Stroke is a medical condition in which the flow of blood towards the brain is poor and causes the death of certain cells. There are two common types of stroke: 

1. Ischemic- due to lack of blood flow
2. Hemorrhagic- due to bleeding

Signs and symptoms of stroke 

Problems with movement
Inability to feel  on one side of the body
Problems understanding or in speech
Vertigo
Loss of vision
Difficulty in carrying out everyday activities
Role of Physiotherapy for Patients with Stroke

The main focus of physiotherapy is to help you use your arms and legs to regain as much strength and movement as possible. 
If you have one-sided paralysis, correct positioning is important to prevent spasm or injury.
It helps you to sit up as this will help you avoid blood clots in your legs, improve your breathing and help you recover quickly.
If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection.
What does a Physiotherapist do?

A physiotherapist advises you on how you should be positioned when lying or sitting, and how often you need to be moved.
Motivates you to be actively involved in your physiotherapy sessions to help you relearn normal patterns of movement
Decides when you should begin to start walking and what equipment is needed to move or support you
Provides therapy to strengthen your limbs and teach you how to move again as independently as possible
Takes care of the fact that no complications should arise and you have a smooth recovery.
Treatment Techniques:

Strength Training: It is evident that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Gaming: Goal orientated computer gaming has proven to significantly reduce upper limb impairment in stroke survivors.
Virtual Reality: Virtual reality training has been shown to be effective in restoring upper limb motor impairments and motor-related functional abilities.
Mirror Therapy: Mirror therapy has been shown to have a beneficial effect on motor control and function compared to conventional therapy.
Robot-Assisted Therapy: It has been shown to have a beneficial effect on motor recovery and function.
In the upper extremity with severe impairment and/or poor prognosis for recovery, Chedoke McMaster Stroke Assessment (CMSA) of Arm and Hand < Stage 4) treatment should focus on maintaining a comfortable, pain-free, mobile arm and hand. Engage in repetitive and intense use of novel tasks that challenge the stroke survivor to acquire necessary motor skills to use the involved upper limb during functional tasks and activities. Engage in motor-learning training including the use of imagery.

Stroke - How Physiotherapy Can Help With It?

How many of us have heard about Extracorporeal Membrane Oxygenation (ECMO) before Tamil Nadu, Chief Minister late J Jayalalithaa was put on it for recovery? Hardly a handful. Patients who are placed on the device have 50-50 chance of survival and while it could not help the late Chief Minister, her condition put a spotlight on ECMO.

What is ECMO?
ECMO is a life support device that is put in place when a patient's heart and lungs stop functioning completely post a cardiac arrest. When the patient does not respond to Cardio Pulmonary Resuscitation (CPR), the patient is put on ECMO.

Function of ECMO
The core function of the device is to separate carbon dioxide from the blood and add oxygen into it. It takes the load off from heart and lungs, providing critical time to the body organs for its treatment and recovery.
Patients are only put on ECMO, if there is a chance that the condition can be reversed.

How does ECMO work?
The device drains blood from a vein, which is attached to an oxygenator machine. The machine then removes carbon dioxide from the blood and adds oxygen to it. Depending upon the condition of the patient, the warm blood is either pumped into the body with the help of the machine or is transferred back into the body through an artery.

How long a patient can be on ECMO?
After seven days of being put on ECMO,there are chances of patient getting an infection.
In case the patient contracts an infection, it is recommended to take the patient off ECMO support.

All About ECMO - Extracorporeal Membrane Oxygenation 

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Stroke is one of the major reasons for disability in adults. In the US alone, 7 million people suffer from a stroke in a year. After a stroke, the affected individual suffers from lots of health issues. They feel week and fatigued. An ache in one side of the body, inability to walk, and social disability are experienced. Emotional and cognitive functioning is disturbed. Continuum care is recommended for the affected individuals and they need interdisciplinary care to ensure they can do things independently. This is where occupational therapy plays a vital role.

What does the therapist do? 

Using a range of evidence-based methods, the occupational therapists can address the physical, emotional, and mental challenges caused by the stroke. Occupational therapy does not concentrate only on the ailment. It takes into account the emotional needs, desires, limitations, and activities of the stroke survivors. It helps them to recoup the skill to get the daily chores done independently. An occupational therapist surveys the home of the stroke survivor and evaluates the risk of hazards. The practitioner also helps the affected individuals in coping with the loss of vision and memory. The physical strength and fortitude are augmented. The major focus will be on making the affected reach the heights of performance in the valued occupations.

How does it help? 

Studies prove that occupational therapy does not only help one to recover faster, but also prevents worsening of the condition further. The stroke survivor, who receives the occupational therapy, is independent when it comes to daily living chores. Wouldn t it be a great improvement on the emotional health when the affected feels he or she can get things done with little or occasional help? Also, this reduces the caregiver burden. The family is relieved that the survivor can eat, bath, and take a few things without someone having to sit closer and help. This mentally boosts the caregivers and the family to motivate the survivor. The stroke survivor also looks forward to the rehabilitation treatment as the occupational therapy makes them feel great.

Transitional and community integration services can make sure that the patients are engaged in their specific environments, once they get back home after occupational therapy in the specialized care center. After a certain period, when the stroke survivors show considerable improvement, the practitioner again evaluates to find if activities like driving can be resumed by the clients. Community mobility of different choices is recommended if the client is not fit for driving. There are driver rehab programs and the driving skills can be regained.

An occupational therapist spends more time with the client than any other healthcare professional. This is because the practitioner is responsible for alleviating the challenges faced by the affected individual emotionally and physically. The practitioner not only helps the client to achieve the goals but also ensures that the client is psychologically motivated whenever he or she is discouraged. Rehabilitation can reverse the damage done to the brain. But it takes lots of efforts to learn the things to do them in a different way. An occupational therapist makes this goal easier for his or her clients.

Occupational Therapy For People Recovering From A Stroke! 

Hypertension is a condition where the blood has to exert extra pressure to flow through the blood vessels. While there is a genetic component to it, the more strong contributing factors are modified lifestyle and dietary changes. There are also a lot of environmental changes that have contributed to this new epidemic. While earlier people in their 50s and 60s would be diagnosed with hypertension, now there are people in 30s and 40s taking hypertension pills. Excess fat accumulation is the major cause of hypertension in younger patients.

There begins the complexity of the issue. Hypertension which requires medications to control it, they lead to side effects and bring in a host of other diseases like diabetes, and obesity which in turn bring in a whole lot of complications. A more easy way to manage would be to prevent and of course, after onset, look at how naturally it can be managed.

Ayurveda has numerous substances that have been proven to have beneficial effects in controlling blood pressure over the past 1000s of years.

1. Celery or ajwain helps blood vessels to dilate and reduces concentration of stress hormones in the blood.

2. Ashwagandha has a wide range of actions and improves the body's ability to handle physical and mental stress. This in turn improves blood pressure, obesity, and depression.

3. Citrus fruits contain vitamin c which prevents fragility of the capillaries (thinner blood vessels).

4. Cow's urine prevents hardening of blood vessels and is of curative value in those who have blood pressure due to hardening of blood vessels. 

5. Triphala which is a combination of amla, haritaki, and bibhitaki helps reduce inflammation that leads to blood pressure, thereby helping to control it.

6. Jatamansi - by helping the free radical damage on the arteries, it protects the arteries and prevents cholesterol accumulation. It also is a very well-proven stress reliever and has additional benefits on hypertension.

7. Arjuna - by helping the metabolism of the bad cholesterol in the liver, this protects the inner lining of the heart and thereby helps control hypertension.

8. Calcium and potassium containing substances help remove sodium and thereby improve blood pressure.

9. Natural herbs like brahmi, sarpagandha, shankhpushpi, and chandana are effective ayurvedic cure and treatment for hypertension.

10. Rasayana treatment from ayurveda is having excellent results, however everyone requires unique rasayan as per their body types.

11. Watermelon helps in dilation of the blood vessels.

12. Aloe gel, barberry, calamus, valerian, skullcap, gotu kola cayenne, myrrh, motherwort, hawthorn and jatamansi have all been shown to help manage hypertension over thousands of years.

13. A glass of warm milk mixed with saraswat powder is also helpful for patients with high blood pressure.

These are natural remedies which were a part of diet since times immemorial. Including them in the diet, reducing processed foods, regular exercise, avoiding alcohol and smoking can be some natural ways to prevent and if required control hypertension. Stress is here to stay, but can definitely be managed with a little conscious effort.

Control Blood Pressure With Ayurveda

Cholesterol is a type of fatty acid that is produced by the liver. The body uses cholesterol to perform various activities such as synthesizing of hormones, bile acid and vitamin D. Ayurveda views it as an important component of the body in terms of lubrication. The Ayurvedic approach of balancing cholesterol is not only to curb the cholesterol amount, but also to strictly control diet so that the secretion of cholesterol can be curtailed. Here are a few Ayurvedic hat-tips that can help to lower cholesterol and restore normal body function of the body:

Medicago satina: They are better known as Alfalfa and is famous for their ability to deal with artery-related diseases. They are capable of clearing arteries that are congested with cholesterol. They can be consumed daily as a whole or by mixing them in juice.
Arjuna: Arjuna is yet another powerful Ayurvedic herb that is mighty powerful in dealing with cardiac conditions such as heart blockages, heart attacks etc. The bark of the Arjuna tree can be taken and consumed in the form of powder. They have the capability to dissolve cholesterol and prevent heart blockages. This should be consumed earlier in the morning, before breakfast with lukewarm water.
Coriander: Coriander is considered to be one of the best herbal diuretic agents. It can revitalize the kidneys and help them perform better in terms of excretion of waste. The kidney, therefore, can flush the excess cholesterol from the body. Coriander can be consumed along with food on a daily basis.
Garlic: Garlic again has been known to mankind for centuries and is extremely beneficial for people suffering from high cholesterol. Two cloves of garlic on a daily basis can completely neutralize the effect of high cholesterol in the blood. Apart from freeing up arteries, garlic has multiple other health benefits.
Guggulu: This herb is one of the popular herbs among ayurvedic practitioners for treating high blood pressure and high cholesterol in the blood. They contain guggulsterones, which is known to be an active blocker of bad cholesterol in the blood. Consumption of 25 mg of this substance can make a person totally free from high cholesterol. They can be taken after any meals.
Holy basil or tulsi: Holy basil is another popular and traditional Indian hub that is extensively used by ayurvedic practitioners to treat high cholesterol in the bloodstream. They can eliminate excess cholesterol through the kidneys. It is used for preparing multiple medicines. It is a proven medicinal herb that is very efficient in dealing with excess cholesterol in the blood. They have the ability to disintegrate cholesterol from the body. 2-3 leaves of tulsi can be consumed on a daily basis.

High Cholesterol - 6 Top Ayurvedic Remedies to Lower It!

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