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Stroke
Strokes are brief episodes involving a lack of oxygenated blood flowing
to the brain (90% are ischemic infarctions), or a sudden bleed within the
brain tissue (10% are hemorrhagic) which causes permanent damage to the
effected area of the central nervous system. In a classic stroke, the
neurologic defects continue to expand for 24-48 hours after the infarction
occurs ("stroke in evolution"). The most frequently seen stroke
is called a "completed stroke," whose symptoms develop rapidly
and maximally within a few minutes to an hour. The term "completed
stroke" also refers to the fully established neurologic deficits after
the stroke, whether from the acute or gradual kind. Neurologic symptoms
solely relate to the area of cerebral infarction.
The course or prognosis of the stroke, also known as CVA - cerebral vascular
accident - is unknown during the early days, unless death occurs. About
35% of patients die in hospital, and the mortality rate increases with age.
The eventual amount of neurologic damage depends on the patient's age,
state of health, and size and location of the stroke. It is unusual for
total recovery to occur but the sooner improvement is seen, the better the
prognosis for minimal deficits. Any deficit present after 6 months is likely
to be permanent, but neurological retraining programs appear to be having
some success. Further CVAs are common.
Stroke is a serious diagnosis. Make sure that you and your doctor definitively
decide that you that you do not have one the following problems, whose symptoms
may mimic stroke symptoms:
- Migraine
- Convulsive seizure
- Neoplasm (cancer)
- Meniere's disease
- Hyperinsulinism in diabetes mellitus patients
- Head injury
- Meningitis
- Uremia (toxic blood due to kidney failure)
- Hepatic coma (liver failure)
- Alcohol or drug intoxication
- Poisoning
- Epilepsy
How Can Physical Medicine Help With Stroke?
Gentle, regular aerobic exercise can help prevent stroke. But if you or
a family member already has suffered from one or more strokes, a simple
hydrotherapy technique may provide relief, and even minimize long term sequelae.
Hydrotherapy is discussed at length in the Introduction to Modalities section.
One technique is to lower your body temperature, with a cold bath for
example, as much as possible without inducing shivering as soon as possible
after a stroke has occurred, or is suspected to have occured. The idea
here is that if the stroke is ischemic (temporary restriction of oxygenated
blood) the body naturally and preferentially preserves blood flow to the
brain, so cooling the rest of the body will cause the blood to shunt rapidly
to the brain. However, if the stroke is hemorrhagic, cooling the body rapidly
will cause vasoconstriction, thereby helping to control the bleed.
Another hydrotherapy technique with a similar rationale is to soak the feet in
a hot foot bath, as soon as possible after the stroke has occurred, while
applying a cold compress to the neck, face and scalp. If this technique
can be applied as a stroke is happening, it may even abort the stroke.
Make sure the ice-cold compress touches the skin over the carotid arteries
under the jaw bone. Mustard paste or powder may be added to the foot bath
to increase the heating effect. Make sure to continue this treatment for
at least 20 minutes and keep adding hot water to the foot bath and make
sure the cold compress stays really cold. Or, you may take a neutral bath
that is neither freezing cold, nor warm. Immersion in water of neutral
temperature is extremely soothing to the central nervous system.
If someone has collapsed due to a stroke, and is waiting to get medical
attention, raise the head gently if you are absolutely sure no spinal injury
has been sustained, and keep the paralyzed side up. Don't let the stroke
victim lie on the paralyzed limbs if at all possible. The paralyzed limbs
may be massaged to maintain proper circulation.
Two of the most distressing sequelae of stroke are inability to speak clearly,
and inability to perform fine motor skills, particularly with the hands.
For someone struggling to regain the ability to speak normally, speech
therapy is highly recommended. And read on, because there is help with
Acupuncture also. To help minimize permanent damage to hand coordination
please begin exercises, such as the exercise ideas listed below, as soon
as possible, and don't give up.
- squeeze a soft or spongy ball with the hands whever you're watching TV or talking on the phone
or enjoying a sunset;
- stretch and reach for objects;
- count coins with the fingers;
- type;
- play piano;
- get some help to figure out safe movements routines that will allow
you to bathe yourself, prepare a meal for yourself and put yourself to bed,
as soon as possible.
Can Diet and Nutrition Affect the Outcome Of My Stroke?
Yes, absolutely. Since strokes often occur because of fatty deposits in
the arteries, which indirectly compromises smooth blood flow to the brain,
it makes sense to eat a low-fat diet. Strokes also occur because of insufficient
integrity of the walls of the blood vessels, so eating foods that improve
vascular tone, notably the dark-colored berries (whose active ingredient
is the blue-black pigment anthocyanadin) would be wise. In general, the
eating principles for minimizing the chance of a recurring stroke, or to
stay as healthy as possible after you've suffered a stroke, are to keep
the diet:
- low in sugar, low in cholesterol
- low in unsaturated fats
- with these calorie percentages: 70% complex carbohydrates, 12-15%
protein and 15-18% fat (preferably NOT animal fat).
- high in fiber
- low in Sodium. Sodium can raise blood pressure, putting excessive
pressure on the vascular system.
Specifically therapeutic foods post-stroke include:
- high Potassium foods such as millet, buckwheat, oats, rice, raw goat's
milk, raw leafy vegetables, watermelon, garlic, onions, cornsilk tea, diuretic
foods such as dandelion greens and grapes.
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A graduate of Bastyr University in Seattle, she completed both the Naturopathic and Acupuncture/Oriental Medicine programs. Her preceptor work (similar to residencies) took place in Seattle, West Virginia and China, 
