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Elizabeth Muchechetere shares her in-depth insight on Strokes and recovery

“My personal view on stroke is that it is a challenging, complex and difficult condition to treat and manage, and it requires both the healthcare and public to play a part in preventing, treating and managing it. This May we need to help raise awareness so that we are ready to tackle it ”
 
Timing Is Everything!

With one in four people being affected by Stroke, these numbers are too high and we need to get them down. I believe stroke is still such a big issue within the UK due its complexity. We know it is an issue and we know the information is out there, but we are not ready and if we are not ready, it can be detrimental. It can be disabling and is known to be one of the leading causes of death if one does not receive immediate and timely medical attention in the UK (Stroke Association Statistics).
 
 
Treatment

Treatment and rehabilitation in my experience is slow and challenging and many take some time recover, but there is always hope. I have also noticed that those who have previously lived an active lifestyle tend to see more improvement than those who have not.
 
One big issue is that there can be long waiting lists for rehabilitation following discharge from hospital and discharge from follow up early supported discharge (ESD) rehabilitation in the community. Frustratingly some patients still require more rehabilitation, but may not be able to access it. As a result, 65% stroke survivors leave the hospital with a disability (The National Report – Stroke Association).
Elizabeth Muchechetere - Strokes and recovery

Types

There are two main types of stroke; ischaemic, which is due to a blocked blood vessel in the brain, and haemorrhagic, which is following bleeding in the brain.  According to the national clinical guideline for stroke by the Royal College of Physicians (2016), about 85% of all strokes are ischaemic and only 15% are haemorrhagic.

Thoughts

British Home is a neurological care home with 80 residents.  34% of our residents have been affected by Stroke, and they all present differently, and therapy is tailored to suit presentation. These are people who never thought a stroke could happen to them and they are all from different walks of life.  Engaging in rehabilitation can be challenging for our residents as they realise life has changed and they are required to put in a lot of work in their rehabilitation with the help and support of our dedicated therapy and care staff, and family input.  I have seen how devastating this could be as at times during rehab, it is important to stop a session and give emotional support and explanation why rehabilitation is important as some may lose hope as the effects of stroke will have caused big changes in their lives.  I have also noticed that those who have previously lived an active lifestyle tend to see more improvement than those who have not.  Anyone can be affected by stroke!
The effects of stroke affect not only the person who has had a stroke, but families at times struggle to come to terms with the sudden vast changes and the teams supporting can also go through many challenges in giving treatment and rehabilitation.

Tackle

According to Blood Pressure UK, stroke is a major cause of death in the UK and the largest cause of disability, but six out of 10 strokes could be prevented by managing blood pressure to a healthy level.
 
So it should be easy to prevent? However, for every 10 people diagnosed with high blood pressure, 7 remain undiagnosed and untreated, and this is more than 5.5 million people in England – data collated by the (NCVIN, 2016). Meaning, not all cases are tracked so can’t be prevented. We now know the treatment of HBP significantly reduces the risk of strong among other conditions (Stroke statistics, 2017), however the number of people diagnosed as having HBP has consistently increased since 2005, (NHS Digital, 2016) and is not slowing down.
 
To tackle stroke and its effects, both the public and healthcare must have a part to play.  The healthcare continues to speak about stroke and how it affects individuals, but the public need to listen and be more aware of the vast information around stroke, its effects, symptoms, management of risks like high blood pressure, diabetes to mention a few.

Diabetes is reported to double the risk of stroke (a paper on Cardiovascular Disease Outcome Strategy by the Department of Health, 2013).  High cholesterol can increase the risk in developing a blood clot which can lead to a stroke therefore it is important to treat and manage it.  Alcohol consumption in large quantities increases the risk of having a stroke while smoking doubles the risk of death from stroke.

With all that in mind, the best way to help prevent a stroke is manage those underlying conditions, avoid smoking and alcohol, and eat a healthy diet, not forgetting regular exercise. Moderate exercise can reduce one’s risk of stroke by up to 27% (Lee CD et al., 2003), while inactivity and a sedentary lifestyle increases risks of an ischaemic stroke by 50% (WHO).

The Future

While there is hope as innovation in the healthcare industry is increasing and improving, there is still a need in the public balancing the stroke risk factors; high blood pressure (HBP), diabetes, high cholesterol, increased alcohol intake, smoking and lack of physical activity (Stroke statistics, 2017), which pose more challenges in stroke occurring and recovery.  We all know what we need to do to help prevent stroke, so it is important we start practicing it.

Sadly some people leave home for work daily, possibly have a stroke at work and never return home.  With stroke, life can vastly change without a warning and we all need to do better to change this. It is everyone’s duty, where possible to take ownership of our health and well-being.