The biggest worry is often about having another stroke. Of all stroke risk factors, none rank higher than having already had a stroke. I know Harvard did a stroke study and found risk of a second stroke is about 2.5 percent in the first two weeks, and about six percent over three months. I forget how many patients were in that study.
Certain supplements might significantly improve recovery. Proper nourishment, especially protein is important. I suggest 1 gram of protein per lean body mass per day. At least 100 grams of protein per day is a good amount to aim for.
An intensive supplement regimen will certainly help. This includes a multivitamin with minerals, vitamin C, a wide spectrum of B vitamins (high doses of vitamins B6, B12, and folic acid).
I remember one study saying researchers found that subjects who had the highest intake of the three B vitamins reduced their risk of ischemic stroke and coronary disease by more than 20 percent. The worst outcomes were seen in subjects who had the lowest intake of vitamin B12. It’s easy to develop B12 deficiency because of poor absorption.
Many studies indicate that patients with elevated levels of the amino acid homocysteine are roughly 1.7 times more likely to develop coronary artery disease and 2.5 times more likely to suffer from a stroke than those with normal levels. The B vitamins I already mentioned help break down homocysteine in the body.
Assuming it’s an embolic stroke, not hemorrhagic (from a burst blood vessel), I’d go heavy on the fish oil, along with high-dose nattokinase. Then, of course, you’d have to add mixed tocopherol E to the fish oil to protect against free radical formation. For stroke, I’d add something like 1,200 iu/day. I’d also add some selenium, since it augments vitamin E in any of its uses.
For Vitamin C five to nine servings of a wide variety of fruits and vegetables each day would put most people in the top vitamin C quartile. Another study (can’t remember), subjects with the lowest plasma concentrations of vitamin C were almost two and a half times more likely to experience a stroke compared to subjects with the highest C levels. One of the most interesting things about this study is that the vitamin C intake difference between subjects with high levels and subjects with low levels was not enormous. The difference between the two groups was equal to the equivalent of only about one and a half glasses of orange juice per day.
The link between folate levels and stroke risk was examined by researchers at Tulane University who assessed 19 years of dietary and medical data collected from more than 9,700 subjects. When folate intake was compared to incidence of strokes and development of cardiovascular disease (CVD), researchers found that subjects who consumed at least 300 micrograms (mcg) of folate daily reduced stroke risk by 20 percent and CVD risk by 13 percent. Dietary sources of folate include spinach, leafy green vegetables, asparagus, beans, and chickpeas.
Let’s make sure she gets these supplements: CoQ10, D3, alpha lipoic acid, resveratrol, and omega-3 fatty acids. Omega-3 Fatty Acids can help inhibit the development of plaques and blood clots. You know me, I like 2-3 grams of omega 3 per day. Coenzyme Q10 inhibits blood clot formation and boosts levels of antioxidants. Get her Vitamin D3 levels checked. Aim for at least 60.
I have heard that Melatonin may be helpful.
Selecting an exercise type or mode for her should be based on her functional capacity, interests, available equipment and time constraints. Any activity that continuously employs large muscle groups and is rhythmic and cardiorespiratory in nature can be used. Once a cardiorespiratory base has been developed and a plateau has occurred, the exercise mode should be manipulated every two to three weeks in order to keep her from physiologically adapting. Walking is the most functional mode of cardiorespiratory activity for someone recovering. Check her balance and walking pattern. Walking on a treadmill seems like a simple place to start.
Chiropractically I would perform gentle spreading of the sagittal suture on the top of the head. Do it so it’s relaxing and soothing. Cervical stairstep technique and gentle gliding of the cervicals is helpful. Try to release suboccipital muscle tension. Improving lost motor function is a priority that can be accomplished during rehab. Of course, performing joint mobilization and soft tissue therapy will enhance her recovery and prevent joint/muscle contracture.
“Plasma vitamin C concentrations predict risk of incident stroke over 10 y in 20,649 participants of the European Prospective Investigation into Cancer – Norfolk prospective population study” American Journal of Clinical Nutrition, Vol. 87, No. 1, January 2008, ajcn.org
“Dietary Intake of Folate and Risk of Stroke in US Men and Women” Stroke, Vol. 33, No. 5, May 2002, stroke.ahajournals.org