Working post-stroke
If you’ve suffered a mild to moderate stroke, returning to work can be good for your recovery, new research suggests. Adult stroke patients who are employed before and after suffering a first stroke are more likely than unemployed adults to have healthier minds two years after the stroke. Those are the findings of preliminary research presented in January 2018 at the American Stroke Association’s International Stroke Conference in Los Angeles. Researchers conducted an analysis of a previous study of 252 working-age adult stroke survivors. Returning to work after suffering a first-ever stroke was associated with lower cognitive decline risk, they found. “Resuming life’s activities is essential in stroke recovery, and going back to work for some individuals is vital,” says Dr. Carolyn Brockington, director of the Stroke Center at Mount Sinai St. Luke’s and Mount Sinai West hospitals in New York City, who wasn’t involved with the research. “Recovery after stroke hinges on the brain being stimulated in order to help create the new neuronal pathways needed to improve the neurological function.”
Returning to the office
You shouldn’t return to work immediately after a stroke, particularly if the effects are severe, says Dr. Matthew Fink, chairman of neurology at Weill Cornell Medicine and neurologist in chief at NewYork-Presbyterian Hospital in New York City. And you may not want to go back quickly if your job is stressful. “After a stroke, we do want patients to have a certain amount of time to be in a low-stress environment to rest and recover,” Fink says. How long that rest period should last typically varies from two to six weeks. You should check with your stroke doctor regarding when you’re ready to return to work. “I always advise patients that if they don’t feel well, they shouldn’t go back to work too quickly,” Fink says. Being able to operate as close as possible to capacity is important for another reason. “When you go back to work, you want to be able to meet the demands of your job,” he says. If you go back too soon and don’t perform well, it can reflect badly on your performance and cause problems with your employer, which can elevate your stress levels. Additional stress would be bad for your recovery. Also, if you return to work before you can perform well, “you run the risk of losing your job, which would add more stress,” Fink says.
Intellectual stimulation
Keeping your mind active is an important component of recovery from a stroke. Going to back to work after a mild stroke, once you’re ready, can be mentally stimulating, says Einor Ben-Assayag, lead author of the recent study and a senior researcher in the neurology department at Tel Aviv Sourasky Medical Center in Tel Aviv, Israel. Being employed before a stroke and returning to work after a mild stroke can be particularly helpful for people in “mentally stimulating [occupations], such as teacher, lawyer, executive, engineer,” she says. Working in these kinds of jobs “activates several interconnected areas in the brain and enhances brain plasticity,” says Dr. Hen Hallevi, head of the neurology department at Tel Aviv Sourasky Medical Center and Ben-Assayag’s co-author on the study. Previous research has associated complex mental activity across one’s life span with a decrease in brain atrophy.
Social interaction
Spending time with other people — such as co-workers — can be an important part of recovery from a stroke, Fink says. “We are social animals,” he says. “Our brains are not designed for us to be solitary loners. It’s normal for us to be with other people.” Talking, listening and responding to other people in the course of a typical day’s work can be a powerful form of brain stimulation. “The more you use your brain after a stroke, the better the chance of recovery,” adds Dr. Amnon (Ami) Beniaminovitz, a board-certified cardiologist at Manhattan Cardiology in New York City. “When we interact socially, we use many brain processes. The key for stroke recovery and improvement is brain activity.”
Mental health
About a third of stroke patients experience depression and/or anxiety, says Dr. Jason Leung, a physical medicine and rehabilitation physician with the Shirley Ryan AbilityLab in partnership with AMITA Health Alexian Brothers Rehabilitation Hospital in the Chicago area. Research suggests a link between idleness and these mood disorders, he says. Returning to work promotes feelings of productivity, which can boost your mental state. Connecting with co-workers and friends on the job is also good for your mental outlook, since isolation can worsen symptoms. Being at work prevents the phenomenon of a feeling of being under “house arrest” that affects many stroke victims and is a major cause of post-stroke depression, which is associated with a greater risk for cognitive decline, Hallevi says.
Stress reduction
Going to work can help you keep to a daily routine, a regimen that’s beneficial to stroke patients by reducing stress, which can be detrimental to their recovery, Fink says. “Novel situations often raise stress levels in people,” he says. “A daily routine is comforting in that it lowers stress levels.” If your job is stressful, however, going back to it quickly may not be the best idea.
Physical activity
Staying physically active is crucial when recovering from a first stroke. Many stroke patients experience weakness in one or more limbs, as well as balance problems. Physical therapy can help, and so can daily exercise, Fink says. You’re more likely to keep your body moving if you leave your home every day to go to work. Such activity is beneficial to your brain. “You have to keep challenging your brain after a stroke to form new pathways and to replace the ones that were lost,” Ben-Assayag says. “Physical activity is a great way to form new pathways and reinforce old ones that can speed up your recovery. Many studies show that exercise, especially running, is particular important for brain health.”
Idle time
If you stay at home for an extended period after a stroke, you may fall into some unhelpful habits, like watching TV all day and night. Passively watching television won’t necessarily harm you, but it doesn’t help your recovery. “Stagnation takes place,” Fink says. If you’re unable to go back to work right away after a mild stroke, there are things you can do to keep your brain active that can help your recovery, Beniaminovitz says. Reading, exercise, dancing, doing puzzles, talking to people, going shopping and walking are all beneficial when recovering from a stroke.
Better sleep
The National Stroke Association reports that sleep disturbances and disorders can affect up to half of all stroke survivors. “We’ve all heard how crucial it is to get adequate, restorative sleep, but for the stroke survivor, it’s critical to help the brain heal and to maintain a healthy energy level,” Leung says. In fact, more recent scientific studies show that poor sleep can even lead to other long-term issues like post-stroke depression. “Keeping to a daily routine — such as going to work — could help you avoid midday naps, which can harm your normal sleeping patterns,” he says. “Usually work calls for getting up at the same time every day, which also helps maintain good sleep hygiene.”
Financial considerations
Many people perceive stroke to be a disease that only affects elderly and retired people. However, stroke can happen in any age group. In fact, nearly one-quarter of strokes affect young working people, says Dr. Ankur Garg, a stroke and interventional neurologist at the Comprehensive Stroke Center of Osceola Regional Medical Center in Kissimmee, Florida. “Returning to work is likely to be very important for a person who was working prior to suffering a stroke,” Garg says. “Not being able to return to work has negative financial consequences such as the loss of a steady income and the potential of losing work-related insurance and retirement benefits. At the same time, being able to return to work after a stroke allows a young working person to be financially independent and contribute actively towards the national economy.”
Other diseases
Long-standing diabetes and uncontrolled high blood pressure are among the most common causes of stroke. “It is well known that physical activity of any form helps control both high blood pressure and diabetes,” Garg says. Returning to work and being more physically active can reduce the progression of diabetes and high blood pressure that occur in part from an inactive lifestyle. In turn, this decreases the risk of having recurrent strokes and other complications of diabetes and high blood pressure.
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9 Reasons You Should Return to Work After a Stroke originally appeared on usnews.com
