Life after suffering a stroke

Dear doctor,
My mum had a stroke recently and was unconscious for some time. Since she woke up, she has been having trouble speaking. She seems to be searching for the words, and has only been using two-word sentences. We are not sure how much she is able to understand. What has happened to her? Can it be fixed? Lewis

Dear Lewis,
Your mother is likely suffering from aphasia as a result of the stroke. Aphasia refers to a brain disorder that causes problems with speaking or understanding when other people speak. The symptoms may vary depending on which parts of the brain are affected and how severely. The main symptoms include challenges with speaking and writing, problems with understanding other people’s speech and challenges with repeating what is said to them. In the event of a stroke, there is damage to parts of the brain due to reduced blood supply to those areas, and the person has symptoms related to which parts of the brain are affected. This means that for your mother, there are likely other symptoms based on which other areas of the brain are affected by the stroke such as paralysis or weakness of one side of the body, blindness, among others.

The aphasia may completely resolve, improve with time or remain the same depending on the severity of damage to the brain. The first and most important step is for the stroke to be managed, and the underlying cause should be managed. In addition, your mother would benefit from speech and language therapy to help improve the speech, and/or help her find other ways to communicate and also help her understand others. The speech therapy can also include the persons close to her so that they are better able to understand her.

How can you know if you have prostate cancer?

Dear reader,
The prostate gland is a part of the male reproductive system located just below the urinary bladder. The prostate produces seminal fluid, which is the fluid that transports sperms and provides nutrition for them. The prostate can have a variety of health problems such as infection, abnormal enlargement and cancer. Prostate cancer is one of the most common types of cancer in males.

Sometimes prostate cancer develops very slowly and is confined to the prostate without spreading to other parts of the body. In the early stages, prostate cancer usually has no symptoms. Advanced prostate cancer may cause problems passing urine, weak urine stream, urine incontinence, blood in urine, blood in semen, erectile dysfunction, painful ejaculation, unintentional weight loss, pelvic pain and bone pain. It is advisable for all men over 40 years of age to have regular prostate check-ups, whether or not there are any health concerns.

Diagnosis of prostate cancer is made through physical examination, ultrasound and/or MRI scans and prostate biopsy. A blood test for prostate specific antigen may also be done.

Depending on the stage of the prostate cancer and the symptoms, then active surveillance may be done, or there may be intervention that may include surgery, chemotherapy, radiotherapy, hormone therapy, immunotherapy or ablation therapy.

Dear doctor,
I am currently five months pregnant. The pregnancy has been uneventful, but my body has really changed. I always feel hot even when other people are feeling cold, and I have noticed that I have varicose veins on my legs. Also, it takes several days before I am able to go for a long call. Is there a way I can be assisted? Eva

Dear Eva,
Pregnancy affects almost all body systems, causing significant changes that may cause discomfort. It is best to be reviewed regularly as advised by your health care team and let them know about your concerns so that they can be evaluated and addressed.

Most of the symptoms during pregnancy are not a major cause of concern, though they may cause discomfort. The hormonal changes and increased blood supply to the skin can make the person feel warmer than usual and even sweat more. While this cannot be cured, you can manage it by keeping the space you are in as cool as possible, wearing light and loose clothing made of natural fibres and showering frequently to cool down.

Varicose veins are enlarged and swollen veins that usually look blue, purple or green in colour. There may also be other symptoms like feeling like the legs are heavy or aching, swelling of the feet, muscle cramps and itching of the skin over the affected area. Pregnancy is one of the risk factors for developing varicose veins. You can manage them by raising the legs when sitting or when sleeping, and using compression stockings. Avoid standing for long or sitting for long with crossed legs. Physical activity, regularly exercise and exercising your feet is also helpful. The hormonal changes can also cause constipation so that you pass stool less than three times a week, and/or the stool is very hard. You can manage this by taking adequate amounts of water; taking a lot of vegetables, fruits and grains and being physically active and exercising regularly. Iron supplements may also cause or worsen constipation and you can discuss with your health care team about a good alternative to taking them. Also, give yourself enough time to use the toilet and consider using a low stool to raise your legs when you are seated on the toilet so that the knees are raised slightly above the hips. It is not advisable to use laxatives, or any other medications during pregnancy unless under the guidance of a doctor.

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