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Science
PATIENT PROGRESS: STROKES
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A series about having, treating and recovering from a stroke.
Wednesday听17 & 24 September 2003 9.00-9.30pm

This is a series about the human brain, its importance, fragility, and its ability to recover after trauma. It鈥檚 also a series about the resilience of human beings - the devastating effects of a stroke highlight frailties - but tales of recovery reveal incredible tenacity both personal and medical.

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Strokes are the greatest single cause of severe disability in the UK. They're caused by an area of the brain being deprived of its blood supply for so long that the cells become damaged and die. They can affect people of all ages, from all backgrounds, of all talents, and they have been documented since the fifth century BC.

In this two part series, poignant personal tales and modern medicine meet literature, as the accounts of stroke patients and those who have cared for them, are interwoven with the words of doctors and therapists seeking to aid the rehabilitation of people following a stroke. Over the years, many men (and women) of letters, most notably Louis Pasteur, and Sir Walter Scott (who recorded his deterioration in his journal), have written moving descriptions of their illness. Throughout the programmes are stories which will strike a chord with anyone who has suffered a stroke, or cared for a stroke patient.


Programme One: A Life-Altering Event

Each year, 130 000 people in Britain suffer a stroke. But at present, stroke care in Britain has a long way to go. The Royal College of Physicians estimates that over 6000 of those stroke victims are dying, and a similar number left disabled, because they do not have sufficient access to a dedicated stroke unit. Isabel Fraser hears of the confusion, frustration and anger that both patients and their families, and doctors feel at the inadequate provision of stroke services. However, there is also hope for the future - improvements are being made with new research enabling doctors to save lives with better drugs and therapies. Patients and their families also tell Isabel about the aftermath of stroke 鈥 what it鈥檚 like for a stroke survivor and their family when they return home often a different person. For many, realizing the enormity of what has happened is a huge challenge, and post-stroke depression is very common. Isabel meets people who have fought to overcome depression after suffering a stroke, and who are leading full lives once more.

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Programme Two: Recovery and Resilience

Much alarmed. I had walked til twelve鈥nd then sat down to my work. To my horror and surprise I could neither write nor spell, but put down one word for another and wrote nonsense.
From the journal of Sir Walter Scott, January 5th, 1826

One of the most debilitating effects of a stroke can be aphasia - the loss of language - be it the ability to speak, listen, read or write. In this programme, people with aphasia movingly talk about living in a world full of language, in which they can no longer fully participate.

At present, conventional after-stroke care takes place over, at best, an eighteen month period.
But many patients feel that they did not begin to recover until two years after their stroke. For many, the first months or even years are a confusion, struggling to come to terms with disability 鈥 some describe it as a 鈥渇og鈥 鈥 and only when it鈥檚 lifted, can they get on with their lives. For others, that鈥檚 simply how long it takes to get better: Isabel hears from men who were unable to speak for two years following their stroke 鈥 yet who can now fluently talk about their experiences.

The accounts of patients, neurologists, and work by language therapists, show that recovery can continue over a much longer time span 鈥 indeed that after many more months, even years, leaps can be made, and the brain can show an extraordinary capacity for adjustment, adaptation and recuperation. Some people's brains may rewire so that the language areas bypass the damaged area, in others the stroke-damaged part of the brain may begin to heal itself. In others still, parts of the brain which were not involved in language ability take on new functions. Ongoing work in West London is examining the brains of patients, some soon after a stroke, others years later, in an attempt to identify the natural ways the brain can repair itself, and how treatments could build upon this.

This programme documents the impacts of a stroke on patients and their families, and the slow, often frustrating, hugely emotional steps to recovery.

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