Kamis, 03 September 2015

INCREASE YOUR ENDURANCE AFTER STROKE

Train like a triathlete with discipline and persistence.

As an Ironman triathlete and occupational therapist, I often tell my clients that their rehabilitation after stroke is similar to my training for a triathlon. It takes persistence, discipline and desire to make progress as an athlete, just as it does to meet the short- and long-term goals in rehab.

                                                                     Walking exercise w/therapist
                                           Treadmill w/therapist

There are many days when I wake up tired and do not feel like going to swim practice before work. But I go because I know the importance of steadily and slowly building strength. There are also times when I do not feel up for the 3-hour bike rides.

It crosses my mind that skipping a workout will not matter in the long run. But once I get going, I always feel better and stronger. By mid-season, I find that climbing hills on my bike for long stretches is actually easier and more enjoyable because I did the prep work for my endurance in the off-season.

                                                                Walk over granule stone


Endurance is a key factor in rehab after stroke. It is actually a very complex part of rehab because it must be built slowly, yet steadily, in order to positively impact the daily routine.

There is a rule of thumb that states,  “for every day spent in bed or in the hospital, one week of physical activity is required to regain the strength that was lost.”                                     
                                                                                             Semi ICU room


Stroke survivors must start slowly and accept that building endurance again will and  should take time if approached correctly. Keeping this in mind, a survivor should work together with a therapist to create measurable and reasonable goals with slow increases in difficulty.

                           
Persistence is important when building endurance. We do not always see the small gains we make, often mistaking this for not making any progress at all.

A survivor may feel ready to stand in the shower again rather than sit on a tub bench. But in reality the body is building the endurance needed to tolerate such a complex activity. If someone is able to handle two minutes of standing at the start, consistency in rehab will steadily increase those minutes to three, four, five and even more over time. The greatest successes happen over time, not overnight.

Discipline is also very important when building endurance. It takes the guesswork out of deciding whether or not to do the exercises or go to therapy every day. Following a basic routine in order to stay active will most likely directly increase endurance.

Committing to a program is committing to oneself. Survivors owe it to themselves to do those additional repetitions of each exercise every day, or add one new exercise to the routine weekly to increase strength and endurance.

Caregivers can help this process by giving the person encouragement and support during the rehab process. Desire is one of the most important components of building endurance.

I can encourage clients to perform activities or exercises during a therapy session. However, I cannot make them do the programs at home. In order to see long-term changes that will move them ahead, the survivor has to want to improve.

That is how they will notice six months later that they are now able to stand in the shower again. With persistence, discipline and desire survivors can slowly, yet steadily, build endurance and positively impact their daily routines. Again, caregivers can help give motivation and feed a survivor’s desire to make progress.


Jumat, 14 Agustus 2015

BINGUNG WAKTU TERSERANG STROKE

                                                            Lepas kateter

Dalam medio Augustus 2015 saya menerima email dari 3 orang yang tidak saya kenal, sedang bingung menghadapi kejadian yang tidak terduga sebelumnya yaitu serangan Stroke orang tua masing masing. Email itu dikirim setelah membaca pengalaman saya yang tertulis di blog ini dengan judul "Stroke batang otak pada umumnya meninggal?"

Ketiga orang tua mereka kena serangan stroke yang sama dengan saya Stroke Batang Otak.
Yang satu mengalami serangan seluas 90% yang kata Dokter tidak ada harapan ternyata terjadi mujizat dan masih hidup.
Yang kedua, katanya dirawat di ruang ICU setelah pindah dari kamar Intermediate atau Semi ICU dan masih memberikan respons.
Yang terakhir, setelah 4 hari di kamar Intermediate sudah pindah ke ruang perawatan biasa hanya tensinya masih tinggi dan naik turun. Selama 5 hari kami terus berhubungan melalui email.

Mereka bertiga sedang bingung apa yang harus dilakukan dan apa yang boleh dan tidak boleh dilakukan. Saya menyarankan beberapa hal dibawah ini :

1. Jangan mengkonsumsi obat lain selain yang diberikan oleh Dokter karena satu pasien diberi obat herbal, yang menurut saya belum tentu cocok dengan setiap pasien dan obat herbal belum melalui proses Laboratorium sebagaimana obat apotik.

2. Jika sudah dikamar perawatan biasa, maka tiap hari agar dirawat perawat physio therapy selama 1 jam agar tangan atau kakinya jangan sampai bengkok nantinya.

3. Setiap 1- 2 jam badannya dibalik dan diganjal bantal agar punggungnya tidak panas karena lama berbaring.

4. Pada umumnya, 4 hari pertama kondisi pasien semakin memburuk, tetapi jangan kuatir, pada hari ke 5 keadaan akan menjadi lebih baik. Jika hari ke 5 tidak membaik juga, kita harus siap menerima yang terburuk.

6. Jika nanti sudah dirawat dirumah, maka dalam 5 - 6 bulan setelah serangan yang disebut Golden period agar diusahakan ke physio theraphy tiap hari, baik ke Rumah Sakit ataupun therapisnya datang kerumah pasien dan latihan jalan di taman atau di Mal setiap hari setelah berjemur di panas matahari sampai jam 9 pagi.

                                                           Latihan di R.Sakit

7. Makanan dan minuman harus betul betul dijaga dengan menghindari makanan yang mengandung gula dan kholesterol.

8. Lain lain bisa bibaca dalam berbagai  Topik di blog ini www.paskastroke.blogspot.com

Setelah memberikan saran tsb diatas, pada hari ke 5 (lima) saya mendapat email dari pasien ke 3 yang mengejutkan :"Ternyata Tuhan lebih sayang kepada Ayah saya", tulisnya dengan mengatakan jam 3 pagi Ayahnya meninggal dunia.

Sedang yang dua orang lagi tidak menjawab email saya lagi dan tidak tahu bagaimana perkembangannya. Tapi yang pasti pasien yang diserang Stroke Batang Otak masih ada harapan hidup seperti saya, yang survive selama 3 tahun stelah Stroke.







Senin, 27 Juli 2015

VIDEO JANGAN MENYERAH, NEVER GIVE UP



                                                               

                                                                

Rabu, 17 Juni 2015

HUBUNGAN JANTUNG DENGAN STROKE

                                                       How the heart work

Jantung berfungsi memompa darah keseluruh tubuh termasuk ke saraf otak. Jika tekanan pompa jantung lemah dan disertai menyumbatnya pembuluh darah menuju ke otak, maka aliran darah dan oxygen ke otak berkurang maka terjadilah stroke. Stroke terjadi karena asupan darah dan oxygen tersumbat tidak mencapai otak.

"Jantungnya normal", begitu saya mendengar komentar dokter jantung kepada perawat setiap visit ke ICU dimana saya dirawat selama seminggu karena stroke. Mulut saya pelo, tidak bisa bicara, tetapi pendengaran dan mata saya normal normal saja. Dokter itu selalu datang visit sore hari memakai baju batik.

Jika jantung saya lemah dan tanpa pertolonganNYA, kemungkinan saya sudah mengucapkan selamat tinggal. Syukur jantung saya masih sempurna karena kebiasaan  rajin olah raga senam, sepeda gunung dan renang 2- 3 kali seminggu. Dan juga tidak merokok.


Oleh karena itu dianjurkan olah raga teratur kalau bisa setiap hari minimum 30 menit bukan sekali seminggu tetapi dalam waktu beberapa jam. Dan hindari merokok yang akan merusak kesehatan jantung.

















Jumat, 06 Juni 2014

ELECTRIC SHOCK TO THE BRAIN CAN HELP STROKE PATIENS' RECOVERY


Stroke patients with brain damage can recover more quickly with the help of small electric currents applied to the head from electrodes on the skull, a study has found.

The tiny electric currents are believed to stimulate the re-growth of nerve connections in the brain that have been lost as a result of oxygen starvation caused by stroke, scientists said.

Tests on a small group of healthy volunteers have shown significant improvements in the sort of brain activity that could also benefit stroke patients, the scientists said.

The research supports the idea that the brain can to some extent repair itself by rewiring and reconnecting itself to bypass damaged areas, according to Professor Heidi Johansen-Berg of Oxford University.
"The brain is far more dynamic than previously thought ... The connecting fibres of the brain change their structure with training,"

Professor Johansen-Berg said. "After stroke, there is widespread subtle damage to connecting fibres, far beyond the stroke itself. However, with repeated practice, patients can increase activity in brain areas that have been disconnected," she told the British Science Festival at Bradford University.

Tests on stroke patients found that playing computer games every day could stimulate the brain to bypass the damaged areas by "recruiting" new connections between nerve cells in undamaged areas. The scientists extended the research by using small electrical currents that are believed to stimulate connections between and re-growth of nerve cells or blood vessels.

The technique involves placing rubber pads on each side of the skull.
Electric currents of around 1 to 2 milliamps are passed from one electrode to the other.

Stroke damage usually affects only part of the brain, which means that other areas attempt to compensate by a "rebalancing" process. "This change in the balance of activity is most common in poorly recovered patients. It is possible that rebalancing the brain might provide a route to better recovery," Professor Johansen-Berg said.