Friday, 28 June 2013

Stroke Recovery in Stoke on Trent

“When you have a stroke, you must talk slowly to be understood and I have discovered that when I talk slowly, people listen. They think I’m going to say something important.” - Kirk Douglas

Just the very mention of the word stroke strikes fear into the minds of most people. It conjures up images of disability, or losing the ability to speak and, in severe cases, even to death. One stroke survivor told me that after suffering a stroke his life quality had changed so dramatically that he sometimes became so depressed and frustrated that he had moments when he regretted having survived. But there is hope, and there is help available too.

Harry (not his real name) was the last person one would have thought was a high risk candidate. He has never smoked or drank, carried no extra weight and has enjoyed a stress free life. He is in his seventies and his wife in her mid eighties. One morning, without any warning, he slumped over the breakfast table. Until the stroke he had enjoyed good health. Harry is a musician. He had been an accomplished organist and choirmaster, teaching the organ and playing in his local parish church. His enthusiasm lead to the installation of a small pipe organ in his house. It is fair to say that music was his life. The stroke has left him incapable of using his left arm and leg. He will never play again. He now depends almost totally on his wife which adds to his frustration. He is now dependent on mobility aids. There is much help available. If stairs are a problem then a stair lift is the answer, used in conjunction with other aids such as a wheelchair, walking sticks and frames and a bath lift, together with regular physiotherapy.

Harry and his wife have now had the stress of moving home to Stoke-on-Trent to receive excellent care based at the University Hospital of North Staffordshire where people suffering Stroke are more likely to survive than anywhere else in the country and also to be near to family as extra support.

Our Stroke service in Stoke on Trent

A stroke occurs when the blood supply is cut off to the brain. Blood carries essential nutrients and oxygen to the brain, and without a blood supply, brain cells can be damaged or destroyed, and are not be able to do their job. Strokes occur in different parts of the brain, and can result in damage to your body, dependent on which part of the brain has been affected. For example, if the part of the brain which controls how limbs move is damaged, the ability to move can be damaged or even lost.
. Source: University Hospital of North Staffordshire NHS Trust
When a person shows symptoms of having a stroke, speed is essential and ringing 999 should never be delayed. Much is being done on TV and in the media to alert the public to F.A.S.T.
Just how common are strokes?
                                Males                   Females               Total
UK                          19,287                   30,079                   49,366
England                15,824                   24,743                   40,567
N. Ireland            489                         750                         1,239
Scotland              1,889                     2,875                     4,764
Wales                   1,085                     1,711                     2,796
It is interesting to note that women appear to be at greater risk of stroke than men.
How can I reduce my risk of having a stroke?
Most medical information suggests that the risk of having a stroke can be reduced by five actions:
Blood pressure 57-365
(Year 3)
Stopping Smoking
Cutting down on how much alcohol you drink
Eating a healthy diet - cut down on salt and fatty foods
Taking regular exercise
Having regular blood pressure checks

Are there signs of hope for stoke patients?

According to the BBC News website, one current experimental procedure involves injecting stem cells into the damaged area of the brain. Science correspondent Pallab Ghosh reports that a UK company is applying for permission to transplant stem cells made from human foetal tissue into the brains of stroke patients. ReNeuron, based in Guildford, has told the BBC that they have what they are calling ‘convincing evidence’ that damaged brain cells, as a result of a stroke, could potentially be regenerated.

Professor Keith Muir of Glasgow University has expressed “surprise” at the moderate improvements in the five patients trialled. However, he stresses that it is too soon to tell if the progress can be attributed to the procedure. The results will be presented at the European Stroke Conference in London.
One patient, 80 year old Frank Marsh, has reported encouraging changes in his condition. The normal period during which some improvement may naturally occur following a stroke is twelve months. Frank had his stroke five years ago. His wife said that he had reached a plateau and progress had stopped. Following the treatment he has gained some hand movement and can now dress himself, tie his shoe laces and hold on to things. To regain such simple actions, which the rest of us take for granted, must bring huge hope to the stroke victim.
Like my friend Harry, Frank is a musician and shares the frustration of no longer being able to play. In Frank’s words “I’d like to get back to my piano and walk a bit steadier and further.”
Source:  BBC News 

What are stem cells?
Stem cells are the body’s raw materials from which all other cells, having a specialised function, develop. If we think of the cell stems as the ‘parent’ then as the cells divide ‘daughter’ cells are produced. These either become new stem cells (self-renewal) or become specialised cells (differentiation) with a specific function such as blood cells, brain cells, heart muscle or bone. Cells can be genetically manipulated to regenerate or repair diseased or damaged tissues.

Who may benefit from stem cell therapy?
In the broad term, we all do because certain stem cells can be used to test the safety and effectiveness of new drugs.

More specifically, benefits may be seen in patients suffering spinal cord injuries, type 1 diabetes, Parkinson’s disease, Alzheimer’s, heart disease, burns, cancer and stroke.

Amongst the latest reported research, involving injecting stem cells into the area of damaged brain of stroke survivors is not without controversy. Scientific research involving both human and animal research and resources is always subject to ethical questioning.

The stark fact is that stroke survivors are currently not going to make a full recovery but who knows what future treatment may achieve. It is more a case of learning to adapt to the situation, aided by some excellent support from the heath experts, suppliers of mobility aids and, very importantly, self help and dedicated carers. It is worth repeating that physical symptoms are not the only obstacle to
be overcome. Understandably, patients experience levels of depression and frustration, sometimes taking this out on those who are caring for them, ironically often those to whom they are the closest such as their partner or children.

What help is out there for carers?

As well as the GP and Occupational Therapists, informed information is available from organisations whose knowledge is based on first-hand experience.
‘One in ten people in the UK is a carer.Being a carer can be a kind, admirable and selfless act. At times though, it can be challenging and carers have told us that they sometimes feel overwhelmed,exhausted and isolated. Stroke is a sudden and serious condition and can come as a shock. Suddenly seeing a loved one unwell can be very upsetting. You might not understand what has happened or may find it difficult to know how to support them. It is natural to feel overwhelmed, but as you come to terms with what has happened, you might want to know how you can help.’


Stroke exercises and treatment

Moving around safely is taken for granted, unless you suffer a stroke. Some survivors experience paralysis of an arm and/or leg, and balance issues add to the difficulties. Some 40% of survivors suffer serious falls within a year of suffering their stroke. Weakness in a muscle or group of muscles results from the inability of brain signals to get through and of course lack of movement results in the muscles becoming weaker. Exercise and movement is essential and a regular programme of exercises set out by an expert physiotherapist is very important. Many of these exercises can be done whilst sitting or lying down. Swimming can be excellent, but of course always under correct supervision. Walking, bending and stretching are all beneficial. Experts warn against fatigue and all exercise regimes should be tailored to the individuals needs.

Treatment is a combination of therapy and medicines. In addition to the motion exercises, splinting or casting can be used to give support or to straighten a foot twisted by muscle weakness. The release of chemicals which cause muscle contraction can be inhibited by the use of botulinum toxin.

Stroke and Kinetics

One other area of interesting therapy is that of kinetics. The ability to use kinetics or 3D pictures of movement, may hold a link to a new procedure to assist with the rehabilitation of stroke survivors by gait analysis, the study of how people walk. The leading research is taking place at Missouri University. It is claimed that cameras installed in people’s homes to collect data and analyse their movement may be able to act as an early warning system to health issues including falling and mobility impairment, providing advanced movement analysis for physiotherapy.  

Meanwhile, at the Royal Berkshire Hospital in Reading, UK, Kinect games are being used to help rehabilitate stroke patients. Titles such as Kinectimals and Kinect Bowling help redevelop coordination following a trauma. Doctors say that the ability to focus on natural movements and activities is vastly beneficial over the traditional physiotherapy where patients would be stretched and pulled to rebuild sensation and muscle strength.

There are also mobility exercises for rehabilitation and stroke recovery based around neurophysiotherapy.  An enterprisinig firm in New Zealand has combined clinical therapeutics developed at Otago in New Zealand ,which is a worldwide centre of excellence in falls rehabilitation, with a computer to help rehabilitate upper body function after a stroke.

Here's a video of it in action.

In conclusion, suffering a stroke is a cruel and debilitating trauma but there is a great deal of help available and the future holds some exciting possibilities to give hope to all, both survivors and carers.  If you would like to visit your local Stoke mobility aids showroom we can show you some of the products that other stroke survivors have found useful, indeed necessary in their new phase of life.