What it takes to recover from stroke

Nusura Namaganda had no idea she could ever suffer from a stroke, until it happened to her in January 2011.
She woke up one morning to discover she could not move her body. The left side of her body—from head to toe had been paralysed. She was immediately taken to Mulago National Referral Hospital.

At the hospital, after doctors confirmed Namaganda had suffered a stroke, she was put on drip and given medication. The doctors also examined her for high blood pressure—a key risk factor for stroke.

But her blood pressure was normal, and so she did not have to stay long in the hospital. A few days later, Namaganda was discharged and aised to undergo physiotherapy instead.

First, she went to a clinic near Mulago hospital, before a relative told her about the Stroke Rehabilitation Centre. It is here that Namaganda spent the next three months undergoing therapy.
Today, the 33-year-old says the quick response to get her to the facility is the reason she is able to talk again. “After the stroke, I have even managed to give birth to another baby who is healthy and doing well,” says the mother of six.

Dramatic recovery
Namaganda’s husband, Sheikh Twaha Tumwesigye describes his wife’s quick recovery as dramatic. “When it first happened, we did not know what the problem was. We just rushed her to the hospital and it is from there that the doctor informed me that my wife had suffered a stroke,” says Tumwesigye. He adds: “She could not do anything on her own, we had to lift her from one place to another. She did not talk for a few months after the stroke.”

What is stroke?
According to Ibrahim Bukenya, the principal physiotherapist at the Stroke Rehabilitation Centre, stroke is an attack which is caused by the interruption of blood flow to the brain.

This happens when there is blockage of blood pressure to the brain, or when there is a burst of the blood vessel.
“Stroke is an emergency. As soon as a person experiences weakness on one side of their face, they should go to the hospital. They should in fact use an ambulance if they can get one,” he says.

Key risk factors
The World Health Organisation says over the years, there has been a global increase in the number of people who suffer strokes, with common risk factors being obesity, diabetes, high blood pressure, high cholesterol in the body, smoking and alcohol abuse.
People prone to migraines also have a high risk of suffering stroke.

Age and genetics are also common predisposing factors for stroke.

While there is no available data to show the extent of the problem in Uganda, Bukenya says the number of survivors seeking rehabilitation services at the centre and other rehabilitation facilities is growing.

“This year alone, we have seen at least 80 survivors. Many more people could be going to other facilities or not seeking services at all because they do not know where to go,” he says.

Rehabilitation
Rehabilitation is an important part of recovery after stroke. Health experts say this helps a person to re-learn skills they lost when the stroke affected part of their brain and body.

At the centre, Namaganda underwent speechphysiotherapy as she had lost the ability to speak and engage in daily activities.

“We took her through various classes of language therapy and trained her to walk again. I can say her recovery has been 95 per cent successful,” Bukenya says. He says most of the cases of stroke survivors that the centre receives return to normal life after rehabilitation.

“We teach them basics such as washing, bathing and feeding. We also train them to use their legs and hands because most stroke cases affect the limbs,” he says. He says after rehabilitation, it is important for a person to keep practising the skills that they have regained.

Bukenya says stroke affects individuals differently, and the recovery rate also depends on the extent of the damage that a person has suffered.

“That is why it is impossible to tell immediately after a stroke if or when a person will be able to return to the day-to-day life that they lived previously,” says Bukenya.

Recovery
Until recently, the treatment of stroke was restricted to basic life support at the time of the stroke. Now, however, experts say treatment can be beneficial when administered soon after the onset of the stroke.

The chances for survival and recovery are also best if treatment is administered as soon as a person who has suffered stroke is taken to a health facility.

“Treatment must be given within four hours after a person has suffered stroke for better outcomes,” Bukenya notes.
After 48 to 72 hours, he says there are no major interventions available to improve a person’s outcome. And when a person is affected on both sides, in what is commonly known as double stroke, the chances of rehabilitation and recovery are minimal. “Also, when a person’s sugar and blood levels fail to be controlled after a stroke, they rarely recover,” says Bukenya.
Generally though, recovery can take between a few months to as long as two years.

Counselling
He says counselling should also be made part of the recovery programme.
“The first counselling is usually given to the caretakers because we need to teach them how to take care of a stroke survivor,” says Bukenya. It is after this that the survivors are also taken through a counselling session to explain to them how to cope and the things they can or cannot during the healing process.

Awareness
However, lack of awareness about strokes remains one of the biggest challenges in trying to address the problem. Bukenya says the public needs to be sensitised on how to identify warning signs.

SSEMANDA’S TESTIMONY

“My name is Stephen Ssemanda. I am 70 years old. In April 2014, I suffered a stroke that paralysed half of the right side of my body. On that fateful day, I woke up early and went through my daily routine.

I am retired so I spend most of my time at home. After going through all my chores, I felt a little dizzy and decided to take a rest.

Little did I know that in the process of resting, I could suffer a stroke. It was one of my sons who found me lying on the bed. I was non-responsive. I was immediately taken to Mulago National Referral Hospital where I spent two days.
The doctors said I had suffered a stroke and gave me medication before I returned home. I have never suffered from heart attack or high blood pressure so it came as a surprise that I could suffer a stroke. I do not even take alcohol. I could not walk, talk or even respond to touch. I also had difficulty with my bowel movement. I did not go to the toilet for over a month.

After being discharged from hospital, I decided to go to pastor Samuel Kakande’s Synagogue Church of all Nations, where they prayed for me. That prayer has been helpful and it is what gives me hope of recovery. The members of the church have also been offering words of encouragement, which has been crucial in my healing.

Physiotherapy
It was from church that I first learnt about the Stroke Rehabilitation Centre. Since coming here, I have been taken through physiotherapy to help me use my limbs gain. I have also been going through speech therapy to help me talk again.

When they first brought me here, I could not walk, talk or move my hands and body. But with the support at the centre, I am slowly learning to make use of my limbs again. At the centre, they teach us to do the things we used to do before we suffered stroke. I can even stand without any support now. In the next few months, I hope to regain all my body functions and return to my normal routine. These days, I come to the centre once a week.

SYMPTOMS TO LOOK OUT FOR

A stroke is caused by the interruption of the blood supply to the brain. This happens when a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue.
Unlike a heart attack, most strokes are painless.
Therefore, the following symptoms should prompt a trip to the hospital as soon as possible.
•Numbness or weakness of the face, arm or leg, especially when it happens on one side of the body.
•Confusion, trouble speaking or understanding speech.
•Difficulty seeing in one or both eyes.
•Difficulty walking.
•Dizziness.
•Loss of balance or coordination.
•Sudden, severe headache with no known cause.
•Fainting.
•Unconsciousness.
The effects of stroke depend on which part of the brain is injured and how severely it is affected. A severe stroke can cause permanent disability or sudden death.

THE NUMBERS
According to the World Health Organisation (WHO), there are an estimated 15 million people worldwide who suffer a stroke each year. WHO says it is the second leading cause of death for people over the age of 60, and the fifth leading cause in those aged 15 to 59.
Every year, nearly six million people worldwide die from stroke, and one in six people worldwide will have a stroke in their lifetime.

elirri@ug.nationmedia.com

SOURCE: Daily Monitor

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