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My Relationship With Stroke

Feature Article The Writer
FEB 20, 2017 LISTEN
The Writer

It was the year I entered University that I first encountered Stroke. I returned home from school with an overnight bus and found the doorway to the single room I shared with my mother and 2 siblings crowded. The crowd parted amidst murmurs and I walked in. My mother was lying on the floor-mat with the left side of her face without her usual crease and the left side of her body limp. When she attempted to speak, her words were slurred. She was taken to the hospital in a taxi. It took her nearly a year to recover partially. It was my first encounter with stroke and one of the most important factors in my decision to become a physician. Last month, here in the US, I saw a patient who told me, with her daughter that she had right-sided weakness the previous evening but had decided to go to bed, hoping she would feel better the next day. In the process, like my mother, she had lost precious hours before seeking care. And this week, one of my childhood friends who had a stroke was laid to rest.

Stroke is essentially a problem with the blood supply to the brain. The blood vessel is either blocked or it ruptures, leading to destruction of brain tissue. There are therefore three kinds of stroke-- ischaemic in which the vessel is blocked, hemorrhagic in which the vessel ruptures and Transient Ischaemic Attacks that are short-lived strokes that warn of future strokes. In terms of impact, with apologies to President Trump, stroke has a huge or " bigly" impact. In 2011, it caused, globally, 6.2 million deaths, which was more than HIV, T.B. and Malaria combined!. It is the 5th leading cause of death in the United States. 70% of those affected by stroke do not recognize the symptoms and nearly a third delay seeking care for more than 24 hours when optimal care can be given only in the first 3 hours.

There are long-term effects--- on bladder control, pain in the hands, Depression, weakness and emotional problems. Then there is disability. It is the second leading cause of disability in middle and low income countries, behind Dementia.

We need to recognize stroke quickly when it strikes. We can do this by knowing about FAST.

When a person has stroke, the Face is twisted, the Arms/Legs are weak, the Speech is slurred and it is Time to get help by calling emergency services or getting to the hospital.Thus the acronym FAST. Not all these manifestations will be present in every patient. Thus when someone has a stroke they should get to the hospital as soon as possible. Time is Brain!! In the hospital, doctors would order blood and imaging tests that would help determine treatment. The treatment may include blood pressure medicines, clot busters, blood thinners and sometimes surgery.

Before we get to recognizing stroke, we can prevent it-- by addressing the risk factors-- including Hypertension, Diabetes, High Cholesterol, Smoking and Drinking, as well as inadequate exercise.

So here is what we can all do.
1: Learn about about FAST.
2: Appreciate the significance of Transient Ischaemic Attacks and heed its dark warning. A TIA should rouse in every person the sense of relief and dread every soccer fan who does not support Real Madrid feels when early in a match, Ronaldo rises gracefully to meet a perfectly weighted cross with a header which comes off the post or misses narrowly. They know the next cross that finds Ronaldo's head will probably be a goal. But if the warning of a TIA is heeded, we may prevent a stroke in one third of TIA patients who later have full-blown strokes.

3: Check your health to identify and address the risk factors. My mother had never checked her Blood Pressure till the day she had her stroke. One third of Diabetics do not know they are Diabetics. Too many of us smoke, drink or do not exercise. Addressing these diseases and factors will reduce the chances of stroke.

4: Share this with at least six family members or friends.

God bless you.
Arthur K

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