How Best to Avoid Having a Stroke

Eighty per cent of strokes can be prevented by being aware of controllable risks. A stroke occurs when blood circulation to the brain fails and cells die as a result of lack of oxygen. Controlling risks can help prevent this.

Strokes are caused by either a blockage of blood flow or by bleeding into the brain. The following are things that can be done to help prevent having a stroke:

- Keep high blood pressure under control as it can make you susceptible to developing blood clots. If high blood pressure is left untreated, it can be a precursor for a stroke. It should be checked regularly by your family doctor and if it is higher than it should be there are things that can be done to control it. You can change your diet by eating healthy foods and by exercising. Exercise will make the heart stronger thereby requiring less effort for it to pump blood through the body. It is also important to avoid excessive sodium as it can contribute to high blood pressure. In some cases this may not be enough and medication may be necessary to keep it under control.

- Atrial fibrillation can increase the risk of stroke by five hundred per cent. It is an abnormal heartbeat and can cause blood to pool in the heart. Atrial fibrillation can be very serious and should not be taken lightly. Most times, as in my mother's case, medication is required to control it and constant attention and awareness of it is often required.

- Smoking is something every person has control over and it is wise to avoid as it doubles the risk of stroke. Smoking clogs the arteries, raises the blood pressure, damages blood vessels while narrowing them and causes the heart to work harder. Nicotine and carbon monoxide damage the cardiovascular system which can increase the risk of stroke.

- Over consumption of alcohol has been linked to stroke risk. It has been recommended during various studies than no more than two drinks are advisable for males and one drink for females should be consumed and less is better.

- High cholesterol should be checked regularly also by your family doctor. It can clog the arteries and puts those with it at a higher risk for strokes. High cholesterol can be regulated by diet and exercise but when this doesn't work, medication may be required.

- Diabetes can create a risk for getting a stroke. Diabetes II can sometimes by controlled by diet and exercise but in any case, it is something that should be taken care of and monitored by a family physician.

- Obesity can create a risk of stroke also. However, it can be controlled with a proper diet of fruit and vegetables, grains, nuts and foods low in calories. Regular exercise is also important; at least five times a week is suggested. It doesn't have to be strenuous. Walking and swimming are an excellent way to stay in shape and help your heart to stay healthy.

- Circulation problems can also lead to blocked arteries and can cause a stroke. Medication may be required to control this problem. It will be necessary to follow the advice of your doctor.

- Transient Tschemic Attack (TIA's) should be treated. They are mini strokes lasting usually only a short period of time. It is important that they be treated as they can lead to more serious strokes. My suffered suffered from these and was prescribed medication by her family doctor. She had them for years but because she took medication for them, she fortunately never did have a more serious type of stroke.

Having a risk factor for stroke doesn't necessarily mean you'll have a stroke. My mother has been proof of this. But it does mean that a particular effort should be made to control the controllable risk factors.

Can Anyone Have a Stroke?

Anyone can have a stroke. About one quarter of all strokes happen to younger people and children. Babies have even had strokes. But almost eighty percent of all strokes can be prevented.

There are many risk factors. Men are at higher risk for stroke than women but women are one and a half times more likely to die than a man will. However, middle aged women are more at risk than middle aged men. People of South Asian, African-American or Hispanic have an increased risk than those of European origin and usually they have strokes at a younger age.

Controllable risk factors are: high blood pressure, high cholesterol, diabetes, poor circulation, smoking, alcohol, obesity, poor diet and inactivity. Uncontrollable risk factors are: age, gender, race, family history, being aged 55 or older or being male. Also those suffering from atrial fibrilation or TIA's (transient ischemic attack which are mini strokes) are more likely to experience a stroke.

Other uncontrollable risk factors are a genetic predisposition/genetic disorder which may be a gene mutation leading to damage of blood vessel walls in the brain, blocking the blood flow. Each child of a parent with a family history of this disorder has a fifty percent chance of inheriting the disease.

Your stroke risk is also higher if a parent, grandparent, sister or brother have already had a stroke. Also, those who have previously had strokes, TIA's or heart attacks are at a far greater risk of suffering from a stroke than those who have not.

Strokes are considered to be more common in the southeastern part of the United States than in other areas. There is also evidence that strokes are more common among low-income people than those who are more affluent. Alcohol and drug abuse are also considered to be high risk factors.

One in six people will have a stroke some time in their lifetime. Based on this information and the fact that there are so many risk factors involved pertaining to what is controllable and what isn't, we now know, as many people have long held to be true, that the risk is not only in being over sixty-five years of age.

And because thee are so many risk factors, and because younger as well as older people can have strokes, it is important to remember the following warning signs: F.A.S.T.: F. - Face drooping; A. - Arm weakness; S. - Speech difficulty; T. - Time to call 9-1-1.

So can anyone have a stroke? Technically almost anyone can but it's important to remember that there is much we can do to prevent a stroke from happening. But it is also important to remember that much of what happens concerning our health can be controlled by how we treat our bodies.

Strokes and Emotions Following a Stroke

Emotions and behaviour can change following a stroke. Approximately one third of all stroke survivors experience some emotional problems.

Emotional problems can result in depression, anger, frustration, feelings of loss and denial. There may be communication disorders which will include aphasia - to do with verbal abilities and auditory comprehension where they are unable to speak or read, write or comprehend numbers. Or there may be motor speech disorders with slurred or garbled speech. All of these difficulties will affect the emotions creating sadness and possibly depression.

Extreme emotions will interfere with the rehabilitation process. Emotions are hard to control, partly because of chemical changes within the brain caused by the stroke. It is also a reaction to the challenges of dealing with the effects of a stroke. There can be rapid mood changes also causing crying or laughing that may not be appropriate, feelings of hopelessness, changes in eating and sleeping, anger, anxiety and apathy.

Anxiety causes sleep disturbances and can cause difficulty with concentration. The stroke sufferer may avoid going out in public or even seeing friends. Irritability, another problem, can also cause problems with concentration and the sufferer may tire more quickly.

Apathy is a dangerous emotion for a stroke survivor. Its symptoms can be lack of enthusiasm, motivation, listlessness and they may exhibit no interest in anything. For the stroke sufferer, if they have apathy they will likely not wish to work diligently at their rehabilitation. This is detrimental to their long-term health and their chances of having fewer disabilities.

It is important for a stroke-impaired person to find ways to relax, i.e.: soak in a warm bath, listen to calm music, meditate or go for a walk. Writing down worries or talking to a friend or family member may also help. However, if it continues for quite a while and all else has failed, it may be necessary for them to see their family doctor. Medications may also be necessary.

Stroke recovery groups are also good for the stroke survivor because often talking about the effects of their stroke with others who are going through the same thing can help. Acknowledging their feelings will likely help them deal with their emotions also. It is also important for a stroke sufferer to be informed. The more they know, the more able they can help themselves.

Emotions following a stroke are often closer to the surface and may possibly intensify reactions to situations that may not have bothered them prior to their stroke. As upsetting as it is for the stroke survivor when their emotions are chaotic, it is good to know that in almost all cases, these intense feelings will go and eventually they will feel more like themselves.

Problems with emotions following a stroke can result in personality changes. But as the stroke-impaired person begins to feel more like themselves, these changes often will cease to exist.

Learning to Adjust to Life Following a Stroke

Statistics indicate that strokes are often life-altering. Sadly, fifteen percent will die, twenty-five percent will recover with only minor impairment and ten percent will almost completely recover. But the rest, fifty percent, will require some type of care.

There are huge challenges in adjusting to the effects of a stroke. There will likely be fear, apprehension, uncertainty and usually life changes. It will be important for the stroke sufferer to gain some control over his/her life and to work towards independence. They will need to work diligently to improve their emotional and physical well-being by thinking positively. It will be important for them to remain positive as expectations, by necessity, will be altered.

Adaptations will have to be made to overcome limitations. Practicing daily will be necessary as continual effort will have a cumulative effect on their abilities. It will be important to set goals, to do things they enjoy, to be social and to try new things. It will be important also to accept the many changes in their life and to adjust to how their stroke affects other people. It will be natural to initially fear the future because strokes affect the body, mind and emotions.

Following a stroke there may be paralysis, weakness in the limbs, difficulties with balance or language, pain or vague sensations of feelings in their body, cognitive and memory problems, feelings of frustration, feeling a sense of loss, difficulties with bowel or bladder control, fatigue, trouble swallowing or difficulty maintaining their hygiene. There may also be depression. It will be important to seek help if depression is suspected.

In some cases, brain cells may be only temporarily damaged. In other cases, different areas of the brain will take over from the damaged areas. Rehabilitation will play a large part in helping the brain sufferer. Goal setting will also be important. And as with everything, a proper diet is necessary.

It will be important for either the stroke-impaired person or his/her caregiver to ask questions regarding their care, to allow him/her to express their wishes and opinions and to be made a partner in their own health care. It will be important to keep them informed and to encourage them to join a stroke support group.

Special equipment may also be required following a stroke, i.e.: a cane, walker, wheelchair, orthotic devices or communication aids. There are also services available such as meals on wheels and transportation services.

Adjusting to the effects of a stroke will be different for each stroke survivor because, like every brain injury, each stroke is different also. A lot will depend on the attitude of the survivor and how hard he/she is willing to work at rehabilitation. It will also depend on the severity of the stroke and where it was. Whether there is a family member and/or caregiver available to assist with follow-up care and rehabilitation will make a difference too in both physical recovery and in a positive attitude.

Helping Victims of Strokes

More than 700,000 people suffer from a stroke each year in the United States. Strokes are the fourth leading cause of death in the United States and the most common cause of long-term disability. One American dies of a stroke every four minutes.

It is thought that sensory stimulation, i.e.: gentle touching of the face and hands, etc. or talking in a soft voice to the person who is suspected of having a stroke may reroute the brain's blood supply while waiting for an ambulance to arrive. By doing this, it is hoped that the stimulation may assist in keeping cells from dying while a person is experiencing a stroke.

There is also a drug available that breaks up blood clots if it is administered within three hours following a stroke. However, it doesn't work for everyone and of course, getting help quickly is of paramount importance.

But what is required after someone has had a stroke? A person who has suffered from a stroke should begin rehabilitation no longer than 24 to 48 hours following their stroke because most will require at least some rehabilitation in order to become as independent as possible in the future.

It may be necessary to relearn some skills that may have been lost, i.e.: walking or talking. They may have to learn new ways of doing things, i.e.: how to bath, dress themselves or to eat. They may only be able to use one hand. If that is the case, they will have to practice repetitive exercises to strengthen the stroke-impaired limbs. If there is some weakness or paralysis on one side of their body, they should use those limbs to do basic activities for their daily living. Once begun, it may be an ongoing process to maintain and refine these skills.

Strokes can affect both speaking or understanding; motor control, i.e.: their face, arm or leg usually on one side of their body; sensory disturbance problems; memory and cognitive problems; emotional disturbances, i.e.: psychological trauma as a result of the stroke, and depression. As in other brain injuries, stroke victims will not usually experience all of these problems and the fortunate ones will have only mild limitations that may require little rehabilitation.

Many people are involved in stroke rehabilitation: the patient, family member, caregivers, doctors, rehabilitation nurses, physical therapists, occupational and recreational therapists, speech therapists, and vocational therapists.

As a family member, if you have been there when the stroke happened, your most important task is to get your loved one to the hospital as quickly as possible because early intervention will mean there will be a more positive outcome.

It is important if a family member has had a stroke that he/she and/or his family members/caregivers do all they can to work towards rehabilitation so they are not one of the more negatively impacted.

Strokes - An Acquired Brain Injury

In order to optimize stroke recovery, it is paramount to have early diagnosis and appropriate and immediate medical care. When this is done, a patient's treatment and rehabilitation can begin.

Recognizing the symptoms of a stroke are important though so that immediate action can be taken. They are: numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; trouble seeing out of either one or both eyes; difficulty walking, dizziness or loss of balance, or a sudden, severe headache.

If a stroke is suspected you must immediately call 911 or an emergency response system in your area. There is a very limited window from the onset of symptoms to when therapy can successfully be used. To determine whether it is a stroke or not, have the person smile. Their face should move symmetrically. Also ask them to raise both arms so that any evidence of paralysis will be evident, and to speak a simple sentence. While waiting for the ambulance to arrive, the person should lie flat to allow the blood to flow to the brain. If there are definite stroke symptoms, do not give them aspirin in case there is any bleeding.

Once a stroke patient has become medically stable, rehabilitation can begin which will initially teach him/her how to manage their own personal hygiene, feed themselves, get in and out of bed and to use the bathroom on their own.

Further rehabilitation may include a physical therapist, occupational therapist, speech and language pathologist, psychologist and recreation therapist depending on the severity of the stroke. This type of rehabilitation will help to promote independence in their daily lives. Responses to treatment and their overall recovery will, however, depend mainly upon themselves and their own personalities. Part of early recovery is spontaneous which are natural abilities that will automatically begin to come back, especially during the first few weeks following a stroke. But significant recovery can be made even years after a stroke. Rehabilitation works best when stroke survivors and their families work together.

After rehabilitation in either a formal rehabilitation program or as individual services, the person will eventually be able to return to community living. During this stage they may have to learn to do common tasks in a different way. It may be that they will have to use their opposite hand to write or do things they originally did with their other hand. They may require velcroe on their shoes instead of laces or if it has been a serious stroke, they may require the use of a wheelchair.

Strokes can affect the body, mind and feelings. And because a stroke is an acquired brain injury, they may have many of the same deficits that those who have suffered a traumatic brain injury have been faced with. They may be unaware of their injury, have problems with their memory, experience lack of judgment and motivation as well as other cognitive problems, and fatigue and depression.

The most important thing in having a successful outcome following a stroke is that there is an early diagnosis, with immediate therapy and treatment. Without early treatment, there is the risk of life-long consequences to the patient such as disabilities that could possibly have been prevented.

Don't Let A Stroke Get You

Strokes are an acquired brain injury affecting the brain as well as the body. (New beliefs are now that strokes also fall under the category of a traumatic brain injury.) There are things you can do to help prevent this from happening to yourself or to any of your loved one. How can you prevent it from happening?

Strokes don't just strike those in their sixties, seventies and eighties. Even those in their thirties and forties should be aware of the dangers of strokes because they are at risk also. What can you do to help prevent getting a stroke? The following steps are a good beginning:

- Are you overweight?
Eat a low fat diet. Know what is healthy and what is not. Some of the healthy foods are nuts, fish, vegetables, fruits, yogurt and whole grains. Avoid junk foods and late-night snacking. Avoid foods high in sodium and drink a lot of water. Avoid restaurant food which is always high in sodium and fat content.
- Do you have high cholesterol?
- Do you have high blood pressure?
Often these go hand-in-hand but not always. Even those who are not overweight can have high blood pressure and high cholesterol. Get cholesterol and blood pressure checked regularly.
- Do you get enough exercise?
Exercise every day and on those days where you don't feel you have enough time, do things like walking from the end of the parking lot, take the stairs instead of the elevator and do some exercises while you're watching the evening news.
- Do you have a lot of stress in your life?
A lot of our stress is the pressure we put on ourselves. Many of the things we think we have to do right now can wait, i.e.: doing the dishes, returning that phonecall, vacuuming or picking up after our family just because we've always done it. Enlist your family member's help in getting things done. Take time to relax.
- Do you smoke?
Smoking is not good for you. It restricts your blood vessels.
- Do you have diabetes?
It is important to keep this disease under control not only for general health reasons but as a prevention for strokes as well.

The statistics are not good. The incidence of stroke is expected to double in the next ten years. Also it is expected that Canadian children will be the first generation who are not likely to live longer lives than their parents. That is a sad outlook for the next generation. But with simple lifestyle changes perhaps we can prove these statistics to be wrong.

Besides making healthy changes to our lives, it is important to know the symptoms. They are as follows:

- A sudden numbness or weakness in the face, arm, leg or on one side of the body.
- Sudden confusion, trouble speaking or understanding when others are speaking.
- Sudden trouble seeing out of one or both eyes, or possibly experiencing double vision.
- Sudden difficulty in walking, feelings of dizziness or lack of coordination.
- A sudden extreme and severe headache.
- A feeling of nausea.

There is a three hour window of opportunity to successfully treat a stroke. It is imperative to call 9-1-1 immediately and get medical help as soon as possible. Getting the proper help could make the difference in avoiding a lifelong disability.

The Story About Strokes - An Acquired Brain Injury

An acquired brain injury is caused after birth and can contribute to cognitive, physical, emotional and behavioral impairments. A stroke is when blood flow to a part of the brain stops. Brain cells can die and the patient may be left with permanent damage.

There are two major types of strokes:

- The ischemic stroke is when a blood vessel that supplies blood to the brain is blocked by a blood clot. If a clot forms in a narrow artery, it is called a thrombotic stroke. If the clot breaks off and travels to the brain, it is called a cerebral embolism.
- A hemorrhagic stroke is when a blood vessel in part of the brain bursts open and blood leaks into the brain. This usually causes a severe headache.

The causes of a stroke are high blood pressure, atrial fibrillation, diabetes, high cholesterol, a family history of strokes, being over fifty-five years of age, living an unhealthy lifestyle, having heart disease, being overweight, drinking heavily, smoking, using illegal drugs, ethnicity, a previous history of strokes or TIA's and women over thirty-five who are on birth control pills, especially if they smoke.

Some of the symptoms are a severe headache, slurred speech, inability to speak or to understand, loss of balance or coordination, confusion, numbness or tingling on one side of the body, vision problems and muscle weakness.

For best prognosis, it is extremely important to get medical treatment within three hours of first symptoms but no later than four to five hours. At the first signs of a stroke, it will be imperative to call 911 in order to get immediate treatment. This reduces disability and can save lives. Medical staff will examine and possibly give a clot-dissolving drug, do tests with probably tests using all or some of the following - an Angiogram, a CT scan, an MRI, and an Echocardiogram. There will probably be lab tests done as well.

Treatment and prognosis will depend on the cause of the stroke, the severity of the stroke, what has been affected and how quickly treatment was begun. There may be bladder and bowel problems, muscle and nerve problems, speech, memory and thinking difficulties as well.

There are three coping strategies for emotional problems related to strokes:

- approach-oriented coping where the patient consciously works towards minimizing the emotional challenges of the acquired brain injury;
- passive coping which indicates a lack of motivation where patient chooses not to express his/her emotions;
- avoidance coping where the patient actively avoids coping with their emotions. With this type of coping, there is usually a high level of depression.

Patients who have suffered a stroke may possibly need physical therapy, occupational therapy, speech therapy and swallowing therapy. And because it is common for patients to at least initially experience memory loss, rehabilitation in this area may be required as well as using memory aids such as a diary, calendar or a daytimer.

To reduce your risk of of having a stroke, exercise at least thirty minutes each day, eat a nutritional died rich in fruits, vegetables and beans, low-fat dairy products and foods that are low in sodium and fats.

Because a stroke is loss of blood to the brain, the importance of early medical intervention can't be stressed strongly enough in order to reduce the likelihood of a more debilitating disability.

Acquired Head Injuries and Personality Changes

Although there are many causes of acquired head injuries, strokes are the most common. And because strokes are usually followed by stress, anxiety, depression and physiological changes the stroke sufferer is experiencing, personality changes are quite often the result.

In many cases, the sufferer is having difficulty moving and speaking and will have lost their independence as a result of their stroke. Those who had pre-stroke tendencies towards handling stress well, coping with adversity and were optimistic by nature, are more likely to react better following a stroke. Those whose pre-stroke personalities made them prone to anger, anxiety or depression will find stroke rehabilitation discouraging. Lack of motivation is a common reaction with the latter group when recovery is slow and especially if there are many setbacks. And depression and apathy can follow quickly thereafter.

Personality changes are differences in behavior, thinking and interactions of someone from what their normal character has previously been. Personalities are vulnerable to changes following a stroke but these changes may not always be permanent. Once there is an improvement in their abilities, their personality may return to their pre-stroke behavior and way of looking at things.

Some stroke sufferers may have uncontrolled bouts of crying or laughing. Some may have reduced patience and increased frustration levels, be more impulsive, lack self-confidence, be self-centered, more emotional or behave inappropriately. Others may suffer from post-traumatic stress disorder which is a fear of helplessness. Some have difficulty functioning socially and many have symptoms of identity loss which can lead to changes in their personalities. Identity loss is the feeling that many stroke sufferers have because of how they see themselves following a stroke. Their lives have been altered, especially if there have been major changes in their functioning abilities.

The following are some of the ways to help a stroke victim:

- treat them with respect and listen to what is bothering them;
- offer praise when they make an effort to work towards recovery;
- allow them to make choices. It is often necessary, however, to ensure that their choices are not ones that will place them at risk;
- discuss their personality changes with them and determine if they can identify and understand the changes in themselves;
- if they have an awareness, help them towards developing compensatory strategies;
- express your feelings about the changes and encourage them to discuss how they feel about the changes;
- discuss with them how personality changes have impacted their relationships.

If they are uncomfortable discussing their personality changes with someone close to them, perhaps it would be easier for them to do it with a third party, unbiased person who is not closely involved with them. Being aware of their personality changes can help considerably towards being able to work on them.