Stroke is a leading cause of death and disability in Saint Lucia and around the world, affecting over 15 million people annually. It can leave people unable to walk or talk, and usually affects one side of the body, causing impaired movement and often paralysis. A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
There are two main causes of stroke: a bleed caused by a leaking or burst blood vessel, or a blood clot which causes a blocked artery. Once the cause has been identified, treatment can begin. The first step is to rule out other possible causes of symptoms, such as a brain tumour or a reaction to drugs. After carrying out tests and identifying the type of stroke, treatment will either focus on stopping the bleed or dissipating the blood clot. Most times this can be achieved with medication.
In severe cases, surgery may be indicated. If the stroke is minor, known as a TIA (Transient Ischaemic Attack), function may be recovered without any intervention. But this should be seen as a warning sign, and measures taken to reduce the risk of a more serious future event.
Once the condition causing the stroke has been stabilised, the main focus is on improving strength and function. The brain is a remarkable organ, capable of recovery and regeneration, and the sooner the process starts, the greater the chance of recovery. Rehabilitation is a major part of treatment and recovery largely depends on the part of the brain affected, how quickly treatment was received and the extent of damage to the brain. In some cases, function will never be as it was before, but the aim is to improve function and regain independence.
In order to improve your recovery and return to function and independence, it is important to start your rehabilitation early, with emphasis on moving correctly and not allowing compensatory techniques. Regaining strength and balance are the first steps to getting back on your feet. Getting up and out of bed every day should be a priority, and guidance from a physiotherapist can help you achieve your goals. Not everyone will achieve a full recovery, but learning new ways to be independent can reduce the burden on family and friends.
Physiotherapy rehabilitation programmes often focus on regaining movement and function so that activities of daily living, such as bathing, dressing and eating, and mobility skills, such as transferring between bed and chair/wheelchair, walking and wheelchair skills, can be done independently and with ease.
The symptoms of a stroke seem almost limitless and can affect people in different ways. The most common symptoms are:
• Problems with speaking and understanding, vision, balance, coordination and swallowing. You may experience confusion. You may slur your words or have difficulty understanding speech.
• Paralysis, numbness or weakness of the face, arm or leg. This is usually on one side of the body but can affect both.
• Headache, dizziness and unsteadiness.
Although not all strokes are preventable, steps can be taken to minimise the risk. As mentioned earlier, strokes can be caused by blood clots and there are certain factors that increase the risk of having a stroke (and a heart attack). So, by modifying your lifestyle and certain behaviours, you can reduce your risk.
• Smoking or exposure to second-hand smoke can increase your risk; the chemicals found in tobacco can damage your arteries.
• Check your blood pressure at least once a year, as most often there are no notable symptoms. If your blood pressure is high, your doctor may prescribe medication to prevent damage to the arteries.
• Being overweight can increase your blood pressure, which is a leading cause of stroke. It can also put you at risk of developing other health problems linked to stroke, such as high cholesterol, high blood sugar, and heart disease.
• Have your cholesterol checked regularly. If high cholesterol is detected, this can be treated either by changes to your diet or medication.
• If you have diabetes, it is important to follow a healthy diet and keep your blood sugar levels as close to normal as possible.
• Monitoring your alcohol intake is important. You should drink no more than 14 units a week and these should be spread throughout the week with at least two days each week where you do not have any alcohol at all.
Despite taking measures to reduce the risk of a stroke, it is a disease that can affect even the healthiest of people. All we can do is be aware of the risks, make changes where possible, and ensure that if the worst should happen, our bodies are strong and healthy enough to make the road to recovery less of a battle.
