Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Sunday, September 12, 2010

Stroke fatigue

This is one of the least understood side effects of a stroke. While I was still in the hospital if I had 10 minutes between therapy appointments I would fall asleep. I was also on the general muscle relaxant, baclofen, which was supposed to lessen my spasticity. It didn't do that at all so I was left with the side effect of extreme fatigue. Finally talked my doctor into trying something else. Zanaflex, which was no better, also a general muscle relaxant.. Since there was no diagnosis on what was causing the fatigue I self-diagnosed myself that I had sleep apnea. It was proven correct after going thru a sleep study in which I would quit breathing 6 times an hour. This was a fairly mild case of sleep apnea but I did convince my doctor that I wanted to get a CPAP machine. What a mistake. With the positive air pressure going into my nose constantly, I had to actively concentrate on my breathing to make sure I could exhale against the pressure. It worked for about a week but I did not get any lessening of the fatigue. I finally quit using it during the second week when one night I spent two hours concentrating on breathing thru the mask. At that point I decided that living with the apnea was more restful than trying to use the CPAP machine. I have no idea what waterboarding feels like but that is how I would describe the feeling of breathing against the CPAP machine.
I have heard that our brain is about 2% of our body weight but uses 20% of the energy, so the speculation is that the brain is rebuilding as it recovers and needs that much extra energy.. If I want to function at work I have to have a large cup of coffee. On weekends I can sleep for 10-12 hours or take 2 hour naps during the day. Personally I think there is a chemical imbalance in the brain after a stroke and researchers just need to focus on that. Recovery could occur so much faster if we all weren't battling fatigue all the time. For myself I am still quite cardivoascularily fit, resting heart rate of 53 at age 53 puts me in the athlete category. If I am an athlete, why am I so fatigued all the time?

This article basically says I don't know
Why am I so tired after my stroke?

Its a tossup between spasticity and fatigue as to which I consider worse and neither one has any understanding of even how to approach it. With a stroke survivor in charge we would at least come up with some ideas rather than washing our hands of it.


  1. Hi yes but must we choose fatigue or spasticity? I wonder if the 2100 Mg of Gabapentin I take ( for spasticity) is making me too tired to get fit and do things.

  2. i would look at the side effects at
    Back pain; changes in vision (double or blurred vision); clumsiness; constipation; diarrhea; dizziness; drowsiness; dry mouth; nausea; stomach upset; tiredness; vomiting; weight gain.
    if it is similar to either baclofen or zanaflex the fatigue was stupid, lets make everything tired in the hope than the specific muscles you want to work have enough energy to overcome their agonists.

  3. I have been given so many reasons for the fatigue, with the majority blaming me (because I am depressed), from the brain is working hard to repair itself (22 years c'mon) to that I am having to expend so much energy because I have to consciously force my body to move. I looked at all my defects and figured that my hypothalamus was either wiped out or severely damaged, and this part of the brain controls the production, dissemination and utilisation of virtually all neurotransmitters, so goodbye to endorphins, dopamine and noradrenaline for boosting my energy. Occasionally I do have a good couple of days, and this overwhelms me, but I know that I could not go back to a genuinely busy life and still be able to keep going.