Suffering a stroke hurts everyone in the family
Suffering a stroke hurts everyone in the family
By Maria Kegel
JAKARTA (JP): At 38, Liswar Saybi had it all.
He was a high-income executive who was promoted to marketing
manager the year before at a major timber company.
But in December 1982 Liswar suffered a stroke that paralyzed
his entire left side and impaired his speech.
"I lost everything. It was so emotional -- I cried every day.
Moving my body was the biggest difficulty for me."
He said he could not continue his career, and subsequently had
a nervous breakdown.
The company paid for his one month hospitalization, and his
family supported him. Physiotherapy and speech therapy helped him
regain some of his independence, but it was slow going.
About one and a half years later, he was introduced to a
pediatric nurse by his neighbors, and "my situation improved
after we got married".
Secretary of the Indonesian Stroke Foundation Dr. H. Suhardi
said the effects of stroke are felt emotionally, economically and
socially both for the victims and their family.
He said the patient deals with anger, repeatedly asking "why
me and why can't I walk".
They can overreact to simple situations, get angry easily and
have mood swings, and if the anger is allowed to continue, it can
lead to depression, he warned.
Jaka Ahmad was 10 years old when his father had a stroke. He
said his father subsequently became bad-tempered, and he found
himself "hating him because of it".
"Everything my two sisters and I did seemed to be wrong. He
used to be a very active man, but then all he could do was spend
time in a wheelchair or in bed."
It took one and a half years before family members could
adjust to the situation, but Jaka said even now, 14 years after
his father's stroke, there were still family upsets.
A specialist in rehabilitative medicine at Cipto Mangunkusomo
Hospital, Dr. Widjaja Laksmi, has worked extensively with stroke
victims and their families.
"It's really a difficult time for both the family and the
patient, so when we do rehabilitation, the family and patient are
present here together," she said.
Frustration runs high as the patient may be able to understand
what is being said, but they cannot respond, she said, adding
that the stroke's impact could make them either overconfident or
underconfident about their abilities.
"Strokes affect productive people in their 40s and early 50s
who might be at a top position in their company. Suddenly they
may have to walk with a cane, but they are not mobile enough and
cannot communicate, so they are no longer the decision makers or
teachers, and this lowers their income substantially."
Effects
Widjaja said the number one complaint from families was the
stroke's effects on the victim's cognition, such as a loss of
memory, distorted perception, having little or no attention and
behavioral changes, depending on the location of the stroke.
"A daughter whose mother had a stroke reported that the
patient was angry every day and wanted to watch violent movies."
A stroke happens when a blood vessel, or artery, supplying
blood to the brain bursts, or becomes blocked by a clot.
The nerve cells in that area are damaged and die off within
minutes, and, as a result, the area of the body controlled by
those cells cannot function properly.
The stroke's effects can be temporary or permanent, ranging
from mild to severe, depending on several factors: how much of
the brain was affected; which brain cells were damaged; and how
quickly the blood supply was restored to the affected area.
A person's vision, behavior, speech, thought processes, and
the ability to move parts of the body can be affected. At worst,
a stroke can cause coma or death.
A common example of behavioral changes is a patient will
neglect the side of the body that is paralyzed, which is usually
the left side.
They might forget to slip their left arm through a sleeve when
dressing, saying that it's not their hand, or they eat what is
only on the right side of their plate, so caregivers have to
rotate the plate for them, Widjaja said.
"It's a denial of anything that comes from the left side, so
we have to talk to them from the right side as they won't pay any
attention to what's happening on the left."
Changes in behavior stem from the fact that the stroke affects
the central nervous system.
"There will be a lot of life changes and the problem is how to
adapt now to the challenges and to cope emotionally from the loss
of employment and the struggle to be independent," she said.
A neurologist at the Gatot Soebroto Army Hospital, Dr. Hardhi
Pranata said slurred speech, difficulty in swallowing or chewing,
paralysis of the limbs, a loss in memory and control of bodily
functions were just some of its many effects.
To reduce the risk of a second stroke, survivors take for the
next several years to life a brain metabolic activator and an
antibloodlet aggregation, he said.
Suhardi and Hardhi cited the main risks leading to stroke that
are controllable as: hypertension caused by excessive salt
intake; cardiac problems; diabetes; cholesterol levels in the
diet; smoking; being overweight; inactivity; stress and blood
viscosity.
Hardhi explained that people with two or more of these factors
were at a higher risk than others and should adjust their
lifestyle to help lower their chances of having a stroke.
"Those living in the city have a higher fat intake from eating
at fast food outlets, for example, while in rural areas people
have a different diet, but because they consume more salt, they
run risks, too."
Risks
There are other risks that people are not able to control,
which include age, medical history, the occurence of a previous
stroke and heredity.
"Sex and race are also major contributors to the risk of
stroke, with Africans having higher odds than Causcasians. And
although men are more susceptible to strokes, once women reach
postmenopausal age they run the same risk," Hardhi said.
He added that people often overlooked stroke symptoms, which
may include:
* A sudden developed difficulty in understanding or speaking
simple sentences.
* Blurry or impaired vision in one or both eyes which does not
improve with blinking.
* Any new paralysis, weakness or numbness that appears in your
leg, arm or face, and especially on one side of the body.
* An unexplainable but sudden and intense headache, which is
nothing like you have experienced before.
* Severe dizziness or a loss of balance or coordination,
especially if another warning sign is present at the same time.
If any of the symptoms disappear, usually within 10 minutes to
20 minutes, they should not be ignored, but instead treated as an
emergency.
Suhardi said strokes were on the increase in the country, and
both doctors were concerned about a trend of younger people
suffering them.
Although the average age of a person who has one is 55 years
old, people in their 20s are having them, Suhardi said.
He attributed the development to increased drug abuse.
"There is a higher incidence of strokes among drug users.
(Drug abuse) is a major risk factor, contributing to high blood
pressure -- it is a real trap for our people," he said.