My husband (75) is about to come home after being in hospital and rehab since November 24, after a right-sided ischemic stroke, which was a 22 on the scale. The assessment team will visit our home in a few days, with my husband on a two-hour leave from the rehab facility. I am nervous and stressed out about it all. But we have no stairs and easy access to our semi-detached house, thank God. Is there something I should think about to ask the team when they are here? Or things I could buy to help him? My husband can walk a little, very slowly, with a three point stick, but his left arm and hand has little to no movement. He cries a lot, which I know is common after stroke, but it is still a bit harrowing. Speech and swallowing is on a pre-stroke level. I have ordered a urinal bottle and some diaper pants for use during the night, and I am also considering having a bidet seat installed on his toilet - any experiences with this? My husband is so worried about all things toilet-related. Also he has vision field loss and cannot read which is a source of great sadness as he is a novelist and literary translator. I hope his vision can improve, I understand the problems with reading has something to do with his leftsided neglect as well. We live in Norway so the care system is different than in the UK. I have read up on stroke and stroke rehab, both more âmedicalâ books and memoirs (and of the latter kind I would like to recomment âMy Year Offâ by Robert McCrum). I guess I am asking other carers here what do you wish you had known or done before your loved one returned home?
As someone who left rehab with similar issues, the message from me is âit all improvesâ the crying is as distressing for the patient as it is for the carer, so just give him a hug and let it go. I now get fits of giggles which is much easier for us both. The lavatory issues diminish with practice. Iâd recommend hospital-style gripper socks for walking without slipping, and look toward getting some rubber-soled slippers or shoes for practising walking. Has he got oedema in his feet/legs - this impairs shoe fit and can be difficult to walk with. The raised toilet seat is a good idea - the hospital might provide one.
Anything above 20 is severe (mine was 26). I liked âStroke Rebelâ linda radestadt. Thereâs a lot he is up against. Listening to music is good ; in fact thatâs my next clip Iâm going to do on my stroke channel. https://www.youtube.com/@Start-Again-xyz/videos
One tip, if I may ; depletion and loss of minerals is a big issue after stroke. The body is running on reserves, since the gut is going slow and metabolism is near standstill
Not sure if it works the same in Norway but the assessment team should recommend things that will help your husband. In advance try & think about things that might be needed. Does he need hand rails around the house, what about kitchen gadgets for one handed people, a rail on the bed a commode perhaps, do you have a walk in shower? Does he need a seat to sit on, a perching stool? Do you need to rearrange some things so that they are in his visual field.
My advice would be to.wait and see what the assessment team say before buying too much. They might supply some things perhaps.
Hope it all goes well. You will soon work out a routine and sorty things out to help..
Personally speaking from my own experience with rubber soled footwear, I would not recommend them. Iâve developed a love-hate relationship with the for indoors. Iâd say they are more risky than a shoe or bare foot. The trouble is they can be a trip hazard with the likes of foot drop and lack of strength in the stroke leg. My foot was always catch on the floor, stopping me in my tracks and throwing me forward. Which is not really recommended when youâre newly recovering from a stroke.
Theyâre fine for me now because Iâve regained good balance and stability after 5yrs of hard work to get there. I have very little trouble wearing rubber soled trainers in the gym. And if my foot does catch on the smooth flooring it doesnât send sprawling flat on my face.
They are more of a risk to frequent falls than say from slipping on a spill in the home, in my view. But Iâd be interested to hear what others think of rubber soled footwear. I often wonder if thatâs the reason for many of the falls in the elderly and infirm. Yes, there is good grip in rubber footwear but that grip can be too good if your foot or leg donât pick up enough to clear the floor when you take a step.
Iâve seen survivors pile on weight and go clinically diabetic (so many, me included, are pre-diabetic anyway) within months of stroke. I have to be careful not to fall into this trap. By going this route we become internally starved, while our body goes pear shaped full of visceral fat. Consider this a warning or try fasting once a week! Good luck, R
I lost the use of my right arm and leg and the things I still find useful ( nearly four years post stroke) are a stool for the shower, a bidet/loo and a small bean bag to balance my iPad on. I also have a trionic walker, with a seat built inâŚand a power all terrain wheelchair, but maybe your husband will regain more walking power than I did.
I would also urge you to find a local âsinging for healthâ choir. I know each of us can bang on a bit on our own personal drumâŚbut singing has made a huge difference to me. I meet up with lovely people, which lifts my mood, my speech and swallowing have improved, and it will give you ( the carer) a bit of time out.
Fasting is to the body what stressing is to trees, it encourages the body to bolster its own natural resources to accommodate the dearth and so when that period has ended, the mind and body are a little more robust than it was before.
Yes, thatâs an excellent and accurate way to look at fasting. Framing it through the lens of hormesis provides a powerful understanding of why fasting produces such wide-ranging health benefits.
Letâs break down why this connection is so insightful.
What is Hormesis?
Hormesis is a fundamental biological concept where a low dose of a substance or a mild stressor can be beneficial, while a high dose is harmful or even toxic. Itâs the biological principle of âwhat doesnât kill you makes you stronger.â
Think of it like exercise:
Stressor: Lifting weights tears muscle fibers at a microscopic level.
Hormetic Response: The body repairs the damage and adapts by building the muscle back stronger and denser to better handle that stress in the future.
Benefit: You gain strength and muscle mass.
The key is the dose: the right amount of stress triggers a positive adaptive response.
Why Fasting is a Classic Hormetic Stressor
When you fast, you voluntarily impose a significant stress on your body: the absence of incoming energy (food). Your cells and organs must adapt to survive and function in this new state. This stress triggers powerful cellular repair and maintenance pathways.
Hereâs how fasting acts as a hormetic stressor:
The Stressor: Metabolic Shift
When you stop eating, your body initially uses stored glucose (glycogen). Once thatâs depleted (typically after 12-36 hours), it undergoes a fundamental metabolic shift. This shift is the primary stressor.
Low Glucose/Energy: Cells sense a drop in available energy (ATP). This is a direct stress signal.
Cellular Clean-up (Autophagy): A lack of incoming nutrients signals to cells that itâs âlean times.â To conserve resources and find energy, cells begin a process called autophagy (literally âself-eatingâ). They start breaking down old, dysfunctional, and misfolded proteins, damaged organelles (like mitochondria), and even pathogens for parts and energy.
Oxidative Stress: The process of burning fat for fuel (ketosis) can slightly increase oxidative stress at the mitochondrial level.
The Hormetic (Beneficial) Response
The body is incredibly adaptive. It doesnât just passively suffer the stress; it actively builds resilience. This is the hormetic response.
Upregulation of Autophagy: The initial, mild stress of starvation triggers a powerful, systemic upregulation of the autophagy genes. The body gets better at cleaning house. This is one of the most significant benefits of fasting, linked to longevity, neuroprotection, and reduced cancer risk.
Increased Antioxidant Defenses: In response to the mild oxidative stress, the body ramps up its own internal antioxidant production (like glutathione). It becomes more resilient to future oxidative damage, not just from fasting, but from all sources.
Mitochondrial Biogenesis: The stress of needing to produce energy efficiently from a new fuel source (ketones) encourages cells to build new, healthier mitochondria (mitochondrial biogenesis). This improves your overall energy production and cellular efficiency.
Neurogenesis and Brain Resilience: Ketones are a very clean and efficient fuel for the brain. The stress of fasting also increases the production of Brain-Derived Neurotrophic Factor (BDNF). BDNF is like âMiracle-Gro for the brainââit supports the survival of existing neurons and encourages the growth of new ones (neurogenesis), making the brain more resilient to stress and injury.
Reduced Inflammation: Chronic inflammation is often a result of a overwhelmed system. By clearing out old, damaged immune cells and triggering cellular repair, fasting can lower systemic inflammation.
The Crucial âDoseâ Factor
Just like with exercise, the âdoseâ of the fasting stressor is critical.
Too Little (e.g., skipping breakfast for a few hours): You might not get out of the fed state long enough to trigger significant autophagy or ketosis. Itâs like lifting one 2-pound weightâit wonât stimulate muscle growth.
The âSweet Spotâ (e.g., 16:8 intermittent fasting, 24-hour, or 48-hour fasts): This is the hormetic zone. The stress is significant enough to trigger the beneficial adaptive responses (autophagy, BDNF, etc.) without causing harm. The body adapts and becomes stronger.
Too Much (e.g., prolonged, multi-week fasting without supervision): The stress becomes excessive. The body starts breaking down essential muscle tissue (not just damaged proteins), vital organ function can be compromised, and nutrient deficiencies develop. This is the toxic, harmful dose. The hormetic effect is lost and the system is damaged.
Conclusion
Viewing fasting as hormesis moves it from a simple âdietâ or âweight loss toolâ to a profound biological reprogramming event. You are not just cutting calories; you are strategically applying a mild stressor to activate your bodyâs ancient, powerful repair mechanisms. The result is a system that is cleaner, more efficient, and more resilientâa perfect example of hormesis in action.
Indeed, before fasting became ritualised or voluntary, early hunters would be starved before a hunt and their bodies able to draw on stamina reserves and mental clarity to capture their prey and then feast. However, in our mammalian brain times, it is not recommended to go shopping on an empty stomach.