To Prevent Stroke, Eat Rough Carbohydrate

Dr. Enoma Alexander Bazuaye, is Consultant Physician, Humanist Hospital, Effurun, Warri, Delta State. A papal Knight of St. Sylvester; an alumni of the University of Benin, Edo State, Nigeria and Freedom College of Medicine, Newcastle-upon-Tyne, England, Bazuaye spoke to NATH OMAME, Jr. on stroke; stress; the relationship between stress, stroke and heart attack; the warning signals and the role diet play in managing stroke.

What is stroke?
Stroke is a sudden disturbance to the cerebral blood flow. In order words, there is a sudden disturbance in the blood flow to the brain which disrupts its function. And this results in a sudden weakness of one side of the body, usually manifested in the weakness of the hand and the leg which can also affect the mouth, leading to slurred speech.

What about heart attack?
Stroke is different from heart attack. Stroke is the brain equivalent of what happens in heart. In heart attack, there is usually a blockage of the blood vessel. In the case of stroke, there could be a blockage of the blood vessel or the rupture of the blood vessel which could lead to a dysfunction of the brain. In the case of a heart attack, a blood vessel that leads to an integral part of the heart is blocked, thereby, impairing the function of the heart.

What factors inspire stroke and heart attack?
Any condition that can affect the blood vessels can cause stroke or heart attack Diabetes is a major cause of stroke. Patients with high cholesterol level are also prone to stroke. Any diseased condition that can cause a blockage of the blood vessel or a rupture in the blood vessel can lead to stroke; some are major while some are minor.

Even a minor case of blood clot due to a sickle cell disease can lead to stroke. A heart disease that leads to the formation of clot in the heart that may travel to the brain can also lead to stroke.

Can lack of rest precipitate stroke?
Yes…yes, lack of rest can precipitate stroke. Inability to rest can cause the blood pressure to rise or shot up. Inability to rest can cause other emotional factors that may lead to instability of the body system which could lead to stroke. So, the factors that may lead to stoke are many.

Can sleeplessness or insomnia lead to stroke?
Well… prolonged effect of insomnia or sleeplessness can lead to stroke. Sleeplessness or insomnia are associated with restlessness, and if the person concerned already have the underlying factors of stroke, then, yes, insomnia or sleeplessness can lead to stroke after a long period due to the prolonged effect of inherent stroke factors.

On their own, sleeplessness or insomnia don't usually cause stroke. However, sleeplessness may aggravate blood vessels that are already weak, leading to a rupture or other complications.

Does diet have any meaningful effect on stroke?
Well, yes, in the sense that diet can be a risk factor. If a person regularly takes a diet rich in bad cholesterol, such cholesterol, can in the course of time, clog the blood vessel and with time such a person can actually have stroke.

In this circumstance, what sort of diet would you recommend?
To prevent stroke, one needs to have a healthy life-style of which diet is one of them. It is important to eat right. It is advisable to take rough carbohydrate. Rough carbohydrates are energy giving foods, such as gari; yam; plantain; rice; amala; agidi; semovita, among others. It is unhealthy to eat too much of refined carbohydrates. Refined carbohydrates are sweetie foods such as cakes, flour, fruit juice, nonalcoholic beverages, among others.

Excessive consumption of refined carbohydrate can make a person become fat which could increase the blood level of cholesterol and this could lead to stroke. People should eat healthy carbohydrate and not diet rich in fatty acids.

It is imperative to eat plenty of vegetables, fruits and food rich in protein to reduce the risk of having stroke. To attain a state of calorie balance, regular exercise is important. Exercise is not the same thing as physical activity. Some people say they exercise daily because they go to work, or, trek to the market. Those are not what I mean by exercises.

An exercise is an activity that increases your heart beat to a particular level. And it is advisable you do that regularly, preferably as a daily routine, for thirty minutes.

Will you also recommend such an exercise to people who naturally are weak, or, who have a weak heart?
Nobody is weak naturally. A person can have a particular weakness in a particular part of his body, but that does not make him a naturally weak person. If one has not lived a healthy lifestyle over the years, of course, the heart could be weak; the kidney could become bad, or suffer a stroke, but that does not mean that he is weak naturally.

Some children, due to the circumstances of their birth could be said to be weak and floppy, but for adults, no adult is weak naturally.

What sort of treatment do you normally give to a patient that has stroke?
When a stroke victim is brought the hospital, the first thing the doctor does is to examine the patient to be sure the patient actually has a stroke. In some cases, it may look like a stroke, but not really a stroke.

Here and now we are talking about real stroke. The doctor will examine the level of the stability of the patient. The doctor needs to assess how functional the patient is; is the patient conscious; or is he having upper level consciousness?

The outcome of the assessment will determine how the doctor will manage the patient; either to pass the catheter to help the patient pass out urine or to prevent the patient from vomiting.

The level of the patient's consciousness will determine what the doctor can do for him. It is important to ascertain what part of the brain is actually affected because that will assist the doctor to manage the patient's condition.

The impact of the stroke could be more on the upper limb or lower limb. The doctor needs to carry out a thorough assessment so that he can draw up a long term rehabilitation programme for the patient.

There is need to also determine the cause of the stroke. It is easier to manage the patient if the cause of the stroke is known: whether it is caused by a blood clot or by a rupture of the blood vessel.

On clinical grounds, a thorough examination of the patient may reveal that the stroke was caused by an overlap of symptoms or signs that may be difficult to ascertain. So, the best way to resolve the situation is to do a Computerised Themographic Scan, (CT-Scan), which will reveal the type of stroke, whether it is the bleeding type or blockage type that he has.

The CT-Scan is helpful because knowing the cause makes it easier for the doctor to apply the appropriate treatment. If it is the blockage type, there are drugs the doctor gives to the patient that could prevent further blockage. And if it is the bleeding type and the centre for such treatment is available, then, the patient can be taken there for the clot to be removed from the brain. Unfortunately, it is not an easy thing to do here in Nigeria due to the inaccessibility of sophisticated equipment.

The doctor also needs to assess the patient and draw up a rehabilitation programme that best suits the stroke victim. The extent of the stroke on the brain will determine the programme of drug stability. The doctor should try to mobilise the patient on time if the condition is a minor stoke or a pre-stroke.

In some cases, a doctor can get the stroke victim walking and talking in two weeks. But a second stroke after a first stroke could be dangerous. The rehabilitation programme is usually longer and could take six months or even longer. Unfortunately, some victims never come out of it.

The age of the patient also determines how fast stroke patients respond to treatment. A younger patient would most likely recover faster than a stroke victim who is 65years old. A younger stroke patient would respond to treatment faster because of a better blood circulation in the brain compared to that of an older person.

Family support, psychotherapy and the motivation of the patient are very important. If the patient gives up hope and says, oh!, it is all over, this is the end, then, he may not cope with the treatment, it becomes a matter of his words and what he wishes himself.

What is stress?

Stress is an unusual situation which makes a person to respond to what he doesn't usually encounter in a day-to-day activity. The word stress is used when such a situation becomes a negative situation.

However, stress is something necessary and it is part of human reaction to any condition. We have what we call normal stress, also known as used stress. It is when the pressure on an individual is beyond what an individual can adequately respond to that we say such a person is going through a stressful situation which is usually counter productive.

However, stress is something necessary and it is part of human reaction to every condition.

We have positive stress and negative stress. Positive stress is the normal situation that helps a person to carry out daily activities in every day life.

When a person has a target or anticipates an event which he thinks he cannot meet, then, that can lead to a reaction that can be counter productive and the body will normally express these negative developments in some ways due to the release of some chemicals such as adrenaline in the body.

When the quantity of adrenaline released inside the body is not excessive, such quantity being a normal development is usually of great importance to the body. It helps you to stand firm; gives you energy; sharpens your intellect; keeps you focused; makes you work harder and achieve your goals.

But when you now believe that the task ahead of you is too difficult and that you cannot possibly succeed, then the amount of adrenaline that is released increases; the release of other hormones in the body also increases; and you find out that other unhealthy features begin to appear in the person's body.

The person then develops heart palpitation; reoccurring headache; restlessness; becomes easily agitated; irritated; develops abdominal pain; diarrhea; urinary problems; and in the case of women, irregular menstruation or temporary seizure of their monthly menstrual flow. Stress can affect any part of the body.

How can stress be easily managed?

The easiest way to manage stress is for the person that is going through a stressful condition to know and accept that he has stress. He needs to identify the factors that provoked his stressful condition, so that the factors can be removed. Even if the stressful condition can't be removed, the stressful person should have hope. Being hopeful is a positive sign that the stress can be alleviated. Stressful patients who are hopeful of a positive solution to their problems need some form of psychotherapy. The use of sleeping pills offer only short term solutions; they make the patients sleep for a short while, but the problems remain.

Can a happy family life reduce stress?

It is obvious that a man who does not derive happiness from his marriage is bound to experience a stressful life. The family is the fundamental unit of the society, so happiness at home is important. A happy family is a family where there is no stress.