Stroke, a silent creeper!

Recently, during one of those long night shifts at the ward at the central hospital, I struck up a discussion with one of the older nurses. She had just printed out a copy of acupuncture then came over to where I was seated and asked if I knew anything about it. I clearly didn’t know, not to mention the fact that my mind was tired and eyes sleepy.

She went ahead to narrate to me how one day, years ago, while she was coming for her shift at the ward, she suddenly realized that her left side of the mouth was drooping and almost immediately she couldn’t feel her left hand and leg. She couldn’t understand what was happening to her. Later, within minutes of being admitted she was informed that she had just suffered stroke. That was a surprise for her. Clearly, she wasn’t expecting this. Luckily, the quick action of the medical team that attended to her had saved her from more complications from the disease. She spent few weeks of rehabilitation  therapy at the rehabilitation ward before being discharged as she had recovered well and after few more weeks she was able to return to work. According to Willems and colleagues, 2012, it is feasible to screen patients for in-patient rehabilitation eligibility in the early days following stroke (Willems, Salter, Meyer, Mcclure, Teasell, and Foley, 2012, 112.)

The dictionary definition of stroke is that it is a medical condition in which poor blood flow to the brain results in cell death due to being deprived of oxygen and glucose needed to survive. There are two main types of stroke: ischemic, due to lack of blood flow, and haemorrhagic, due to bleeding. They result in part of the brain not functioning properly. If stroke is not caught early, permanent brain damage or death can result. A stroke is a medical emergency and as such, prompt treatment is crucial. Early action can minimize brain damage and potential complications.

As per the Heart Disease and Stroke, WebMd, 2018, a person who has just had stroke may suffer from symptoms such as trouble with speaking and understanding, paralysis or numbness of the face, arm or leg, trouble with seeing in one or both eyes, headache and trouble with walking. A stroke may be caused by a blocked artery (ischemic stroke) about 80% of strokes or the leaking or bursting of a blood vessel (haemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn’t cause permanent damage.

Many factors can increase your stroke risk. Some factors can also increase your chances of having a heart attack. Some of the lifestyle risk factors include: being overweight or obese, physical inactivity, heavy or binge drinking, and the use of illicit drugs such as cocaine and methamphetamines. Medical risk factors include: blood pressure higher than 120/80mmHg, cigarette smoking, high cholesterol, diabetes, obstructive sleep apnea, cardiovascular disease, and family history of stroke. Other factors may also include; age (people 55yrs or older are at higher risk), race (people of African origin at higher risk than other races), sex (men have higher risk than women), and hormones (use of birth control pills, or hormone therapies increase risk of stroke). (Heart Disease and Stroke, WebMD, 2018).

Mayo Clinic Article on Stroke, 2018, reiterates that some of the complications that arise a result of stroke include; paralysis or lose of muscle movement, difficulty talking or swallowing, memory loss or thinking difficulties, emotional problems, pain and changes in behaviour and self-care abilities. Just like brain injury, the success of treating these complications vary from person to person. In some people recovery may be achieved within a short period of time, whereas for others it may take a life-time. According to Dobkin and Dorsch, 2013, Most survivors of a stroke are left with chronic disability. Rehabilitation efforts during the initial three to six months after stroke should aim to maximize patients’ physical, communicative, and cognitive functioning. Continued improvement in the chronic phase of stroke can occur with regular, progressive skills practice of goal-directed tasks in the home (Dobkin, and Dorsch, 2013, 331.)

According to Heart Disease and Stroke, WebMD, 2018, prevention of stroke is primarily through healthy lifestyle activities such as controlling high blood pressure (hypertension), lowering the amount of cholesterol and saturated fat in one’s diet, quitting tobacco use, controlling diabetes, maintaining healthy weight, eating diet rich in fruits and vegetables, exercising regularly, drinking alcohol in moderation, if at all, treating obstructive sleep apnoea, and avoiding illegal drugs. For people who have suffered ischemic stroke or TIA, the doctor may recommend preventive medications such as anti-platelet drugs or anticoagulants to reduce the risk of having another stroke.

References:

Dobkin, B.H., & Dorsch, A. 2013. New evidence for therapies in stroke rehabilitation. Journal of Curr Atheroscler Rep.; 15(6): 331.

Heart disease and stroke. WebMD. Accessed on 16th May 2018. Retrieved from https://www.webmd.com/heart-disease/stroke#1

Stroke. Mayo Clinic. Accessed on 16th May 2018. Retrieved from https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

Willems, D., Salter, K., Meyer, M., Mcclure, A., Teasell, R., and Foley, N. 2012. Determining the Need for In-Patient Rehabilitation Services Post-Stroke: Results from Eight Ontario Hospitals. Journal of Healthc Policy. 7(3): 105–118.

 

 

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