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    Stroke damage to both sides if the brain
    optimsitic1 posted:
    My brother had a massive stroke 3 weeks ago, the Dr's removed a blood clot from his brain by surgery and also discovered my brother has a heart problem, not sure right now what it is, that caused the stroke.
    He has damage to both sides of the brain.

    He opened his eyes afer 9 days but he was unresponsive to anything, yesterday he seemed to recognize our Uncle and said one word, but the Dr's said he may not have recognized him.

    My questions are, isn't it a positive thing that after being awake but unresponsive for 9 days, he seems to have some kind of recognition and says a word?

    Also, Dr's say they cannot say anything until 2 weeks after the stroke as they will know more then, why is it 2 weeks after?

    Just to add, my brother cannot swallow and has a feeding tube. I am staying positive even though I am in tears, we want him to come back to us.

    Thank you for any help/advice
    Richard C Senelick, MD responded:
    Trying to predict a patient's eventual level of improvement and how long it will take is always difficult. Frequently we are wrong. We tell a family that the person will do well and they do not or we tell a family that there is no hope and over time the person does much better than we would have thought.

    There is no magic period of time. However, one of the best predictors is the rate at which someone gets better. If someone is rapidly improving, then we can safely say they will continue to improve. When the improvement is slow, then it is difficult to tell how long it will take and how much function the patient will regain. Improvement can take place over years.

    When your brother's physicians feel that he is stable, it is very important that your brother go to an intensive rehabilitation program. There is a tendency to send severely impaired patients to skilled nursing homes for rehabilitation, but the amount of therapy and quality of care makes a huge difference. Start looking into inpatient rehabilitation facilities now. Tell his physicians and his case manager that you will want him to go to an inpatient rehabilitation hospital and not a skilled nursing facility that calls itself a rehabilitation center.

    Finally, any improvement is good news and it is much too early to know what the final outcome will be. Your brother may be left with significant disabilities and it may take a long time for him to improve, but the key is to give him every opportunity to improve. You will need to be his advocate and speak for him.

    I laways tell families that bad things happen quickly and good things take time. Prepare yourself for a long journey and embrace all the small victories-- like recognizing your uncle.

    Good Luck.
    After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
    optimsitic1 replied to Richard C Senelick, MD's response:
    Thank you very, very much for your help and advice.

    When we went to see my brother today he was trying to fight 5 nurses who were trying to change him, when he settled down he did seem to have more recognition and we thought he was trying to speak.

    When we saw him moving we were amazed, his right side though seems more weak. He is having a lot of therapy, stilll on a feeding tube but we feel he is making great strides, it's a miracle. The Dr's are still not sure how much he can see especially on the right.

    When we were leaving and said goodbye he tried to raise his arm, thank you so much again for all your advice.
    optimsitic1 replied to optimsitic1's response:
    After seeing my brother move forward he seems to be going backwards now, the staring in to space is happening again a lot, he is very combative, kicking the nurses and will not let them near him, he looks as though he is afraid is the best way to describe it, he doesn't understand they are trying to help him and is not understanding a lot of things said to him.
    They have said they wil have to sedate him to do anything, blood tests etc.

    We noticed the right side of his mouth is drooping, it wasn't before, he can move his right arm more then the left.

    He had a stroke on the left side of his brain first the Dr's said, then in the hospital he had a stroke on the right side of his brain, they say this is very unusual, they surgically removed clots, one from the frontal lobe. They have said the damage is permanent but we won't ever give up hope.

    Again, we are at a loss, he has to have 24/7 care because of the lack of cognitive skills, he can move his right arm more than the left one, is still incontinent and has a feeding tube, he is going to have the nasal feeding tube taken out and they are going to put one in to his stomach again (can't remember the name of it)

    Please, can anyone tell us that the cognitive skills can return????
    Amelia_WebMD_Staff replied to optimsitic1's response:
    I'm so sorry to hear about the turn of events with your brother and hope that things are improving, now.

    Unfortunately, as Dr. Senelick stated, "Trying to predict a patient's eventual level of improvement and how long it will take is always difficult." Each case is different, though cognitive skills can return for some patients, others may not regain such strengths. Here is a Caregiver's Guide on Cognitive Problems as well as a Stroke Rehabilitation Guide .

    Please let us know how you are all doing. My thoughts are with your brother, you and your family.

    Best Wishes! Amelia

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