If you or a loved one has had a stroke, you know just how scary it can be. It’s an emergency that needs treatment fast. A stroke occurs when the blood supply to the brain is blocked or when a blood vessel in the brain bursts. This damages some parts of the brain.¹

But what should you expect in the weeks, months and years following such an event?

No two people’s journey to recovery from a stroke will be the same. It depends on how much of the brain was affected. Some people may have a range of problems:²

• Paralysis
• Muscle weakness
• Trouble speaking
• Memory loss

But healing from a stroke is possible. And there are certain things to expect along the way. Here’s advice on how to navigate the weeks and months following a stroke.

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The first few days after a stroke

Initially, doctors want to stabilize you. “Once you have a stroke, you’re in danger of having another in the next 30 days,” explains Sam Horton, MD. He’s a neurologist at American Health Network, part of Optum, in Indianapolis.

Your doctor will try to figure out what caused the stroke. They will look at your blood pressure and heart rhythm, Dr. Horton says.

They will also try to determine what kind of stroke you had. The two different types of strokes are:

• Ischemic stroke, when a blood vessel to the brain becomes blocked
• Hemorrhagic stroke, when a blood vessel in or around the brain bursts or leaks

“Around 85% of strokes are ischemic. Another 15% are hemorrhagic,” says Brian Silver, MD. He’s the interim chair of the department of neurology at UMass Memorial Health in Worcester, Massachusetts. He’s also an American Stroke Association national volunteer expert.

You will need imaging tests to determine the type of stroke you had.

In the days after a stroke, your doctors watch to see if you have trouble speaking or swallowing, says Gary R. Keilson, MD. He’s chief of neurology at Reliant Medical Group, part of Optum, in Worcester, Massachusetts. These neurological symptoms can signal complications.

“It can be frustrating to the person because they want to be able to eat,” Dr. Keilson says. “But a stroke often involves swallowing difficulty. A nurse or speech therapist may need to check that you can swallow without problems first. Likewise, there may be a speech evaluation to see if there are any speech deficits.”

The doctors in the hospital will tell you how to prevent a stroke in the future, says Dr. Keilson. (Learn more about brain health here.)

“We want to teach the person and their family about what to do to control their blood pressure and blood sugar,” he says. He also stresses the importance of quitting smoking. Cigarette smoking can increase your chance of stroke. The risk of stroke can increase by 12% for every five cigarettes someone smokes per day.³

“Even if we don’t find out the cause of the stroke, we want them to know how to lower their risk of another one,” Dr. Keilson says. 

The first weeks after a stroke

You’ll most likely get medication to prevent another stroke. The medication you get will depend on the cause of your stroke. For example, if you had a stroke caused by a blood clot, you may need to take blood thinners or clot-busting medication.

Most people who have a stroke leave the hospital in less than a week, Dr. Keilson says. “But we will try to get them up and sitting in a chair or maybe even standing up,” he says. “We try to start physical therapy when the person is still in the hospital.” (Physical therapy uses movement and exercise to help a person heal.)

You may have a lot to relearn as you get better. That’s why a strong medical team is essential.

Your recovery specialists might include:⁴

• A physiatrist, which is a medical doctor who specializes in stroke rehab
• A physical therapist to help you become more mobile
• An occupational therapist who can help you relearn daily activities, like bathing and eating
• A recreation therapist who can help you find ways to do the activities you enjoyed before the stroke
• A mental health doctor or psychologist who can help with the difficult emotions having a stroke can bring

How often you meet with each specialist will depend on your specific needs. Some people go to a rehab facility after the hospital to heal. If you’re able to return home, some of your therapists may visit you there.

It’s important to do the exercises given to you by your physical therapist, Dr. Silver says. “It’s like playing golf or tennis,” he says. “How do you become a good tennis player? If you play every six months versus playing three times a week, you won’t play as well. It’s the same with rehabilitation.”

Your care team can also help you figure out if you need any special devices to ease your recovery.

“If there are stairs in your home, you may want extra railings,” Dr. Horton says. “You may need grab bars in the shower. A walker or a cane may also be needed.”

Healing from a stroke can be tough. Some patients may become depressed. Beyond therapy, medications may be helpful. Your doctors can help you figure out the best treatment plan.

For mental health support, work one-on-one with a virtual coach or therapist from AbleTo. Find support now.

The next several months

Recovery can be slow going, and sometimes there can be setbacks. Be patient with yourself, Dr. Horton says. Know that most of the recovery from a stroke occurs within three to six months. But you can keep getting better even after that.

“The previous theory was that you only improved for the first six months after a stroke,” says Dr. Silver. “Now we know you can show improvements for longer. The slope of recovery changes. It’s a little flatter, but it continues to go up.”

As you get stronger and healthier, try to keep your focus on preventing another stroke. Do aerobic exercises three times a week if you’re able, says Dr. Horton. Eat healthy and don’t smoke. Stay away from secondhand smoke, too. It can raise your risk of stroke by up to 30%.¹

And get enough sleep. “Proper sleep is very important for your cardiovascular health,” says Dr. Horton. “I ask patients if they wake up multiple times a night or are tired the next day. If this is the case, you could have sleep apnea.”

As many as 8 in 10 people who’ve had an ischemic stroke have sleep apnea. That’s compared to 4% of the general population, Dr. Silver says. Sleep testing can determine whether you’re one of these patients. If so, there are treatments that can improve your quality of sleep.

Strokes are a serious medical problem. With the help of medication and your team of doctors, you can feel better faster and help prevent another one.

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