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Ask Selah R, M.S. LPC Your Own Question

Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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My husband has had three strokes. He is better and I am grateful.

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My husband has had three strokes. He is better and I am grateful. I really believe that he is not trying to get better physically or mentally. I get extremely angry and have berated him and even physically pushed him. I am terrified,
What do you mean by "he is better" and then "I really believe that he is not trying to get better"?

Why behaviors or symptoms are you seeing that have you concerned?

Selah
Customer: replied 6 years ago.

This could be long, but, in a nutshell, Johnny had 2 strokes in 2/09. He fell backwards and hit his head on the pavement and had a very bad concussion that had him vomiting for a week. While he was in the hospital, he fell in the bathroom and broke a vertebra. He had back surgery to repair it and it is ok. He had weakness on his left side and had a very hard time speaking. There was in-home therapy. He was getting much better, except he had drop-foot, which was caused partially by the stroke and partially because of weight loss and crossing his leg and putting pressure on the nerve on the outside of the left leg. He fell several time, always backwards, and usually hit his head.l The physical therapy was really helping and he was speaking better. In June of 09, he was eating an orange in the a.m. and when I glanced over at him, he looked like a chipmonk. I asked him why he had so much orange in his mouth and he said he was trying to swallow it. He chewed a little more and I told him to lets start over and gave him a plate and had him spit all the orange out. Then, just to be safe, I asked him to stand up. He did that fine. Then I asked him to raise his hands above his head and he did that fine. I asked him to tell me his name and where we lived and he answered correctly. Then I asked him to smile and only half of his face smiled. I called an ambulance and we had him at the hospital within 30 minutes. They gave him the TPA shot, which they could not do the first time because they didn't know exactly when he had the stroke. The TPA really helped. When he went home, he was enrolled in the Quest program, which is for brain injuries. He did that for 6 months. He only fell a couple of more times and not backwards. The drop foot got better, but he still doesn't bring his left foot all the way through when he walks unless he really thinks about it. He is himself, expect that he doesn't have much of a can do attitude and he doesn't seem to want to work to get even better unless I ask him to. He never knows what day it is and he still has gait problems. He is still pretty strong and is lifting weights when his daughter comes over 4 days a week to do a boot-camp style exercise program with me. We try and get him to do as much as possible. This is a wonderful, sweet man who is my heart. I love him with all my heart. We have been married 28 years. When I get angry with him, it is usually because he has messed up on something that I know he can do if he thinks, or when he doesn't do anything to help himself or me. I am comfused about this because I don't know what is stroke related and what is lazy or unconcerned. I was horrified when I pushed him and I get so angry with him that I am really ugly and don't like myself during or afterward. When I ask him what he really wants, he says he wants to please me. That is very hard for me to handle. No one should live only to please another. I have tried praise and I have tried tough love and I have tried everything in between that I know about. Thank you for your time and caring. I would like to send you a pic of us if you can give me an email to send it to.

Wow, you guys have both been through a LOT!

First of all, it sounds like you both have done a tremendous amount of work to help get him as healthy and functional as possible. Kudos for that.

Secondly, I really think he needs to be evaluated by a clinical neuropsychologist to help define what is stroke related, what is depression related, and what tools might help him overcome these barriers. Even though he fell back on his head, he probably has affected other parts of his brain (especially the frontal lobe) which can cause significant issues because that part of our brain is so critically important. It could be that he's had some brain injury from the strokes and the falls, that together have affected his ability to have a can-do attitude, to initiate tasks, to not get distracted, to feel more positive, to have better control over irritability, and other things that you fear he's doing on purpose. You can also then get recommendations to take to a psychiatrist to see what medications might help him function better cognitively and emotionally.

Lastly, have you had time to work through your own psychological baggage? Having your husband go through so much, and be lucky to be alive, while probably still having a fear in the back of your mind that he could have another stroke or die at any time, is a LOT to juggle emotionally, You may need some counseling in order to have a safe place to process all the past stuff, and the current fears, anxieties, worries you have. You also need to make sure that you're still taking care of yourself, and not devoting so much time and energy to his care that you're leading yourself to emotional burnout.

But overall, I hear you describe symptoms we would expect to see in people with brain injuries, so it's not all within his control. I don't think he's being lazy. I just don't think he's been evaluated completely and given the proper tools to help deal with the cognitive and emotional aspects of his injuries.

Best wishes,
Selah
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