Henry Uche
World Stroke Day is observed in October 29th by World Stroke Organisation to underscore the serious nature and high rates of stroke, raise awareness for the prevention and treatment of the deadly body condition, and ensure better care and support for survivors. The theme for this year’s commemoration, “Life After Stroke,” focuses on challenges around stroke and how the survivors and their families are coping with it. In this interview, Dr Noble Oguguo, author of ‘Executive Stress Management and Stop Hypertension’ gives insight.
What do we need to know about stroke?
Stroke is a sudden attack and death of the brain cells arising from shortage of blood as a result of blockage of blood flow to the tissues or as a result of a rupture of blood vessels supplying the area leading to the death of cells and failure of their functions.
How do you see the theme of this year’s commemoration?
‘Life After Stroke’ is a commendable theme by the Medical World who deemed it imperative to consider the life of persons who eventually survive stroke. This is so because surviving stroke poses a lot of challenges viz: physical, emotional and economical in the life of the person. Viewing life after stroke, emotionally talks about how the individual feels after surviving stroke. We are not talking about patients who do not survive stroke; we are talking about survivors of stroke. So, some of these fellows feel disappointed, downcast, depressed, aggressive and sometimes engulfed themselves into self defeatism. We hear some of them say, “I am no longer good for anything, I have become useless, and other frustrating statements, all these make them unhappy. They need a lot of emotional support and psychotherapy from caregivers, family, friends and the wider society and even charity organisations to help them stabilise emotionally. But early management of stroke is very important, that’s the physical rehabilitation because quite often, stroke comes with some physical disabilities, sensory malfunctioning and the likes. The physical disability will require a coordinated physiotherapy attention to the stroke survivors; it helps to rehabilitate the functions in the affected muscles, hands, legs, limbs, tongue, part of the face etc. It also goes further into speech therapy to help them begin to organise their sentences and thoughts to enable them communicate in a manner people can understand them and vice versa.
Aside the physical rehabilitation, they also need economic rehabilitation. Some of these people are thrown out of their sources of livelihood; their means of livelihood has been affected. They need to be supported, pay their bills, eat good food, have roofs over their heads; some whose children are still in school need support. If they are not taken care of economically, rehabilitating them emotionally becomes difficult and will fail because the totality of this rehabilitation is anchored in the ability of the patient to hope for a better future, but when you disconnect any of them from this hope of having a better life, then the essence of living becomes useless and most of them will suffer serious depression and may wish to die.
OK, what are the types of this disease?
Basically, there are three types. One is the ischaemic stroke, which is caused by a blockage of blood supply to some parts of the brain. When this happens, it deprives the affected part of the brain oxygen and nutrients including vitamins and some enzymes etc necessary for the proper functioning of the cells, so the cells starve and die. The second type is the haemorrhagic stroke which occur when a blood vessel inside the brain ruptures, leaking blood into the brain tissue causing pressure on the cells of the brain and damaging them. The third type is transient-ischaemic attack. This is caused by a partial blockage of blood supply to the cells of the brain, but the blockage fizzles out after a while, it does not remain permanent. Most transient -ischaemic attacks subside within 24 hours but it’s a pointer to the possibility of a major stroke, so anyone who has this type should as a matter of urgency be properly investigated and examine to prevent the occurrence of major stroke.
Early warning signs and symptoms
Yes, apart from warning, it’s necessary to state here that there are conditions that lay foundations for the occurrence of stroke. These conditions include; high blood pressure, diabetes mellitus, obesity, lack of adequate physical activities, high level of cholesterol in the blood, excessive intake of alcohol and smoking.
It seems stroke affects mainly the aged…
No it affects all, though it is predominantly with the middle-aged persons to elderly ones, it rises from about 40 years of age and above. The commonest type is the ischaemic stroke. The warning signs are: unexplained pains in one side of the head, unexplained headache, unexplained weakness of the body especially the limbs (hands or legs) all these signs show that all is not well with the body.
Do you believe in some cases that seem to defile all medical approaches (what some people call spiritual attacks)?
No, medically speaking, there’s no room for that. This kind of belief occurs in a resource constrained country like Nigeria where the means of proper medical investigation and diagnosis are limited as a result of economic and social constraints. The people are not sufficiently empowered either through health insurance or by the individual financial ability to access adequate medical care that would investigate the condition properly and fully to find out the underlining cause of the disease and the extent to which damage has taken place, followed by adequate medical attention as required to correct the situation. So because of dearth of requisite resources (facilities and equipments), when the doctor is constrained by these inadequacies or financial limitations of the patients which impedes the thorough investigation of the person, people tend
the situation to what is not easily proven, hence, spiritual attacks from some quarters, while indeed what happened is the limitations from full medical exploration. Medical practitioners cannot do otherwise when modern medical equipments and facilities are not in place to do their jobs; this unfortunate condition is predominant in Nigeria and other African countries. So it is when the wherewithal from either side is lacking, people give the conditions any nomenclature.
Government intervention
First, we must all recognise the fact that these people can be properly diagnosed, treated and rehabilitated and become productive again. That’s why I applaud the theme of this year’s commemoration, “Life After Stroke.” Anyone who survives stroke can still be very useful to himself and the society at large. They must be encouraged. Going forward, government must set up properly equipped stroke centres in all the 36 states of the federation and smaller centres in their local government areas. There should be proper inter-disciplinary and mutil-disciplinary teams to deal with people who have been able to pull through the crisis of stroke. So that they can be properly rehabilitated, that’s the life after stroke.
Hope for survivors
There is still hope for stroke survivors. There should not be too much difference to be attached to stroke survivors. They should be seen like any other person who survives any other ailment. What is important is the person should look forward to a better quality of life. The healthy people around such affected persons should help them because at a point, persons with stroke most times, reject any form of assistance offered to them, they just want to die because they get depressed and fed up with life, but it’s not the end of life. There is still hope for them, because there is nothing God cannot do, even when all human efforts fail. We have the responsibility on our shoulders to give them sense of hope, succour for survival because it is possible to bounce back and become more economically useful to themselves and the society at large.
Preventive measures
Adequate exercises, eating healthy diet, reduction in alcohol consumption, maintaining healthy weight, quitting smoking, avoid self medications; treat sleep apnea, treat diabetes, control high blood pressure, regular medical checkup and other healthy practices are encouraged.