Courageously Facing Stroke Or Brain Injury Diagnosis: Turning Catastrophe Into Power With Knowledge

How did we move on after we were sucker punched by a health issue?  After the shock wears off, you just put your big girl or boy pants on and drive on!

When I share with people that my husband has a brain injury, many will ask if he had an accident.  If I just say he had a stroke, people’s next question is how old was he when it happened.

The assumption is usually that he had some accident that led to a traumatic brain injury or that he is much older than me and had a stroke.

Mark was actually 46 years old and in perfect health when he had his subarachnoid hemorrhage, which is also known as a hemorrhagic stroke.  The cause of Mark’s hemorrhagic stroke was a rare disease called MoyaMoya.

Strokes and traumatic brain injury are generally blanket terms that come with some assumptions for those around us and can often lead to misunderstandings about what the individual has gone through and what the long-term effects and recovery or treatment options look like.

Brain Injury Causes

To better understand the brain injury basics, let’s review causes of a brain injury.

Traumatic Brain Injury Examples

This is usually caused by a trauma to the head that leads to damage to a specific part of the brain.  The most common causes include:

  • Auto accidents
  • Sports injury
  • Falls
  • Combat injuries
  • Violence, such as a physical attack

Anoxic Brain Injury

This type of injury occurs when the brain is deprived of oxygen for so long, that the cells of the brain begin to die.  The most common causes:

  • Near drowning
  • Electrocution
  • Suicide attempt
  • Severe asthma attacks

Acquired Brain Injury

This type of injury happens due to disease or an acute medical event.  Some examples include:

  • Stroke (hemorrhagic stroke or ischemic stroke)
  • Alzheimer’s disease
  • Parkinson’s disease
  • Brain tumor
  • Substance Abuse

Types of Strokes

Hemorrhagic Stroke

For those individuals, like my husband Mark, stroke can also present in different ways.

Hemorrhagic stroke, which accounts for approximately 13% of strokes.  These types are generally caused by a weak vessel in the brain that bursts.  The weak vessel can be a result of genetics (MoyaMoya diagnosis) or from infections, such as meningitis.

Ischemic Stroke

This type is the most common type of stroke and is caused by a blockage in the brain.  Generally this is caused by a blood clot  or due to fatty deposits in the vessels of the brain, impairing the blood flow.  This is referred to as atherosclerosis.

TIA

This is a transient ischemic attack, meaning it is similar to an ischemic stroke, but generally the symptoms will pass in less than 24 hours, making this stroke recovery relatively quick and common.  Often, symptoms may only last a few hours, leading individuals to ignore the symptoms, leading to a more serious ischemic stroke later.

So now that you have a better understanding of brain injury causes and different types of strokes, let’s talk about how we can prevent them.  While you may have already experienced a brain injury or stroke, it certainly doesn’t mean we should not be working diligently to prevent another one!

Stroke Prevention

Let’s start with strokes and what we can do to prevent them.  In Mark’s case, his stroke was caused by genetics, so we were unaware of his condition, but have since worked very hard with a neurologist and neurosurgeon to keep him on the right path to recovery.  I won’t spend too much time going into Mark’s story, because MoyaMoya is so rare.  However, if you are interested in learning more, here is a link to information:

https://www.mayoclinic.org/diseases-conditions/moyamoya-disease/symptoms-causes/syc-20355586

Prevention of strokes looks a lot like everything else we should be doing to care for ourselves and our health.  If you have had habits in the past that have led to some of your current health issues, it is NEVER too late to start working towards good health.

  • Avoid smoking
  • Limit alcohol intake
  • Do some physical activity daily (even 15 minutes of walking)
  • Manage chronic health issues like diabetes and high blood pressure
  • Choose healthy foods
  • Maintain a healthy cholesterol level

If you are caring for someone who has previously had a stroke or who is at risk, watch for the following signs:

  • Confusion
  • Difficulty speaking or understand what others are saying to you
  • Changes in vision
  • Lack of coordination
  • Loss of balance
  • Drooping of one side of the face
  • Numbness and/or tingling to an arm, leg

Brain Injury Prevention

While you may have a brain injury or be caring for someone with a brain injury, it is still important to ensure we are doing everything we can to prevent any further issues or damage.  Ultimately, those who have a brain injury often have an increased risk of falls, leading to an increased risk of reinjuring the brain.

  • Always wear your seatbelt
  • Wear a helmet in sports like football, baseball, etc
  • Wear a helmet when riding a bike, skateboarding, riding a motorcycle, roller skating
  • Prevent falls

I feel like fall prevention needs its own discussion.  Did you know six out of every ten falls occur in the home?  That means while we are in the place we feel the most safe, we have the greatest risk of falling.

So as someone who is both a nurse practitioner and a caregiver for someone who has a brain injury and is a fall risk, here is what we have implemented to prevent falls:

  • Shower bench for bathing with hand held shower for Mark to sit and use
  • Handrails coming in and out of the home, in the bathroom to ensure he has security when moving to and from risky places, like stairs or the shower.
  • Seated wheeled walker for any place we go outside of the home.  We even use it to walk from the car to church.
  • Regular eye exams
  • Daily exercise to improve strength and balance
  • Staying hydrated
  • No throw rugs in the home

I would love to hear what others use in their homes to prevent falls.I am always impressed with caregivers and their ingenuity to keep individuals safe, while still encouraging independence!

Finally, if you or someone you are caring for has had a brain injury, from whatever cause, your biggest question might be what does the future hold? What does our future look like after stroke rehabilitation or brain injury rehabilitation? You may have been given many different ideas of a prognosis, goals, and reality of how much better or challenging life will get.

I’m here to tell you that as a medical professional myself, we are all just giving our best educated guess.  People are all different.  Healing looks different in different people. In Mark’s case, the prognosis for his recovery from a brain bleed was poor.  We were left with very little hope for a “normal life” again.   So the best advice is to just take it a day at a time and work towards recovery the best way you can.

For Mark, I think it’s important for people to know when he initially had his subarachnoid hemorrhage, we were told he would not survive.  Then we were told he would not walk or talk again.  While it was a long road, he did come home with limited walking and talking.  He was incontinent of bowel and bladder and six months after, I believed this was our new normal.

I never gave up trying though.  I kept hopeful that things would get better.  I did my best to make sure he had every opportunity to have the maximum recovery possible.  It was so hard. I cried a lot.

Seven years later, he walks with a walker, he talks, he laughs, he is no longer incontient.  While his brain injury does impair his long and short term memory, he has a wonderful quality of life.

Give yourself grace if you have a brain injury or are caring for someone with a brain injury.  Reach out for help, education and resources if needed.  Even though I was a medical professional for more than a decade when this happened to Mark, I could not have managed my role as caregiver without utilizing all the folks around me, who wanted nothing more than to help us.

 

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