Coping With Stroke – How?
A LEADING cause of death and chronic disability in the Western industrialized world is stroke. The very word “stroke” implies the suddenness with which a “brain attack” occurs. One moment, you may be feeling fine, and the next moment, you feel as if you were hit by a bolt of lightning-a major stroke can abruptly and dramatically change your life. Cruelly maiming and crippling you, it may render you speechless, wreak havoc on your emotions, alter your personality and powers of cognition, and thrust upon you a seemingly endless struggle to regain the normal life you and your family once knew.
Consider Ellen Morgan.* On Wednesday, Ellen was a healthy, active 64-year-old. On Thursday, while shopping with her husband, Ellen suddenly lost her ability to speak, and her face became distorted. Her body weakened, and she lurched as if in a drunken condition. Ellen was suffering a major stroke!
In the aftermath of the stroke, Ellen was so disabled that she could not do the simplest of things, like bathing or dressing herself. Unable to write, knit, or sew, she became plagued with bouts of uncontrollable weeping and overwhelming fatigue. In all of this, Ellen’s thought processes were not impaired; however, feelings of embarrassment would arise when she felt that perhaps others looked upon her as a simpleton. Later, Ellen explained: “Few realize how the shock of this sudden change affects one emotionally and psychologically. I almost felt as though it were the end of my existence as a person.”
What causes a stroke? Is everyone who has a stroke affected in the same way? How have survivors coped with this disease? How do families of stroke survivors cope? What can all of us do to provide support?
STROKE—Its Cause
THE brain is the most delicate organ of the body,” states neurologist Dr. Vladimir Hachinski, of the University of Western Ontario in London, Canada. At only 2 percent of the body’s total weight, the brain contains more than ten billion nerve cells, which are in constant communication to produce our every thought, movement, and sensation. Dependent on oxygen and glucose for energy, the brain receives a steady supply via an intricate system of arteries.
However, when any limited part of the brain is deprived of oxygen for even a few seconds, delicate neuron functions are impaired. If this persists for longer than a few minutes, brain damage results, as brain cells begin to die along with the functions they control. This condition is called ischemia, a lack of oxygen mainly caused by artery blockage. Further damage is inflicted on brain tissue as oxygen starvation triggers a deadly cascade of chemical reactions. The result is a stroke. A stroke also occurs when blood vessels rupture, flooding the brain with blood, which cuts off connecting pathways. This disrupts chemical and electrical flows to the muscles and causes injury to brain tissue.
Its Effects
Every stroke is different, and strokes can affect individuals in ways that are almost limitless. Although no one suffers from every possible consequence of a stroke, the effects may range from mild and barely observable to severe and painfully obvious. The area of the brain in which a stroke occurs determines which bodily functions are impaired.
A common affliction is weakness or paralysis of the upper and lower limbs. Generally, this is limited to one side of the body, the side that is opposite the side of the brain where the stroke occurs. Thus, right-brain damage results in left-sided paralysis, and left-brain damage, in right-sided paralysis. Some individuals may retain the use of their arms and legs, only to find that their muscles shake to such an extent that their limbs seem to go off each in its own direction. The victim looks like a novice skater trying to keep his balance. Dr. David Levine, of New York University Medical Center, says: “They have lost the kind of sensation that tells them whether or not their limb is moving and where it is in space.”
Upwards of 15 percent of survivors experience seizures, resulting in episodes of uncontrolled movements and, commonly, in periods of unconsciousness. Also, feeling pain as well as changes in sensations is common. A stroke survivor who experiences constant numbness in his hands and feet says: “There are nights when something touches my legs and I wake up because it seems as if I am receiving electric shocks.”
Stroke outcome may include double vision and problems with swallowing. If the sensory centers of the mouth and the throat are damaged, further indignities can be suffered by stroke victims, such as drooling. Any of the five senses can be affected, causing disturbances in sight, hearing, smell, taste, and touch.
