Rush the stroke victim to the hospital, not the clinic!

Muthusamy, seen here doing his rehab as Nagasundari guides him, still experiences shaky legs while walking, as well as disturbances to his sleep pattern. — RAJA FAISAL HISHAN/The Star

The brain is an incredibly complex, yet resilient organ, as it possesses the ability to repair itself through the process of neuroplasticity.

This means that the brain is capable of changing, reorganising or growing neural, or nerve, networks.

In stroke patients, a portion of these connections are damaged, and although the tissue damage at the core of the stroke cannot be reversed, neuroplasticity may rewire functions to new, healthy areas of the brain.

“The longer the patient waits to go the hospital after stroke symptoms appear, the more the damage to the brain, so don’t delay, even if the symptoms are mild.

“Sometimes patients wait for a day or two before seeing the doctor.

“Time is critical as the damage can be long term,” says Nagasundari Sivan, the physiotherapist in charge of Nasam’s Petaling Jaya branch.

For ischaemic strokes, clot-busting drugs have to be given within four-and-a-half hours from when symptoms first start.

And the sooner these drugs are given, the better.

Quick treatment not only improves the patient’s chances of survival, but may also reduce complications.

After treatment, the patient should start rehabilitation as soon as he or she is able to.

Nagasundari explains: “The golden period of post-stroke rehabilitation is within three to four months.

“The level of learning is faster when the ‘wound’ is fresh, especially with regards to speech therapy.

“If you start later, you can still reap the benefits, but the outcome may be slower or not as good.”

Severe leg pain

Retired technician Muthusamy Kumarasamy, 70, admits that he never paid much attention to his health despite having diabetes and high blood pressure for a decade.

Often, he would forget to take his medications and repeated reminders from his wife and four children – three of whom are medical doctors – would fall on deaf ears.

He loved riding motorbikes, and when he was still working, Muthusamy, who lives in Petaling Jaya, Selangor, would take day trips to Seremban, Negeri Sembilan; Melaka and other local cities.

In June 2022, he started experiencing severe lethargy and leg pain.

Not wanting to disturb his children, he walked to the nearby clinic and collapsed as soon as he arrived.

He was rushed to Universiti Malaya Medical Centre where he was confirmed to be having a stroke.

Bedridden, he was warded for almost two months.

He recalls: “After I was discharged, my children sent me to an Ayurvedic centre in Seremban, to rehabilitate.

“I stayed there for a few months, adhered to the strict schedule, lost some weight, and eventually, I was able to walk slowly.”

After returning home, one of Muthusamy’s children enrolled him in Nasam, where he has been continuing his rehabilitation therapy.

“I come here five days a week to take the group exercise class, and while I am getting better, my legs are still shaky when I walk.

“Nowadays, besides going to Nasam, I walk every morning in my neighbourhood park.

“Otherwise, I’m mostly at home as my family won’t allow me to ride the bike,” he says.

Afraid of getting another stroke, he takes his medications diligently and spends time with his grandchildren.

But he laments: “I can’t sleep at night, and even with the sleeping pills the doctor prescribed, I can’t sleep for long – maybe it’s a side effect of stroke, I don’t know.”

According to studies, almost half of stroke survivors experience sleep-wake cycle disorders, also known as circadian disturbances, where their sleep schedule is no longer determined by day and night as healthy people’s sleep are.

Stroke survivors also frequently suffer from insomnia as in Muthusamy’s case, which causes them to have trouble falling asleep or staying asleep throughout the night.