When John Uwandu suffered a partial stroke while driving to work, some months ago, he said that the day started on a good note, without any inkling that things were about to change in his life and family. The young man, a tech analyst with one of the upscale technology firms in Lagos told Saturday Sun that he feels so lucky to be alive, given the health scare he suffered. He is grateful that he wasn’t on full speed on an expressway when he suffered the partial stroke.
In his early forties, Uwandu is a friendly, outgoing and hardworking man devoted to his family. He is the primary provider for his family that consists of himself, his wife and three children. But today everything has changed due to his health challenge. According to him, on that fateful day, he was driving to work when he started feeling some strange sensation in his body. He slowed down on his street in Surulere area of Lagos. That was when he suffered the stroke.
He was rushed to hospital by some people who saw him struggling with himself. There, he had his blood pressure stabilized immediately. Even though he has lost the ability to use the right hand side of his body, he is optimistic that his life would return to normalcy because he has employed the services of a physiotherapist who comes twice a week to massage him.
“At my age, I didn’t believe that I would suffer a partial stroke because I have lived an active life,” he said. “I saw my whole life pass before my eyes and I thought that was the end.” Today, he still struggles to eat or do things with his right hand. But he is happy to be alive to enjoy the company of his wife and children.
Different people, different strokes: Olawode’s story
On a Friday night just three months ago, Mrs. Funke Olawode had a busy day cleaning the house, in company of her 11-year-old daughter and eight-year-old son. They enjoyed one another’s company while at it, washing clothes and arranging things. Suddenly, she felt dizzy and uneasy. She felt as if her spirit was leaving her body. To stabilize herself, she had to lie down because she felt faint and unable to support herself. Her right side felt like it was being pierced with pins and needles and when she tried to squeeze her hand, it couldn’t respond.
The 40-year-old woman, a trader at a popular market in Ketu area of Lagos said she started panicking. Next, she noticed that it was becoming hard for her to swallow saliva. At this time, she thought she was dying because she didn’t understand what was happening to her. According to her, “I pushed myself up and tried to tell my children what was happening, but nothing was coming out. They just kept asking what’s wrong and all I could do was just make slurred noises.”
Her children started screaming when they saw blood coming out from her facial region and making her to keep turning her head from side to side in a vain attempt to stop its flow. They alerted their neighbours who rushed to the scene to administer first aid before rushing her to the hospital.
Olawode stated that she spent one week in the hospital before she was allowed to go home. All the same, she still finds it hard to make use of her right hand. Even though she has engaged a therapist to help out, the health and physical effects of the stroke she suffered are still visible. “I am now six weeks post-stroke and although the physical effects are getting better, I am suffering from anxiety, neuro fatigue, forgetfulness, confusion, sensory problems and constant headaches,” she said.
While she was in hospital, the mother of two couldn’t wait to get home, but as soon as she did, she had an overwhelming sense of fear and panic. The events of that fateful day kept replaying in her head. She told Saturday Sun that she never realized how common strokes were, especially in young people until she met other people with the same health challenge in the hospital.
She wishes she knew more about stroke beforehand and the invisible effects it leaves on the body and mind of people. She is building her confidence gradually by going back to her stall in the market. And her children are happy to have their mother back home.
Three weeks after she came back from the village where she had gone to take care of her sick mother, 38-year-old Peace Okpo had a stroke. That fateful morning, she woke up feeling well-rested. But after having her bath and getting ready to leave for the office, she felt a tingling numbness in her face. Initially, it came as an off-and-on sensation, making her feel that she was just getting a migraine.
She told Saturday Sun that she became agitated when it happened again but this time lasting longer than the previous ones and making her tongue so numb that she couldn’t eat properly. She also noticed that her left arm was very weak and uncoordinated. She tried to lift a cup but it felt heavy. By this time, she became worried and started making her way to the door to call for help. But she made that decision too late. Before she knew what was happening she fell down and felt her face starting to twist, together with her hands and legs. She couldn’t remember for how long she lay on the floor before her neighbour walked into her apartment, on discovering her door wide open.
According to her, the numbness and tingling sensation happened a few times over the day and the following day. “I had an MRI scan which confirmed I had small ischaemic strokes,” she said. “My arm was weak and clumsy but improved over the next two months.” In medical circles, one of the effects that Okpo suffered from is known as dysarthria. This is characterised by weakness of the muscles used for speech, and, often, leading to slurred speech. She also experienced extreme cognitive fatigue and became hypersensitive to sound and light.
“I honestly thought I’d be back to work in a few weeks time once my arm had recovered, but in fact I lost my job as I wasn’t able to return,” she said regrettably. “I didn’t understand the impact and it took me a long time to understand, the causes and how to try to manage it.” Even though she survived her ordeal, she found the fatigue bizarre. She would get a tight squeezing pressure in her head, which affects her balance and her head would become too heavy to hold up. Sometimes, things would look like she is not looking at them through her own eyes as they appear sort of unfamiliar and almost alien to her. Her lower jaw becomes heavy, when she talks and she finds it hard to put words together.
“At such times, I become disorientated and unable to process information,” she said. “My limbs are heavy and uncoordinated. There’s a tingling, burning sensation in my hands and face. I’m unable to get my words out. Basically, it’s like shutting down.”
Davies’ unfortunate death from stroke
While Okpo is suffering from temporal suspension of her physical abilities, Mr. Andy Davies, a father of four wasn’t so lucky. He died five days after suffering a stroke attack. The 46-year-old man suffered a stroke at home while watching television and having a chat with his wife. According to sources, he got up at a point to get something from the bedroom but never made it there. He collapsed suddenly before he managed to shout and attract his wife’s attention.
Davies’s widow, Stella, said he didn’t remember much about the journey to the hospital because he woke up looking lost and confused.
The woman who, today, is mourning the death of her husband said he was a hardworking family man who did different jobs to put food on the table. He was a driver, a generator technician, an errand person and a washer man. According to Stella, after the stroke, “he didn’t remember anything that happened until he woke up in the hospital. When he opened his eyes, he looked disoriented and confused. He kept staring at me and the people around who had been praying for him to wake up.”
The widow stated that her late husband was discharged from the hospital after three days because he kept insisting that he wanted to treat himself with herbs and not orthodox medicine. With tears flowing down her cheeks, she told Saturday Sun that her late husband was already getting better before he died two days after returning home from hospital.
“I was already happy that he was responding well to treatment but got the most devastating blow of my life when he suddenly gave up the ghost two days later. I couldn’t cry for a while when I held his lifeless hand,” she said. Stella said she was confused, angry and heartbroken. “He was a good man who didn’t deserve to die at 46,” she noted. Their children are still too young to understand that their father is no more.
A doctor’s view
So why are Nigerians suffering or dying from stroke at such a young age? That is the question Saturday Sun asked a doctor, Emmanuel Adetayo.He started by throwing lights on what stroke is all about. “A stroke is the sudden death of brain cells in a localised area due to inadequate flow of oxygenated blood,” he said. “Without access to the blood that supplies oxygen and nutrients and removes waste products, brain cells begin to die quickly.”
He added that depending on the region of the brain affected, that stroke may cause paralysis, speech impairment, memory loss and reasoning ability, coma, or even death. The doctor, however, noted that despite being a fairly common medical emergency, many people often do not know what to do when someone in the family or around them suffers a stroke attack.
“Stroke occurs rapidly and their symptoms also often appear suddenly, without warning,” he said. “However, paying heed to some early signs like confusion, including trouble with speaking and understanding, headache with altered consciousness or vomiting are some of its symptoms. Other symptoms include numbness particularly on one side of the body, trouble with seeing, in one or both eyes and trouble with walking, including dizziness and lack of coordination.”
He warned that that stroke is one of the leading causes of adult disability and death worldwide. Fifteen million cases of stroke occur globally each year and greater than one-third of these are fatal. Two-thirds of all strokes are known to occur in developing countries. According to statistics, crude stroke prevalence is 1.14/1000 population while 30-day case fatality rate in Nigeria may be up to 40%.
“It has been documented that 90% of incident stroke is due to modifiable risk factors while the recurrent stroke is 80% preventable through optimal risk factor modification. Stroke risk factors are often undiagnosed in Nigeria until stroke occurs and this is often due to lack of its awareness and prevention. Some risk factors of stroke can be readily identified during community screening using cheap and non-invasive techniques. These risk factors include hypertension, proteinuria (an excess of protein in the urine) and obesity. The most common risk factor, for all types of incident stroke worldwide is hypertension. Hypertension often remains undiagnosed in many Nigerians unless detected during routine community or hospital screening, or unfortunately at presentation with stroke or other cardiovascular complications.
“This coupled with a prevalent lack of public awareness of warning signs and risk factors of stroke may be partly responsible for the mounting burden of stroke in low-income countries like Nigeria.”