The Effects of StrokeHealing after an Ischemic Stroke.

By Dana Wyss

Hope (name changed to protect privacy)

Hope is a 57 year old African American female.

Hope works in an inpatient psychiatric hospital for adolescents. Her line of work exposed her to a very high level of stress.

She was feeling sick and asked for time off work by the request of her MD.

While at home she lost touch with work and family on a Tuesday 5/6/14.

On Sunday 5/11/14 police broke down her door to find her on the floor unconscious. It was confirmed that she suffered from an Ischemic Stroke at the hospital.

Ischemic Stroke

“An Ischemic Stroke

occurs when a clot or a

mass clogs a blood

vessel, cutting off the

blood flow to brain

cells. The underlying

condition for this type

of obstruction is the

development of fatty

deposits lining the

vessel walls. This

condition is called

atherosclerosis.”http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=iscstr

Hope suffered a Left Brain

Stroke Hope suffered the following symptoms which indicates the stoke occurred in

the left brain.

o Paralysis on the right side of the body

Right arm, hand, fingers

Facial droop

Partial paralysis of right leg

Able to move right foot

Speech/language problems (Broca’s Area affected)

Unable to speak the first week.

After week two able to understand speech but struggled to get words out.

Behavioral style

Her behavior and personality were intact

Memory loss

Some memory loss related to names, certain words, people who had visited, what happened the day before her stroke up until in the hospital.

Immediate Treatment

Medical Care in Hospital

Restore blood flow to the

affected area of the brain as quickly as possible

Alteplase(thrombolytic

therapy)

The medicines used for the

early treatment of ischemic stroke are alteplase,

aspirin, and anticoagulants.

Consultation with a

neurologist (physician who specializes in the brain) and has intensive care services

and imaging (eg, CT scan or MRI)

http://www.uptodate.com/contents/ischemic-stroke-treatment-beyond-the-basics

Rates of Recovery

10 percent of stroke survivors recover almost

completely

25 percent recover with minor impairments

40 percent experience moderate to severe

impairments requiring special care

10 percent require care in a nursing home or

other long-term care facility

15 percent die shortly after the stroke

http://www.stroke.org/site/PageServer?pagename=REHABT

Within a week Hope was

transferred to rehabilitation. This was a good sign and pointed to possible full

recovery or recovery with only minor

impairments.

Treatment in the Rehabilitation Center included:

Occupational Therapy

Speech Therapy

Physical Therapy

Dietary education

Medical treatment

Visits with Hope

Hope and I visited several times throughout this

experience.

She had a positive attitude and it was a pleasure to

see that her personality and humor was present each

visit.

Each week there was significant progress in her

speech and movement.

This class helped me to have in-depth conversation

with her regarding her stroke, treatment and future

plans that others either avoided or could not

understand.

Consultation

As an art therapist I was determined to use this

class and my knowledge of art to assist hope in

her journey to recover. I consulted with a physical

therapist to create activities for us to do together

to further support her healing.

Hope struggled with “tip of the tongue” as she

called it

Later at night when tired she struggled to think of

how or what to say

When focusing too hard to say or remember

something she would say and write nonsensical

things

Helping the Speech flow

We did art (painting, drawing, coloring) to help her with her dexterity, expression, creativity and to have time together without speech.

We used card games, dominoes and watched TV shows while talking to help the speech flow.

The more she focused just on speech the more she struggled to find the words

The more she struggles the more frustrated she would become

By using distraction it helped her speech to come more naturally

Why Art Heals

Art expression bypasses Broca’s area of the

brain and gives access to traumatic and general

memories that facility healing. Van Der Kolk, 1994

Friends and Family

One important aspect of Hope’s recovery was

the support she received from friends and

family. She had a great deal of love, visits and

kind words.

Current ProgressMD and hospital were surprised by the rate of her progress and

determination to heal. She has surpassed expectations

considering the length of time between the stroke and first

treatment.

Speech is greatly improved

Still has difficulty at night

With certain words or phrases

When tired

Movement in right arm up and down

Able turn arm back and forth

Some movement in fingers

Recovered all movement to right leg

Able to walk unassisted

References

• Ischemic Stroke retrieved on July 10, 2014 from http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=iscstr

• Rates of recovery retrieved on July 10, 2014 from http://www.stroke.org/site/PageServer?pagename=REHABT

• Treatment of stroke retrieved on July 10, 2014 from http://www.uptodate.com/contents/ischemic-stroke-treatment-beyond-the-basics

• van der Kolk, BA. (1994) The body keeps the score: memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry. 1994 Jan-Feb;1(5):253-65.