NEWS RELEASE : Urgent Call to Action on WHO in Relation to COVID-19-Related VTE

A SYSTEMATIC APPROACH FOR MANAGING VENOUS THROMBOEMBOLISM IN PATIENTS WITH COVID-19

A Systematic Approach for Managing Venous Thromboembolism in Patients with COVID-19: A Multinational Consensus Statement from the International Society on Thrombosis and Haemostasis (ISTH) on Behalf of the International Thrombosis Community

Introduction

With more than 6.7 million confirmed cases worldwide[i] and nearly 400,000 deaths to date (7th June 2020) during 2020,[ii] the COVID-19 pandemic is one of the most significant healthcare crises of our time. The spread of COVID-19 has been varied, with some regions having sporadic transmission and relatively few hospitalized patients with COVID-19 pneumonia, and others where significant transmission has overwhelmed health services. While the disruption to health services continues, it is vital for the World Health Organization (WHO) to share the lessons of how best to prevent, diagnose, and treat patients with COVID-19 with health systems globally, and to learn about agreed clinical best practice approaches, which may improve patient outcomes.

The WHO should be congratulated on the publication of interim guidance on the Clinical Management of hospitalized patients with COVID-19[iii], the second iteration of which was published by the WHO in late May, which serves as a useful first step resource for health systems internationally. However, more must be done to meet the needs of front-line clinicians caring for patients with COVID-19 to ensure quality care, by addressing significant gaps in expert clinical guidance surrounding the prevention and management of venous thromboembolism (VTE) in COVID-19 patients.

COVID-19 and Venous Thromboembolism (VTE)

Venous thromboembolism (VTE) is a condition in which a blood clot forms most often in the deep veins of the leg, groin or arm (known as deep vein thrombosis , DVT) and travels in the circulation, lodging in the lungs (known as pulmonary embolism, PE). Together, DVT and PE are known as VTE – a dangerous, potentially deadly, medical condition.[iv] Hospital-associated VTE (describes VTE occurring in hospital and 90 days post discharge) accounts for 60% of all VTE.

Emerging research indicates that:

  • People with COVID-19, especially those hospitalized with the moderate (requiring supplementary oxygenation) and severe (requiring mechanical ventilation) COVID-19 pneumonia have a high incidence of VTE[v]
  • COVID-19 pneumonia is associated with a marked hypercoagulability, including high levels of fibrinogen and very high D-dimer levels;
  • In patients with COVID-19 pneumonia, there is a major inflammatory response which can lead to micro-clots – immunothrombosis – within the lungs. This likely contributes to the high levels of mortality seen in patients with COVID-19 pneumonia;
  • Some countries are facing difficulties in accessing low molecular weight heparins (blood thinners), a WHO essential medicine, that is a vital prophylactic and treatment for VTE in hospitalized patients with COVID-19.

Call to Action on WHO in Relation to COVID-19-Related VTE

To reduce harm from COVID-19 associated VTE, the International Society on Thrombosis and Haemostasis, together with the undersigned national, continental and international clinical representative organizations, urgently calls on the WHO to endorse and share the application of a system-wide approach to VTE management on a global scale, as part of the international COVID-19 response that seeks to:

  • Highlight the importance of a systematic approach to VTE prevention, diagnosis and treatment for patients with COVID-19; including those isolating at home, those hospitalized and those post discharge;
  • Meet the needs of front-line clinicians caring for patients with COVID-19 to ensure quality care by improving health worker education about VTE in COVID-19 management that incorporates up-to-date consensus recommendations in the next iterations of WHO interim guidance on the Clinical Management of COVID-19 (ensuring a VTE expert(s) is enlisted to the Guideline Development Group);
  • Signpost hospitals to accredited up-to-date evidence based clinical information portals on VTE related COVID-19 clinical guidance, such as the ISTH COVID-19 Resource Page;
  • Highlight to member states the importance of making available all WHO Essential Medicines, in particular low molecular weight heparins (blood thinners), which provides vital prophylactic and treatment for VTE;
  • Improve COVID-19 VTE data collection and research to support regular updates of evidence-based clinical recommendations; and
  • Encourage the implementation of a global VTE risk assessment tool for hospitalized patients.

VTE not only can kill, but can also have devastating co-morbidities, which significantly impact the quality of life for patients who survive COVID-19 and an associated VTE[vi] .

Until there is a vaccine for COVID-19, there is no better way to address this public health challenge than for the WHO to prioritize the development of systematic and integrated approaches to COVID-19-related VTE prevention that can be implemented in secondary and tertiary settings globally.

We urge the WHO to act now and offer our collective resources and expertise to assist in such an endeavor.

Link to ISTH and 70 organizations around the world  that have signed the Consensus statement

Website: https://www.isth.org/news/517212

Signed on behalf of ISTH

Claire McLintock ( President) Jeffrey Weitz (President -Elect)  Beverley Hunt, O.B.E.(Chair, World Thrombosis Day)

REFERENCES

[i] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200527-covid-19-sitrep-128.pdf?sfvrsn=11720c0a_2

[ii] Ibid

[iii] https://www.who.int/publications-detail/clinical-management-of-covid-19

[iv] www.worldthrombosisday.org/issue/vte/

[v] “Clinical Guidance on the Diagnosis, Prevention and Treatment of Venous Thromboembolism in Hospitalized Patients with COVID-19,” Journal of Thrombosis and Haemostasis (JTH).

[vi] Ibid

 

Depression, a big Challenge to Recovery/Rehabilitation after a Stroke

 

Depression, a big Challenge to Recovery/Rehabilitation after a Stroke

“About one in eight survivors of stroke have suicidal ideation, according to a study published online in the Journal of Neurology,”. Depression affects the survivor’s quality of life after a stroke. It also make it more challenging for those affected with stroke to recover. Findings from current studies shows that, depression can also increase the risk of cardiovascular disease (CVDs), which in turn increases the risk of experiencing a second stroke. Mortality rates are 10 times higher in people who experience depression after a stroke (Ginta et al).

Depression is a common experience for persons living with stroke and their carers . It’s commonly caused by biochemical changes in the brain. When the brain is injured, the survivor may not be able to feel positive emotions as a result of the effect from the injury. Depression can also be a normal psychological reaction which may be experienced by persons living with stroke and their carers.

Possible causes of depression may include a combination of biological, psychological and social sources of distress. Research suggest that these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain (AHA).

Common symptoms of depression Includes:

  • Thoughts of death or suicide, or suicide attempts.
  • Feelings of hopelessness, pessimism, guilt, worthlessness or helplessness.
  • Persistent sad, anxious or “empty” mood.
  • Restlessness and irritability.
  • Loss of interest or pleasure in hobbies and activities.
  • Decreased energy and fatigue, and feeling “slowed down”.
  • Difficulty concentrating, remembering and making decisions.
  • Insomnia, early morning awakening , oversleeping.
  • Appetite, overeating or weight changes.

Caregivers/carers must be aware of the emotional state of those living with stroke in order to provide the needed support at all times.

Category of persons with stroke who are at risk for depression

  • Those who have had previous mental illness.
  •  Females.
  • Those with  previous  traumatic brain injury.
  • Those with history of  Parkinson’s disease or other neuromuscular disorders.
  • Those who live alone.

It’s very important to seek help from professionals such as; Clinical psychologist, psychologist , psychiatrist, clinicians.  Treating depression improves mood,  boost physical, cognitive and intellectual recovery. Social support for persons living with stroke is very crucial in the treatment of depression.

Several studies shows that, depression goes hand in hand with lower levels of support (AHA).  Look to your family, friends, stroke support group such as SASNET GHANA’s stroke support community, etc  for help. Health professionals, carers, family members, friends, etc, involved in recovery processes must be aware of the survivor’s depressed condition and  respond to it appropriately. It is very important we  note that ,when we provide the right treatment and support to persons living with stroke, it helps to ease the pain and move the survivor down the road to recovery.

Register for free to receive psychological support online  :  care.sasnetghana.org/ask-charway/

ACCESS FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

More Women are Dying from Stroke

More Women are Dying from Stroke 

 

Stroke is a leading cause of death and number  one cause of serious long-term disability (cdc) globally. Stroke reduces mobility in more than half of stroke survivors and imposes greater burden on families, society, etc. Stroke is the third leading cause of death in women. Stroke also kills more women than men each year especially in Africa. A stroke can permanently disable a person. But many strokes are preventable and treatable. Every woman can take steps to prevent stroke by knowing her risk factors and making healthy changes.

According to studies, 60 percent of women who have stroke will die from it, compared to 40 percent of men who may live with some forms of disability for awhile as a result their  strokes. Women and men are different, and so are their signs and symptoms for stroke,. 27% of women could name more than two of the six primary stroke symptoms.

7 out of 10 women according to studies, said they are not aware they are more likely to have a stroke than men, and were not at all or only somewhat knowledgeable about risk factors (memorialcare).

Stroke in Women

A stroke can happen in different parts of the brain in women. The brain is divided into four main parts:

  • The right hemisphere.
  • The left hemisphere.
  • The cerebellum, which controls balance and coordination.
  • The brain stem, which controls all of our body’s functions that we don’t think about, such as heart rate, blood pressure, sweating, or digestion.

A stroke in the right half of the brain can cause:

  • Problems moving the left side of your body.
  • Problems judging distances. You may misjudge distances and fall. Or you might not be able to guide your hands to pick something up.
  • Impaired judgment and behavior. You may misjudge your ability to do things. You may also do things you would not normally do, such as leave your house without getting fully dressed.
  • Short-term memory loss. You may be able to remember events from 30 years ago, but not how to get to the place where you work today.

A stroke in the left half of the brain can cause:

  • Problems moving the right side of your body.
  • Speech and language problems. You may have trouble speaking or understanding others.
  • Slow and cautious behavior. You may need a lot of help to complete everyday tasks.
  • Memory problems. You may not remember what you did 10 minutes ago. Or you may have a hard time learning new things.

A stroke in the cerebellum can cause:

  • Stiffness and tightness in the upper body that can cause spasms or jerky movements.
  • Eye problems, such as blurry or double vision.
  • Balance problems.
  • Dizziness, nausea (feeling sick to your stomach), and vomiting.

Strokes in the brain stem are very harmful. Since impulses that start in the brain must travel through the brain stem on their way to the arms and legs, patients with a brain stem stroke may also develop paralysis (Womenshealthgov)

Stroke is no friend to women. It kills more women than men.The higher stroke risk in women might be due to:

  • Pregnancy –The risk of stroke in pregnant women is 21 per 100,000, with the highest stroke risk during the third trimester and post-partum. Those with high blood pressure should be treated with medications and monitored closely.
  • Preeclampsia – This is high blood pressure that develops during pregnancy. Preeclampsia doubles the risk of stroke later in life. If you have any history of hypertension, talk to your healthcare provider about taking low-dose aspirin starting in the second trimester.
  • Birth control pills – Birth control pills have become much safer over time, but women who are already at risk of stroke should take extra precautions. Get screened for high blood pressure before the pill is prescribed. And never smoke while taking oral contraceptives.
  • Hormone replacement therapy – This type of therapy should never be used to prevent stroke in post-menopausal women.

  • Migraines with aura –Migraine with aura is associated with ischemic stroke in younger women, particularly if they smoke or use oral contraceptives. Smokers with migraines accompanied by aura should quit immediately.
  • Atria fibrillation and Heart diseases – This increases stroke risk among women.

Women are at a higher risk for a stroke, it is therefore important for women to take care of themselves. Especially, getting lots of rest to ease tension or stress, eating the right foods and being physically active, Avoiding tobacco smoking, secondary smoking or Shisha (electronic smoking), avoid intake of alcohol.

Stroke sudden symptoms of stroke

Sudden numbness or weakness of face, arm or leg, especially on one side of the body.

Sudden confusion, trouble speaking, or understanding.

Sudden trouble seeing in one or both eyes.

Sudden trouble walking, dizziness, loss of balance or coordination sudden severe headache with no known cause.

Stroke symptoms in Women

Ideally women may report symptoms that are different from the common symptoms of stroke, they may include;

  • Loss of consciousness or fainting.
  • General weakness.
  • Difficulty or shortness of breath.
  • Confusion, unresponsiveness or disorientation.
  • Sudden behavioral change.
  • Agitation.
  • Hallucination.
  • Nausea or vomiting.
  • Pain.
  • Seizures.
  • Hiccups.

Women group(s)/ individuals are invited to sign up to the “Ask Dr Charway –Felli ” to receive more information on stroke prevention.

Register for free support online here :  care.sasnetghana.org/ask-charway/

FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

7 THINGS TO DO IN ORDER TO PREVENT A STROKE IN THIS ERA OF COVID19

7 THINGS TO DO IN ORDER TO  PREVENT A STROKE IN THIS ERA OF COVID19

Stroke prevention can start today. Protect yourself and avoid stroke, regardless of your age or family history. It’s very important to  safe guide yourself from being infected with the novel Corona virus ,COVID19, it’s  equally important to prevent a  stroke in this challenging times of COVID19.

What can you do to prevent a stroke?

You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control(modifiable) —provided that you’re aware of them. **Knowledge is power**. If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk.

Globally, stroke is a leading cause of mortality and disability and there are substantial economic costs for post-stroke care(Global Burden of Disease ,GBD)

Stroke, the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain, is also a leading cause of dementia and depression.Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low- and middle-income countries.(Walter Johnson, et al.)

How to prevent stroke

Here are seven ways to start reining in your risks today to avoid stroke, before a stroke has the chance to strike.

1.  Lower blood pressure

 High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.

Your ideal goal: Maintain a blood pressure of less than 120/80(with respect to your age) if possible. For some older people, this might not be possible because of medication side effects or dizziness with standing.

How to achieve it:

 Reduce the salt in your diet, ideally to no more than 1,500 milligrams a day (about a half teaspoon).

Increase polyunsaturated and monounsaturated fats in your diet, while avoiding foods high in saturated fats.

Eat 4 to 5 cups of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.

Get more exercise — at least 30 minutes of activity a day, and more, if possible. Quit smoking, if you smoke.

Contact your Doctor on your blood pressure medicines and report any side effects when taking  these drugs.

2.  Lose weight

 

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

Your goal: While an ideal body mass index(BMI)  is 25 or less, that may not be realistic for you. Work with your doctor to create a personal weight loss strategy.

How to achieve it:

 Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI).

Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day.

3.  Exercise more

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

Your goal: Exercise at a moderate intensity at least five days a week.

How to achieve it:

 Take a walk around your neighborhood every morning after breakfast. Start a fitness club with friends.

When you exercise, reach the level at which you’re breathing hard, but you can still talk. Take the stairs instead of an elevator when you can.

If you don’t have 30 consecutive minutes to exercise, , break it up into 10- to 15-minute sessions a few times each day.

4.  If you drink Stop

Drinking  alcohol as a person living with Stroke or NCDs is not SAFE to your health. Substitute alcohol  with sugar free fruit drink and water . Its not advisable to take alcohol as a person living with Stroke /NCDs .

Your goal: Don’t drink alcohol .

How to achieve it:

Take a lot of water every day and substitute alcohol for sugar free fruit drink  .

Seek support from a doctor , a psychologist or support group.

5.  Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke.

Your goal: If you have atrial fibrillation, get it treated.

How to achieve it:

 If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.

You may need to take an anticoagulant drug (blood thinner) such as warfarin (Coumadin) or one of the newer direct-acting anticoagulant drugs to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.

6.  Treat diabetes

Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

Your goal: Keep your blood sugar under control.

How to achieve it:

 Monitor your blood sugar as directed by your doctor.

Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

7.  Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly.

Your goal: Quit smoking.

How to achieve it:

 Ask your doctor for advice on the most appropriate way for you to quit.

Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.

Don’t give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.

Identify a stroke using the  F-A-S-T  test

Too many people ignore the signs of stroke because they question whether their symptoms are real. “My recommendation is, don’t wait if you have any unusual symptoms,” Dr. Rost advises. Listen to your body and trust your instincts. If something is off, get professional help right away.”

Signs of a stroke include:

  • weakness on one side of the body.
  • numbness of the face.
  • unusual and severe headache.
  • vision loss.
  • numbness and tingling.
  • unsteady walk.

Harvard Health Publishing  (June 2013). 7 things you can to to prevent stroke.

GET FREE SUPPORT : Person living with stroke and their carers can  have answers to their mind boggling questions and access information on stroke care and support  by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

Visit our  website below for more information

http://:care.sasnetghana.org    or email us : info@sasnetghana.org

Helpline + 233594989496 or  WhatsApp us +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support from the Professionals

Register for free support online here :  care.sasnetghana.org/ask-charway/

 

EATING, SWALLOWING AND TOOTH /MOUTH CARE FOR A PERSON LIVING WITH STROKE – HOME CARE /SUPPORT

EATING, SWALLOWING AND TOOTH /MOUTH CARE FOR A PERSON LIVING WITH STROKE – HOME CARE /SUPPORT

HOW CAN I HELP THE PERSON EAT?

The person must do the following:

  • Sit up for all meal.
  • Sit up straight.
  • Keep the head slightly forward.
  • Look at the food.
  • Rest arms on a table.
  • Keep the feet flat on the footrest of the wheelchair or on the floor.
  • Take small bites and sips.
  • Move the chewed food to the middle of the tongue before swallowing.
  • Drink from a full glass or use a straw to prevent the head from tipping back.
  • Sit up for at least 20-30 minutes after eating for food to be digested.

VERY IMPORTANT:

If the person often coughs or chokes when eating, ask to see a speech therapist. He/she can check whether the person can swallow food and drink safely, and give the necessary advice to improve swallowing.

The carer must do the following:
  • Sit up for all meal.
  • When standing, put your foot on a low support, such as a wooden block or low bench.
  • Always keep your back straight; don’t bend it.
  • Use your arm closet to the person to support his/her head.
  • Place food between the teeth, on the stronger side of the person’s mouth.
  • Give thick fluids and food with a smooth Yogurt, custard and thick soups are easiest to swallow.

  VERY IMPORTANT:

  • Don’t let the person’s head tip to the side or back.
  • Don’t let the weak arm dangle or fall off the table, armrest or tray.
  • Don’t let the foot slip off the footrest of the wheelchair.

 

HOW CAN I HELP THE PERSON DRINK?  

 

  • Put your finger on the person’s cheek, chin and lower jaw to help him/her close the lip or mouth. Take care not to tilt the head back.
  • When using a straw, always out it on the strong sides of the mouth against the check.
  • If the person cannot drink from a cup or use a straw, use a syringe (injection, consult a nurse or speech therapist first) without the needle to put fluid into the mouth.
  • Pace it on the strong side of the mouth, against the cheek. Squirt fluid in the direction of the cheek.

 

HOW CAN I HELP THE PERSON BRUSH HIS/HER TEETH?

 

  • Let the person sit in front of a mirror.
  • The person must sit up straight.
  • Keep the head upright.
  • Let the weak arm rest on a table or on the edge of a
  • Stand behind the person and look in the mirror.

IMPORTANT : Person living with stroke and their carers could also receive answers to the above stated problems by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

E.S, S., & J.S, V. (2015). Stroke Care at Home. Western Cape South Africa: Center for Rehabilitation Studies Stellenbosch University.

http://:care.sasnetghana.org   online or email: info@sasnetghana.org

Helpline + 233594989496 or on WhatsApp +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support .

Register for free support online here :  care.sasnetghana.org/ask-charway/

 

Stroke Association Supportnetwork-Ghana (SASNET-GHANA) Rebuilding Lives After Stroke.

Championing the Right of Persons Living With Stroke/NCDs

A call on governments to act FAST against Stroke/NCDs Now

Over 17. 5 million people are affected by disability due to stroke while six million deaths are recorded annually worldwide. Stroke is the second major cause of death and disability worldwide. Stroke/NCDs have no respect for age,gender, social status ,etc.

One Voice Against Stroke

As persons living with stroke/NCDs, we may come from diverse background with differences but our firm desire to  fight for our lives and to champion for our  right unites us. We can’t wait any longer , we are demanding an improved health system in providing  the right care and support to meet our individual (personalised care based on our needs) need with respect to our age,gender,social status,et al.

“The slow improvement in the health status of our people has been a matter of great concern. There is no denying the fact that we have not paid adequate attention to this dimension of development thus far” Manmohan Singh, Prime minister India,2005.

Persons living with stroke had been challenged with delayed diagnoses,access to health care, high cost of treatment(most survivors are not able to afford the cost of treatment nor  rehabilitation service) ,support after stroke and stigma which are  related to our disease every day . We might be living with stroke but our disease do not define us.

Action Now

Persons living with Stroke/NCDs and carer partners are united for action now  , demand to be heard ,thus Our Views Our Voices must be Heard!!. Our Views Our Voices (OVOV)  an initiative of  the Global NCD Alliance.

Meaningfully involved to championing the right of persons  living with Stroke /NCDs

Micheal Uchunor  a person living with stroke and an advocate for persons living with stroke leads in  Championing  the right of persons living with Stroke/NCDs , supported by the African Stroke Organization (ASO)

 

Surviving a stroke 8 years ago when I was 33 years old turned me into a committed Advocate for Stroke and other NCDs with  stroke related  risk factors such as diabetes and hypertension.

I founded  a stroke support organization (SSOs) and registered it as  Michael and Francisca Foundation which is based in Lagos Nigeria . Our core objective   is to create public awareness , provide support to all those impacted by stroke with  hope to provide them with a  meaningful life after stroke.

Before i had the stroke, I was working with  Development Support Institute (DSI) , DSI  Export  agricultural products such as Cashews, Cocoa, wood etc. After my stroke , the company didn’t  require my services any longer ,it was really hard time  for me and my family by then . Stigmatization and sidelining of persons living with stroke/NCDs are  huge societal issues that  must be stamped out from our societies .  I was later recruited  and  trained by Stroke Action Nigeria to become an entrepreneur (Stroke Entrepreneur ) with an  aim to  operate my foundation and  gradually  turn it into a profitable venture that will contribute towards achieving the SDG #3  ensure healthy lives and promote wellbeing for all ages.

The Foundation had provided  support to over  135 stroke survivor and their carers to help them cope with life after stroke challenges.

The foundation  will continue collaboration with other  organizations /agencies such as faith organizations like Sacred Heart Catholic Church Ojota , African Stroke Organization(ASO) , other SSOs and international donor agencies like UMMI – Italian Missionary Medical Union that provide free medicines to persons living with strokes  and  advocate for  governments  to implement the  Universal Health Coverage  policies which aimed  to leave no one behind in terms of access to health care and support . Presently I have been Appointment as a member of  NCD Alliance Global Advisory Committee on the “Our View, Our Voices” initiative.

I’m calling on all persons living with stroke , care partners , the African Stroke Organization(ASO) ,World Stroke Organization(WSO) ,et al. to support me and  speak with one resounding voice against stroke and to  demand for an improved  care and support for persons living with Stroke /NCDs across the globe especially in Africa.

CARING FOR A PERSON LIVING WITH STROKE AT HOME- HOW TO POSITION A STROKE SURVIVOR

HOW TO POSITION A STROKE SURVIVOR

When stroke survivors sit or lie down in the right way, it can help them recover faster and function better. Sitting or lying in incorrect positions may worsen problems such as stiffness, pain or interfere with awareness of the weak side.

HOW SHOULD THE PERSON LIE IN BED?

General guidelines:
  1. Use a firm mattress (not too soft, not too hard), or place a wooden board such as an old door under the mattress.
  2. The wall should always be on the person’s strong side.
  3. The person should lie with the weak side of the body towards the door, TV, visitor’s chair and so This will help him/her not to forget or ignore the weak side.
  4. The person should spend as little time as possible in bed.
  5. When in bed, the person should lie on his/her sides instead of on the back.
  6. Turn someone who cannot move at all every two to three hours to prevent stiffness and bedsores.
How to sit up and lie on both sides(only if the person cannot get out of bed)

  1. Keep the elbow away from the body and in comfortable position.
  2. Keep the weak hand open, with nothing in it. lying on the strong side, put something under the weak elbow and hand to support it.
  3. When lying on the weak side, don’t let the person lie on the shoulder joint. Place the shoulder in front of the chest and not under the body.
  4. the upper knee.
  5. pillows or a folded blanket under the upper knee and foot so that it is fully supported.
  6. If the bed is not wide enough, let the weak hand and arm rest on a box or table next to the bed. Check that the box or table is just as high as the bed not lower or higher.

                                         


 1 .The person may lie on his/ her back only for a short time only.

2.Put the bedside table on the weak side.

3.Let the person sit up straight with legs stretched out in front.

If you put a pillow under the knees it may be more comfortable.

 4. The back should be against the wall or headboard.

If the person cannot be moved closer to the upper part of the bed,

place a chair or stool between him/her and the headboard.

 5.Put pillows or a folded blanket behind the back as support

6.Make a lap table from a box , on which the arms can rest.

The person should only sit like this if he/she cannot get out of bed.

       

Important message for  carers and care providers

Don’t let the person lie in bed with a stack of pillows stuffed behind him/her back. This may cause the following:

  1. Bedsores.
  2. Breathing problems.
  3. Problems with swallowing.
  4. More stiffness in the arm and leg.
  5. A bent spine and forward head position.

 

E.S, S., & J.S, V. (2015). Stroke Care at Home. Western Cape South Africa: Center for Rehabilitation Studies Stellenbosch University.

IMPORTANT : Person living with stroke and their carers could also receive answers to the above stated problems by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

http://:care.sasnetghana.org   online or email: info@sasnetghana.org

Helpline + 233594989496 or on WhatsApp +233262463986

Sign up to  Ask Dr Charway –Felli Platform for more  support .

Register for free support online here :  care.sasnetghana.org/ask-charway/

COMMON PROBLEMS AFTER A STROKE AND WHERE TO SEEK HELP FROM.

COMMON PROBLEMS AFTER A STROKE AND WHERE TO SEEK HELP FROM

PROBLEMS

  1. Shoulder pain/shoulder and hand pain.
  2. Urinary tract (bladder) infection.
  3. Constipation/diarrhea.
  4. Sliding or falling out of wheelchair.
  5. Behaviors problems.
  6. Aspiration (Choking/coughing after swallowing).
  7. Bedsores.
  8. Depression.
  9. Double vision or – Only seeing on one side.
  10. Reactions from a prescribed medication.
  11. Stroke centers/units/support /Treatment.

 

WHERE TO SEEK HELP FROM

  1. Physiotherapist/ Occupational therapist.
  2. Clinic/doctor/nurse.
  3. Clinic/doctor/nurse.
  4. Physiotherapist /occupational therapist.
  5. Occupational therapist/Clinical psychologist /social worker.
  6. Speech and language therapist /nurse.
  7. Doctor/nurse/physiotherapist/ Occupational therapist.
  8. Clinic/doctor/occupational therapist /social worker.
  9. Clinic/optometrist/occupational therapist.
  10. Doctor/pharmacist/Hospital/clinic.
  11. SASNET-GHANA Team/Help line.

IMPORTANT : Person living with stroke and their carers could also receive  answers to the above stated problems by signing up to the Post Discharge Stroke Support(PDSS) Program by the Stroke Association Supportnetwork-Ghana (SASNET-GHANA).

http://:caresasnetghana.org  online or

by signing up to  Ask Dr Charway –Felli Platform for support .

Register for free support online here  care.sasnetghana.org/ask-charway/

 

 

 

 

 

 

 

 

 

 

 

NEWS RELEASE-GLOBAL STROKE LEADERS LAUNCH RADICAL STROKE AND DEMENTIA PREVENTION STRATEGY

 

GLOBAL STROKE LEADERS LAUNCH RADICAL STROKE AND DEMENTIA PREVENTION STRATEGY

The World Stroke Organization (WSO) has published a radical strategic framework that aims to transform prevention of stroke and dementia.

Published in latest edition of The Lancet Neurology, the WSO Declaration on Global Prevention of Stroke and Dementia, recognizes the commonality and reciprocity of stroke and dementia risk and calls for urgent action by governments and healthcare policy bodies to address the limitations of current prevention strategy. Over the past ten years the adult lifetime risk of stroke has increased from 1 in 6, to 1 in 4.

Without new evidence-based interventions, the WSO projects a current trajectory of disease that will lead to an annual death toll of 12 million stroke deaths and 5 million dementia deaths by 2050.

Highlighting the need for action in low- and medium-risk populations, who will ultimately represent 80% of the stroke and cardiovascular disease burden, the Declaration identifies four interdependent interventions that will significantly reduce the incidence and prevalence of stroke and dementia. The strategy also takes into account the specific challenges experienced by governments and communities in Low- and Middle- Income countries, putting in place a lower cost alternative to current prevention approaches.

 

Key principles of the Declaration

1 Adoption of population wide strategies that reduce exposure to stroke risk factors such as tobacco, alcohol and food policies, as well as action to address environmental risk factors, including air pollution, across the lifespan of the whole population.

2 Implement and promote the adoption of motivational mobile technologies, e.g. the WSO endorsed StrokeRiskometer to identify individual risks and support action on lifestyle risk factors among adults.

3 Access to low dose combination of generic blood pressure and lipid-lowering therapies in one polypill for middle age and older adults with at least two behavioural or clinical stroke risk factors.

4 Investment, training and deployment of community health workers to facilitate implementation.

WSO presents combined research evidence that shows a combination of these interventions would lower the incidence and of stroke by 50% and dementia incidence by 30% while contributing to decrease in incidence of other non-communicable diseases which share common risk factors.

Another proposed shift of approach is to change the way risk is communicated to patients, by health professionals. Current categorization into low-, medium- and high-stroke risk can give a false sense of security for those who are told they are low or medium risk and may not take into account all risk factors that are present. The global stroke body instead calls for a more holistic approach, that places stroke risk on a continuum and encourages early intervention and a life-course approach to risk reduction.

WSO President Prof Michael Brainin, who champions the organization’s prevention effort said ‘COVID-19 has spurred previously inconceivable levels of government intervention and individual behaviour change around the world, but we have been effectively living with a stroke pandemic and a failing prevention strategy for years.

The need for radical action is clear and our prevention principles provide low cost, evidence-based approaches that if implemented globally would not only save millions of lives but would deliver savings of hundreds of billions of dollars annually. This is money that will be desperately needed to strengthen global health systems and to fuel economic recovery in the wake of COVID-19.’

For more information please contact Anita Wiseman awiseman@kenes.com

1 The World Stroke Organization is the only global body solely focused on stroke. With around 90 organizational members from countries in every global region, we represent over 55,000 stroke specialists in clinical, support and community settings. The WSO vision is a ‘life free from stroke’. We work towards this vision through a strategic programme that addresses key factors in stroke mortality and morbidity at global, regional and national levels. Our strategy combines evidence-based advocacy, context-sensitive guidelines, tool kits, clinical education and training programmes and public campaigns that aim to raise awareness of the symptoms of stroke and stroke prevention.

2 WSO is an NGO in official consultative relations with the UN Economic and Social Council and a WHO implementation partner.

 

Lancet. (2020). news-and-blog/news/global-stroke-leaders-launch-radical-prevention-strategy. Retrieved June 2020, from World Stroke Organization : https://www.world-stroke.org

WORLD SICKLE CELL DAY Friday 19th June 2020- Safe Guiding Children Living With Sickle Cell Globally

Sickle Cell and Stroke

What is sickle cell disease?

Sickle cell disease (SCD) is a family of inherited disorders, of which the most severe and common is sickle cell anaemia(HbSS).

SCD affects how red blood cells carry oxygen around the body, is a lifelong condition that affects both males and females, and is the most common genetic disorder globally. Sickle cell disease can cause fluctuating symptoms ranging from pain and infection to anaemia and fatigue.

People with SCD have abnormal haemoglobin. When this haemoglobin gives away oxygen it sticks together to form long rods in the red blood cell. These rods become rigid and can change the red cell from round and flexible to a shape like a sickle. It is because of this shape that sickled red blood cells cannot flow easily through small blood vessels . This means the small blood vessels can get blocked and stop oxygen from flowing.

Who does sickle cell disease affect?

Sickle cell disease is the most common genetic disease in the world. Commonly found in people whose families come from Africa, South or Central America , Caribbean islands, Mediterranean countries , Asia,  India, and Saudi Arabia

Recurrent Strokes in Sickle Cell Disease Children

Children who have suffered a stroke in the past have a high risk of having another stroke. SCD children have a 67 percent risk of recurrence with strokes recurring up to nine months apart.

The cause of such a high rate of recurrence is believed to be a rise in white blood cell count accompanied by a drop in hemoglobin (the protein in red blood cells that carries oxygen) after the first stroke.

“Silent” Strokes in Sickle Cell Disease Children

Recurrent overt strokes are not the only problem for SCD children. So-called “silent” strokes can also cause significant morbidity. Strokes are usually diagnosed by observing motor deficits, but silent strokes occur without obvious outward symptoms like movement difficulties. They can be detected only through brain imaging devices such as MRIs. It’s estimated that 17 percent of SCD children under the age of 14 have silent strokes and the rate increases to 23 percent by the age of 18, with the size and number of lesions increasing.

Silent strokes often occur in frontal areas of the brain, the area responsible for executive abilities (mostly having to do with academic achievement and memory). These strokes can impair intellectual ability, academic ability, attention, visual-spatial skills, language, and long-term memory. Early detection through screening and brain imaging is of the utmost importance, since imaging can help prevent recurrences.

Predictors of stroke in Sickle Cell Disease children

By far, the strongest predictor of stroke in children with SCD is a previous stroke. In predicting the risk of stroke in SCD children without a previous event, studies have revealed signs or symptoms that often occur before a stroke. These may include:

  • A history of seizures.
  • A previous transient ischemic attack (TIA) or “mini-stroke”.
  • New or increased frequency of pain syndromes such as acute chest syndrome (ACS).
  • Nervous system infections.
  • Trauma.
  • Increased blood pressure.
  • Decreased hemoglobin level.
  • An abnormal result on an image of cerebral arteries called a transcranial doppler (TCD) ultrasonograph.
  • Increased white blood cell count.
  • Increased cerebral blood flow pressure.
  • A history of snoring and/or confirmation of sleep apnea (a condition in which breathing stops briefly during sleep).

NB. If your sickle cell child has any of these conditions, please discuss them and the possibility of stroke with your physician. For children with a high risk of stroke, or a history of stroke, blood transfusions can help prevent occurrence or recurrence.

Management of SCD

Management of sickle cell anemia is usually aimed at avoiding pain episodes, relieving symptoms and preventing complications. Treatments might include medications and blood transfusions. For some children and teenagers, a stem cell transplant might cure the disease.

 

Resource. (2020,June). Retrieved June Monday, 2020, from The internet Stroke Center & Sickle Cell Young Stroke Survivors: http://www.strokecenter.org/  https://www.scyss.org/