Sunday 6 November 2011

Stroke update

I want to describe the symptoms that I'm feeling, and how they've changed since I had my stroke on 17th October - almost three weeks ago. I've definitely improved in some ways, having recovered much touch sensation, but I'm also feeling more pain and cold.

My stroke (for which I'm still awaiting a definite diagnosis, by the way) was a pure sensory stroke. It hasn't affected my mobility or cognition in any way. That is, apart from a slight lack of confidence when using my left hand. Fortunately, I'm right handed.
Half Michelin man
Currently, I'm feeling the following symptoms pretty much all the time, but all only on the left side. In short, I feel like my left side has been blown up like a balloon, but the sensation is different in different parts.

In my face, I feel like I have a black eye and cauliflower ear, and am a bit numb on the chin. The ear is constantly slightly painful, as if someone had punched me there quite hard a few hours ago. The eye sometimes feels a bit dry, and I use optrex eye drops a few times a week. I don't know if it really is dry, but the eye drops do seem to help.

My neck feels stiff, which is a symptom that has come on in the past few days. Lifting heavy shopping bags hurts my shoulder more than it should. The upper arm feels constantly as if I have a blood pressure monitor inflated on it, but isn't painful. The lower arm including part of my hand (but only the little finger) feels like it's slightly sunburned. When I'm tired, or cold, the pain extends right up my arm, and becomes quite serious. I haven't resorted to pain killers yet, and have no idea if they would work, but this does keep me awake at night somewhat.

My side, over my ribs, feels like it's ballooned up. When I wear a heavy coat, it feels like I'm carrying a few phone directories under my arm. That's the most peculiar of all the sensations, since it feels like my arm should be sticking out almost horizontally. And yet, there's no apparent motion impairment. Between my rib cage and my waist is numb, but I'm please that the chafing sensation at the waist has subsided now.

When I sit down, it feels slightly uncomfortable. It always feels as if someone has left a wooden ruler on my chair, so I always have to check that there's not actually anything there. My thigh also feels constricted, just like the upper arm. Also like the upper arm, it can become painful when cold, but not to the same extent. From the knee down, I feel relatively normal!
Signs of improvement
There have been changes, particularly over the first few days, and I'll try to describe them. On the day of my stroke, I was sitting in an armchair and tried but failed to lift my arm. Looking down, I realised my arm had slipped off the arm of the chair, and was trapped between my side and the chair arm. Within a day or so, I'd recovered enough sensation in my arm that that wasn't possible.

Also, on that first day, I was walking very tentatively because I could not feel the weight on my foot, so I wasn't sure of my balance. In fact, I was walking independently and quite well, but I had to look down to be sure of myself. The next day, though, I was walking normally, and my wife still complains that I walk too fast!

The strangest sensation on that first day came when I need to remove ear-plugs after an MRI scan. MRI scans are very noisy, and the radiographer had inserted ear-plugs for me. After the scan, though, I was left to remove them myself.

I took the right one out first. Then, I raised my left hand, and touched something, but what? It had to be my ear, but neither my hand nor my ear was giving me any clues. It was simply impossible to remove the plug with my left hand. So, I reached around with the right. It was still tricky. Of course, I couldn't see, so I had to grope around to find the plug in what felt like someone else's ear. A week later, when I went for a repeat scan, I had no problem inserting and removing an ear plug with my left hand.
Pain management
I mentioned that I've not been using pain killers. That's partly because the pain isn't severe, and partly because I'm concerned about how pain killers might interact with my other medication - which included aspirin for the first two weeks. The best way to deal with the pain is just to get on with life, and take my mind off it. Staying warm helps, too.

From what I've read, there's a good chance that things will improve, but it could take a few months and may not be a complete recovery. Exercising the affected areas might help - apparently recovery in the arm is more common than in the leg, and that may be because the arm gets more exercise just in daily activity.

Finally, on the Thursday after the stroke, my wife printed out some diagrams of a body, and we compared how a simultaneous light touch on both sides (for example, on both elbows) felt. At each point, I rated the sensation on the left compared with the sensation on the right. At many points, I could only just sense something on the left, and at some points not at all. At other points, I was super-sensitive. We repeated this exercise a week later, and there was a dramatic improvement almost everywhere. However, there are many other types of sensitivity - to heat, to sharp pricks, to cold and so on, and we've not measured any of those.

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