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Showing posts with label stroke. Show all posts
Showing posts with label stroke. Show all posts

Saturday, 24 May 2025

I am stronger now a better person than I was before my stroke

Beating the odds: Jenithaa conducting a training programme.


In July 2017, I woke up during the night with the feeling gravity was pinning me to the bed. 

I managed to get up and shuffle to the bathroom before waking my wife. My left side didn’t seem to be responding as it should. We’re both familiar with the F.A.S.T (Face. Arms. Speech. Time) signs of stroke so when we switched on the light and saw there was no change to my face, we went back to bed. We hoped whatever was going on would sort itself out by the morning. 

However, the next day things were clearly not right so we went to hospital. I was assessed by the stroke team and had a scan of my brain. My scan didn’t show anything and my symptoms were deemed to be related to a virus, so I went home.  

Back home, I nearly fell over in the driveway as my leg failed to step out of the car. I still had movement in my left limbs, but they were reacting slowly. I couldn’t walk unaided. I needed assistance getting into the house and getting into bed, where I stayed until the next morning. By then, the situation had worsened and I went back to hospital in an ambulance. 

I was assessed again and had another brain scan. This time the doctor saw a stroke. 

I had been diagnosed with an irregular heartbeat nine years earlier when I was 47. My cardiologist, at the time, conducted a treadmill test and echo test. She concluded that my heart was strong and my arteries were clear. I was otherwise well, so I was told not to worry and enjoy life. 

The doctors in the hospital detected my heart irregularity and said I had atrial fibrillation (AF), and that is what caused my stroke. According to the Stroke Foundation, atrial fibrillation affects more than 400,000 Australians and many of those people don’t even know. People with AF are five times more likely to have a stroke. 

My occupational therapist put everything in context. She said my white blood cells were stripping away the dead brain cells and other cells were taking on the job of that part of my brain. But these cells needed to learn, so the more I did or tried to do, the better chance they would have of establishing new pathways for messaging to the rest of my body.

This made sense to me so I kicked into gear – well, not quite ‘kicked’ but motioned at least. My left side was impacted so I started working on it. I ordered a banana with breakfast each morning and spent a few hours holding and twirling it in my left hand until I got sick of it and ate the sucker. I worked out I could use the bed rail as a makeshift tricep lifting machine to strengthen my left arm, until the nursing staff caught me. They thought l might break the bed so they brought in some dumbbells. I did other exercises as well and noticed the more l did, the more movement was coming back. I was excited to wake up and see what my brain had learnt the day before and how it would respond today.

After a week, I moved to a rehabilitation hospital where I did occupational therapy and two physiotherapy sessions each day. I was determined to improve, and I did my own workouts in between. I was told I would be there for up to four weeks, but was discharged after two weeks. I wanted to stay longer because I felt there was more improvement I could make, but I was sent home and continued as an outpatient. 

Once I was home, I had a garage gym I began working out in and also hit the local gym every day focusing on what I could turn this new body of mine into. 

On my first day back at the gym, I picked up 12 kilogram dumbbells in each arm, which is what l used before the stroke. The first few days were pathetic attempts to use these weights, but I persisted. Amazingly the strength came back fairly quickly and I now use 17 kilo dumbbells. 

I took an initial three months off work as a home loan specialist to rebuild my body, then another three months to try and build brain endurance as brain fatigue would hit and it would hit hard. When I was able, I’d go to the gym as l found the blood flow and endorphins would give the brain fatigue a run for its money and replace it with muscular fatigue – which was much nicer.

I couldn’t have done any of this without the love and support of my family. They were my cheer squad. My wife was my rock and my recovery journey has inspired each of them to some degree in different ways. 

Emotionally, I never felt upset or depressed. I had a pretty simple approach to my situation – I had lived 55 great years, married a wonderful woman and we had raised great kids. My life to me was a book – I didn’t write it; it was written for me and I have no idea how many chapters are in my book. No-one does. 

The reason I wanted to share my story was partly to highlight that not all the F.A.S.T factors need to be present when a stroke occurs.  But more importantly, stroke doesn’t mean your life is over. The human body is an amazing thing and the recovery journey I’ve been on has shown me what it is capable of doing. 

Although it has taken time, my journey has been exciting in many ways as l watched my left side become operational again. I am actually stronger now than l was pre-stroke. I have also returned to work – all that within eight months.  - 
 By Greg Crawford


Greg exercising

‘I am now a better person than before the stroke'


Beating the odds: Jenithaa conducting a training programme.

KLANG: She was at the height of her career when the inevitable struck, leaving her physically and financially devastated.

However, years later, Jenithaa Santhirasekaran, 56, believes that the stroke she suffered in 2011 was a blessing in disguise.

Jenithaa, who was then a country director for the Malaysian AIDS Council overseeing an externally funded programme on community action and harm reduction, recalled: “The stroke and the physical disability that followed made me look at myself, and life in general, from a different perspective.

“I was doing very well before it happened, but I was proud, arrogant and self-centred, believing I had the best career, as well as wealth and glamour.”

The mother of three daughters aged 33, 22 and 17, and grandmother of a six-year-old girl, had also served as the executive director of outreach organisation PT Foundation before joining the Malaysian Aids Council.

Jenithaa recalled how the turning point in her life came after she was injured in a snatch theft incident that resulted in her suffering injuries to her head, face and neck.

“I was on medical leave for two weeks and suffered from nausea and headaches and felt faint all the time long after my medical leave ended.

“Two months later, when attending a meeting in Bali, I suffered a stroke in my hotel room,” said Jenithaa.

The stroke rendered her unable to walk and talk, and also affected her right eye.

After being hospitalised in Bali for two weeks, she was allowed to return home to Malaysia and was readmitted here two weeks later after suffering fits.

Wheelchair-­bound but able to speak by then, Jenithaa said she went for everything she believed could help her, such as ayurvedic treatment, massages and acupuncture.

“I was jobless, broke and an OKU (orang kurang upaya – a person with disabilities) and after a while I had no money left in my bank account.

“There came a time when there wasn’t even any food in the house to feed my children and that truly devastated me and made me feel useless,’’ said Jenithaa, adding that it was then that she decided to take her own life.

Desiring to spend one final day with her three daughters, then aged 19, eight and four, Jenithaa emerged from her room, where she had been isolating herself, to be with them.

However, when she saw how much her children loved her and their happiness upon seeing her, Jenithaa chose to fight back and refused to let the stroke control her life.

“I stopped using my wheelchair and held on to walls and objects while teaching myself to walk again.

“I also literally begged, borrowed and stole to raise my children in the condition that I was in.

“I made myself ‘thick-skinned’ and asked for help but unfor­tunately lost so many ‘friends’ during this time after I approached them to seek financial help,” said Jenithaa, who became a single mother when her youngest daughter was born.

She also called up friends and acquaintances and started going out to let people see her in her post-stroke condition.

Jenithaa added that she started taking any job that came her way as well as pursued courses and developed herself into a speaker, forum panellist and advocate for the differently-abled.

“I am now a certified neuro-­linguistic master practitioner and trainer, clinical hypnotherapist, disability equality training ­trai­ner, non-governmental organisation management trainer, environment social and governance trainer and a diversity, equity and inclusion trainer.”

She added that she has also developed and run modules on emotional well-being, climate change and innovative parenting and has conducted over 100 workshops to date.

Jenithaa said she is currently completing a diploma in integra­ted psychotherapy specialising in childhood and adulthood abuse, trauma, grief health and past life regression therapy.

Despite sight not yet fully retur­ning to her right eye, her right leg completely numb, her right hand disabled and her speech sometimes impaired, Jenithaa added that she has finally found herself.

“I am happy that I am now a better person than I was before the stroke happened.”

She can be contacted at jenithaa69@gmail.com

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Sunday, 15 September 2024

Critical to improve health literacy

People must learn to modify diets to prevent lifestyle diseases such as diabetes

Image Credit: Created with the assistance of DALL·E 3

 

PRIME Minister Datuk Seri Anwar Ibrahim’s reminder to the people to take health knowledge seriously is timely.

At the launch of the 2024 National Wellness Month celebration last weekend, he reminded people to understand the dangers of excessive sugar consumption, saying that campaigns on health literacy or sugar reduction, as well as health literacy policies, would only be effective if people began changing their eating habits now.

For a start, let’s recall what we ate and drank in the past 24 hours, just to have a perspective of our sugar consumption.

From roti canai to teh tarik and the myriad of kuih, these foods all contain sugar.

When people say that they have cut sugar from their diets, I wonder if they realise that their bodies convert the carbohydrates they consume into sugar.

Staples like rice, bread, noodles and fruits are also high in carbohydrates, so maybe we need to take a good look at our food portions too.

Not long ago, the Health Ministry introduced the Malaysian Healthy Plate campaign with the hashtag #sukusukuseparuh

My friends were talking about it and I thought it was a clever way of introducing the concept of meal portions to the public.

The campaign encourages the public to limit their carbohydrate intake to fit a quarter segment of the plate. Another quarter of the plate should be filled with protein and the remaining half, with fruits and vegetables.

Now the key is making this meal formula part of our lifestyle.

Growing up, I watched my paternal grandmother suffering from diabetes.

She had her first stroke a day before I turned one. She must have been about 53 years old then.

However, I remember my paternal grandmother having a healthy diet. She took me along for her evening walks, took her medications on time and never skipped doctor’s appointments.

Over time, she became bedridden, before she passed away at the age of 70 in 1994.

She was an attractive woman in her youth but everything went downhill when she became sick.

After the stroke, her mobility was limited, preventing her from maintaining her active lifestyle.

My maternal grandmother also suffered from diabetes and her mobility, too, was limited after a stroke.

She had never cared about her diet and was a teh tarik addict. There was always an unlimited supply of condensed milk from my grandfather’s grocery store.

I dare say her enjoyment of this popular drink and her eventual poor physical mobility contributed to her eventual death.

As a child, I watched my grandmothers become weak, lose their speech and become bedridden before their deaths.

They were both diabetics and would have had poor health literacy in their younger days.

Thankfully, both my parents are healthy and my dad just turned 80. I believe this can be attributed to their balanced diets.

I’m also conscious of my own family’s consumption and manage this through my cooking.

Besides food, physical exercise is also necessary. It is no longer an option to say that we have no time to exercise.

A walk in the park may be possible depending on the weather.

However, I believe it is time that more public gyms are created. These gyms could be open from morning to midnight and made accessible to the public for a minimal fee.

The Bangsar Sports Complex at in Bangsar, Kuala Lumpur, has a public gym and it is managed by Kuala Lumpur City Hall. The entrance fee is just RM2.

I hope local councils, especially the ones with city status, will create public gyms with cardio and weight-training equipment.

Cardio activities such as Zumba could also be held at public spaces and should be promoted to the community.

More community-based sports for children, such as football and netball, should also be spearheaded by elected representatives.

Prevention of non-communicable diseases such as diabetes, hypertension and high cholesterol will reduce taxpayers’ funding of the nation’s healthcare services.

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Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose.

Diabetes and insulin


Summary

  • People with type 1 diabetes must inject insulin every day, often up to 4 or 5 times per day.
  • There are different ways to inject insulin ranging from a syringe and needle, to an insulin delivery pen, to an insulin pump.
  • Your doctor or diabetes nurse educator will teach you about how, where and when to inject insulin, and how to store it safely.
  • Even with the help of your doctor and diabetes nurse educator, it may take a while to find the right insulin dose to reduce your blood glucose to your target levels.
  • What is Type 2 Diabetes?

Type 2 diabetes is a common metabolic condition that develops when the body fails to produce enough insulin or when insulin fails to work properly, which is referred to as insulin resistance. Insulin is the hormone that stimulates cells to uptake glucose from the blood to use for energy.


Image Credit: Created with the assistance of DALL·E 3

When this is the case, cells are not instructed by insulin to take up glucose from the blood, meaning the blood sugar level rises (hyperglycemia).

Prevalence and Risk Factors

People usually develop type 2 diabetes after the age of 40 years. However, people of South Asian origin are at an increased risk of the condition and may develop diabetes from age 25 onwards. The condition is also becoming increasingly common among children and adolescents across all populations. Type 2 diabetes often develops due to overweight, obesity, and lack of physical activity, and diabetes prevalence is on the rise worldwide as these problems become more widespread.

Heterogeneity and Genetic Factors

Type 2 diabetes is a heterogeneous disorder characterized by varying degrees of beta cell dysfunction in concert with insulin resistance. The strong association between obesity and type 2 diabetes involves pathways regulated by the central nervous system governing food intake and energy expenditure, integrating inputs from peripheral organs and the environment. Genetic susceptibility and environmental factors, including the availability of nutritious food and other social determinants of health, play significant roles in the development of diabetes and its complications.

Global Impact In 2021, the global prevalence of diabetes mellitus was estimated to be 6.1%, representing 529 million people, with prevalence estimates in certain regions as high as 12.3%. Type 2 diabetes accounts for 96% of cases, and greater than 50% of type 2 diabetes is attributable to obesity. The trajectory of the diabetes pandemic is concerning, with an estimated 1.31 billion individuals projected to have diabetes by 2050.

Types of Diabetes

Also known as juvenile diabetes, type 1 diabetes usually occurs in childhood or adolescence. In type 1 diabetes, the body fails to produce insulin, so patients have to be given the hormone. This is why the condition is also known as insulin-dependent diabetes mellitus (IDDM).

Type 2 diabetes mellitus is also called non-insulin-dependent diabetes mellitus (NIDDM) since it can be treated with lifestyle changes and types of medication other than insulin therapy. Type 2 diabetes is significantly more common than type 1 diabetes.

Symptoms of Type 2 Diabetes

The increased blood glucose level seen in diabetes can eventually damage a person’s blood vessels, nerves, and organs. The body attempts to remove the excess glucose through urination, and the most common symptoms of type 2 diabetes include the following:

  • Polydipsia (increased thirst)
  • Polyphagia (increased hunger)
  • Polyuria (increased frequency of urination), especially during the night
  • Extreme fatigue, weight loss, and sudden loss of muscle bulk.

Some of these symptoms are also seen in type 1 diabetes, but type 2 diabetes symptoms tend to develop more gradually and can take months or years to manifest. This can make it more difficult for people to tell they have an underlying health condition, and often, people have had type 2 diabetes for a long time before it is finally diagnosed.

Risk Factors

Several factors can increase a person’s risk of developing diabetes. Examples include:

  • Overweight or obesity
  • Unhealthy diet
  • A waist measurement of 31.5 inches or more among women
  • A waist measurement of more than 37 inches among men
  • Low levels of physical activity
  • Raised cholesterol
  • High blood pressure
  • South Asian ethnicity
  • Smoking

A family history of diabetes also increases a person’s risk of developing the condition. Studies have shown that the offspring of families where one parent has diabetes have a 15% increased risk of developing the condition and that offspring born to two parents with diabetes have a 75% increased risk.

Complications of Type 2 Diabetes

The high blood glucose seen in diabetes can damage blood vessels, nerves, and organs, leading to a number of potential complications. Some examples of the complications caused by diabetes include the following:

Cardiovascular Disease

Persistently high blood glucose levels can lead to atherosclerosis, increasing the risk of heart disease and stroke. This includes narrowing and clogging of blood vessels with fatty plaques, which can disrupt blood flow to the heart and brain.

Nervous System Damage

Excess glucose in the blood can damage small blood vessels in the nerves, causing a tingling sensation or pain in the fingers, toes, and limbs. Nerves outside of the central nervous system may also be damaged, a condition known as peripheral neuropathy. If nerves of the gastrointestinal tract are affected, vomiting, constipation, and diarrhea may occur.

Diabetic Retinopathy

Damage to the retina may occur if tiny vessels in this tissue layer become blocked or leak. The light then fails to pass through the retina properly, which can cause vision loss.

Kidney Disease

Blockage and leakage of vessels in the kidneys can affect kidney function. This usually happens due to high blood pressure, and blood pressure management is an integral part of managing type 2 diabetes.

Foot Ulceration

Nerve damage in the feet can mean minor cuts are not felt or treated, leading to a foot ulcer developing. This happens to around 10% of people with diabetes.

Prevention, Treatment, and Care

Blood sugar should be regularly monitored to detect and treat any problems early. Treatment involves lifestyle changes such as eating a healthy and balanced diet and regular physical exercise. If lifestyle changes alone are not enough to regulate the blood glucose level, anti-diabetic medication in the form of tablets or injections may be prescribed. In some cases, people who have had type 2 diabetes for many years are eventually prescribed insulin injections.

Maintaining a healthy blood glucose level, blood pressure, and cholesterol is essential to preventing the complications of type 2 diabetes. Overweight or obese individuals with diabetes often significantly reduce the extent of their symptoms by making adjustments to their lifestyle.

Recent Therapeutic Advances

Maintaining a healthy blood glucose level, blood pressure, and cholesterol is essential to preventing the complications of type 2 diabetes. Recent advances in therapy include the use of GLP-1 receptor agonists, which have shown positive effects beyond glycemic control, such as weight loss and reduced cardiovascular mortality. These therapies represent a new era in diabetes treatment, impacting both metabolic control and cardiorenal complications.

Gut Microbiota and Type 2 Diabetes

The gut microbiota (GM), comprising trillions of microorganisms in the gastrointestinal tract, plays a crucial role in the development of obesity and related metabolic disorders, such as type 2 diabetes. Studies show that GM dysbiosis is linked to increased energy extraction, altered metabolic pathways, and inflammation, contributing to obesity, metabolic syndrome, and type 2 diabetes. The GM influences nutrient absorption, immune regulation, and energy metabolism.

Impact of Diet and Lifestyle

Dietary habits significantly influence GM composition and microbial metabolites that regulate host metabolism. A Western diet, rich in fat and sugar but low in fiber, is associated with GM dysbiosis. Conversely, adherence to a Mediterranean diet increases short-chain fatty acid (SCFA) levels, promoting metabolic health.

Microbial Diversity and Health

The human GM consists of approximately 100 trillion cells, with the highest diversity found in the colon. A diverse GM is rich in number and variety, playing a key role in maintaining metabolic health. Disruptions to GM diversity due to diet or medication can lead to metabolic diseases.

Emerging Therapies Targeting GM

Potential therapies targeting GM include dietary modification, prebiotics, probiotics, and fecal microbiota transplantation (FMT). These interventions aim to restore a healthy GM composition, improving metabolic health and reducing the risk of type 2 diabetes and obesity.

Sources

  1. NHS. “What Is Type 2 Diabetes?” NHS, NHS, 18 Aug. 2020, www.nhs.uk/conditions/type-2-diabetes/.
  2. National Institute for Health and Care Excellence. (2022, June 29). Overview | Type 2 diabetes in adults: management | Guidance | NICE. Nice.org.uk; NICE. https://www.nice.org.uk/guidance/ng28
  3. http://www.diabetes.ca/files/Prediabetes-Fact-Sheet_CPG08.pdf (no longer active)
  4. Diabetes UK. “Type 2 Diabetes.” Diabetes UK, Diabetes UK, 18 May 2023, www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2.
  5. “Type 2 Diabetes - Symptoms and Causes.” Mayo Clinicwww.mayoclinic.org/diseases-conditions/type-2-diabetes/home/ovc-20169860.
  6. Sasidharan Pillai, S., Gagnon, C. A., Foster, C., & Ashraf, A. P. Exploring the Gut Microbiota: Key Insights into Its Role in Obesity, Metabolic Syndrome, and Type 2 Diabetes. The Journal of Clinical Endocrinology & Metabolism. DOI:10.1210/clinem/dgae499, academic.oup.com/.../7718329?login=false
  7. Diabetes mellitus—Progress and opportunities in the evolving epidemic Abel, E. Dale et al. Cell, Volume 187, Issue 15, 3789 - 3820, https://www.cell.com/cell/fulltext/S0092-8674(24)00703-7

Further Reading