Strokes in Canada

This article was published in The West End Times September 24, 2011.

As the fourth leading cause of death in Canada, stroke affects thousands of people across the country.

Each year, there are approximately 50,000 strokes in Canada resulting in 16,000 deaths. That is, one stroke every 10 minutes. A stroke survivor has a 20% chance of having another stroke within two years.

About 80% of strokes are ischemic caused by the interruption of blood flow to the brain due to a blood clot. About 20% of strokes are hemorrhagic caused by uncontrolled bleeding in the brain.

About 300,000 Canadians are living with the effects of stroke. I know that I have recently talked about strokes but today I want to re-emphasize the importance of fast action when symptoms occur.

For every minute delay in treating a stroke, the average patient loses 1.9 million brain cells, 13.8 billion synapses, and 12 km of axonal fibers. Each hour, in which treatment does not occur, the brain loses as many neurons as it does in almost 3.6 years of normal aging. Canadians spend a total of 3 million days in hospital because of stroke.

One May evening, George was walking with his wife when, all of a sudden, he felt an intense headache coming on. A few days later, he woke up in the hospital, unable to express himself or to understand what others were saying. Simon, a 57-year-old husband and a father of two teenagers, was now aphasic. I have had recent calls about rehabilitation after stroke in the community and I want to talk about one of the great difficulties people have…. “Dealing with Aphasia.”. 30-40% of people who have suffered from a stroke have some degree of Aphasia. Aphasia is an acquired language disorder due to brain damage. People with Aphasia may have difficulty with language in all forms: understanding what others are saying, putting their thoughts into words, understanding what is read, writing (with pen and paper and on the computer) and judgment, or problem-solving skills. Aphasia can range from mild (sometimes difficulty thinking of a word) to severe (little to no ability to speak). All people with Aphasia have some degree of difficulty recalling words. This is like “having that word right on the tip of the tongue” feeling all of the time.

A person with Aphasia may say one word but mean to say something else. Individuals with Aphasia find that some things are much easier to say than others. The more the person has to think about what he/she is saying, the harder it will be. “Automatic” phrases are generally easier to say because they don’t require much thought or are over-learned. Some examples are phrases such as “good morning“, “I don’t know“, “uh oh” and swear words.

Words that are can be difficult for people with Aphasia are often very close in meaning, opposites, or can seem to have abstract meaning. People with Aphasia can mix them up or substitute one for another. Some examples include: Man/Woman, Left/Right, Yes/No.

Once we lose the ability to communicate, life becomes even more difficult. These language problems have a serious impact on an individual’s personal and professional life, as well as on his/her overall functioning in society. Physical changes as a result of a stroke are devastating but with time and physiotherapy, we can see improvements. Dealing with Aphasia is often a much slower process and we don’t always have the resources for the necessary long term rehabilitation. Rehabilitation within the healthcare system for individuals with Aphasia can last anywhere from a couple of months to a few years. The Speech-Language Pathologist should take part in that process through evaluation and intervention services.

Unfortunately there are not enough of them and often their attention is focused on children with speech difficulties.

What are we going to do about this huge problem?? You might have already thought about a solution….More frequent access to therapists and therapy using, you guessed it, “Technology.” Therapists can teach the treatment exercises to other health professionals and caregivers and care can be provided on an ongoing, frequent basis. This can be done remotely with an occasional follow-up by the speech therapist. This can only be possible if we embrace change and believe in the options. To be continued…

What if it was you or your loved one?