Here's why the 90-day 'golden period' in post-stroke rehabilitation is vital

Crapola like this is just reinforcing the tyranny of low expectations from your stroke medical professionals.  You'll just have to ask them why they have such fucking low expectations. 100% recovery is the standard. Why the hell can't they get you there? Are they that fucking incompetent?
https://www.business-standard.com/article/news-ians/here-s-why-the-90-day-golden-period-in-post-stroke-rehabilitation-is-vital-comment-118061900254_1.html


A stroke can hit anyone at any age. India reports more than 1.8 million cases every year, of which almost 15 per cent affect people in their 30s and 40s.

A stroke or a Cerebro Vascular Accident (CVA) results from a sudden blood loss to the brain or bleeding within the brain resulting in the impairment of neurological function. Obesity, smoking, hypertension, alcohol consumption, diabetes and family history are considered some of the common factors leading to a stroke. While effective treatment for stroke is evolving in the country, a largely neglected area is the 'golden period' of post-stroke rehabilitation.
The first 90 days after recovery of a stroke are referred to as the 'golden period'. This phase is considered extremely important in the complete rehabilitation of a patient since most of the neurological recovery happens during this time.
This is why the 'golden period' is significant:
* In the absence of continued monitoring by a team of skilled nurses and doctors, critical signs in a patient could be overlooked consequently leading to a relapse, disability with profound effects on the quality of life or moving to a vegetative state and death.
Some of the critical signs to watch for after a stroke are:
Symptoms of heart disease - chest pain, fatigue, congestion et al
Deep vein thrombosis - swelling, pain or tenderness in the legs
Pneumonia - fever, shortness of breath
Seizures - tingling sensation, partial loss of consciousness
Depression - feelings of anxiety, irritability, helplessness
* Early rehabilitation in an organised care setting can prevent other common post stroke complications like recurrent stroke, bed sores, aspirations, spasticity and infections.
* A reliable prognosis (the likely course of a medical condition) in all patients is made within 12 weeks from a stroke's onset. The majority of neurological effects of a stroke can be reduced if early, intense and consistent rehabilitation is initiated.
* With the right rehabilitation care provided by a multidisciplinary team of doctors, within the first 90 days itself there will be noticeable signs of improved functional outcomes in the activities of daily living in a stroke patient. These interventions will enhance socialisation and minimize changes of mood issues like depression.
The key objective of stroke rehabilitation is to restore health in an individual through neurological recovery (mainly through neuroplasticity), functional recovery with task-specific training and improving the quality of life by focusing on emotional wellbeing.
The primary steps of rehabilitation care which needs to be initiated within the first 90 days of the Golden Period are:
* Base assessment & risk profiling - The recovery prognosis of a patient should be made as per the severity of the disease, by taking into account any co-morbidities including high blood pressure, diabetes, hypercholesterolemia and preventable risk factors like falls, aspiration, infections et al.
* Goal setting - A multidisciplinary team of care providers including physicians, speech therapists, occupational therapists, nurses, physiotherapists and dieticians should work with the family to set realistic and mutually agreeable goals for enhanced recovery.
* Regular evaluation - Performance indicators should be rigorously monitored to continue/ modify the care plan. Stroke affects differently in individuals and hence each care plan should be customised as per the individual's condition.
* Empowerment - Soon after discharge from a critical care setting, depending on the intensity of the condition a stroke patient should decide to choose the next care setting. He/she should be advised to handle the disease/risk factors and ideally moved to an organised rehabilitation setting for an empowered and accelerated recuperation.
As India battles a rising stroke epidemic compared to other developing nations, it is high time we focused on specialized programmes of stroke rehabilitation to effectively overcome the disability.
(Dr Vijay Janagama is Director - New Initiatives, SuVitas Holistic Healthcare. The views expressed are personal)
--IANS
vijay/vm/tb

Why Rehabilitation Is Key for Stroke Recovery

More trying to pass off crapola stroke recovery as good news. 
https://www.kindredhealthcare.com/resources/blog-kindred-spirit/2018/03/06/why-rehabilitation-is-key-for-stroke-recovery

Stroke recovery has come a long way(Bullshit, 10% full recovery is a horrendous failure rate) because of widespread education on how to identify strokes as they’re happening to help people get care faster and specialty care and rehabilitation. Now, more than seven million people survive strokes each year.

The level of recovery each person can expect depends on different things: where in the brain the stroke happened, how much of the brain was affected, how healthy the person was before their stroke, the amount of rehabilitation they participates in and how much support they have from loved ones.(Fucking low expectations, get out of stroke if you are that incompetent)

Most people see the biggest improvements over the first three to four months following the stroke, especially in a hospital setting, but it’s not unlikely to continue recovery up to two years later. Here is what you can expect.

Rehabilitation

Rehabilitation is key for stroke recovery. No two strokes are the same, so patients will require different levels of care to regain their health and quality of life. Post-stroke rehabilitation can include:

• Physical therapy – helps with regaining strength and ability to get around
• Occupational therapy – helps a person relearn motor skills and how to do daily activities again
• Speech therapy – assists with the ability to speak clearly
• Nutritional care – creates a nutrition plan to stay healthy through recovery
• Patient/family education – provides information on the care plan to both the person in recovery and their loved ones so they have the skills they need to make the most of the journey

Caring for a Loved One After Stroke

It’s important to be an advocate for your loved one when they’re regaining their independence. Try to monitor their behavior and abilities for any negative changes, and notify the care team if you notice any warning signs, such as:

• Dizziness or imbalance that leads to falls
• Difficulty with daily activities or hobbies they used to enjoy
• Mood swings or trouble controlling emotions
• Depression, which occurs in 30-50% of people in recovery, which can affect rehabilitation success
• Change in your loved one’s abilities that appear as a setback in abilities

Experiencing a stroke can be alienating as a person adjusts to their new normal. Ask your case manager, social worker or discharge planner for community support groups and resources that could help your loved one to feel like they aren’t going through this journey alone. These tips from the American Stroke Association can help you as a caregiver as well.

The Good News

Did you know that up to 80% of strokes are preventable? By lowering your blood pressure and incorporating a healthier lifestyle you can reduce the chances that you may suffer from a stroke.

At Kindred, we offer stroke recovery programs in multiple locations, depending on the individual’s needs:

• Transitional care hospitals
• Inpatient rehabilitation hospitals
• Home care

Early Intervention

Immediate medical attention is essential to improve the odds of recovery. Know the signs of a stroke and call 911 as soon as possible. The acronym FAST is easy to remember and outlines the main signs of stroke:

F – Face drooping

A – Arm weakness

S – Speech difficulty

T – Time to call 911

To find out more about strokes, visit the American Stroke Association. Kindred Healthcare is the national sponsor of Together to End Stroke,  a program that elevates awareness about high-quality rehabilitation, patient support and using the rehabilitation and recovery guidelines from the American Heart and American Stroke Association. 

If you have questions about stroke recovery, call 1.866.KINDRED to speak with a Registered Nurse 24 hours a day, seven days a week. We’re here to listen and we can help. 

A multi - centre study of how goalsetting is practised during inpatient stroke rehabilitation

This just proves that patient goals are ignored and stroke survivors have to accept the low expectations of their recovery. YOU have to scream at your providers that you expect 100% recovery NOT the dumbed down goals they will push on you. Make them uncomfortable in explaining why they know nothing about getting you to 100 % recovery. You should have them apologizing to you for their incompetence. 
https://www.research.manchester.ac.uk/portal/files/59205416/AAM_G_S_practice_during_ip_pt_stroke_rehab_Clin_Rehab_2017.pdf