By: Jean Johnson for Veins1
One minute 61-year-old David Lowell was walking across his living room outside of Flagstaff, Arizona. The next he was on the floor trying to figure out what was happening to him and knowing it was serious. Three weeks later in the acute rehabilitation center in Flagstaff, he endured painstaking hours of therapy six days a week to try and recover movement in his left leg and arm.
| Learn the signs of stroke:
1. Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
2. Sudden confusion, trouble speaking or understanding
3. Trouble seeing in one or both eyes
4. Trouble walking, dizziness, loss of balance or coordination
5. Sudden severe headaches with no known cause
“It’s slow,” Lowell said with speech that has become reasonably easy to follow since the stroke first hit him. “But even getting out of bed is an ordeal. You hate to be so dependent on people.”
As far as what Lowell and other stroke patients can expect in the way of recovery, experts underscore that progress is a highly individual matter and influenced by a number of factors.
Medical director of the acute rehabilitation center at Providence Portland Medical Center in Oregon, Molly Hoeflich, M.D., said, “I’ve been in stroke rehab for 20 years and although I have seen trends, I’m still fooled all the time. One of the best things that can happen is for me to tell a patient that they probably can’t expect much more recovery. Those are the ones who will turn around and make outstanding gains.”
That said, Hoeflich noted that most of the textbooks say stroke patients get most or all of their recovery in the first three months. “My clinical experience has born that out for the most part,” Hoeflich said. “But there is also a small group of patients that seems to not start their recovery for a month or two. The usual uphill slant of recovery we generally see seems to get delayed until all of a sudden they will seem to take off. So, clearly the three-month window wouldn’t apply there.”
OHSU Stroke Center Helmi L. Lutsep, M.D. added that “even though patients that are doing well will probably max out in two to three months, those with more severe strokes will keep on improving through the six-month point. Even two years later they will get new function, although it might be through another mechanism than just the brain healing.”
Time frames aside, Hoeflich underscored that stroke patients who have hope tend to do much better. “My job is to provide realistic expectations for patients,” said Hoeflich, “but we’re very careful to encourage people and leave the door open for the successes that can take place.”
“A whole assessment is needed for us to make a plan for appropriate therapy. What age is the patient and how motivated are they? What was the status of their health prior to the stroke? Is there good family support? What’s the extent of the cognitive deficits? Those types of questions,” Hoeflich said.
Also, Hoeflich explained that “there have been really exciting things happening in the last year around stroke recovery. Between advances in long-term therapy and progress in managing initial early stages of recovery, things are starting to show real promise.”
Promise is what David Lowell and other stroke patients live for. Each year 550,000 Americans – about one person every 53 seconds – suffer a stroke. It is a leading cause of disability and third leading cause of death in the nation. The idea that new research is pushing the field of stroke recovery to new heights, then, is encouraging. Thus, even as stroke patients cling to the hope that their bodies will recover, they can also hold onto the news that science is doing its part to help push the envelope as much as possible.