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World Stroke Day-Time saved is brain saved

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Tenzin Lhaden

October 29 is marked as โ€˜World Stroke Dayโ€™ and theme this year for the day is โ€˜Precious Timeโ€™.
The Bhutan Stroke Foundation observed the World Stroke Day. The main mission to celebrate this day was to facilitate and create better stroke care toward fulfilling Gross National Happiness and to formulate and facilitate holistic, inclusive stroke therapeutic services and stroke related research.

The World stroke day was marked to create an informed public of the risks and the signs of stroke, to draw Government attention and influence policies on rising cases of stroke, prevention of stroke, better stroke treatment and long term stroke care in the country, to promote non-medical, home-based and community-based rehabilitation services for stroke patients so that they can return to jobs or seek new jobs or start a business and be once again a productive citizen. The day is also market to foster partnerships with the Ministry of Health, hospitals, international and national universities, research institutes and CSOs, and to facilitate, collaborate and commission stroke research and be the national body solely focused on stroke.

A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die. A stroke can cause lasting brain damage, long-term disability, or even death.

โ€œI knew about strokes only when my wife has to go through it. Her deteriorated health even caused me depression as I was not able to do anything about it. Therefore I started this Bhutan Stroke Foundation in 2019. However, due to Covid 19, we could not do much on it. We recently started working on it from 2021 and it has been about two years now,โ€ said Dawa Tshering, the founder of Bhutan Stroke Foundation.

Doctor Tashi Tenzin, Jigme Dorji Wangchuk National Referral Hospital, said that when the whole part of the brain does not get blood supply, it is called ischaemic stroke. The second one was called hamraaz stroke wherein the part of the brain will be bleeding because of either blood presser or because of some other conditions.

When somebody gets stroke, there are signs and symptoms. The signs and symptoms of a stroke vary from person to person but usually begin suddenly. Common signs and symptoms are sudden numbness or weakness in the face, arm or leg, sudden difficulty in speaking or understanding, or sudden state of confusion, sudden trouble seeing with one or both eyes, sudden trouble in walking, sense of dizziness, loss of balance or coordination, sudden and severe headache with no known cause.

โ€œWhen blood supply to the brain is interrupted, a stroke, also known as a transient ischemic attack or a cerebrovascular accident, occurs. As a result, the blood cannot deliver nutrients and oxygen to the brain. Brain cells start to die within minutes of being deprived of oxygen and nutrition. If it damages brain cells, sudden bleeding in the brain can also result in a strokeโ€ said Dr Tashi Tenzin.

He further added every second counts when a person is having a stroke. Time is extremely valuable as brain tissue and millions of neurons start to deteriorate. In the nation, non-communicable diseases are to blame for 70% of fatalities. If the person gets the stroke once, one must take a medication for the rest of their lives, and if they forget to take one, it will lead to another ailment. However, many people are uninformed of strokes, and very few people are aware of them. In our lifetimes, 1 in 4 of us will experience a stroke, and each year 6.5 million people pass away as a result. The number of stroke cases is rising alarmingly, even in our nation.

โ€œSince Bhutan is a GNH nation, health care is free. However, free smoking has just been allowed in country, which runs against to the countryโ€™s commitment to free services. One such cause of strokes is smoking and alcohol consumption. Another cause is that we, the Bhutanese are so fond of dry fish. The saltiness in fish is hazardous for the health. However, strokes can be prevented by living the healthy life, 30 minute of exercise in a day is must and also by having a healthy dietโ€, doctor added.

Bhutan has basic stroke cares because stroke was mainly caused by heart disease, because of blood pressure and diabetes.

Many of these are caused due to life style; smoking, alcohol and rich dietary intake which leads to diabetes and heart diseases leads to hypertension and other diseases.

Bhutan and in many other countries, the most common cause of stroke is blood pressure. Some of them are treatable within the country and others have to be referred outside the country. Since the scope of promise for a stroke patient depends on the time speed to start treating stroke as to minimize damage of the brain, India becomes the nearest and best option for the referral.

There are some patients which can be treated within 4 hours of stoke, with the blood thinner medicine called TPA, Thrombolytic therapy. This treatment is available in the hospitals of Mongar, Gelephu and Thimphu.
โ€œWhen the potential stroke patient is brought to the hospital, immediate CT scan of the brain is taken which takes 3 to 5 minutes. Then we know whether it is a bleeding or it is lack of blood supply in the brain and immediately, the blood thinner can be given. And if patient reaches beyond 4 and half hours, then there is other treatments which is called cloud removal. But right now in Bhutan, we do not have such facility and it may take some years for Bhutan to have such facility,โ€ said Doctor Tashi.

Many developed countries have facilities for very fast treatment but in Bhutan even the basic things which are there are not able to be availed because of the delay in the treatment.

The distance from the hospital and the delay in identifying and referring on time could make all the difference of stroke patientโ€™s life. That 4 and half hours delay, has slimmer chances and more likely to lead either death or disability. And globally, the second is the leading cause of death to stroke patients. โ€œWe donโ€™t have exact figures how many people die from stroke but then the incidents of stroke and prevalence of stroke may indicate that many are dying from stroke,โ€ doctor added.

With regards to the prevention, over 90% of cases of stroke can be prevented because it is all life-style related diseases. Eat healthy, live healthy and keep stroke at bay.

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