Rehabilitation is vital
UNIVERSITI Kebangsaan Malaysia Medical Center senior consultant neurosurgeon Associate Professor Datuk Dr Jegan Thanabalan said it is difficult to predict how much improvement there is going to be in stroke survivors as it depends on the site and extent of brain tissue involved.
“However, don’t give up. Stroke survivors need to have their rehabilitation sessions,” he said.
He added that young patients need to be motivated as it will improve their chances of recovery.
Dr Jegan explained that recovery is dependent on which part of the brain is affected as different parts of the brain control different functions.
“In general, the right brain controls the left body, and the left brain controls the right body.
“If you have a stroke on the left side of the brain where speech is the dominant area, then you may have severe speech disturbance,” he said.
Although recovery depends on which part of the brain is affected, Dr Jegan said for stroke survivors, recovery must start from the day they suffered a stroke.
“Improvement will occur within the first six months to a year after the stroke.
“In that time, it is important to make sure that proper rehabilitation is carried out. Patients can’t miss that golden time period.
“We want to prevent progression of the stroke and improve outcome,” he said, adding that having good family support, motivation and constant physiotherapy sessions are important factors in improving a patient’s well-being.
Statistics by NASAM reveal that stroke is the second leading cause of death in Malaysia, with more than 50,000 people suffering a stroke every year.
Dr Jegan said diabetes, hypertension and cardiac diseases are major contributing factors to a stroke.
“Hypertension is a major influence in stroke. We know that it can occur even in the young, and we have seen that happening. Maybe it is the lifestyle, the stress at work or it could also be due to certain medical conditions,” he said.
He also said the majority of young stroke survivors were not aware that they had risk factors that could lead to a stroke.
“Not having it and not realising you have it are two very different things. If patients are in the highrisk group, then they must have a medical check-up and a proper follow-up.
“Also, if your lifestyle is not on par with what is acceptable, then you need to change it,” he said.
Thus, he advised Malaysians to control their disease and not let the disease control them with proper lifestyle modifications and medication.
Dr Jegan also said stroke does not just affect the patient but also the family.
“The family will have to devote their time to take these patients for rehabilitation as having a stroke patient in the family can be challenging.
“Sometimes, even the family needs counselling,” he said.
Dr Jegan said that if the family support is strong, then the rehabilitation for the stroke survivors will also be better.
“Some of the patients can’t move and they are placed in front of the television for long periods of time.
“This may not be the best thing for them,” he said.
He added that stroke survivors need to “train their brain”, and be taken to rehabilitation sessions.
“Having group sessions with other stroke survivors and sharing their experience and challenges can be motivating for the patient and even for the caregivers,” he said.
He listed caregivers as the most important person in the treatment plan.
“It is not the doctors or anyone else that are with them at home. It is the caregivers at home that play a vital role in rehabilitating stroke survivors,” he said.
He added that caregivers have to learn what sort of rehabilitation is needed for the patient from the rehabilitation specialist.
“They need to care for their loved ones to prevent secondary problems like pressure sores, contractures, venous thrombosis and urinary tract infection.
“How to exercise them, carry them, and transfer them, that is why physiotherapy and rehabilitation is so important.
“Caregivers need to accompany the patient to these sessions and take part so that they can learn how to do these for them at home,” he said.