Stroke recovery will be the topic of Bonitas House Call on November 5 at 9am on SABC2.
Of the 240 South Africans who will have a stroke today, 60 will die. For the remaining 180 people, the extent of their recovery will vary greatly.
In the event of a minor stroke, a person could be back at work in a few weeks, but the sufferer of a serious stroke may have to be cared for by family or a caregiver for the rest of their lives.
A stroke is a brain injury that is usually caused either by a blood clot or blockage in a blood vessel in the brain, known as an ischemic stroke, or by a blood vessel rupturing, leaking into the brain and causing irreparable damage, which is referred to as a hemorrhagic stroke. About 75% of stroke sufferers will be older than 65, but it can strike anyone at any age.
The prognosis for recovery depends on the severity of the stroke and the degree of damage caused to the brain. The major concern for the doctor treating the patient will be to prevent another stroke from occurring. About 30% of people who have had minor strokes will have a second, more serious stroke later in life.
The risk of a second stroke increases if the patient is of advanced age or suffers from a chronic condition such as type two diabetes, hypertension, high cholesterol or obesity. The risk is also exacerbated if the patient is a smoker or heavy drinker.
Basically, the underlying reasons for the stroke must be thoroughly understood to minimise the risk factors. When someone is sufficiently recovered from the acute stage of the initial stroke, the next step is to focus on the patient regaining the functional abilities that have been lost. Depending on the extent of the brain damage, some patients will be able to recover without the need for rehabilitation, whereas others will be too disabled to undergo any rehabilitation programme.
Of those suffering a stroke, 48% will be paralysed on the one side of the body and 22% will experience difficulty walking. This will require a comprehensive combination of occupational and physical therapy so that the patient can achieve some level of independence with day-to-day activities. Between 12% and 18% of stroke sufferers will be unable to talk properly or left with slurred speech.
A speech therapist will have to work with the patient to help them relearn this function. Being unable to swallow is another common result of a stroke that can be improved with therapy. One of the cruellest aspects of a stroke is the psychological damage it inflicts.
Anxiety disorders are common and about 32% of sufferers will be clinically depressed. This depression comes with sudden bursts of emotion and inexplicable mood swings that can oscillate from laughter and happiness one moment to uncontrollable crying and deep sadness the next.
It is extremely distressing for the patient as well as their family.
Between 24% and 53% of stroke victims will be left with such physical or mental disabilities that they will be reliant on family members or caregivers to help them with the most fundamental tasks. These families need to have a well—developed coping mechanism, because life with a patient who has had a severe stroke can be extremely demanding.
Incontinence of the bowel or the bladder, or both; disabilities affecting the most basic tasks that are part and parcel of daily living; cognitive problems affecting the memory, attention span and learning or thinking abilities—these symptoms all extract a heavy toll on loved ones. The sad fact is that many strokes are preventable.
If more people ate healthily, cutting back on saturated fats, sugar and salt, exercised frequently, lost weight, controlled their cholesterol, kept their blood pressure in check and, for those with type two diabetes, carefully monitored their blood sugar levels, strokes could well become a rarity.
Stroke recovery will be the topic of Bonitas House Call on November 5 at 9am on SABC2
This article originally appeared in the Mail & Guardian newspaper as a sponsored feature