01 May 2011
By Rachel Chan
One day last June, Mr Lim Jew Hong woke up to find that his mouth had become crooked and slanted to one side. He also had difficulty speaking.
Suspecting that he had suffered a stroke during the night, the 74-year-old quickly asked his daughter to send him to hospital for emergency treatment. At Singapore General Hospital (SGH), doctors confirmed that Mr Lim suffered a stroke and prescribed treatment that included physiotherapy. Three days later, he was discharged. Half a year later, he made a full recovery.
Early treatment helps
Mr Lim was lucky to have survived – only a third of stroke patients do. Another third become permanently disabled, and the rest die from it. In Singapore, stroke is the fourth leading cause of death and the No. 1 cause of disability. Worldwide, 15 million people suffer a stroke each year.
But it wasn’t just luck that played a part in Mr Lim’s recovery. His decision to seek treatment quickly may have been a more important reason. According to Dr Mohammed Tauqeer Ahmad, Registrar, Department of Neurology, National Neuroscience Institute, SGH, early treatment can stop a mild stroke from turning more severe, which in turn can lead to disability or even death.
“If a patient is seen within three-and-a-half hours of stroke symptoms occurring, a clot-busting drug can be given which can stop the stroke from progressing,” Dr Ahmad said, adding that other treatments such as surgery or physical therapy can also be effective in curbing the disease’s advance if the patient is treated within 24 hours. The time window is important as powerful drugs like blood thinning medication is only effective when used within the first three to four hours of a stroke occurring.
Stroke symptoms may go away within hours of appearing, lulling patients into thinking they had experienced nothing serious. As a result, they may delay or not seek treatment. “Our data suggest that more than 50 per cent of SGH stroke patients seek treatment only 24 hours after symptoms occur,” said Dr Ahmad. “But, if left untreated, a stroke can progress from mild to moderate, and from moderate to severe.”
Get out of bed
Early treatment is vital as quickly returning blood supply and oxygen – through drugs or surgery – to the area of the brain that has experienced a bleed or blockage helps stop or reverse damage to the brain cells. When the cells are permanently damaged, the parts of the body that they control will not be able to function properly or at all. That is why many stroke patients are left paralysed on one side, or have difficulty walking or talking.
As well as medical or surgical treatment, physiotherapy also makes up an important part of a stroke patient’s recovery plan. Resting in bed can lead to the muscles getting weaker, said Ms Dawn Tan, Principal Physiotherapist, SGH.
Indeed, said Dr Ahmad, recent studies have found that exercise therapy can be started very early. At SGH, physiotherapists begin therapy on patients during their stay in hospital, while nurses also encourage them to get up and about.
“During physiotherapy sessions, we move the patient’s hands, legs and joints. With this mobilisation, we believe that the patient’s condition can improve,” said Dr Ahmad.
Stroke patient Mr Lim believes he benefited from physiotherapy. “The exercises were easy and helped me to move my arms and legs. The physiotherapist guided me through the exercises which lasted an hour,” he said.
After patients are discharged, physiotherapy and exercises remain a part of their treatment, in addition to medication and regular checkups.
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