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Stroke Aftermath - Part 2 "Late Effects"

On last month’s intro, I presented a brief description of the three COMMON types of strokes but there is a fourth type and we will get into that in a sequel. For now, let us return to the rehab and medical vernacular of how strokes are addressed after the acute phase. Any residual symptoms that were not resolved shortly after the event or rehab outcomes that were not retained are called “late effects” and may be treated weeks, months, or years after having a stroke under insurance coverage. Unfortunately, many survivors believe their unresolved issues are permanent after they are discharged, which MAY NOT be the case, but how does one know? We have heard the saying, “If at first you don’t succeed, TRY, TRY AGAIN!”

Stroke survivors must be discharged from in-patient or out-patient rehab when clinicians/therapists cannot document the continuation of progress. But instead of seeing it as a plateau needing to be challenged, most believe the patient has reached their “Maximum Rehab Potential.” In-patient rehab is optimal immediately after a stroke due to daily therapies, however, when a patient returns home and back to a familiar environment, they are able to achieve better quality sleep and nutrition which helps the brain heal tremendously. Morale can be better at home, provided they have family/caregiver support. A positive mental state is what facilitates continued progress and brain cells CAN regenerate (“neurogenesis”) in the absence of stress and with the optimal environment. Our brains are always seeking “homeostasis”: internal balance and stability.

A stroke may affect vision in many ways depending on the area of the brain that was injured because our visual cortex takes up a lot of brain space. For example, field cuts (blindness to the right or left of both eyes), called hemianopsia and cranial nerve palsies cause the loss of control of one or both eyes. Other visual disturbances include:

  • blurry vision

  • double vision

  • moving images

  • dry eye and sensitivity to light.

When stroke affects the areas of your brain that process information you see, it can cause problems such as:

  • visual neglect

  • judging depth and movement

  • recognizing objects and people

  • visual hallucinations.

Patients with visual processing damage may be referred to a neurologic ophthalmologist, orthoptist, or low vision clinic where occupational therapists(OTs) have specialized training in vision rehabilitation. Neuro-specialized OTs also address visual disturbance after stroke or head injuries. Neurogenesis needs skilled guidance for proper “re-wiring” especially when there are greater deficits. This is when specialized rehabilitation is warranted but often people, not knowing where else to go, return to the place where therapies were discharged, and the potential is missed.

Please note, no two rehab centers are alike because the clinicians are not the same. Most therapists have a passion for a particular deficit or treatment modality and may have specialized niche training. Likewise, no two patients are the same in their “late effects.” A new set of clinical eyes can offer a fresh start for untapped rehab potential!

Integrative Therapeutic Solutions treats all neurologic conditions including visuomotor conditions because we treat THE WHOLE PERSON in body, home, and community. Don’t wait to rehabilitate, Re-INTEGRATION IS STILL POSSIBLE!

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