Stroke Awareness

Introduction

A stroke is when a part of the brain is damaged because of a problem with blood flow.

Strokes are common and according to stroke.org.uk in the UK alone, a stroke happens every 5 minutes. They can occur in both adults and children.

When someone has a stroke, they can lose important ways in which their brain works. For example, some people lose some of their ability to move or speak. Strokes can be fatal and are one of the main reasons people cannot work in the UK.

Statistics

Strokes are the…

4th biggest cause of death in the UK.

One of the biggest factors with strokes is an individual’s age, and it is a lot more likely for strokes to occur in people over the age of 55. Annually, it is the cause of 35,000 deaths a year which equates to a life being lost every…

17 Minutes (brainresearchuk.org.uk)

Whilst having a stroke at an older age is more common, there is evidence of strokes also occurring in younger people. The National Institute for Health and Care Excellence found between 2007-2016 over…

1/3 of strokes happened in adults aged 40-69.

In 2019 Stroke Association released research which showed 15% of people who survived strokes and returned to work felt unsupported by their employers with…

37% of stroke patients under the
age of 65 giving up work

…and 9% missed out on promotions or were made to feel redundant.

The FAST Test

The signs of a stroke vary from person to person, but the most common test is known as the FAST test. Symptoms of a stroke usually start suddenly.

FACE – Has their face dropped on one side? Can they smile? Has their mouth or eye become drooped?

ARMS – Can they lift and hold up their arms? Do they have any numbness or weakness?

SPEECH – Is their speech slurred? Are they able to talk? Can they understand clearly what you’re saying to them?

TIME – Call 999 as soon as possible if you notice any of the symptoms above.

Strokes can also cause symptoms which affect balance, such as having trouble walking or standing. Vision can also be affected. A stroke is caused by bleeding in the brain so can also cause a sudden, severe headache.

Other than the FAST symptoms there are also many more signs of a stroke, a few to be aware of are listed below:

  • Sudden loss or blurring of vision
  • Being sick or feeling sick
  • Confusion
  • Balance and co-ordination problems
  • Difficulty swallowing, also known as dysphagia
  • Sudden and severe headaches that cause blinding pain

If you or someone around you is experiencing one or multiple of the symptoms above, it is important to seek medical attention immediately.

Types of Stroke

There are 2 types of stroke:

  • Ischaemic stroke which happens when a blood vessel in the brain gets blocked.
  • Haemorrhagic stroke, which is caused by bleeding in the brain or surrounding area.

It is important to note the different types because the treatment and outcomes depend upon the type of stroke, the time that has passed from the onset of the first symptom, and the individual’s medical conditions.

Ischaemic strokes are the most common type, and this is where the flow of blood and oxygen to the brain is blocked due to a blood clot. These clots usually form in areas where the arteries have narrowed or are totally blocked because of fat build up in a process called Atherosclerosis.

Haemorrhagic strokes can also be referred to as cerebral haemorrhages, Intercranial haemorrhages or subarachnoid haemorrhages, and this is the less common form of a stroke. These can occur when the blood vessels inside the skull burst and bleed into and around the brain.

The main cause of this type of stroke is high blood pressure as this weakens the arteries in the brain and causes them to become more likely to rupture.

All strokes are medical emergencies. If you or someone else seems to be experiencing any symptoms associated with a stroke, call 999 and ask for an ambulance right away.

Transient Ischaemic Attack (TIA)

Transient ischaemic attacks or TIA’s are also referred to as ‘mini strokes’. They are essentially the same as an ischaemic stroke and present the same symptoms however they last for a shorter period of time, usually from a few minutes to 24 hours.

A TIA is a blood clot blocking the supply of blood and oxygen to the brain however in this case the clot moves away and in doing so the stroke symptoms stop.

The FAST test is still the most effective method to use as if you see any of the signs, you are unable to tell whether it’s a TIA or a stroke just by looking at someone’s symptoms.

If you experience a TIA it can indicate that you’re at an increased risk of having a stroke but by following suggested treatment and making some healthy lifestyle changes, you can reduce this risk.

It is possible you could experience some after effects after a TIA, such as fatigue and emotional episodes, however as the brain is without blood and oxygen for a shorter amount of time than a stroke, the chances of having lasting disabilities is reduced as less damage is caused to the brain cells.

Risk Factors

There are many different risk factors that can increase an individual’s chance of having a stroke such as:

  • Age
  • Smoking
  • Obesity
  • High blood pressure – Also known as Hypertension
  • High Cholesterol
  • Irregular heartbeat – Also called Atrial fibrillation
  • Diabetes
  • Excessive alcohol consumption

All the above risk factors can be managed using either medication or by making simple changes to our lifestyles, for example:

  • Stop smoking if you smoke
  • Get regular exercise – NHS recommend 150 mins a week
  • Reduce salt intake
  • Cutting down on your alcohol consumption – The recommended guidelines by the NHS are 14 units per week which is the equivalent to 6 medium (175ml) glasses

Diagnosis & Treatment

Strokes are generally diagnosed using a combination of physical tests and scans to get a clear image of the brain.

It is possible to treat strokes once the cause and the type of stroke has been determined. In some cases, they can be treated using medication and in others surgery may be needed but most importantly it is vital to get medical treatment as soon as possible after any suspected signs of a stroke have been identified, to reduce the amount of damage caused to brain function.

Prevention

It is always best to take as much preventative action as possible to reduce the risk of a stroke occurring and making simple lifestyle changes can make a big difference.

It is possible to have blood tests carried out to check cholesterol levels and blood sugar levels, your pulse can be checked to monitor for an irregular heartbeat, blood pressure can be taken along with swallow tests and echocardiograms.

Changes to our lifestyles don’t need to be dramatic to have a positive impact on our health and wellbeing.

Returning to Work

The thought of returning to work after experiencing a stroke can be daunting but one of the main things that can help the process is to plan ahead.

The length of time someone may be off work after a stroke is completely dependent on individual circumstances and the severity of the stroke they experienced, for example a person who experienced a small stroke may be able to return to work within a few weeks but for others it could take months or even years and only the individual will know when the right time to return is.

It is very important to be factual with your employer and tell them the details they may need to know such as the date of your stoke, what the date is that you’re likely to be discharged from hospital and also a date that you will be in touch with them to have a discussion about your recovery and the next steps.

Other things to keep in mind when communicating with them about your stroke are any changes that you have experienced whether they are physical, behavioural, or mental. For example, some experience emotional changes such as anxiety, worry or a loss of confidence and this may slow down your journey with returning to work.

It is also very important to note that after a stroke or TIA you are unable to drive for a minimum of 1 month and after this time frame is comes down to the type of stroke experienced and any disabilities you may have as a result. Any changes could mean a change to the type of driving licence you hold and for some it can mean losing their license completely, there is a link below with more information on the guidelines of whether you do or do not need to inform the DVLA.

Supporting employees following a stroke

When an employee feels they are ready to have the conversation around returning to work it is very important to be supportive in anyway possible. People who have experienced a stroke can experience a level of trauma as strokes can happen very suddenly and can be very shocking. Changes can be physical, cognitive, mental, and behavioural so it’s important to consider all of these aspects when returning to work.

Having open conversations with the employee around the effects the stroke has had on them can not only help them to feel comfortable sharing their experience, but it will also give you as the employer the best idea of the ways in which you can help to make any changes needed for them to return.

An occupational health referral can often be useful in terms of workplace adjustments which may be required to facilitate a successful return to work plan.

A few ways you can help to support the employee are:

  • Be flexible with appointments whether they’re for consultations, therapy, or counselling and become familiar with the company’s absence and time off policies so you can best advise the employee on whether the time will be paid and the best way to go about requesting this leave
  • Be aware that the employee will not be able to drive for a minimum of 1 month so may need allowances for extra travel time
  • They may need more frequent breaks to help with fatigue and concentration problems
  • Considering a phased return to work could be very benefi cial and considering adaptations to working hours and the employees workload, it is unrealistic to give them the same amount of work in a reduced amount of time
  • One of the most important factors is to be patient. Stroke patients could have potentially gone through life altering changes very unexpectedly and will be learning their new sense of normality