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– You become crippled in an instant. Tongue and lips are dead, as if they were under dental anesthesia. You look at your hand and you cannot move it – says Michał Figurski. He was lucky – in the same situation half of Poles cannot eat, walk or use the toilet on their own. Stroke in Poland reaches 30- and 40-year-olds. Only rehabilitation could help them. But not the one offered by the National Health Fund.
We remind you of the text that appeared on our website in 2016
In Poland, the number of people dying from stroke is one of the highest in Europe. Within an hour, eight people have a stroke, three of whom die. Of those who survive, every second person becomes an invalid. That’s 25 percent more people than in other countries. – The main reason for this is limited access to rehabilitation – specialists are alarming. The situation is all the more dramatic as the first year after stroke is crucial.
No pills will help
A well-known journalist and radio and TV presenter, Michał Figurski, struggled with the paresis of the left side of his body after a stroke. Initially, he could neither walk nor speak. – I couldn’t move my left hand. I felt as if I wanted to guide the hand of a stranger sitting next to me. I had a problem with getting up, and when I finally managed to do it, I had the impression that I was hanging in the air because I couldn’t feel my left leg at all – he recalls.
Today, thanks to intensive therapy, he speaks as before and regains control over his body. He pays for the therapy. The one offered under health insurance lasts only 3-4 months. Unfortunately, this time is not enough for almost anyone who has had a stroke to regain independence. – A stroke is a devastation of the body. No pills will help. Rehabilitation is the only salvation. It should be reimbursed in the same way as pharmacological treatment – says the journalist.
- Check: Do your research and avoid a stroke!
I will hire a rehabilitator privately
Many patients are in a similar or worse situation – they can only dream of a private rehabilitator, because they lack money. Plus, they have no idea where to go for help. In Poland, there is no central registration system thanks to which people after a stroke could enroll in rehabilitation under the National Health Fund.
In 2016, journalists from Fakty TVN made material about 45-year-old Robert Wierzbicki, who had suffered a stroke and was qualified for treatment at the 22nd Military Health Resort and Rehabilitation Hospital in Ciechocinek in 2036, ie in … 20 years. There are many more people like Robert in Poland.
Meanwhile, rehabilitation after a stroke is to begin immediately, while the patient is still in bed. And this is on the first or second day after the stroke. Directly from the hospital ward, one third of patients should immediately go to an intensive stay of at least several weeks. This is the only chance to regain independence.
– If the patient was lucky in the misfortune and ended up in a hospital with a rehabilitation ward, he may be referred automatically. However, if there is no such ward, after leaving the clinic, a frantic search for a rehabilitation site and waiting in line begins. Meanwhile, early – usually five-week therapy is just an introduction to further rehabilitation – says physiotherapist Adam Siger, vice president of the Brain Stroke Foundation.
This happiness he talks about happens only to half of Polish patients. They begin rehabilitation in the first days of their stay in the hospital. They have physical therapy, occupational therapy, speech therapy, neuropsychotherapy, and good nursing care.
The problem with post-stroke rehabilitation is well known to physiotherapists, because they observe the patient closely. They postulate to increase funds for the financing of early rehabilitation, carried out within six months after the stroke. A few years ago, they organized protests all over Poland and wrote letters to the Ministry of Health. With no effect. Where does such poor access of Polish patients to rehabilitation come from? From the low valuation of these services by the National Health Fund – for a week of stay in the neurological rehabilitation department, he pays about 1,8 thousand. zloty. Privately, this service costs over a thousand zlotys more.
With a stroke like playing the piano
A stroke causes part of the brain is ischemic and causes necrosis. Until recently, it was believed that nervous tissue was unable to regenerate. Fortunately, it turned out otherwise. Even a healthy person does not use all of the brain, and when some of it dies, the rest can take over other functions. For this to work, you need stimulation. Stimulating the body to move activates the brain.
– It’s just like a child learning to play the piano. Initially, he can knock out sounds with just one finger. Continuous exercise activates the brain and the young pianist is able to coordinate the work of both hands on the keyboard. Rehabilitation works on the brain in a similar way, explains the neurologist Dr. Adam Kobayashi. He talks about many of his stroke patients returning to work:
– One of them – forty years old, was unable to walk and move his right arm as a result of a stroke. After two years of rehabilitation, he came to me on his own and informed me that he was starting work. Another patient, due to a stroke, stopped seeing in one eye. Rehabilitation also brought good results in this case. The sick person can even see and drive a car – says the doctor. He also remembers the coach of the first league volleyball team, who returned to his profession thanks to intensive rehabilitation after a stroke.
Quick rehabilitation is a miracle
– Many effects of a stroke can be reduced thanks to treatment and intensive and professional rehabilitation – says Adam Siger. It is difficult to get into early post-stroke rehabilitation. At its second stage, the so-called secondary rehabilitation, even worse. Patients wait for her even … five years.
What does it mean? The fact that everything that was achieved right after the stroke in the rehabilitation department of the hospital is wasted. The patient can, of course, buy the therapy privately, but its monthly cost in a specialist center is about PLN 6–9. And the best institutions want up to 15 for it. A patient who needs therapy at home has to pay about PLN 100 per hour, which means that he has to spend PLN 2 per month. For many patients, this is an unattainable amount. Especially since the disease prevents them from working. – Unfortunately, rehabilitation available in Poland covers only 40 percent of the patient’s needs – says Dr. Kobayashi.
There were no blows
Doctors emphasize that any persistent, previously unprecedented headache requires diagnostics. Especially since the symptoms of a stroke are often unusual. The most characteristic symptom is drooping of one eyelid, corner of the mouth, paresis of the arm or leg.
“Sometimes you don’t even feel it,” explains Dr. Kobayashi.
If someone close to you notices it, he should ask: “put both hands out in front of you”. The symptom of a stroke will be holding one hand higher than the other. Alternatively, we recommend: “squeeze your hand, first with your left hand, then with your right hand”. The difference in the strength of oppression is already an indication to call an ambulance. Also the situation when someone cannot touch his nose with his finger with his eyes closed. Of course, speech disorders are also disturbing symptoms. The sick person may gibberish as if they were drunk. It also happens that he has trouble understanding what is said to him.
– The problem with a stroke is that it doesn’t hurt. As opposed to a heart attack, which manifests itself in severe pain. Meanwhile, every minute counts, warns Dr. Kobayashi.
Unfortunately, the doctors themselves do not recognize a stroke in time. And although it is not a problem for an experienced neurologist to say that something is happening in the central nervous system, a headache or tingling in the arm or leg is so little characteristic that other doctors may ignore it. “And the time when you can help the patient the most is about four and a half hours,” explains Dr. Kobayashi.
Find out more:
- We don’t deal with strokes
- How is rehabilitation after a stroke?
- Stroke rehabilitation – act fast
Death every six seconds
The statistics are appalling. It is estimated that every sixth person in the world will suffer a stroke. Every six seconds someone will die from it and every six seconds someone’s quality of life will decline.
In Poland, the number of people dying from stroke is one of the highest in Europe. Of those who survive, every fifth does not walk, and almost half need help with basic activities – eating or using the toilet. This condemns patients to job loss and isolation.
– Man becomes depressed and does not find the strength to fight to return to normalcy. Meanwhile, rehabilitation requires a lot of self-denial. I am motivated by the fear that my illness might prevent me from doing what I like. I am in a hurry to live – says Michał Figurski and emphasizes that it is very important in such moments to have the support of a psychologist.
Youth does not protect
In Poland, as many as 75 people have a stroke each year. 85 percent of the cases are ischemic strokes, 15 percent are cerebral hemorrhages. In recent years, the number of strokes among young people has increased by as much as 30 percent. Their main causes in young patients are heart defects, an inborn tendency to clots in blood vessels, dissection of the cerebral and intracerebral arteries as a result of traffic accidents, injuries during sports and intense exercise. Hypercoagulability is especially dangerous in combination with smoking or contraception, as well as untreated atrial fibrillation, hypertension and diabetes.
Prevention of strokes is primarily physical activity, a diet low in animal fats, not smoking, controlling blood pressure, cholesterol and blood sugar levels.
Sounds reasonable. Only who of the young people working from morning to night in corporations has the strength and time to remember and implement it?
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