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    Specialty News Cardiology

    Stroke: The more intention about risk, the more proper prevention | Part 2

    22 June, 2023

    Confident and proactive before a stroke. All you need to know for adequate care and prevention. Don’t let a lack of information threaten your heart health. Check out this article for more details on the causes, symptoms, prevention and improvement of your health.

    The effects of stroke

    It is essential to understand that no two people are affected by stroke similarly. The effect of a stroke on a person depends on which part of the brain has been affected and how much damage has been caused.

    Thought processes and understanding

    Cognition

    The effects of a stroke on cognition are varied and complex. People can have problems in many areas relating to thinking and reasoning. This can include difficulties with planning to carry out a task and making decisions. The stroke team will work with you to identify any problems you may have. They will help you find ways to manage and plan tasks to regain independence successfully.

    Concentration

    For example, you can’t concentrate on following a TV program or reading a book.

    This could be due to the effect of both the stroke and tiredness. It may be helpful to set little goals you hope to achieve or short-time limits for any activities you wish to perform. It may be frustrating to set yourself a huge task and be unable to complete it, but it can help to break down the task into smaller, more manageable steps. You can also concentrate much better on several small studies than on huge ones. If you need more help, you may be eligible for other occupational therapy.

    Memory

    For instance, it isn’t easy for you to remember facts from the recent and distant past and how to do specific tasks.

    Memory problems are common after a stroke. It may be helpful to try and establish a routine for your daily activities. Try writing things down and have several calendars and clocks on view to remind you of the date and time.

    Use a diary or stick reminders in prominent places so you don’t forget necessary appointments.

    Perception

    Perception means making sense of the world around you. For example, recognizing previously familiar objects may be complex. The occupational therapist will work with you to develop strategies to manage any difficulties you have with this.

    Communication

    Dysarthria

    This is a disorder of speech.

    It is caused by weakness or incoordination of the muscles around the mouth, face or voice box, making speech sound slurred, quiet, slow or indistinct. Dysarthria may be mild and only noticeable when you are exhausted. In severe cases, it can make your speech difficult to be understood, even by people who know you well.

    Dysphasia/aphasia

    Dysphasia and aphasia mean the same thing and refer to a language disorder. Aphasia can affect talking, understanding, reading, writing and using numbers. It affects everyone differently. Some people may struggle in just one area, but difficulties across all regions are prevalent. Aphasia does not affect intelligence, but it does make it challenging to get messages in and out; and express your thoughts, feelings and wishes.

    There are many ways to help someone with aphasia, and the Speech and Language Therapist can advise on what is most helpful to you or your relative. A “total communication” approach is often practical. This includes using many strategies and words to help the person with aphasia understand and express themselves. Plans to try to involve giving concise information using simple language, writing down important words, using gestures and encouraging the person with aphasia to gesture or write or draw what they are trying to tell you. Using photographs, pictures, or objects such as calendars or maps may also be helpful.

    Speech and Language Therapy can help you improve your communication.

    Swallow

    Dysphagia is the name given to difficulty swallowing after a stroke. It is caused by weakness or incoordination of the mouth and throat muscles. If you have difficulty swallowing, you will be assessed by a Speech and Language Therapist who will advise you about the safest consistencies for eating and drinking. These may include softer food or thickened drinks. If it is recommended, you need to alter your diet or fluids. You must follow the recommendations, as swallowing problems or an unsafe swallow can result in food or liquids going down the wrong way into your lungs. This is called aspiration and can result in a chest infection or pneumonia, which can be very serious.

    Coughing whilst eating or drinking or choking can be signs of swallowing difficulties. If you have concerns about this, your general practitioner (GP) can refer you to a Speech and Language Therapist.

    Continence

    It is common to experience problems regulating and controlling your bowels and bladder after a stroke. This may be due to damage in the area of the brain which controls the bowels and bladder or due to lack of mobility. Constipation is common and may be avoided by drinking at least 8 glasses of fluid daily and increasing your fibre intake in fruit, vegetables, cereals and whole-meal bread.

    Incontinence is a complex topic to discuss, as it can cause embarrassment. It is also assumed that little can be done to improve the problem. This is untrue. Should you suffer with your bowels or bladder, please speak to one of your team.

    Tiredness/ fatigue

    This can come on suddenly after apparently little effort. It is widespread after a stroke and could significantly impact your well-being. Your brain is working very hard to compensate for the damage caused by the stroke, and this tiredness is typical. Often an afternoon nap helps to relieve the fatigue. You should not “work through” the exhaustion as this may make you wearier. You are not lazy if you put your feet up! You are recharging your energy levels to enable you to continue with your day-to-day activities. Talk to the team about managing fatigue.

    Emotional changes

    Everyone’s response to their stroke is different, and it is prevalent to feel a range of emotions which changes over time. Feelings of anxiety and low mood are widespread, but you may also go through periods of feeling frustration, loss, grief, sadness and denial. These are normal responses to what has happened and do not require treatment unless they become a particular problem for you.

    There are many ways of managing these feelings which include:

    • Staying involved in the things you enjoyed before your stroke, even if the way you are involved, needs to alter slightly.
    • If possible, continue to see close friends and family and talk to them about your feelings. If you prefer not to speak to your family, make an appointment with your GP.
    • Accept some help to manage changes after your stroke. For example, you are buying meals to be put in the oven/ microwave rather than cooking from scratch or sharing the responsibility of your finances with someone you trust.

    These may be temporary measures whilst you are recovering.

    Emotional lability; this is an unprompted or uncontrollable tendency to laugh or cry at things, even if it is inappropriate. These emotional responses are poorly understood and not easy to control. It is estimated to affect one in four people in the first six months after their stroke and often settles with time.

    Professional consulting: ThS.BS.Dao Thi My Van

    For more Stroke: The more intention about risk, the more proper prevention | Part 3

    For more Stroke: The more intention about risk, the more proper prevention | Part 4

    For more Stroke: The more intention about risk, the more proper prevention | Part 5

    For more Stroke: The more intention about risk, the more proper prevention | Part 1