Text by Henrylito D. Tacio
Photo credit: flintrehab.com
If you smoke, drink alcohol excessively, use illegal drugs, and don’t exercise, then you are most likely to have a stroke. The following are also risk factors for stroke: abnormal heart rhythm, cardiac structural abnormalities, high blood cholesterol, and lipids, and high blood cell count. These health problems may also cause you to be struck with stroke: high blood pressure, diabetes, heart disease, and history of transient ischemic attacks.
The above risk factors can still be changed or managed. But there are risk factors that you can’t do anything. To name a few: older age, gender (stroke occurs more often in men), history of prior stroke, and heredity or genetics.
Stroke is deadly; if not managed immediately, it may result in death. In Davao Region, an average of 85 deaths are recorded each day, according to the Philippines Statistics Authority (PSA). Cerebrovascular diseases, which include stroke, is the second leading cause of death.
The true stroke prevalence in the country is uncertain, but reported estimates vary between 0.9% (2005 data) to 2.6% (2017) of the population. Currently, the Philippines is home to almost 110 million people.
In a study conducted by Dr. Jose C. Navarro of the University of Santo Tomas Hospital, he estimated that about half a million Filipinos would be affected by stroke, costing about $350 million to $1.2 billion in medical care.
A stroke is a medical emergency. “Early action can reduce brain damage and other complications,” reminds the Mayo Clinic.
Time lost is brain lost. According to Dr. Ceferino L. Rivera of the Manila Adventist Medical Center, a person loses 12.1 billion brain cells per stroke. “If you have a stroke, you will lose 340,000 brain cells per second, 20 million per minute, and 1.2 billion per hour,” he said.
These are the symptoms of stroke, the US Centers for Disease Control and Prevention says: Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
“Don’t confuse a stroke with a heart attack,” reminds Dr. Isadore Rosenfeld, author of The Best Treatment. “A stroke is what happens when the blood supply to a portion of the brain is interrupted; a heart attack is what you suffer when the blockage is in an artery within the heart.”
Actually, there are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). The Department of Health reported that only 36% of the total stroke deaths are not attended by any medical personnel.
The Philippine Health Insurance Corporation, the country’s national health insurance system, reimburses only P28,000 and P38,000 for ischemic and hemorrhagic strokes, respectively. Both cover professional and healthcare institution fees.
As a result of the Local Government Code of 1991, the management of health systems were transferred from the national level to the provincial, city, and municipal level or the local government units (LGUs). “Coping to the new responsibilities that came with devolution posed a challenge to some LGUs, leaving some health facilities poorly equipped and staffed, thereby affecting the quality of health services,” observed the Frontiers-published study, “Current State of Stroke Care in the Philippines.”
In Davao City, the Stroke Society of the Philippines listed the following hospitals as stroke-ready: San Pedro Hospital, Southern Philippine Medical Center, Davao Doctors Hospital, and Metro Davao Medical and Research Center.
The good news is: the first reading of an ordinance establishing a Stroke Rehab Center in the city has been approved by the city council. “… The discussion was very fruitful and we have already invited several stakeholders so we can open the rehab center soon or hopefully this year since it is really a big help,” Councilor Lorenzo Benjamin Villafuerte, who proposed the ordinance, was quoted as saying by Edge Davao’s Maya Padillo in a news report.
Villafuerte is the chair of the Civil Political and Human Rights Committee; he is also a member of the Committee on Health. Once the ordinance is approved, he is optimistic that the First and Third Districts may follow suit. In the Second District, a Stroke Center is located in Tibungco.
“Right now, the only center that offers free physical therapy is my center located in barangay Calinan Poblacion named Kap Louie Physical Therapy Center in honor of my father who unfortunately died of a stroke,” Villafuerte pointed out.
The Geneva-based World Health Organization seems to agree with the observation of Villafuerte. “Access to appropriate care is difficult for many people with neurological disorders, their families and caregivers,” the UN health agency stated.
Neurological disorders are medically defined as disorders that affect the brain as well as the nerves found throughout the human body and the spinal cord. In the Philippines, stroke is one of the neurological disorders causing the biggest health burden, along with dementia, epilepsy, meningitis, and migraine.
Those who survived a stroke may have to undergo physical therapy (PT). This type of treatment is suggested by doctors among those who have had an injury or illness that makes it hard to do daily tasks.
“Physical therapy involves exercising and manipulating the body,” says The Merck Manual of Medical Information. Techniques include range-of-motion exercises, muscle-strengthening exercises, coordination exercises, ambulation (walking) exercises, and general conditioning exercises.
The Frontiers-published study said only 15.8% of the country’s hospitals have rehabilitation units. In a national survey, only half of the hospitalized stroke patients get referred to rehabilitation, with the median number of days from admission to referral being three days.
“Aside from inadequate access and facilities, the reasons for discontinuing therapy included cost and physician’s decision to defer therapy due uncontrolled blood pressure, cardiovascular instability and physical inability of patients to tolerate early active treatment,” the study said.