Is combativeness a side effect of hemorrhagic stroke

Brain and nerves
1

My husband suffered a hemorrhagic stroke in June.  Had some initial side effects with memory, etc. but other than that has recovered nicely.  He is on seizure meds twice a day and has to take his blood pressure morning and evening since a severe spike in blood pressure is the only cause they have been able to determine caused it. Ever since tho is is very combative and flairs up at insignificant things and rants on an on about them.  Is this common after a stroke?  It is extremely frustrating as everything seems to evolve into a major argument.

 

2

You are looking for a simple answer to a very complex question, one which you will probably never get from the medical profession.

If you could give slightly more info, that would help.

My qualifications for answering; I suffered a haemorrhagic stroke (I take it from your spelling you are US based) back in April 2014 at the age of 48, going on 49. I've suffered it, been through it and self analysed.

3

Hi there, my ex husband (we're still friends, long story) had a milder stroke than your husband his was called left sided lancunar I think, 10 weeks ago, he lost most of his speech though that is now returning, anyway he is also very combative, he walks with me and my dogs most mornings on our local common and I actually think that if a heather plant was inhis way he would start ranting at it, he also trys to pick rediculous arguments with me over the slightest thing, 2 mornings ago Iparked in a slightly different position to normal and that was enough to set him off, I have worked with stroke patients and I think that some of it stems from sheer frustration at not being able to do or say what they want or used to be able to, perhaps you could seek advice from your doctor? I can't do that for obvious reasons but if you do I would be very interested to know the outcome.

Good luck.

Phoebe.

4

I know the frustration level  we have, even for the most patient person, is much higher. I also had a lacunar stroke, no aphasia, but I feel my personality is different. More annoyed at  anything. Mine was 4 years ago, and I think I am different than I was, less positive all around even tho I worked hard at it to recover muscle/leg use.  It is also possible being herded into the VA 's new "no pain meds for you" program  of serious meds reduction (for other health problems) also did NOT help.

So my reply to both Melly and Phoebe, to all, actually is   behaviors over time will be different person to person-- how well we respond to the event, our recovery, add in other life issues, stressors (financial, family, lack of resources, etc)  and this medical life changer will affect anyone!

I find I no longer tolerate stupid behavior, rudeness, especially from strangers or  "front desk" type staff. I even called the home insurance guy  a "really dull man"...he HEARD that of course, came unglued, but he wan't hearing my issue about a  property damage problem. 

There was a really silly movie called HENRY where the  family man (harrison ford) turns into a lovely person when he was a total  jerk before)  ...dream on.  Our brains are BEYOND complex, we may never be what we were in personality, or coping,   but  if FAMILY will sett  firm but gentle "ground rules"  it may help the person COPE..and realize they can't be acting out endlessly. 

Here are two things I have read on dynamics of anger handling: 

1.  a family had a toy doghouse on top the refrigerator..each member had a little plastic dog... when mom was upset with anyone of her brood or husband, she placed that  one's dog in the doghouse..a quick glance could tell you where you stood. so you could address the issue sooner.

2. The child's "time out" rule..  when they act out - say"you have 2 more minutes to rant, then I ask you to calm down."    some hand them a foam bat to go hit a  stuffed toy, or hand a small "scream here" pillow.

There are ways to address the person's acting out without constantly causing clashes and disharmony for all.

I live alone..so when I hung up from arguing with the insurance 'dullard'  I picked up the cuddly cat, closed my eyes and let her warm, affection sooth my temper. it works every time

5

I have heard specialists say that after a stroke or TIA you can become much more emotional so probably it can affect how you react to events. Maybe get specialist advice on how to deal with it as ranting will push BP up a bit. Hope things calm down.

6

I replied below on some tactics you can use to regain some control over situations. There are probably good articles online on "coping skills" for family members. Asking YOU to be always the  patient one is unfair too.. so finding an outlet or discussion group may help.  

Caregivers/family members  need a break, you can't be expected to absorb it all 24/7..you need an outlet too!! Your mental health is just as important to long term family dynamics, I encourage you to  find resources.

I wish you the best

7

That really depends on where you stroke happens (terrible if frontal lobe), but I think you are confusing TIA/ischaemic with haemorrhagic which is totally different.

8

He's 71 and the stroke happened in June.  Got to the hospital in record time and they confirmed stroke immediately after CT scan.  Also, confirmed he'd had a seizure in the ambulance.  After meds wore off he was unable to remember things like my name and some other things, however, most started coming back slowly.  We were only in the hospital for about 36 hours.  Allowed to return home with seizure meds and instructions to take blood pressure twice and day and record.  If it went above a certain number we were to return to the hospital immediately. No other restrictions, including driving.  I noticed issues with memory like forgetting directions to places while driving, and other things.  Everything seemed to slowly return to semblance of normalcy except he started lecturing about random things and being combative at any given moment.  First, we could be having a normal conversation, even having fun and the next minute he will start an argument even tho it's something we both agreed on a few minutes before?!  And lectures abound, He will go on and on.  He will come into the house and I'll ask how his golf was and he'll say something mean and with attitude and I can't say anything that doesn't make it worse.  He seems angry often.  But it comes on suddenly. None of the doctors recommended therapy after the stroke, but I think it would be helpful.  I try thanking him for small things and he will say something really sarcastic, nasty and talks under his breath.  The lectures and attitudes are not just directed at me since our girls (who are grown and don't live at home) have noticed too.  But it's mostly him and I since I retired last year (10 years after he did)  He's cut back on most of his activities like his tennis teams and part time golf course work schedule.  And he no longer really wants to travel unless I say ok, I'll go by myself (I've only left him overnight once since the stroke to visit my daughter who lives 3 hours away)  I'm 9 years younger and I had planned to travel in retirement.  His personality is totally different.  I'm really concerned and don't know where to turn.

9

Hi, every person who has had a stroke has different after effects, some can resolve quickly while others can stay with us for a long time, I have had 2 strokes and felt different after each one. The first one I had when I was 40 and spent 5 weeks in a stroke unit and the next one was at 45 and that was a 6 week stay as I got pneumonia and a few other problems while in hospital. I am not the person I was before, after the first one I constantly worried about getting another one and after the second one it is still the same fear. I have aphasia which comes and goes, no noise tolerance , and am constantly frustrated by the little things that I cant do today that I could do last week. Every day is different , some days I can cut up my food and other days my hands shake so bad that I can hardly feed myself. I am 51 yrs old and have basically lost 11 yrs of normal life and know it will never come back. My son found a site online that my family used to better understand how my mind and body was affected and it helped them a lot. Maybe give it a visit and see if it gives you an insight into how your husband feels. It is ... and has a lot of different advice. I wish you both all the best for the future. Take care .

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10

I think Dee answered it quite well. However, having this sort of stroke certainly for an initial period does have personality changes and this couple with the fact that relatives don't understand this (and there is no reason that they should know what it is like) leads to immense frustration. Frustration at the situation, the lack of help from the medical profession, relatives not understanding, it all boils over and we lash out at those nearest and dearest.

I would see your GP and ask for him to be referred to a stroke clinic, a psychiatrist maybe. I saw one along with all the other medical staff and they at least understand what is happening.

The stroke dot org is a very good organisation that can guide you and is useful to talk to, they have weel trained people.

11

Thanks for all the responses. Very helpful. I wish the doctors had the insight to provide some of this information and also to recommend follow up with therapy etc.  it should be the standard of care!

12

I remember the day I got discharged, and only because I forced it through threatening to self discharge, as I had been there nearly two months and no help was being given. I remember my wife asking the nurse if there was any help or anything she needed to know and the nurse saying, no, here is his medication, you will get a letter from your GP to see him.

When I mentioned this to my GP, he said hospitals are very good at fixing physical problems but useless at the follow up care that is needed. It will take months, possibly over a year, before his thought process becomes more reasonable. The shock of what is happened, coupled with the lack of help leads to deep frustration. I know that I upset my wife, but I was only focussed on me, I was the victim.

Speak to your GP, to see what support is available. I live near a good stroke rehab hospital and I had outpatient appts. with the neuro physio, neuro consultants, speech therapist and the psychiatrist. I had to find a it, with the aid of my GP.

But you are not alone, they just dump people out of hospital and leave them to fend for themselves. I would also as said previously, contact the stroke org and they will give you advice and help.

13

Yes everything you have said sounds very familiar. I didn't get any support offered. My daughter in law was very concerned that l had been sent home to an empty house without any support.

She telephoned my go and he was extremely condescending to her and rude. Why should this lady contact me and ask me these questions about one of my patients who has not been ofered any support. In fact l was not invited or given an appointments with my gp. He actuality retired and all l can say is good riddance to him. I then had the opportunity to change my gp and joined a wonderful practice with such caring staff who ask how you are and offer support and genuinely care about their patients. It was wonderful to experience a such care. I think we just have to be brave and insist on support. Thank goodness there are websites like this where we can share experience and get good support from other people. Take care RHGB l have had no help regarding my stroke as you say I make my own enquiries and l have just moved and will sign on to another practice. I will be sorry to leave my present practice and Hope l will find another with the same good level of care. 

14

Mellysmell , I sent you a private message. Take care