The human brain continues to fascinate and intrigue me. Ever since I can remember, I have been fascinated by human behaviour and have always been intrigued by why we do the things we do. Growing up as an only child until my sister arrived at the age of 14, I spent most of my time observing the adults in my family – especially at family gatherings and social occasions.
A few weeks ago (3 weeks now to be exact) an aunt of mine “suddenly” had a stroke. I say “suddenly” because I am sure that there were warning signs that nobody noticed or chose not to notice. This is an aunt who religiously took her blood pressure medication every day, tried her best to exercise in some form or other each day and carefully watched her diet. Yet, she had a stroke. Why?
According to her GP, the stroke happened exactly one year after she stopped getting medication from him, yet she took medication every day which leads to the question – where was she getting her medication from? Was she being supplied by a pharmacist who was not insisting that she provide an updated prescription every six months? Well, let’s get back to my fascination with the human brain.
The aunt I’m referring to here – the stroke occurred on the left side of the brain which means that her right side is completely paralysed and she has lost her speech – she cannot speak at all and only makes grunting noises when she cries or tries to laugh. She is unable to swallow and is being fed through a tube which goes through her nose all the way down into her stomach.
The first week after her stroke she was extremely emotional and cried like a baby for no specific reason when she saw her visitors. As suddenly as the crying started, it stopped. She would stare at us for a few seconds before indicating (by the look in her eyes) that she recognised our faces. It was as if you could see the brain ticking over as it dawned on her who she was looking at.
Trying to have a conversation with her was difficult because you could not be sure how much she was able to understand or comprehend. Not being able to speak at all, made things even more difficult because there was no verbal response. Nonetheless, we continued believing that some of the words spoken would get through to her.
From the second week there was less crying and more evidence of recognition – as we approached the bed she would attempt to smile indicating that she was happy to see us.
This week (the third week) she was so proud to show us how she can manage to pull herself up into a sitting position in bed all by herself (with her left arm only), still not using her right leg or arm. When she kept sticking her left foot out from under the covers, I pretended to play the piano on her toes and she giggled – a response, yay! When I spoke about the weather, I indicated using my hands that it was windy and my hair blew all over the place, again a giggle (response). At the end of visiting hour, I left her with a challenge – the next time I visit, I want her to chase me down the passage (me on crutches and her chasing me from behind) – again, a giggle. All in all, I would say she was not only a lot more responsive but there was also a lot more comprehension of the spoken word in just 3 weeks which is absolutely wonderful as far as I am concerned.
What I find fascinating is that her brain still does not seem to acknowledge the right side of her body. When we move her right hand, arm or leg, there is no sign of acknowledgement that we are on that side or that we are moving that side of her body. When we raise her hand/arm into her line of vision, she stares at the hand and arm as if she is asking “what is that?” Even when she was showing off her skills of pulling herself up into a sitting position, there was no indication of her brain actually acknowledging that she had another arm or leg she could use to help her achieve her goal of sitting up in bed. When her hospital gown fell off her right shoulder and we pulled it back up, she looked at what we were doing as if she was asking “what are you doing?”.
I have heard some people say that the brain is so marvellous that when one part is damaged, it is able to re-route instructions to another functioning part. I have also heard people say that when a person recovers from a stroke, their first conversation is usually a repeat or a continuation of the last conversation they had before the stroke.
How true is this, I wonder? My aunt was alone at the time of the stroke – my uncle was home but was in another part of the house. By the time he found her, she was already non-responsive so we have no idea exactly how long it was between the time she actually had the stroke to when my uncle found her. I mention this because with her being alone at the time of the stroke, I wonder what the last conversation was that she will recall once she recovers from the stroke.
I have read that with a stroke in the left hemisphere of the brain, it is normal to have some memory loss. How much memory loss my aunt will have we have yet to find out. I read a blog recently of a man whose wife also had a left hemisphere stroke and he had to start teaching her the alphabet all over again by using the ABC song usually taught to those in kindergarten. He then slowly progressed to little words like C-A-T spells CAT and so forth. He also suggested in his blog that when asking a recovering stoke patient a question, you ask one question at a time and not two questions at once because this is too much for the brain to handle at once. For example do not ask questions like “what would you like for lunch?” the question is too broad, the patient will not know how to answer the question and will cause a certain amount of stress/anxiety which is not good for a recovering stroke patient. They should be kept stress and anxiety free at all times so rather ask “do you want something to eat?” if the patient says “yes”, then ask “would you like a sandwich?”, if yes, then ask “would you like cheese?” and so forth. Always only ask one question at a time – never do a this/that or either/or questions.
I will be following my aunt’s progress very closely because I am really fascinated by how the brain recovers from a major trauma like a stroke. Will my 70something aunt now have to be re-taught like the kindergarten children she used to teach? How much memory will she lose and how much memory will remain after the stroke? Will she remember the last conversation she had before the stroke? Will she just pick up from where she left off or will she have absolutely no idea and start all over again?