A  friend of mine told me this story recently of something unusual that happened to him.
It was one of those typical Monday mornings, when he had a hundred and one things to do at the office.
His head was throbbing and his pulse was racing. He had several things to do and too little time to do them .
He always got to his office early and had to leave late. His work diary was full for the day, and his phone was beeping because he was already late for his next appointment.
He had just come out of the bank, where there had been in a  long queue.
The bank clerk had annoyed him, by asking him to fill in bank forms, in order to conduct his business.
Something he considered archaic because almost all banks had gone electronic now.
He lost his temper when she insisted he would not be served until he had filled the forms.
He lost it, exploded and ended up in the bank manager’s office.
He offloaded his frustrations on the bank manager, who keen to keep peace had him served from his office.
When he got out to the bank car park, he could not find his car.
His three phones were now competing for his attention, each blaring out their alarms, reminding him that he had now missed two appointments.
When he raised his third phone to answer the call from his secretary, who was calling to let him know he was late for his board meeting, he realised he had forgotten her name.
He was startled and cut the line. He turned to find  three bank security guards staring at him.
He tried to ask them where his car was, but what came out of his mouth was gibberish.
When in exasperation he attempted to walk away he staggered and fell against the security guard on his left, who caught him just in time.
When the three guards carried him to their small office at the gate to the building and he slumped on their couch, he realised something was wrong.
His whole left side was cold and he could not lift his hand to his face. He caught his reflection in the mirror and realised he was dripping saliva from the corner of his mouth on the left.
The senior guard picked up the phone to call for help, he raised his right hand to dissuade him.
He was not going to allow himself to be a spectacle at the bank, especially after the spectacle he had created inside, in order to get served.
He signalled for them to give him some time. Slowly his mind returned to him, he gave the guards a tip, called in sick and took the week off.
He admitted the experience had frightened him. He also admitted that he had been too scared to seek any medical advice at the time.
So many years later, when he had gained the courage to talk about it, he confided in me, and wanted to find out what happened to him that day.
1.What  is a stroke?
2.What causes a stroke?
3.What can I do to prevent it?
1.What is a Stroke?
Many people will admit to having had some frightening health experiences which they have concealed.
Especially to those who are closest to them.
The experience has alarmed them so much they can hardly admit it to themselves.
Often this is because they are worried about what it might mean for their future and that of their families.
Nothings is perhaps more frightening then suddenly losing control of your body or worse still your mind.
A stroke is a medical condition in which there is a sudden break in the flow of blood to a part of the brain.
This results in part of the brain stopping to work partially or completely.
The brain is responsible for all the functions of the body, so when part of the brain stops working properly then the body parts, which are controlled by it, will stop working too.
The commonest type is, like the one my friend described, where half the body stops working.
In that situation one side of the body from the head to the toe, experiences a “Zesco” blackout.
So the left face for example becomes cold and stops moving.
The person finds they cannot move their left hand or left foot.
If they tried to walk they stagger and fall onto the left side.
A simpler way to look at  it, is to think of the  Brain as  the central controlling unit of the body, when it fails to get power then the whole of the body will fail to work properly.
Take for example the Kariba dam, when the water levels are low, the power generation becomes low, and it fails to bring electricity to the whole country.
In the same way, when the blood flow to the brain is low, then the brain fails to get enough energy to work properly so it shuts down.
When the brain shuts down part of the body shuts down too.
The next question is what can cause this sudden break or block in the blood flowing to the brain.
There are three common causes for this, which are a big clot of blood ( called a Thrombus in medical terms), a smaller blood clot  from the heart (called an embolus) or a tear in the blood vessels( bleeding or haemorrhage).
Medically the Strokes are of two types an Ischaemic stroke(a stroke from blockage of the blood vessels of the brain) or a Haemorrhagic stroke(a stroke from bleeding from a blood vessel in the brain).
The stroke from a small block in the blood vessels, may be able to unblock, on its own.
This is what happened in the story of my friend.
If this happens within a short time, it is called a Transient Ischaemic Attack (TIA) or a mini Stroke. The person can recover completely and within a very short space of time, and no one may even notice it. A bleeding or Haemorrhage stroke has a worse outcome.
2.What causes a Stroke?
Perhaps the first question should be how common is this problem in Zambia?
Studies have shown that one of the main type of patients treated in Zambia for rehabilitation, are of stroke victims.
Up to 65 per cent of patients seen at the University Teaching Hospital  for physiotherapy are for strokes as described by Muyanga and his colleagues.
It has also been shown that strokes are the second leading cause of death in Zambia after HIV disease, and account for five per cent of all deaths in Zambia.
Up to 9,000 people die annually in Zambia due to strokes.
Zambia is ranked 11th among deaths from strokes.
What causes strokes? We have seen that strokes are caused by diseases of the blood vessels in the brain.
Therefore it follows, that strokes are essentially due to poor health of the blood vessels in the body in general, but particularly those in the brain.
There are three key factors that affect the health of blood vessels, these are age, diet and disease (key of which are sugar disease, high blood pressure and HIV infection).
With age the blood vessels narrow and weaken.
Therefore, there is an increased risk of  stroke after the age of 45years.
The type of food we eat also poses a risk to our blood vessels.
With an increase in western type diets which are rich in harmful fats( saturated fats or animal fat) as well as starchy foods(buggers, pizzas, subways etc).
Therefore, there has been a 10 per cent increase in strokes in developing countries in contrast to a 10 per cent decrease of strokes in developed countries.
The blood vessels have high levels of circulating fats, these deposit in the blood vessels wall, and lead to narrowing.
When the blood vessels narrow, this slows the flow of blood in the blood vessels, leading to clots formation (the so called Virchow’s phenomenon).
Specific diseases that weaken the wall of the blood vessels, and lead to rupture of the blood vessels.
Several studies have shown a rise in Zambia of high blood pressure, diabetes(sugar disease) and HIV.
All these condition are responsible for the rising level of stroke disease in Zambia.
Up to 35 per cent of men were found to have high blood pressure (Goma and Siziya) and nine per cent of people were found to have Diabetes in Lusaka ( Diabetic Association of Zambia).
In addition  stress, smoking and alcohol damage blood vessels and increase the risk of stroke.
3. What can I do to prevent it?
The transient Ischaemic Attack is the body sending a warning to you that you need to slow down.
Recently the well-known British medical journal the Lancet reported in a large population study that people who work over 55 hours in a week at their work place have an increased risk of getting a stroke.
Over work stress and anxiety increase stress chemicals in the body which damage blood vessels as well as increase the blood pressure and sugar levels.
All these factor will increase damage to the blood vessels. You can reduce your risk of a stroke  by reducing salt and sugar, reducing smoking, reducing stress and take statins.
Take some time to know what your blood pressure is like.
A normal blood pressure will be about 140/90 mm of Mercury.
Your diet is important, if you can generally reduce your salt and sugar in take this will keep your vessels healthy.
Stop or reduce smoking and alcohol intake, try and control or reduce your stress levels.
Take your holidays, reduce your work hours, take your allotted leave days.
Watch what you eat. Try and eat fish, in particular white meat.
Avoid animal fat and red meat.
Eat boil or roasted rather than frying your  foods. Take statins and low dose aspirins(75mg), these lower the fat levels and thin the blood. Exercises at least 20 minutes a day and keep your waist below 110cm in size.