Types of stroke: How the two types of stroke happen
A stroke can happen in two main ways. Either there is a blood clot or plaque that blocks a blood vessel in the brain or a blood vessel in the brain breaks or ruptures.
Blocked artery (causes an ischaemic stroke)
Strokes caused by a blood clot is called an ischaemic stroke. In everyday life, blood clotting is beneficial. When you are bleeding from a wound, blood clots work to slow and eventually stop the bleeding. In the case of stroke, however, blood clots are dangerous because they can block arteries and cut off blood flow.
About 4 out of every 5 strokes are ischaemic. There are two ways an ischaemic stroke can occur.
Bleed in the brain (causes an haemorrhagic stroke)
Strokes caused by a break in the wall of a blood vessel in the brain are called haemorrhagic strokes. This causes blood to leak into the brain, again stopping the delivery of oxygen and nutrients. Haemorrhagic stroke can be caused by a number of disorders which affect the blood vessels, including long-standing high blood pressure and cerebral aneurysms.
An aneurysm is a weak or thin spot on a blood vessel wall. The weak spots that cause aneurysms are usually present at birth. Aneurysms develop over a number of years and usually don’t cause detectable problems until they break.
About 1 in every 5 strokes is haemorrhagic. There are two types of haemorrhagic stroke.
Mini stroke
A transient ischaemic attack (TIA) is sometimes termed a minor stroke or “mini stroke”. When the signs of stroke are present but go away within 24 hours, the term TIA is used. The causes and symptoms of a transient ischaemic attack (TIA) are similar to those of a stroke.
TIA episodes usually last only a few minutes but may last for several hours. They generally disappear quickly and unfortunately, are often ignored. Just like a stroke, a TIA will require emergency treatment. About 1 in 5 people who have a TIA will have a major stroke within the next three months and a large part of the risk occurs in the first few days. TIA should never be ignored.
TIA’s should be regarded as a warning sign that the person is at risk of a stroke and should be investigated promptly.
It is important that if stroke symptoms occur the person sees a doctor promptly, even if the signs go away and you feel completely better. The doctor will try to find the underlying cause of the TIA and then organise treatment to lower your risk of another transient ischemic attack or stroke.
This article has been sourced from the Stroke Foundation and can be accessed at www.strokefoundation.com.au
Disabilities associated with stroke:
Stroke is often thought as an “Old Persons” impairment but Strokes can happen to anyone at any age including babies and young children.
Depending on which part of the brain is damaged from the stroke will determine the impact and ramifications on a persons life and functioning.
A hemi paralysis for example will impact on one side of a persons body and depending on which side sustained the damage from the bleed, other aspects such as speech and eating may also be affected.
Sexuality after Stroke:
Sexuality and any type of disability is still something that is largely unacknowledged. Considering how many adults are in relationships when they have a stroke, the lack of discussion in initial or follow up support, typifies the enormous gap in this aspect of peoples lives. Sadly it also reduces their Partner to “Carer” and ignores this aspect of their relationship and humanity.
There are many secondary aspects to acquiring a disability that also need to be taken into account:
Depression is a common issue following a stroke – seeking timely medical advice is paramount to treatment.
Anxiety about how your condition may be exacerbated by any type of activity, including sexuality and intimacy.
Changes in the body and outward appearance such as weakness in a limb (such as an arm) or down one side of the body, reduced sight, hearing or continence issues can all significantly affect a persons self esteem.
Medications for lowering blood pressure can also impact libido, penile erection and reduced vaginal lubrication, tiredness and an increased amount of time to orgasm are commonly reported.
So… What are the options?
First and foremost you and your partner need to talk.
Choosing a time when you are both feeling comfortable and relaxed. This may be difficult if you have support workers coming in to assist with showers, dressing, therapy and attending appointments. If there are other family members around such as children, this can be even more difficult. However this has to be made a priority. Ask a neighbour or family member to take the kids overnight, ensure that appointments and service providers are recorded in a diary so there are no surprise visits.
Reconnecting with a partner after an illness or acquiring a disability may feel like having to become re-acquainted. Things that felt good before may no longer be possible. Additional issues such as reduced sensation on the affected side, Vaginal dryness or worrying about continence can be addressed with a little planning that will become second nature.
Vaginal dryness:
A good quality Lubricant is essential. While products such as K-Y Jelly are an option, there are a number of specifically developed personal Silicone and water based options that also have less chemicals ( perfect for people who are sensitive or who are more likely to develop thrush). Brands such as “Astroglide” Sensitive Skin Ultra Gentle GEL do not include Glycerine which can cause yeast infections in susceptible women.
Silicone Lubricants do not contain Glycerine and as with any good quality lubricant a small amount is usually sufficient and therefore more economical. Brands such as “Pjur”, “Wicked” and “Swiss Navy” all have specific products for people with increased sensitivity and can also be used as a massage oil.
Erectile dysfunction
Difficulty in getting or maintaining an erection is a common issue for men with a range of conditions including strokes.
There are a number of products available on the market that can assist erectile dysfunction such as penis pumps, enhancement (or cock) rings and a new product called “The Pulse” that can enable a man to go from flaccid to ejaculation. “The Pulse” can be used as a couples toy. The penis pumps increases the blood flow into the penis and is then maintained with the use of a silicone ring to keep the blood in place. If and erection is possible an enhancement rings can be used independently to maintain the blood in the penis and are relatively cheap to purchase. Enhancement rings are available with vibrating bullets to add additional sensation to both partners and in rechargeable options, eliminating the need for manual dexterity to change batteries.
Reduced sensitivity to a limb or one side of the body:
Something as simple as changing sides on the bed if the person has a Hemi paralysis may be needed to ensure that any visual or auditory impairments are considered (You don’t want to frighten your lover because they don’t see or hear you when you approach!).
The use of pillows or other props to support affected limbs and modify positions may take you both some getting use to but it will also provide protection to these areas and reduce the likelihood of unintended injuries to the affected area/s .
Remember, Sex and intimacy is supposed to be fun and taking the time to make time with each other enriches and maintains your relationship.
Continence:
Anyone finding themselves in a situation where control of bladder and/or bowel function is compromised will feel anxious about having sex. The simple answer is to ensure that both are empty prior to intimacy.
Reducing fluid intake an hour or so before hand may also help.
If a catheter or stoma bag is in place then emptying them before sexual activity will also help to reduce the likelihood of mishaps.
Where else can you get advice?
The most important professional person should be your G.P. Having a good relationship that enables you to discuss all aspects of your health and wellbeing including sexuality is vital!
If you don’t have that type of relationship ask for a referral to sex counsellor ( Stabilise will be adding a list on the website in the near future- http://www.infostabilise.com) or contact and organisation such as the Stroke Foundation in your state.
All products mentioned are available via http://www.infostabilise.com
When a person develops a disability, their partner can often find that their own identity is often waylaid by society and replaced with a single, gender neutral term of “Carer”. Unfortunately it also means that the partner is presumed to be above any basic human requirements such as rest, personal time and even less recognized, as a sexual being.
Stabilise 