Brain is the controlling center of all activities performed by our body. The functional ability of brain is mind-boggling; it takes inputs from the body organs, analyzes it, and gives instruction for performing action, all these done with precision in less than a second! For performing so many activities non-stop, the brain requires a continuous supply of blood. Any interference in this supply may lead to a condition called stroke, where the area of the brain devoid of blood supply stops working. It may be temporary or permanent.
Stroke-ing the brain
Disruption of blood supply to any part of your brain due to rupture of blood vessel carrying oxygen and nutrients to your brain or blockage of the blood vessel due to formation of clot is termed as stroke. When supply of oxygen and nutrients is disrupted, brain cells get damaged. As the brain cells, neurons, once damaged are incapable of self regeneration, they die quickly sometimes causing damage beyond repair to the person. Stroke is a medical emergency and needs urgent medical attention
Stroke is of two types. The most common type of stroke is called ischemic stroke which is caused by blockage of blood vessel in the brain. The second type is termed as hemorrhagic stroke which is caused by the rupture of the blood vessel in the brain. When blood supply to the brain is temporarily interrupted, it is called Transient Ischemic Attacks (TIA) which is sometimes called as “Mini-stroke”.
Brain has four parts namely the right hemisphere, the left hemisphere, cerebellum (back of the brain) and the brain stem (lowest part of the brain that connects to the spinal cord). Depending on the part of the brain that is affected, stroke exhibits different effects. Stroke affects people in various ways depending on the part of the brain that is affected. You may experience a sudden numbness or weakness on one side of the body involving face, arm or leg. You may feel sudden confusion and have difficulty in speaking or understanding speech. Your eyesight may suddenly become poor in one or both eyes. You may not be able to walk properly and feel dizzy. You may suddenly lose balance and have inability to coordinate your actions. Some people may also have sudden severe headache with no known cause. If you experience these symptoms, call the emergency immediately, as time factor is very important in preventing damage to the brain.
Rehabilitation process
Stroke survivor is affected by mental and physical disabilities because of the damage caused to some part of the brain. The objective of the rehabilitation is to make the stroke survivor re- learn the lost skills and become self-manageable and productive, as soon as possible. These skills involve coordinating the movements of limbs, carrying out tasks to overcome the disabilities and repetitive practice of these skills by making the survivors of the stroke to prevail over their illness.
Rehabilitation generally begins within 24-48 hours of the stroke, and is given in an acute care hospital once the patient’s condition is stabilized. As most of the patients are paralyzed, the initial objective of rehabilitation is to restore the movement through exercises. This can be assisted by a therapist, called as passive exercise; and if the patient can do independently without the assistance, then it is called active exercise. Rehabilitation experts such as nurses and therapists help the stroke survivors to learn to perform the usual and complex tasks as well such as bathing, dressing, using the rest room etc. For some stroke survivors rehabilitation could be a continuous process and could take years.
Risk of another stroke
Especially during the first year of the first stroke, you are at higher risk of having another stroke. Following are the ways to reduce the risk of another heart attack.
- Control your blood pressure: Stroke patients are advised to maintain their blood pressure less than 140/90 mm Hg.
- Do not smoke: Nicotine increases the risk of stroke, heart attack, cancer and lung diseases. If you are a smoker, quit smoking.
- Control your weight: Obesity and overweight enhance the risk of stroke, heart attack, diabetes, high cholesterol and cancer.
- Maintain a healthy diet: Eat foods less in fats, high in fiber and less in salt. Avoid consuming alcohol more than two drinks a day.
- Control your cholesterol: Reduce total cholesterol levels and also LDL cholesterol through proper diet and medications such as statins.
- Regular exercise: Being physically active and engaging yourself in regular physical activity can boost HDL Cholesterol and reduce high blood pressure, overweight, diabetes and stroke.
- Blood thinners: Your doctor may prescribe medications such as aspirin or plavix (clopidogrel) or warfarin to reduce the risk of blood clotting and to reduce the risk of another stroke.
- Regular doctor visits: Have regular checkups with your personal physician to manage blood pressure, maintain weight, control cholesterol and other risk factors.
Depression after stroke
Stroke results in many problems never experienced before and as such it is normal to feel depressed after the stroke. But in some patients, this could turn to be a major depressive disorder which needs medical attention. This disorder could persist every day for at least two weeks. The stroke survivor with depression may be sad, unhappy, in low spirits and may lose interest in things the person used to enjoy. There could be other problems such as feeling of guilt, feeling worthless, restless, changes in appetite or weight, sleeping problems, feeling of tiredness, body aches including headache, digestion problems, sexual problems, feeling of hopelessness, anxiety and thoughts of suicide.
Driving car after stroke
Stroke affects people in various ways. Some stroke survivors may be able to drive and some may not. Stroke can interfere with your ability to think, react, communicate and see. You should think carefully not only in your best interest but also in the interest of others whether to drive or not. You should check with the concerned regulatory authorities whether you are allowed to drive or not. If needed, you may have to undergo assessment or specialized training or modify the vehicle you drive. Though you feel as if you are losing independence, yet, if you are advised not to drive, then it is better to make adjustments in your life.
Recover from stroke through support
Your relatives and friends can visit you often and help you to relax and recover from the effects of stroke. They can spend time with you by playing cards, watching television, listening to music and help you in your speech therapy. They can help you to practice the skills of rehabilitation. They can offer emotional support by taking care of you in the times of need by being with you physically and helping you to overcome your disabilities. The more support you have from your relatives and friends, the better are the chances of recovery.
Going beyond rehabilitation
Stroke survivors as well as their friends, relatives, loved ones, medical healthcare professionals and community health providers face number of issues. Only a few can afford the rehabilitation expenses, others cannot access and few others are left with decisions as to how they should continue the remaining journey of their life with stroke. Stroke survivors need to go beyond rehabilitation to reintegrate into normal lives, keeping in touch with other stroke survivors, enjoying the life at hand, knowing more about stroke and its effects and building emotional and physical strength to face the repercussions of stroke.
