Acceptance And Normalisation Of Psf: Part And Parcel
Often, stroke survivors asked other forum users is this tiredness normal? , obtaining a plethora of affirmative responses. This can be summarised by the idea proposed by one participant that PSF is a guest youre stuck with, youve just got to learn to live with it and that the feelings are normal and all stroke survivors can relate to the tiredness . Along with the reassurance that tiredness is very common post stroke , forum posters acknowledged fatigue as an after effect of stroke. One post from a survivor held that tiredness is common and can last for years post stroke . Normalisation was a recurring response to queries about PSF, demonstrated by the stroke survivor who wrote the exhaustion as other posts have said is normal .
Check Your Medication For Side Effects
Sometimes fatigue is a side effect of certain medication. Check to see if fatigue is listed as a side effect on any of your medications. If so, talk to your doctor. They may be able to switch medications, or offer other ways to improve fatigue.
Even if youre fairly certain your medication is contributing to your fatigue, always talk with your doctor before making any medication changes.
How Do You Get Rid Of Stroke Pain
You may be given painkillers such as paracetamol or codeine to help relieve the pain in your shoulder. For more severe pain you may be given a non-steroidal anti-inflammatory drug such as ibuprofen.
What helps nerve pain after a stroke?
Anticonvulsants, such as gabapentin and pregabalin, have been used with some success in managing post-stroke spasticity and can be helpful in treating the associated pain.
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Experiences Stroke Survivors Make
Stroke survivors are likely to experience some type of physical or mental disability after the incident, due to brain damage. This can make daily activities difficult and decrease the quality of life. As a result, you may feel low in energy due to these disabilities for example, walking and talking may take more energy than they did before the stroke, quickly leading to fatigue. Emotional issues such as depression and anxiety can also contribute to fatigue. There is an increased chance of depression and anxiety in stroke survivors, which has been shown to contribute to fatigue.
What You Can Do About Post
Medical treatment. Medical treatment for post-stroke pain is generally disappointing.
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Leaving The Hospital After A Stroke
Your care team will formulate a discharge plan that will depend on your level of functional impairment. After the hospital stay, you might continue your rehabilitation:
- In an inpatient rehabilitation unit or independent rehabilitation facility, if you can benefit from being monitored by a physician and can tolerate three hours of therapy per day
- At a subacute rehabilitation facility, if you require a slower course of rehabilitation with one to two hours of therapy daily
- At home with visits to an outpatient rehabilitation clinic as needed
You dont have to be at 100% health to return home after a stroke, says Pruski. If you can perform most of your regular daily activities in your home environment and/or you have family support to assist with these activities, you can go home.
What Is It Like Living With This Fatigue
Every experience is different , below is how stroke survivors living with post-stroke fatigue describe their experiences:
Its been two and half years since my stroke and extreme mental fatigue still affects me every day. Its inconsistent and unpredictable.
I try to pace myself, the fatigue makes it difficult to plan so I take it one day at a time. If I have plans I must completely rest in the day leading up to them and a few days after any event or outing may be needed for recovery time.
It took me a long time to understand that rest means no noise, TV, reading, chatting, etc. Improvements do happen, but they are subtle and take a long time. Be patient with yourself and dont feel guilty for resting its a necessity!
I find the heavy fogginess distressing. Some days my brain feels OK-ish, some days like concrete, some days like wading through mud and on others like walking through porridge. I never know what the next day will be like. I do what I can most days, sometimes pushing myself too hard
We also asked our members their best tips for managing post-stroke fatigue and we have categorised them into 5 Key Tips.
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Psf As A Multidimensional Phenomenon
This study highlights the complexity and multidimensionality of PSF, which included closely interacting emotional, cognitive, physical and social aspects. When measuring complex constructs such as fatigue, a multidimensional measurement instrument is preferable in order to have a detailed assessment of all relevant dimensions . For example, both symptom intensity and symptom interference measures are considered vital, as stroke survivors might report fatigue as very distressing and significantly interfering with daily life, despite reporting relatively low fatigue intensity, and vice versa. This is in agreement with symptom experience in cancer patients, showing a non-linear relationship between symptom severity and symptom interference . In order to have a more comprehensive assessment of PSF that includes all relevant dimensions, there is a need for a new PSF-specific PROM.
Caring For Someone Who’s Had A Stroke
There are many ways you can provide support to a friend or relative who’s had a stroke.
- helping them do their physiotherapy exercises in between their sessions with the physiotherapist
- providing emotional support and reassurance that their condition will improve with time
- helping to motivate them to reach their long-term goals
- adapting to any needs they may have, such as speaking slowly if they have communication problems
Caring for someone after they’ve had a stroke can be a frustrating and lonely experience. The advice outlined below may help.
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Fatigue A Major Barrier To Recovery After Stroke
Fatigue is closely related to poorer physical recovery after stroke, according to a new study by the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery.
A third of people who have a stroke experience debilitating fatigue, which may be caused by depression, sleep disturbances, lesions in the brain, or other unidentified factors.
Post-stroke fatigue is paralyzing, says Dr. Bradley MacIntosh, lead author and a neuroimaging scientist at Sunnybrook Research Institute. It is characterized by extreme tiredness, weakness, and exhaustion. It is the feeling that even if I could move, it would take too much effort. Sunnybrooks Dr. Walter Swardfager, scientist in the Brain Sciences Program and senior author of the study adds: It is easy to imagine how these symptoms might impact recovery, given the many benefits of being physically active after a stroke.
To complicate things, some symptoms of fatigue overlap with post-stroke depression, making it difficult to disentangle their impacts on different aspects of stroke recovery.
If fatigue is misidentified as depression, some anti-depressants may, in fact, make fatigue worse. There is no proven treatment for fatigue after a stroke, says Dr. Swardfager. We need to identify how fatigue poses a barrier to recovery, and understand the causes of fatigue so that we can treat it specifically.
Motor Recovery And Residual Disability
Patients who feel that they have not made a full recovery are significantly more likely to be fatigued than those who make a full recovery. However, in patients with excellent neurological and neuropsychological recovery, as in patients with minor stroke or TIA, post-stroke fatigue may be the only persisting sequela, which may severely limit a complete recovery of their previous level of functioning. Even if the prevalence of fatigue after a minor stroke is usually higher than after TIA, fatigue can also be present after a transient neurological deficit. In these cases, the influence of additional depressive and anxious factors on the impact of fatigue should be addressed . However, Winward et al. have described that patients with minor stroke reported significantly higher levels of fatigue at 6-month follow-up than those with TIA and this difference was independent of measured potential confounders for fatigue, including anxiety, depression, recent life events, relevant blood tests, and medication this suggests that an excess of fatigue in patients with minor stroke indicates a causal association between fatigue and cerebrovascular accident. Although fatigue can be related to increased physical efforts associated with severe neurological deficits, the presence of fatigue in stroke patients with little or no motor deficit suggests that this excess of fatigue, compared with TIA patients, is most likely attributable to central mechanisms.
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Driving After A Stroke
If you have had a stroke or TIA, you can not drive for 1 month. Whether you can return to driving depends on what long-term disabilities you may have and the type of vehicle you drive.
It’s often not physical problems that can make driving dangerous, but problems with concentration, vision, reaction time and awareness that can develop after a stroke.
Your GP can advise you on whether you can start driving again 1 month after your stroke, or whether you need further assessment at a mobility centre.
What Causes Atrial Fibrillation
Atrial fibrillation is usually due to damage to the heart’s electrical system from conditions such as longstanding uncontrolled high blood pressure and coronary artery disease . Atrial fibrillation is also the most common complication after heart surgery.
Below are a few common risk factors that can cause atrial fibrillation:
- The risk of atrial fibrillation increases with age.
- Patients with heart disease such as heart valve problems, congenital heart diseases , heart failure, coronary artery disease, or a history of heart attack or heart surgery have an increased risk of atrial fibrillation.
- Patients with uncontrolled high blood pressure with a stressed lifestyle are at an increased risk of atrial fibrillation.
- Patients with severe health conditions such as thyroid problems, sleep apnea, diabetes, kidney disease, or lung disease are at an increased risk of atrial fibrillation.
- Patients who consume alcohol and smoke cigarettes are at a high risk of atrial fibrillation.
- Being overweight or obese increases the patients risk of atrial fibrillation.
- A family history of heart disease or atrial fibrillation may also increase the risk of atrial fibrillation.
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Normal Vs Abnormal Worsening After Stroke
Its important to acknowledge that the stroke recovery process does not move in a straight line.
Taking two steps forward and one step back is normal.
In fact, taking two steps forward and four steps back sometimes is also normal.
A good rule of thumb to determine if your regression is normal or not is to zoom out and look at the big picture. Is there an overall pattern of progress?
Drawing by Demitri Martin
Your backward steps should be overcome by your forward steps in the long-run.
However, if you wake up one morning and the secondary effects of your stroke are dramatically worse than the previous night, then its time to seek immediate medical attention.
Interfering And Aggravating Factors
The stroke survivors described how fatigue interfered with their lives and how different factors aggravated fatigue. Four categories of interfering and aggravating factors were identified: emotions, cognitive performance, activities in daily life, and participation in society. Having fatigue interfered with all these aspects of their lives, and in addition, different factors in all four categories could aggravate their fatigue.
PSF also affected the stroke survivors emotions. Having an acute stroke was a frightening experience for the stroke survivors, and the continuous presence of fatigue after the stroke perpetuated their perception of feeling unwell. This contradicted the stroke survivors understanding of their stroke as a one-time incident from which they had fully or mostly recovered. The stroke survivors also lacked motivation, worried that people would perceive them as lazy and experienced sadness related to how fatigue interfered with their lives:
I have to say that it is quite depressing. Several times, like after that Sunday, I thought: Do you know what? Now you have been wasting a whole day on nothing. Nothing, you have not done anything.
Frustration with being fatigued was also described by the health professionals:
It takes time and it is a test of patience that is difficult for the patients to accept. They get really frustrated because they are so tired.
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Overcoming Excessive Sleep After Stroke
Excessive sleeping after stroke is common during the early stages of recovery as the brain works hard to heal itself. However, excessive daytime sleepiness could signify other problems that deserve a conversation with your doctor.
If your daytime sleepiness is caused by depression, sleep apnea, or other problems, treating these conditions can help decrease your sleepiness. Otherwise, certain medications such as modafinil can increase alertness. Your doctor can help you choose the best treatment for you.
We hope this information on excessive daytime sleepiness can help you find ways to boost your energy and continue your recovery from stroke.
Who Is More Likely To Have Post
There have been several studies that attempt to determine who is more likely to experience fatigue after a stroke, but this research is inconclusive and requires more testing. One study shows that women, older people, and those who suffered from fatigue before their stroke are most likely to experience it. However, other studies show that younger people and those
who were in shape before the stroke took place can also experience stroke-induced chronic fatigue. The bottom line is that this is a very common post-stroke condition that almost every type of survivor will battle with.
This type of tiredness can range from mild to severe, but it does not depend on the severity of the stroke that is, someone who suffered a severe and debilitating stroke can have the same or an even lesser amount of fatigue than someone who suffered a mild stroke.
It all depends on your body and your healing process. Fatigue is common to see after different types of stroke, including hemorrhagic and ischemic. However, it is more likely to experience fatigue after stroke than a Transient Ischemic Attack .
Comparison With Other Literature
PSF is reported as one of the largest unmet needs in stroke survivors. Despite this, fatigue is only recently starting to be included within prominent clinical guidelines. This is largely due to the lack of high-quality studies and methodological variation evident in the PSF literature. In a report by the European Stroke Organisation on evidence-based stroke rehabilitation, although several topics are discussed, fatigue is noticeably missing. The absence of guidance for clinicians working with this population is reflected in the absence of a standardised approach as was apparent in the online forum posts.
Does Post Stroke Fatigue Go Away Jobs
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Take A Holistic Approach
As with all things balance is key and looking at your lifestyle can really help. Is your diet balanced and does it contain enough nutrients to help combat your fatigue? Are you moving or exercising when you can and to your own pace?
I pace myself, eat healthy and exercise and have a nap when needed
Im recovering from 2 strokes and 1-2 hours exercise a day seams to help me.
I found a sertraline antidepressant had a good impact on my mood. Its a major trauma you must come to terms with.
Personally, balance is imperative! Balance between rehabilitation and rest.
What Is Atrial Fibrillation
Atrial fibrillation is a condition in which the heart beats irregularly and rapidly. During atrial fibrillation, the hearts two upper chambers beat irregularly without coordination with the two lower chambers of the heart.
The symptoms of atrial fibrillation often include a feeling of racing or pounding heartbeat , shortness of breath and weakness. Due to this irregular heart rate, patients may have an increased risk of severe heart and brain-related complications such as heart failure and brain stroke.
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