What is a stroke?
WHILST some people may completely recover from strokes, the majority of people who have strokes often end up with some type of permanent disability.
Some people who have large strokes may become paralysed for life on one side of their body. A small stroke may result in a person having a temporary disability such as experiencing a weakness of their leg or arm for a period of time.
But what is a stroke?
In simple terms, a stroke is a “brain attack” which occurs when the flow of blood to an area of the brain stops even for a brief moment or when a blood vessel in the brain ruptures.
A woman said, “We sat down at 730am to have a quick breakfast hoping to leave for Kariba (holiday resort) at 0800am. All of a sudden I noted that my husband was confused, he couldn’t even realise that I am his wife, and he started calling me his uncle. He dropped his cup of tea and he could not stand up, I rushed him to the nearest 24-hour medical centre, and they said it was a stroke.”
When a stroke occurs, a person may either lose abilities that are controlled by the affected area of the brain such as the ability to remember things or to bend and relax muscles. The findings of this review suggest the burden of stroke in Africa is high and still increasing.
There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures. There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures.
The signs that a person has had a stroke are many and they include a paralysed face, arm or leg, confusion, vision loss, feeling dizzy, struggling to walk, speak or to understand issues (Mayo Clinic).
Strokes that are not diagnosed and treated early may result in permanent brain damage, with affected persons needing daily assistance with things such as bathing, brushing teeth, toilet and eating. Some strokes cause death.
Major causes of stroke Blood pressure is both our friend and our enemy. As our friend, blood pressure is simply the strength through which blood pushes against the sides of the blood vessels when it is moving round the body (blood circulation). Blood Pressure UK states that when our hearts beat, they pump blood round our bodies, to enable our bodies to have the energy and oxygen they need. Blood pressure becomes our enemy when it is high, because it results in the heart working much harder to pump blood to the body, thereby increasing a person’s chances of having a stroke and eventually being disabled.
Some people refer to high blood pressure as a “silent killer” because we cannot determine our blood pressure by looking at our bodies, hence some people may have high blood pressure and may not know it until a medical emergency occurs.
Another cause of stroke and ultimately disability is the presence of high cholesterol in our bodies. Cholesterol is a waxy fat like substance that is manufactured by the liver because it is needed by our bodies.
Similar to blood pressure, cholesterol can be both our friend and our enemy. As a friend, cholesterol helps us to survive by generating Vitamin D, making certain hormones and helping us to digest food (good cholesterol). However, cholesterol can become our enemy when it becomes too high due to eating fatty foods. It can then cause us to have strokes and disabilities (MacGill, 2016) as well as heart attacks, dementia, and damaged kidneys.
Preventing stroke
Continuous eating of fatty foods such as fries (chips) and fried chicken can increase cholesterol levels in our bodies (bad cholesterol), resulting in stroke and disability.
One woman said, “In my house it was everything in the pan, I would deep-fry almost anything, I loved fried food. Little did I know that I was digging a grave for myself. Last year I had a stroke and I lost my vision, the hospital said I was overweight and I had high cholesterol in my body. Now the rule in my house is very little or no fat in cooking.”
Maintaining a healthy weight is important because being overweight can increase the risk of having stroke and disability. Some people think that sitting on a sofa and watching TV all day long, whilst the housemaid serves them with all kinds of fatty foods is some form of “good living”, but the reality is that such a lifestyle is unhealthy. Maintaining a low-fat diet and healthy weight keeps our cholesterol and blood pressure under control, thereby reducing our chances of having stroke and disabilities.
Driving to and from one’s doorstep every day in the name of “good living” or “luxury” only serves to deny us physical activity. Whilst some people can afford cars that take them from one point to another, there is need to set aside time to engage in some form of physical activity such as 30 minutes of aerobics, brisk walking or jogging every day. Lack of physical activity results in one becoming overweight, having high blood pressure, high cholesterol, diabetes and increased chances of having strokes and disabilities.
People who smoke are three times more likely to have strokes than non-smokers, cigarettes contain a substance called nicotine, which makes them highly addictive. This also negatively affects blood pressure and cholesterol levels.
If you don’t smoke, please do not start but those who already smoke may benefit from quitting. Stories have been told of long-time smokers who are now paralysed and they have speech and vision problems due to strokes. Drinking too much alcohol may raise one’s blood pressure, thereby increasing their chances of having a stroke and ultimately disability. The Centre for Disease Control and Prevention in the US states that one alcoholic drink for women per day should be enough and a maximum of two per day for men is adequate. Furthermore, men and older people are more likely to have strokes than women and younger persons.
However, when women stroke, they are more likely to die than men. Risk among women is increased by contraceptive pills, pregnancy and childbirth. Certain health conditions also increase a person’s vulnerability to stroke, such as a previous stroke, heart disorders and diabetes.
Some causes of stroke stem from family histories of health issues that make people become more vulnerable to high blood pressure, high cholesterol, and ultimately disabilities.
Way forward
There is no need for all of us to become nutritionists in order to know the kinds of food that make a healthy diet which reduces the risk of having strokes and disabilities. We also do not need a lot of money in order to maintain a healthy diet, but in part we should not put a lot of salt in our food. In any case, some of the foods that constitute a healthy diet can be grown in our backyard gardens or in the village - sweet potatoes, spinach, tomatoes, carrots, okra and onions.
A Harvard Health report recommends oats porridge, soya-based food, beans, nuts, barley, whole wheat bread and fruits (oranges, lemons, grapes, apples and strawberries) and foods that are rich in fibre such as brown rice, jacket potatoes (the skin is important) and cereal.
Fatty fish (salmon, tuna, sardines, mackerel, and trout) are highly recommended. Why “fatty” or oily fish” when we want to reduce fats that go into our bodies? Oily fish contains good fats compared to the fats that are found in most meats. Margarine, fullfat dairy and red meat increase cholesterol.
If we suspect that a stroke has occurred, it is not wise for us to diagnose the stroke on our own, consulting a doctor is necessary. Early treatment of a stroke can minimise brain damage or limit complications and prevent additional strokes. We should also try to manage our health by regularly having blood pressure and cholesterol checks, so as to prevent some strokes and disabilities. ◆ Dr Christine Peta is a public health care practitioner who, among other qualifications, holds a PhD in Disability Studies. Be part of international debate on how best to nurture a society which is more accessible, supportive and inclusive of disabled people. Partner with Disability Centre for Africa (DCFA) on dcfafrica@ gmail.com