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! 

The heart pumps pure blood to all parts of the body through a network of arteries. These are thicker in the beginning and become finer and thinner as they reach the various organs. These arteries are lined by a layer of epithelial tissues and as blood flows through them, the heavier cholesterol / fat molecules settle down along the walls. 


This attracts more and more fat molecules to settle down.  This is known as atherosclerosis (hardening of the arteries). Over a period of time, the vessels circumference reduces and the blood supply to the target organ reduces. This impacts proper functioning of these organs and when this happens to the major organs like the heart, kidney or the brain, conditions like stroke or thrombosis or heart attack can occur.


This condition, known as coronary artery disease, is becoming a major cause of deaths.  While that is the bad news, the good news is that it is largely lifestyle dependent, and if steps are taken, it can be prevented, and in the early stages, the damage completely reversed.


Preventive measures: 
1. Diet: A low-fat, high-fiber, heart-healthy diet consisting of Omega-3 fatty acids is recommended by doctors, especially to people who are prone to develop heart disease.  This also requires reduced salt, increased unsaturated fats, reduced triglycerides and reduced sugar.  Include loads of fresh fruits and vegetables, whole grains, nuts and seeds and fish oils. Include multivitamins or other supplements after checking with your doctor.


2. Exercise:  Regular exercise in any form increases the efficiency of the circulatory system, keeps the cholesterol levels in check and helps in blood pressure management.  Exercise in any form is advisable, based on individual preference. A moderate physical activity of 30 to 45 minutes per day is advisable.


3. Smoking: This is one of the major risk factors for smoking, and quitting or controlling smoking is one of the best methods to prevent coronary artery disease.


4. Alcohol consumption:  While moderate alcohol consumption is believed to be healthy for the heart, excessive alcohol consumption is a strict no-no.  Binge drinking especially is shown to cause heart attacks.


5. Weight management: Check with your doctor on what is ideal BMI for you and work out a plan to keep your weight under check.


6. Regular medications: If you are on blood pressure or diabetes medications, ensure you do not miss them.  Keep a constant check to ensure your readings are managed well. 


7. Watch out:  Ask your doctor if there are specific symptoms that you need to watch out and seek medical support if you see any of them.


Coronary disease is not treatable fully, but can be prevented and managed effectively to improve the overall quality of life.

Coronary Artery Disease - 7 Ways You Can Prevent it 

During breathing activity, chest wall moves out & in, lungs expand & relax. For the smooth movement of the lungs inside the chest cavity, they are lined by pleura.

Pleura includes two thin linings, the layer lining lungs is called visceral pleura and the one lining chest wall is called parietal pleura. The cavity formed between these two layers is called Pleural cavity. It contains a small amount of lubricant called Pleural fluid which helps smooth sliding of two pleural surfaces. Any condition which results in inflammation of the pleural surfaces or accumulation of excessive fluid in the pleural cavity gives rise to symptoms attributable to pleural involvement or disease.

Pleural effusion is nothing but the collection of excess fluid in the pleural cavity. Excess fluid in the pleural space is not normal and can occur due to a variety of reasons. Depending on the chemical composition it is broadly divided into two categories, transudate and exudate. 


What Causes Pleural Effusion?

1. Transudate pleural effusions 

Transudate pleural effusion is formed when fluid leaks from blood vessels into the pleural space. Chemically, transudates contain less protein and LDH than exudates. It is generally seen in the following conditions.

Congestive heart failure

Liver failure or cirrhosis

Kidney failure or nephrotic syndrome

Peritoneal dialysis

2. Exudate pleural effusions 

Exudate pleural effusion is caused by inflammation of the pleura itself and are often due to diseases involving the lung. Following are some common illnesses giving rise to exudate pleural effusion.

Tuberculosis
Pneumonia
Lung or breast cancer
Lymphoma
Pulmonary embolism
Post chest wall trauma or surgery
Asbestosis and mesothelioma
Secondary to intra-abdominal pathology 
Pancreatic pseudocyst, etc
Symptoms of Pleural Effusion -

Chest Pain: Chest pain is mainly due to irritation of the pleural lining. The pain is sharp, localized and worsens with a deep breath, yawning, coughing which is usually described as pleuritic. If the effusion causes inflammation of the diaphragm the pain may be referred to the shoulder or the upper abdomen. As the pleural effusion increases in size, the pain may increase or disappear altogether due to the separation of inflamed pleural surfaces.

Shortness of breath: As the effusion grows larger with more fluid, the harder it is for the lung to expand and the more difficult it is for the patient to breathe resulting in shortness of breath.

Other Symptoms: Other symptoms are generally attributable to the underlying disease process.

Diagnosis of Pleural Effusion -

Patient s Detailed History and Clinical Examination are the mainstays of diagnosing pleural effusion and it s the underlying cause. Following investigative modalities are generally opted for working out the final diagnosis before instituting appropriate therapy.

Chest X-ray: X-ray will help indicate the presence of fluid. 
Chest Ultrasound(USG): will help in confirming the presence of the fluid and it s localization which in turn can guide the physician about its quantity and its capability.
CT Scan: CT scan of the chest may at times be required to ascertain the underlying cause or to know about any other co-morbid conditions.
Thoracentesis: Thoracentesis is a procedure used to sample the fluid from the pleural effusion. Using a long thin needle, fluid can be removed and sent for testing to confirm the diagnosis.
This can be just for diagnostic purposes or can even be used as a therapeutic procedure.
Chemical analysis of the fluid will help determine the type of pleural effusion.
Treatment of Pleural Effusion -

Treatment of underlying Disease: The treatment of a pleural effusion usually requires that the underlying illness or disease is treated and controlled to prevent the accumulation of the pleural fluid. Like anti-TB therapy for Tubercular etiology or treatment of Cancer in malignant pleural effusion, etc.

Thoracentesis: As discussed earlier Thoracentesis can be used as a therapeutic procedure to remove excess fluid and help lung expand and function properly.

Tube thoracostomy: Thoracostomy or chest tube insertion may be done to drain and treat fluids which cannot be removed by needle aspirations, e.g. empyemas (pus collections).

Pleurodesis: Some pleural effusions reoccur multiple times; sclerosing agents that induce scarring such as talc or tetracycline was used to prevent a recurrence.

Decortication: If sclerosing agents fail, surgery may be required, called Decortication.

Pleural Effusion - What Is It?

Automatic Implantable Cardioverter Defibrillator is an electronic device that is located in the chest of the patient suffering from arrhythmia. Arrhythmia is a condition which causes abnormal rhythm of heartbeat in the patients. It is a life-threatening condition. The device is located in the chest to correct the rhythm of a heartbeat.

AICD device works in two ways:

Firstly, it tries to correct the abnormal heartbeat rhythm and release high- speed heartbeat pace. This is called cardioversion. Patients with AICD generally do not feel the process.

However, if the effect of cardioversion is null then the device will give a mild electric shock to the patient's heart to correct arrhythmia and reset the rhythm.

This second method is called defibrillation. The patient can feel the defibrillation.

The modern-day AICD device is programmed to store the data about the patient s heart rhythm. Doctors use the programmed device which contains your condition and provides medically correct therapy.

Preparation for AICD Implantation

The patient is required to fast six hours before undergoing the surgery. On admission, prescribed medicine is given to the patient and the latest heart condition is measured by an ECG test. If the patient is on blood-thinning medication, then it will be stopped 24 hours before the surgery.

The procedure will be carried out by a cardiologist. The patient will remain under observation in the hospital for at least two days.

Procedure

The entire process of setting up the device in the chest of the patient takes about 2 hours. The patient is sedated, and the area below the collarbone is numbed for the operation. A small incision is made in the chest area. With the help of imaging techniques, cardiologist sets up the device in the chest. The device is then connected to the veins and the heart. After the surgery, the patient is kept under observation. Heart rate, blood pressure, and overall health condition are observed by the doctors to determine successful implantation of Automatic Implantable Cardioverter Defibrillator (AICD). Post Procedure After the successful recovery of the patient, doctors usually discharge the patient with AICD attached. The doctors give complete care instructions of the device along with health. Doctors also guide the patient through the list of activities that one can and cannot perform. AICD is a life-saving device. Hence, proper care and regular check-ups are recommended by the doctors. The regular check-up of the device is also essential since the device runs on a battery. The doctors also train the patient about the workings of the device. They will also explain about the mild shocks of the device one may receive to correct the arrhythmia. Before leaving, make sure the site of the surgery is dry and healing, and you do not have a fever for the past 24 hours.

AICD Implantation - Know Procedure Of It!

Coronary artery disease or CAD is the name given to the heart condition in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased.

Blockages usually happen when cholesterol-containing deposits called plaque deposit in your arteries. Plaque narrows the lumen of your coronary artery which means your heart gets lesser and lesser oxygen and nutrients to function properly.
Inflammation is also to blame for coronary artery disease.
Common symptoms of CAD include

Angina or pain in the chest
Shortness of breath
If the blockage is complete, you can get a heart attack.
Common Diagnostic tests
When you go to a heart specialist, she will ask questions about your medical history and follow it up with a physical exam and order routine blood and diagnostic tests to confirm CAD like:

Electrocardiogram (ECG): An ECG records electrical signals as they travel through your heart revealing evidence of a previous heart attack or one that s happening. Holter monitoring is a type of ECG where you wear a portable monitor for 24 hours as you go about your normal daily activities. Abnormalities in the results suggest reduced blood flow to the heart signaling CAD.
Echocardiogram: This test uses sound waves to produce images of your heart. It helps your doctor determine whether all parts of your heart wall are contributing to your heart's pumping activity. If certain parts are moving weakly it can mean damage to muscle due to a heart attack or because of receiving too little oxygen- again signaling CAD.
Exercise Stress test: This test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an ECG. Sometimes, medication to stimulate your heart may be used instead of exercise.
This again detects areas in your heart that receive less blood flow.

Cardiac catheterization or angiogram. A special dye is injected into your coronary arteries to observe blood flow through your heart in a test known as an angiogram.
The dye is sometimes also injected into the arteries through a long, thin, flexible tube called catheter that is threaded through an artery in your leg to the arteries in your heart. This procedure is called cardiac catheterization. This test is very good in diagnosing CAD as the dye outlines narrow spots and blockages on the X-ray images of your heart.
Heart scans. Computerized tomography or CT can help your doctor actually see calcium deposits in your arteries that can be narrowing your arteries. If a substantial amount of calcium deposits are found, coronary artery disease could be the reason.
MRI scans are also done to diagnose CAD.

Common Tests For Coronary Artery Disease!

Cholesterol is either ingested in the food (about 25% ) we eat and some of it is produced by our body (remaining 75%). Cholesterol is needed by the body to produce steroid hormones and bile acids. It is an aspect that is required by the body and if in too much quantity, the same can cause havoc in the body. The best is to maintain the right balance of cholesterol in our diet. The same requires lifestyle and dietary modifications.

The first step in creating your low cholesterol diet plan is to eliminate foods high in saturated fat and bad cholesterol.

Low cholesterol foods diet mainly includes:

1. High-Fiber Diet- Soluble fiber reduces bad cholesterol. Good food sources are oatmeal, fruits and vegetables.

2. Cooking oil- Fats makes about 30 % of your days intake. A combination of oils works the best. Foods rich in saturated fats are butter, ghee, cream, and cheese. These need to be taken in moderation or avoided. Avoid fried foods. Not more than 10% of total calories should be from Polyunsaturated Fatty Acids (PUFA) and the remaining should be from Monounsaturated Fatty Acids (MUFA). The best sources of PUFA are plant based oils, sunflower, corn, soybean, cottonseed and safflower. MUFA are found in the largest amounts in olive, canola, mustard, almond and peanut oils.

3. Avoid Trans fats- Read labels carefully and do not reuse oil used for frying.

4. Go lean- Choose lean meat and fish. Fish is a good source of omega-3 fatty acids. Foods high in omega 3 help you lower down the risk of cardiovascular disease. Tuna and salmon are a good source of omega-3 to name a few.

5. Eat a wide range of fruits and vegetables- This will help ensure that your body meets all the vitamins and nutrient requirement. Fruits and vegetables are relatively low in calories. Apples and pears are known for soluble fiber, which reduces bad cholesterol levels. It is best that you eat good quantities of the same.

6. Include low-fat dairy products- avoid ghee, cheese, cream, paneer and butter. Opt for lighter and healthier options.

7. Exercise well - Exercise at least 30 mins per day. Workout will help you burn extra fat resulting in lowering cholesterol levels.

Cholesterol - How To Manage It?

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