Friday, November 15, 2019

Stroke care and prevention

Oct 21. 2019
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Welcome to the Health Talk programme of Thonburi Healthcare Group (THG). The Here is THG’s Jin Well Being County (a senior living complex with comprehensive medical services in Rangsit area of Bangkok).

Dr Tanatip, Medically, we call it a cerebrovascular disease, while people generally call it paralysis or hemiparesis and it can affect the face or legs. Sometimes, patients are bed-ridden. This disease is among the top killers in Thailand.

Statistics shows that there are an annual 400,000 fatalities in Thailand with cancer being the No 1 killer accounting for about 70,000 deaths, followed by cardiovascular and then cerebrovascular diseases, each accounting for about 35,000 deaths. Together, the number of deaths is about 70,000.

 

Then, road accidents lead to another 20,000-plus deaths.

 

All these factors account for nearly half of the total fatalities annually. In fact, both heart attack and then brain attack are caused by blood vessel problems. Both diseases have a high fatality rate. If you survived these two diseases, then there could still be challenges since your capacity could have been reduced from say 100 per cent to 70, 60 or 50 per cent. That means the quality of life will be affected, causing concerns among medical professionals as well as family members and relatives.

 

Who are among the high risk groups? Generally speaking, senior citizens with diabetes, high blood pressure and cholesterol etc are among the risky groups. Risk factors are similar to those of heart or renal diseases. However, we’ve started to see younger stroke patients as young as 45. Lack of exercise is another factor.

 

Please talk about F.A.S.T. This is a method to observe those who may have suffered from the cerebrovascular disease. The first F represents face or facial drooping. Some people will have facial drooping or facial numbness. A represents arm as they may have arm weakness or leg weakness or both. Then, S stands for speech as people suffering from stroke may have difficulty to talk as the disease affects a part of the brain that controls speech.

 

T stands for time. Worldwide, we have been campaigning for a fast track to treat stroke patients. The golden period for patients to get medication to address the blood clotting problem is within 4-5 hours. The sooner is the better. It will enhance the effectiveness of treating stroke patients. If the patient is  treated within the first 4-5 hours of suffering from the disease, the outcome can be as high as a 70 or 80  or even 100 per cent recovery.

Can you talk about caring for stroke patients?  Yes, that depends whether it’s ischemic stroke which is due to the lack of blood flow or it’s hemorrhagic which is due to bleeding , both of which resulting in parts of the brain not working properly.

 

In the former case, patients can be treated with injection of medicine to address the blood clotting problem. Regarding the hemorrhagic case, it’s more challenging, as patients may need a brain surgery. The acute care period is the first 4-5 days after treatment.

 

Afterwards, it is the rehabilitation process for a better recovery. Patients need physical therapy to regain their muscle strength after suffering from stroke since our muscles will lose strength if they are not used for two weeks or longer. Once the brain recovers, the patient can then return to use their arms and legs.

What is Jin Well Being’s service for patients needing rehabilitation? In fact, we’re planning to open a new hospital especially for this patient group as well as those with chronic illnesses (inside Jin Well Being County) to provide long-term care. The planned Thonburi Burana Hospital will have no surgery room as it is designed to mainly provide rehabilitation care and related services so patients may return to a normal lifestyle as soon as possible.

 

In addition, Jin Well Being has residential units with a friendly environment allowing the patients’ loved ones and relatives to visit with ease and comfort. Altogether, here is a place like your  home and a hospital, especially for patients who need long-term care. They don’t need to go to a big hospital with all state-of-the-art facilities since their medical condition is no longer critical. The big hospital is also very expensive, costing more than 10,000 per day. However, these patients cannot stay at home either, due to the need for professional healthcare.

 

We provide all medical and nursing services while family members and relatives can come here as often as they like and there is no restriction on visiting hours. We also have a lot of walking space with gardens and trees as well as fitness and other facilities.

 

More importantly, the patients will live in a community of those who have similar challenges so they will make friends and give one another moral support. Those who have seen improvements from the rehab process can also help cheer up newcomers. This is a very important and useful feature of staying here to recover and return to a normal lifestyle.

 

What’s your advice on stroke prevention in the first place, especially for younger age groups from 40-45 years onwards?

 

Generally speaking, you have to manage your diet and avoid being overweight, exercise regularly at least 3-4 days a week. If you have high cholesterol or high blood pressure, it is necessary to put it under control either by changing your lifestyle or medication. You may try to lose weight and do more exercises to manage these risk factors.

 

In the event that you have had a stroke and survived with a reduced physical capacity of, say, 60 or 70 per cent, you can still live another 20 or 30 years. Just don’t lose your will power.

 

Last but not least, what is the cerebral aneurysm? Is it related to stroke? Regarding cerebral aneurysm, there are many causes and in some cases the causes are unknown. An analogy is like a water hose for gardening (blood vessels in the brain) is somehow swollen, doctors may do a surgical clipping to isolate an aneurysm.

 

There are cases that such an operation is performed before bleeding, that’s an effective treatment. In other cases, it may be too late, patients may not survive or may suffer paralysis. After all, prevention is always better.

We thank Thonburi Healthcare Group and Jin Well Being for the venue. Please contact them for further information on the long-term care service.

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