Health : Stroke - how to manage

“Dr, he is here for 7 days and I see no improvement,” this was the complaint of the son of an elderly man hospitalized due to stroke. As such the patient was stable but paralysis of the limbs was persistently present, due to which the family was feeling frustrated. Stroke is the condition which results from sudden cessation of blood supply to part of brain that results in partial or total loss of function of affected body part. It occurs due to either blockade of a cerebral blood vessel (supplying blood to brain) or rupture of a blood vessel cutting off blood supply to affected part. The manifestations depend on whether it is a major blood vessel damaged supplying blood to a greater part or small one and the state of adjoining collateral vessels. If a major blood vessel is occluded and surrounding connecting smaller arteries do not compensate the affected perfusion, paralysis and other neurological deficits are sure to follow. Whenever stroke develops, it is alarming to the onlooker. A normal healthy person suddenly develops asymmetry of the face and may be unable to move his limbs. Paralysis of one half of the body with or without involvement of the face is the most common manifestation. But apart from that one may have sudden unconsciousness, sudden blindness, visual disturbances or hearing loss on one side, features which develop due to particular areas of the brain that have been damaged. . Because of the frightening nature of the features which develop, family members take the patient to the nearest health care facility possible. Out of their concern, they desire rapid recovery for the patient. After getting all possible tests done and giving all prescribed medicines to the patient, when the patient does not recover in 3 to 4 days, they often feel disappointed. People start searching for higher referral centres to seek advanced treatment in hope of rapid recovery. Those without means wish to take their patients home. It is unfortunate but true that nobody can predict as to when a person will recover completely after a stroke? It may take weeks or months. Recuperation depends on many factors, general health of a person being one of them. A person previously keeping good health and vitality may recover faster than somebody who is weak from before. Underlying cause for stroke is another factor. Usually a hemorrhagic stroke (one that occurs due to rupture of a blood vessel) has a poor prognosis. Uncontrolled high blood pressure, diabetes, high lipid levels also hinder recovery. Hence it is important to follow dietary restrictions and take regular treatment for the same. Alcohol and smoking also delay recovery due to accelerating ongoing atherosclerosis, which is the root cause for majority of cases of stroke. Hence they should be given up. While waiting for return of the patient to a normal or near normal state, it is vital for the family members to nurse the patient very well. The patient should be kept clean and dry always, otherwise there is high risk of developing treatment resistant bed sores. Changing the position of decubitus of the patient also helps in preventing bed sores. Changing position and putting the person on their sides, helps prevent aspiration of saliva and fluids which is a potential risk for developing pneumonia. For feeding, the individual should be propped up on pillows to avoid aspiration. Sometimes people who are on way to recovery after stroke, succumb to bed sores or aspiration pneumonia, hence one has to be very careful about these aspects. Healthy nutritious diet is useful for promoting general health and aids in improving paralysis. In case of a person unable to swallow, nasal feeding is one option. Small quantities of mashed soft eatables like boiled potatoes or eggs can be given from mouth. Professional physiotherapy is certainly helpful in improving the power of paralyzed limbs. But if somebody does not have the time or means to take professional help, simple exercises of the affected limbs can be executed passively by any family member. The paralyzed limb has to be put in entire range of motion, slowly without jerks. It should be initiated with a small number of times and then the number can be increased gradually. Stroke is alarming but with good patient nursing and exercises, majority of the affected people recover very well. rachna212002@yahoo.co.uk