The Stroke Association Support Network of Ghana is calling on government to enroll all stroke survivors onto the Livelihood Empowerment Assisted Program (LEAP) which is being enjoyed by persons living with disabilities (PLWD).
According to the association, the absence of adequate rehabilitation services and centers in the country and the high cost of medicines for stroke survivors is fast becoming an alarming problem for relatives and family members of stroke (CVA) survivors.
According to statistics, over 600 thousands Stroke survivors are living in Ghana with stroke being the second highest cause of death in Ghana.
Stroke , sometimes called a brain attack occurs when blood flow to the brain is interrupted.
Ischaemic stroke, the most common type of stroke is caused by a blockage of blood vessels in the neck or brain, most often caused by a blood clot or severe narrowing of the blood vessels.
Hemorrhagic stroke which is the second most common kind of CVA is however caused by a break in the blood vessel which results in bleeding into the brain.
Globally someone suffers stroke every 40 seconds and it is estimated that 7 million people in the world die as a result of stroke yearly.
The Global Stroke Bill Of Right states that a person who has had a stroke have the right to receive the best stroke care and be supported in their recovery but that has not been the case for dozens of stroke survivors in the country.
Life after CVA has not been easy for many survivors in Ghana, from lost of work to stigmatisation.
Many other survivors have been rejected by friends and family members but the family members who stay on to assist their relatives who survive stroke go through challenges of their own.
With the growing concern of stroke mortality and other cardiovascular diseases in Ghana, the Stroke Association Support Network of Ghana in collaboration with GoTHERAPY an advocacy, awareness and CVA prevention organization has organised a 3 weeks community life after stroke program aimed at strengthening stroke survivors access to quality rehabilitation services.
The program has begun at the Saviour memorial hospital in Akyem-Osiem in the eastern region.
The purpose of the community base program is to empower people with CVA, their families and the communities through raising awareness, promoting inclusion, reducing poverty, eliminating stigma, meeting basic needs and facilitating access to health among others.
Robin Famatta Baker, Executive Director and Co-founder of GOTHERAPHY is worried over the lack of rehabilitation services, centers and existing structures in the country contribute to the slow pace of the rehabilitation process of stroke survivors
Rehabilitation services and drugs for CVA survivors is on a high and survivors say they need help but unfortunately government has not done much to support CVA survivors in the country.
Ad Adams Ebenezer, director of operations for the Stroke Association Support Network of Ghana is however calling on government to enroll all stroke survivors onto the Livelihood Empowerment Assisted Program to reduce the burden on stroke patients.
Source: Kofi Siaw
What you need to know about Stroke
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
A CVA is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.
Symptoms
Watch for these signs and symptoms if you think you or someone else may be having a stroke. Pay attention to when the signs and symptoms begin. The length of time they have been present can affect your treatment options:
- Trouble with speaking and understanding. You may experience confusion. You may slur your words or have difficulty understanding speech.
- Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in your face, arm or leg. This often happens just on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile.
- Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
- Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you’re having a stroke.
- Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of coordination.
When to see a doctor
Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear. Think “FAST” and do the following:
- Face. Ask the person to smile. Does one side of the face droop?
- Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise up?
- Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?
- Time. If you observe any of these signs, call 911 immediately.
Go to the hospital immediately. Don’t wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.
If you’re with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.
Causes
A CVA may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn’t cause permanent damage.
Ischemic stroke
About 80 percent of strokes are ischemic strokes. Ischemic CVA occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:
- Thrombotic stroke. A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions.
- Embolic stroke. An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus.
Hemorrhagic stroke
Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels. These include:
- Uncontrolled high blood pressure (hypertension)
- Overtreatment with anticoagulants (blood thinners)
- Weak spots in your blood vessel walls (aneurysms)
A less common cause of hemorrhage is the rupture of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation). Types of hemorrhagic stroke include:
- Intracerebral hemorrhage. In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and are also damaged.High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause an intracerebral hemorrhage.
- Subarachnoid hemorrhage. In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache.A subarachnoid hemorrhage is commonly caused by the bursting of a small sack-shaped or berry-shaped aneurysm. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow.
Transient ischemic attack (TIA)
A transient ischemic attack (TIA) — sometimes known as a ministroke — is a temporary period of symptoms similar to those you’d have in a stroke. A temporary decrease in blood supply to part of your brain causes TIAs, which may last as little as five minutes.
Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your nervous system — but there is no permanent tissue damage and no lasting symptoms.
Seek emergency care even if your symptoms seem to clear up. Having a TIA puts you at greater risk of having a full-blown stroke, causing permanent damage later. If you’ve had a TIA, it means there’s likely a partially blocked or narrowed artery leading to your brain or a clot source in the heart.
It’s not possible to tell if you’re having a CVA or a TIA based only on your symptoms. Even when symptoms last for under an hour, there is still a risk of permanent tissue damage.
Risk factors
Many factors can increase your stroke risk. Some factors can also increase your chances of having a heart attack. Potentially treatable CVA risk factors include:
Lifestyle risk factors
- Being overweight or obese
- Physical inactivity
- Heavy or binge drinking
- Use of illicit drugs such as cocaine and methamphetamines
Medical risk factors
- Blood pressure readings higher than 120/80 millimeters of mercury (mm Hg)
- Cigarette smoking or exposure to secondhand smoke
- High cholesterol
- Diabetes
- Obstructive sleep apnea
- Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm
- Personal or family history of stroke, heart attack or transient ischemic attack.
Other factors associated with a higher risk of stroke include:
- Age —People age 55 or older have a higher risk of stroke than do younger people.
- Race — African-Americans have a higher risk of stroke than do people of other races.
- Sex — Men have a higher risk of stroke than women. Women are usually older when they have strokes, and they’re more likely to die of strokes than are men.
- Hormones — use of birth control pills or hormone therapies that include estrogen, as well as increased estrogen levels from pregnancy and childbirth.
Complications
A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. Complications may include:
- Paralysis or loss of muscle movement. You may become paralyzed on one side of your body, or lose control of certain muscles, such as those on one side of your face or one arm. Physical therapy may help you return to activities affected by paralysis, such as walking, eating and dressing.
- Difficulty talking or swallowing. A stroke might affect control of the muscles in your mouth and throat, making it difficult for you to talk clearly (dysarthria), swallow (dysphagia) or eat. You also may have difficulty with language (aphasia), including speaking or understanding speech, reading, or writing. Therapy with a speech-language pathologist might help.
- Memory loss or thinking difficulties. Many people who have had strokes experience some memory loss. Others may have difficulty thinking, making judgments, reasoning and understanding concepts.
- Emotional problems. People who have had strokes may have more difficulty controlling their emotions, or they may develop depression.
- Pain. Pain, numbness or other strange sensations may occur in the parts of the body affected by stroke. For example, if a stroke causes you to lose feeling in your left arm, you may develop an uncomfortable tingling sensation in that arm.People also may be sensitive to temperature changes, especially extreme cold, after a stroke. This complication is known as central stroke pain or central pain syndrome. This condition generally develops several weeks after a stroke, and it may improve over time. But because the pain is caused by a problem in your brain, rather than a physical injury, there are few treatments.
- Changes in behavior and self-care ability. People who have had strokes may become more withdrawn and less social or more impulsive. They may need help with grooming and daily chores.
As with any brain injury, the success of treating these complications varies from person to person.
Prevention
Knowing your stroke risk factors, following your doctor’s recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you’ve had a stroke or a transient ischemic attack (TIA), these measures might help prevent another stroke. The follow-up care you receive in the hospital and afterward also may play a role as well.
Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:
- Controlling high blood pressure (hypertension). This is one of the most important things you can do to reduce your stroke risk. If you’ve had a stroke, lowering your blood pressure can help prevent a subsequent TIA or stroke.Exercising, managing stress, maintaining a healthy weight and limiting the amount of sodium and alcohol you eat and drink can all help to keep high blood pressure in check. In addition to recommending lifestyle changes, your doctor may prescribe medications to treat high blood pressure.
- Lowering the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaque in your arteries. If you can’t control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication.
- Quitting tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting tobacco use reduces your risk of stroke.
- Controlling diabetes. You can manage diabetes with diet, exercise, weight control and medication.
- Maintaining a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing as little as 10 pounds may lower your blood pressure and improve your cholesterol levels.
- Eating a diet rich in fruits and vegetables. A diet containing five or more daily servings of fruits or vegetables may reduce your risk of stroke. Following the Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.
- Exercising regularly. Aerobic or “cardio” exercise reduces your risk of stroke in many ways. Exercise can lower your blood pressure, increase your level of high-density lipoprotein cholesterol, and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to 30 minutes of activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week.
- Drinking alcohol in moderation, if at all. Alcohol can be both a risk factor and a protective measure for stroke. Heavy alcohol consumption increases your risk of high blood pressure, ischemic strokes and hemorrhagic strokes. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent ischemic stroke and decrease your blood’s clotting tendency. Alcohol may also interact with other drugs you’re taking. Talk to your doctor about what’s appropriate for you.
- Treating obstructive sleep apnea (OSA). Your doctor may recommend an overnight oxygen assessment to screen for OSA — a sleep disorder in which the oxygen level intermittently drops during the night. Treatment for OSA includes oxygen at night or wearing a small device in your mouth to help you breathe.
- Avoiding illegal drugs. Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can narrow the arteries.
Preventive medications
If you’ve had an ischemic stroke or TIA, your doctor may recommend medications to help reduce your risk of having another stroke. These include:
- Anti-platelet drugs. Platelets are cells in your blood that form clots. Anti-platelet drugs make these cells less sticky and less likely to clot. The most commonly used anti-platelet medication is aspirin. Your doctor can help you determine the right dose of aspirin for you.Your doctor might also consider prescribing Aggrenox, a combination of low-dose aspirin and the anti-platelet drug dipyridamole to reduce the risk of blood clotting. If aspirin doesn’t prevent your TIA or stroke, or if you can’t take aspirin, your doctor may instead prescribe an anti-platelet drug such as clopidogrel (Plavix).
- Anticoagulants. These drugs, which include heparin and warfarin (Coumadin, Jantoven), reduce blood clotting. Heparin is fast acting and may be used over a short period of time in the hospital. Slower acting warfarin may be used over a longer term.Warfarin is a powerful blood-thinning drug, so you’ll need to take it exactly as directed and watch for side effects. Your doctor may prescribe these drugs if you have certain blood-clotting disorders, certain arterial abnormalities, an abnormal heart rhythm or other heart problems. Other newer blood thinners may be used if your TIA or stroke was caused by an abnormal heart rhythm.
