much as I loved my unexpectedly visiting relative (of course, I should have offered to make reservations for them, but in the scramble, this didn't even occur to me...).

It's helpful to enlist friends, neighbors and perhaps church members in the casserole brigade - also, yard work may be something which needs to be done. Who generally rakes the leaves? Any practical help of this kind is usually very welcome.

Good luck to your friends - keep us posted about this gentleman's recovery. He is blessed to have such a devoted daughter - and she is blessed to have you as a caring friend.