•LAGOS Doctor, ANTHONY ONWUALU Reveals
Stroke is now very common in Nigeria. Many celebrities suffer it almost on a daily basis. What are the figures for the Nigerian situation? The Nigerian Stroke Organisation (NSO) says 100,000 people suffer stroke in the country every year. And that one in four persons has a risk of developing stroke in a lifetime. In a statement issued by its President, Abayomi Ogun, to mark the 2019 World Stroke Day, the association said stroke was preventable if the risk factors were identified and controlled. Further, it revealed that the topmost 10 risk factors for stroke are hypertension, dyslipidemia, regular meat intake, central obesity and diabetes mellitus. “Other top risk factors,” it said, “include higher income level, stress, cardiac diseases, high salt intake and tobacco use; whilst green vegetable intake and physical activity are protective.” So, how can people prevent stroke and how can those who already have it manage it? These and many others were the questions City People’s Contributing Editor, IYABO OYAWALE asked Lagos Doctor, Anthony Onwualu. Find his responses below:
What are the different kinds of stroke?
The two main types of strokes are Ischemic Stroke, which is caused by the blockage of an artery, and Hemorrhagic stroke, which is caused by the bleeding of an artery. Under Ischemic stroke, we have Thrombotic stroke, which is caused by blood clots that develop in the blood vessels in the brain. We also have Embolic stroke, which is caused by blood clots that develop elsewhere in the body and travel to the brain’s blood vessels. There’s also Transient Ischemic Attack. This kind of stroke happens and resolves itself within 24 hours. Under Hemorrhagic stroke, we have Intracerebral stroke, which is caused by bleeding from the vessels in the brain. We also have Subarachnoid stroke, which is caused by bleeding in the space between the brain and the membranes covering the brain.
How does stroke manifest?
It can manifest in different ways in people. But the most common are: sudden numbness or weakness in one side of the face, arm or body, slurry speech or difficulty understanding speech, blurry vision, loss of balance and coordination, loss of control of some bodily functions, and sudden defecation.
Who is at risk of suffering a stroke?
Risk factors for stroke include: if you are 55 or older, if you’re obese, black people have higher rates of stroke, history of strokes in the family, lack of physical activities, smoking, and diabetes.
How can stroke be managed?
To manage stroke at home (this should be after you have been discharged from the hospital), the patient should manage their weight, be on a healthy diet, stop smoking and drinking alcohol, start an exercise routine, manage blood pressure, and go for regular medical checkups.
Can people who suffer partial stroke be cured?
I will not say “cured” in the sense of it, but with a good health care regimen and physiotherapy, you can live at least a good normal life. Some of your movements may be slower than usual but you will be able to function properly.
How can stroke be prevented?
The best advice would be to live a healthy life, and that involves, eating healthy meals and drinks, maintaining a healthy weight, engaging in regular exercise, stopping smoking, limiting alcohol intake, checking your cholesterol regularly, and controlling blood pressure and diabetes.
What significant challenges do stroke survivors face?
They do face a lot of challenges but I think the most painful challenge I have seen or experienced is not being able to do things for themselves. Not being able to bathe or go to the toilet themselves. You need assistance to eat, wear clothes, and move.
Most stroke survivors see themselves as burdens on their loved ones or caregivers. This can sometimes lead to isolation and depression.
The perceived shame of not wanting people to see you as you are now is also a big challenge. It is not easy at all.
Living with a stroke has costly short and long-term complications. Can you elaborate on them?
Well, this is heavy on the family. To break down the cost implications:
·Physiotherapy at least 4 times a week
·Live in nurse or caregiver
·Constant medical checkups
·The mental health toll on both patient and family that a lot of people overlook.
These are just a few cost implications and this is post-hospital discharge. The cost of hospital treatment is another head-wrangling issue; especially in Nigeria. It is not an easy burden to bear, financially or psychologically.
What advice do you have for caregivers of stroke survivors?
Learn everything about physiotherapy and communication. If you are lucky, your patient will be a good one but most of the time, a lot of stroke survivors are angry and distant, some have self-pity which is all understandable, as a caregiver, patience, and understanding should be your watchwords.
What are the statistics of stroke sufferers in Nigeria?
According to a study done in 2008 by Kolawole Wasiu Wahab (a Professor of Medicine (Neurology) & Director of Centre for Research, University of Ilorin), the current prevalence of stroke in Nigeria is 1.14 per 1000 while the 30-day case fatality rate is as high as 40%.
How can people take responsibility for their health to avoid having a stroke?
Eat a healthy diet, exercise more often, quit smoking, limit alcohol intake, etc.
What role does high blood pressure play in having a stroke?
To put it as easily as possible, the higher your blood pressure rises over a period of time, the higher your chances are of having a stroke.