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.

Assessment Tools for Concussions

As there is more awareness of the dangers of concussions, particularly when playing sports, most now realize that concussions have to be assessed early and that proper follow-up care is necessary. As a result, there are now several assessment tools now available for the amateur, scholastic and professional level of athletes.|

The following are some of the diagnostic and assessment tools now being used:

- The C3 Logix system is an assessment tool that was initially used for research into Parkinson's disease but is now being used to assess those with concussions. It determines rate of dizziness, balance and visual disturbances. The data is stored in the system, eliminating the guesswork and makes managing brain injuries, and particularly concussions, easier. Tpad2's are currently being used along with the C3 system as the assessment tool. A baseline assessment is done on players pre-season so that if there should be a suspected concussion then another follow-up assessment will be done to compare the two assessments in order to determine the degree of the injury. Another assessment may be done during the recovery period to determine rate of injury improvement and another before the player is allowed to return to the game. By doing these types of assessments, it ensures that no player will be allowed to play with any symptoms that have not been resolved. This data collection system assesses the neurocognitive symptoms, balance, reaction times, memory and motor function to determine brain health so that concussions can be better managed. It is portable and accurate and is able to focus on moving objects. It can test athletes at all levels.

- SCAT2 is another diagnostic assessment tool for determining concussions. It is a standardized method of evaluating athletes for concussions from as young as ten years and older. The SCAT2 also does pre-season baseline testing of athletes.

- ImPact Sports Concussion Assessment and Cognitive testing is also utilized. It tracks the injury from the time of concussion and throughout the recovery process.

- The C3 Application is often used with the ImPact Sports Assessment. It is an iPad based application to assess concussions. All information is put into the medical record system so that follow-ups can be made. As part of this assessment, there will likely be a physical assessment done as well, i.e.: a drop test and a balance test.

There are approximately 500,000 sports related concussions in the United States each year. MRI's and CT scans do not detect concussions. Because concussion symptoms can be very difficult to correctly determine the degree of injury, these diagnostic assessment tools are a huge advantage to medical professionals as well as athletes to ensure that proper care is received and that hopefully long-term problems can be avoided in the future.

These diagnostic assessment tools are being used more and more frequently within schools and universities in the United States. Hopefully the advantages of their use will begin to be realized.

Brain Injuries and Behavioural Problems

Behavioural problems quite often are a result of brain injuries. There can be many problems or few depending upon the severity of the injury and in what part of the brain the injury is located. Some of the potential problems are as follows:

Mood swings, depression, hyperactivity, aggression, sexual inappropriateness and/or promiscuity, lack of initiative or motivation, changes in emotional control, lack of impulse control, poor concentration, lack of empathy, fatigue, thoughtless or hurtful remarks, difficulty in relating to others, excessive demands, personality changes, a tendency towards being frustrated, irritated or angering easily. Unawareness of others' feelings is other another deficit and may be something that has to be relearned. Another serious and very common problem is short-term memory difficulties, as is a lack of awareness of their deficits.

If a brain injury survivor is affected with any of these behavioual problems, it is very stressful for family members and caregivers. It may be important to have cognitive and behavioural rehabilitation and possibly the help of a neuropsychologist. It will also be important to have an assessment done which will help both the survivor and the family member. And because behavioural problems not only affect relationships but performance in school and work, it will be necessary to attempt to alleviate the problems or at the least, to help cope with their impact. The following are some of the things that can be done in order to help minimize problems associated with behavioural changes following a brain injury:

- to be calm and speak in a soothing manner when the brain injured survivor is angry or frustrated;

- help them attempt to problem-solve their difficulties;

- use anger management strategies and remain low-key;

- avoid confrontation if they are angry;

- attempt to distract;

- attempt to identify any triggers so as to avoid future difficult situations;

- encourage the survivor to join a support group;

- be non-judgmental;

- help a sufferer of a brain injury to have positive experiences by offering encouragement and support;

- avoid arguments and criticism;

- help them to have a schedule and structure in their lives;

- don't give too much information at one time;

- establish consistency and always remain calm;

- and, if depression is suspected, have survivor see the doctor and if necessary, ensure that he/she gets treatment.

A total reversal of behavioural problems following a brain injury may not be possible. Modifying behaviour may be a more realistic goal while working towards improved quality of life and successful community integration.

Developing adaptive behaviour requires recognizing triggers and anticipating factors preceding the behaviour. These may be internal such as fatigue or hunger. External factors may be a frustrating task or increased levels of stimulation. Prior signs to difficult behaviour may be pacing, becoming fidgety, their face may become flushed, or they may begin muttering to themselves. Early intervention when a problem arises may assist them, over time, in changing their behaviours.