Laura Evensen, MPH, the Behavioral Research Director of the stroke division at New York-Presbyterian Hospital, is researching why some people are less likely to have a stroke than others. She tells us how life changes for people after they've had a stroke.

Q: What are some of the biggest challenges that you see people face after having a stroke?

A: Most of the problems that people face when they're recovering from stroke happen about a month or two after they have it. Right after people have a stroke, they seem to react strongly-they're ready to go-ready to make the recovery happen. It's not until later when their recovery progress slows down and they aren't improving as quickly as they had been right after they got home from the hospital that it starts to get very difficult. The person has met the maximum amount of progress that they can make for that moment, and at the same time the physical therapist, speech therapist and other therapies are usually cut off.

Stroke survivors tend to make the most progress in their therapies during the first few months after having a stroke. However, insurance companies are generally unwilling to pay for therapy after this time, when the person isn't progressing as quickly, as they say they don't think that the patient will progress further. This isn't true, and the best thing a stroke survivor can do is work with their therapists while their insurance is paying for it, to learn exercises that they can do on their own.  This way, the therapies can last as long as the stroke survivor wants. Additionally, survivors should connect with local community services such as pools with classes for seniors, walking clubs and other low-impact exercise programs in order to keep regular exercise in their routines and get some social interaction.

Q: What makes this part of recovery so hard?

A: This is hard for a person who is recovering from a stroke because they are not only making little to no progress, but they are also being told that they cannot have any more physical, speech or other kind of therapy because of their lack of progress.

At this same time a person begins to realize that they are no longer dealing with just a temporary disability. They have to start adjusting to their new life and find their place in the community again.

Q: What would you say would be most helpful for people in recovery from stroke a month into their recovery?

A: During this time it's especially important to have close friends, family members or a community of social support to rely on. After having a stroke, many people find it hard to get their social lives back.  Sometimes it's because the person feels embarrassed about something that's happened to them as a result of having a stroke, such as having a hard time talking, trouble using an arm or leg, or their face drooping. It could also be that the stroke survivor just doesn't feel like interacting with other people and chooses to be alone.  Family, friends, or a support network are the best people to get someone to stop isolating themselves and start doing the activities that he/she loves and enjoys.  This all helps the stroke survivor regain a healthy sense of self and recover.

If you would like more information about joining a bilingual stroke support group in Northern Manhattan, please contact Laura at 212-342-1498 or via e-mail at: lab46@mail.cumc.columbia.edu.  You can also contact her colleagues Carly Klein at 212-305-1372 or ck2316@mail.cumc.columbia.edu; or Veronica Perez at 212-342-4749 or vp2184@mail.cumc.columbia.edu.

Read more from Laura Evensen by clicking the links below:

• Social support
• Stories from stroke survivors
• 3 signs of stroke
• Support groups
• Getting involved with your community after a stroke

To listen to our interview with Laura Evensen, click here for our podcast page.

Harlem Word is a series of interviews with Harlem health experts, written by HHPC and reviewed by our Health Advisory Board.