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Stroke of Alfonso
- Written by Alex Zuniga, PT
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After so many years working with many stroke(CVA) patients, I have been made acutely aware of the outcomes of this very cruel disease. It strikes with very few warnings. Anyone can never be 100 percent safe from it if he is meant to have it. I have worked with stroke patients who were either the healthiest people in the world or the most unhealthy people. Stroke can occur due to unhealthy habits, of course, like smoking, eating wrong kinds of food, stressing out, the likes. Then there are those who stroke like it is some kind of destiny or fate. They palpitate and stroke out. They sit in an airplane for hours and throw a clot and stroke out. Young mother delivers a baby and strokes out. Unlucky fellow undergoes a surgery, mostly one involving carotid arteries, or repair of a small bowel obstruction, or an orthopaedic surgery, a heart surgery, a pacemaker placement and then - strokes out. And of course, there are those who carry the most perfect ingredients for a stroke - diabetes, high blood pressure and high bad cholesterol. So there is a lot of valid reasons for a stroke and anybody can have a very high risk for stroking.
I am not blogging here to tell you all about the medical and physiological basis of stroke and how to address it comprehensively, that would involve volumes but I want to share simple stories, these are stories of the stroke people I meet everyday who show the human angle of a condition that we sometimes think as only a disease. I see the impact of this horrible disease on real people everyday and this gives me all the more reason to avoid it as if my life depends on it.
Imagine waking up in the morning in a strange hospital bed being turned and washed and assisted by people you’ve never met before. You don’t feel half of your body and you can not move it either. You, a man who just yesterday was so independent, who was probably working, maybe playing golf, maybe managing the people around you, maybe teaching the brightest minds in the country, maybe proud of your past sports glory or health glory are now right there on a strange bed in a strange room in a strange hospital, surrounded by strange people you’ve never met before.
Someone will roll you on one side to wipe you clean after placing that miserable bed pan underneath you. Then another would poke your private part to attach that dreadful catheter. And the worst is when they get you up. You realize you are so dizzy you’d fear of falling, and that fear, that fear will dominate your life from that point on. Fear of falling, fear of looking again at yourself on a mirror, fear of losing your identity, your freedom, your independence, your speech, your job, your usefulness, your reliability and you start crying, moaning, losing sleep and wondering - what happens now?
Alfonso did not trouble himself when he felt dizziness associated with some right side weakness. He is 48 years old, has three kids and one is about to go to college so steady income from work is necessary. His dizziness is probably due to lack of sleep last night and as for the weakness on his right side - ah, he probably got some muscle strain from lifting heavy machinery in the sugar mill he works. Maybe he hit some nerves - how many co-workers complain of muscle weakness after work? And how they all felt better after a few days. The body rights itself anyway after a few days. If this gets worse, maybe then he’d see a Doctor, but right now, he doesn’t want to appear weak, you see, men aren’t supposed to be weak. Men are the strong, unbreakable, invincible pillars of society. He is a father. He has mouths to feed.
He showered, dressed and came to work.
It hit him big time at work.
His dizziness got very severe, his right side became number and weaker. He stumbled. Could not walk. He could not speak clear words. He was brought to the local hospital where Stroke was automatically diagnosed. He was then ambulanced to a bigger hospital that offered Comprehensive Stroke treatment. In this bigger hospital his Stroke was confirmed. Associated with that were his high blood pressure, a sugar reading of over 400 and high cholesterol. These were all made worse by his history of smoking.
So now Alfonso is right here in front of me, staring at me but really not looking at me. He frequently smiles and when he verbalizes his meaningless utterances, I have to conjure in my mind what they mean - what could he be saying to me?
Stroke is one of the most devastating diseases a man could suffer from. Why humans suffer it the most, I don’t know. I may be mistaken here, but I don’t hear of dogs and cats and horses stroking out. What is in our human anatomies that lead us to develop a clot, have that clot travel and be blocked in the smallest vessels of our brains until that part of the brain, deprived of nutrients and oxygen, fails ? What is in our anatomies that would explode our blood vessels due to high blood pressure until (similar to clot) deprives a part of the brain of life? These are questions that may baffle us forever and maybe someday we’d find an answer and hopefully medical immunity - (don’t we all wish to have a vaccination against strokes and heart attacks?) But for now, the best safety measure we can do is prevention and reduction of risks.
Majority of us know some of those risks can be controlled while others cannot be. The things we can do to control risks include proper diet and nutrition, exercises, avoiding smoking and stressing. Other things we can can control either via lifestyle or medication include hypertension, diabetes, heart palpitations, development of clots, and high cholesterol. And the best way to manage them is to know them. So a Doctors appointment, even for simple check up can save us a lot of sorrows later.
Alfonso would eventually recover from his Stroke’s acute phase to begin his very very long recovery. I try to be cheerful but the mantle of sadness had already descended upon him.
It is very easy to descend to depression when you get sick. The prospect of becoming subnormal is akin to being subhuman. Every time you get up you will need someone to assist you especially during the early phase. Sometimes you’d have to rely on a bedpan, or a commode where someone you’d never met before will handle the most intimate and private tasks you usually manage privately by yourself. And God forbid you get the non-committed health workers (and there are some of those), you’d be in a struggle between anger, resentment and intense desire to regain back independence but cannot.
Close your eyes and imagine this: You are in a dark hospital room, awake and unable to move half of your body. You call for help and no one comes until minutes later. You watch a TV show you never wanted to watch, your eyes travelling to the hands of the clock on the wall ticking non-stop. Imagine how many you could have done if only you were independent. How many walks, how many drives, how many working hours, how much time spent with friends and families you could have spent were you not confined in this hospital?
Stroke is no laughing matter.
Although stroke is like any other disease which we can never prevent if we are meant to have it, there are a few things I follow myself to minimize its occurrence on me. I am emphasizing the word ‘minimize’ here.
First thing first: Check with your MD. Pay close attention to blood glucose (most especially A1C), blood pressure, cholesterol. Other conditions you might want to know are heart conditions especially atrial fibrillation. And family history. If most of your family had stroke, you are also at risk. If you need to medicate, please do.
Quit smoking if you are a smoker. Eat healthy and try to achieve your BMI which is your ideal body weight according to your height. My BMI is 169. I am currently at 165.
To help you with that ideal BMI goal, diet and exercise go hand in hand. Diet should be ideal - avoid extremes. Increase variety. Reduce portion size.
Weigh yourself regularly.
Buy a blood pressure reader. If you are suspicious of heartbeat abnormalities, get a hold of O2Sat reader which can read both your oxygen sat level and heart rates on a constant basis. And if diabetic, please read your sugar frequently.
With exercise, always start slow. Avoid crowd-drivers if you must. Crowd-drivers are those who are always trying to set the pace of any work-out. These are the people we are drawn to follow. I personally avoid them because I do my own pacing and cadence. I build up my exercise routine based on how I feel, not who I can keep pace with or worse, who I can beat.
Most of all, do not undervalue rest and de-stress. Avoid fatigue points. And if you get fatigued whether at work or with family and friends or to many things to do at home, please stop and take slow breaths. Or better, discover a hobby that will take your mind away from it all. Walk in a park or close to the beach. Watch a good movie. Read a good book. Sleep.
Then if after all these you still suffered a stroke, you can tell yourself you did all you could do and will feel less guilty about it.
Diabetic Journey 5
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One thing I can tell you is this: No matter how bright and perfect our life plans could be, there will always be a disruption somewhere. Either we succumb to the disruption or beat it by ignoring it. It is both saddening and enlightening for me. Here I am, living my pseudo perfect world: Running, losing weight, maintaining my glucose levels, enjoying my new found place in Lake Worth where I can run to the beach nearly everyday, walk among the neighborhood clubs before I call it a day, even work out in a gym less than 2 blocks away from my condo when suddenly a family member gets sick and I am the only one who can help. In an instant, I become a caregiver.
My perfect life was thrown out the window.
I was immersed into emotional turmoil, work re-arrangements, financial losses, stresses left and right with Doctor’s appointments, lab appointments, shopping for medical equipments, teaching the sick family member independence while I am away working - whew! I lost sleep, I lost my flow of exercises, I even missed some meals. Then I had to deal with my anger. Anger because the cause of all these disruptions was something preventable if only the patient had listened to what her body was telling her.
This makes me stop and ponder about life - now I see this inevitability of life’s destiny - we are born, we live a bumpy ride of a life, then the ride will involve other passengers we need to take care of, and then, we die. I know this is kind’a morbid. But I refuse to succumb to it. One thing I learned in my hospital work is that, when a family has to deal with a member’s incapacitation due to illness, the whole dynamic of their lives is interrupted and (more than once) I saw a spouse, a child, a parent or sibling abandon everything in their lives to fully embrace endless worrying. And I am not lying when I say that once, a patient’s wife died of heart attack while visiting her sick husband in the hospital. Recently I had a patient whose mother died while he was going through rhabdo that resulted into his amputation. And everybody blamed him for her death due to her worries. Worst of all, she’s all he got.
I need to emphasize this: Sickness is inevitable and no amount of worrying will help that sickness. When I see a patient’s family looking haggardly, unkempt, teary eyed constantly, I advise them to go somewhere, find a resting place, forget the reality for a while. It is seriously unfair to damage oneself due to something that is part of Nature whether we are prepared to handle it or not.
I now have a first hand experience dealing with unexpected family member’s health crisis - yes, I lost sleep over it, yes, I was angry, yes, I kept on visiting and visiting, dealing with insurance, dealing with home equipments and home health follow ups and what’s next and then next after that. Surgery? Disability? I resorted to working non stop (thinking that working non-stop will make me forget). One night, the stress simply broke me down. My blood pressure shot up and I became dizzy at one point.
I realized that I too, can get lost in a world of despair.
I needed to find a way to protect my health. I abandoned my worry. It was much easier for me because I can resort to Computer Programming. I somehow sensed in my earlier life that soon, given my age, I have to deal with some crisis such as this and I must have something to resort to to prevent the ill effects of worry. So I took computer programming. My other options are exercise and maybe reading but running can exhaust me quickly and reading? I can easily lose the book I am reading when I worry. Sometimes having friends or bigger family can help and I am not lucky to have many of those around me here.
That is a lesson or a message I can impart to whoever becomes a caregiver one of these days. It is inevitable in our lives and we must be ready to handle it when it comes. It is important to discover oneself’s interests and passions that can temporarily transport us away from the current worries of life. It is also important to nurture as many ‘real’ friends as we can or at least be nearer to family that could shield us from despair.
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