KALIFA SARAH CLYNE
Dizziness, trouble walking, paralysis on one side of the body, blurred vision, speech problems and severe headaches are all symptoms of a stroke. Former West Indies off-spinner Ranjie Nanan experienced no symptoms at first when he suffered a stroke on March 31. Nanan was at the Queen's Park Oval for a cricket match between T&T and Barbados. At lunch time he tried to stand three times but was unable to. "I got up eventually and walked to my car and started driving," Nanan recalled, his speech now slurred. "I couldn't make it home. I remember a relative came for me and drove me to the Couva hospital." Nanan lost the ability to move the right side of his body. He was transferred to the San Fernando General Hospital where he stayed for a week before returning to his home. Now, several weeks later, Nanan can move both hands and feet. He attends physical therapy every two weeks and although he has slowed down in certain activities, he has improved tremendously. His physical therapy includes exercises for different parts of his body and massages. Adrian Rampersad, 40, of Chaguanas, had a stroke four years ago. His wife, Shelly, says even though her husband is unable to work and or take part in many activities he once enjoyed, like hiking and swimming, his physical condition has improved since his stroke.
"He could barely move on his own and needed help with everything. He got very depressed because he was so young and we didn't expect anything like this to happen to him," Shelly said. "Things are a lot better. He attended physical therapy at the hospital and we did exercises at home." Adrian now enjoys going to the movies and the beach and generally enjoys life. However, he still can't speak properly. While there is a huge demand for physiotherapists in the public health sector, there is no reason why stroke victims should go abroad for treatment says public relations officer of the Physiotherapists Association of T&T, Stacy De Gale. De Gale explained that a stroke occurs when there is a clot or blood flow is blocked to an area of the brain. She said anyone can suffer a stroke but there is a higher risk among men, people with a family history of strokes and smokers. "Going to the United States to seek treatment is not better than staying in T&T," said De Gale. She said she was disappointed when she heard that former prime minister Patrick Manning, who suffered a stroke earlier this year, opted for treatment outside of T&T. "When it comes to a stroke the most important intervention after a patient is stable physical therapy and T&T has very good, trained physical therapists," said De Gale. Private hospitals have state-of-the-art machines for rehabilitation of stroke patients. De Gale admits that physiotherapists are not given any priority in the health sector and in public hospitals here physiotherapy departments are archaic and have not been updated in about 30 years.
"In 1977 at the South West Regional Health Authority there were seven physical therapists on staff. There are still seven physical therapists on staff today," she said. De Gale, who has 12 years experience as a physiotherapist, said therapy can be the key component in rehabilitation of a stroke patient. "Whether we like it or not, you can have physical therapy from now until doomsday and it will only do so much regardless of where you get the treatment. "What a stroke victim requires is early intervention and consistency in treatment. Physical therapists in T&T have been managing stroke patients for years." De Gale said treatment involves a team of professionals, including speech therapists, medical doctors, nurses, internists, psychologists and in some cases neurologists. Dr Peter Baggan, a medical practitioner, explained: "There are two types of strokes, embolic and haemorrhagic. Both need to be managed in two steps." He said the first step is the acute phase, where stabilisation of the patient takes place. During this phase the patients immediate needs are attended to and the extent of the damage caused by the stroke is assessed. "Then we have the recovery phase, which takes longer because the patient has to go to rehab and retrain the muscles with physiotherapy." Dr Baggan said in T&T access to physiotherapists is limited but hospitals have systems in place to handle patients. "Some hospitals-I know Port-of-Spain has it for sure-have physical medicine departments where patients can come with their family members and learn how to do physiotherapy on their own," he said. "A lot of the time depression becomes an issue and people lose motivation because they are not be able to do things they regularly did before." Dr Baggan said it is important for patients to get psychological therapy as well.