By Deborah Bamisaye
…Wife: Kola, like seriously! I know you’re not a fish, but you need to drink like one! Water, water, water! That’s the answer…
Mr. Kola: (chuckles). You sound like a broken record. But you’re not a doctor, so why should I listen? Let the doctor talk to us now & stop self-medicating.
Wife: How can you call my water advice self-medication? I don’t know the quarrel you picked with water o, claiming it makes you frequent the toilet. I sought details online about some of these things; I want you to recover fast or you think it’s easy aiding you to walk around the house. I beg, all I know is your brain needs the water to bounce back.
Doctor: (smiling) Mr. Kola, your wife has got a point. Hydration is your secret weapon. It keeps your blood flowing and helps your brain fight back.
Mr. Kola: Alright, Doc. How much water are we talking about? A swimming pool?
Doctor: (laughs). Not quite. Think eight glasses a day. Add soups and natural juices too. Drink up, take meds, and keep moving gently. Don’t worry, you’ve got this!
Mr. Kola: If drinking water makes me healthier and keeps my wife happy, I’m all in!
Wife: You! You ehn! Thank you Doctor, jare. So, shall we go now? Gently dear, try, put your leg here…hold me now…Driver, come I beg…
Doctor: Gently please! See you next month.
Wife: Bye Doctor, thanks for everything.
A Comeback is Ugly
Stroke recovery is a complex process that requires careful attention to multiple aspects of health, including nutrition and hydration. Hydration plays an essential, yet sometimes underestimated role in stroke rehabilitation – by supporting brain healing, preventing complications, and enhancing overall recovery outcomes.
Why Hydration Is Crucial in Stroke Rehabilitation
After a stroke, many patients face difficulties such as reduced consciousness and swallowing impairments (dysphagia), increasing the risk of dehydration. Studies indicate that up to 62% of stroke patients experience dehydration during hospital admission due to these challenges. Dehydration thickens the blood, impairs circulation, and can worsen neurological outcomes, hampering recovery efforts. Adequate hydration helps maintain blood fluidity, prevents venous thromboembolism (blood clots), supports kidney function, and improves cognitive recovery by ensuring the brain receives sufficient oxygen and nutrients.
Hydration Assessments and Management
Early identification of dehydration risk is critical in stroke rehab. Healthcare teams are advised to assess hydration status within the first 4 hours of hospital admission using validated screening tools. For patients with swallowing difficulties, alternative fluid delivery methods (like thickened liquids or intravenous fluids) should be used until safe swallowing is established through speech-language pathologist (SLP) assessment.
Regular monitoring of fluid balance, electrolytes, and hydration-related complications is recommended, especially in severe cases. Environmental factors (such as room temperature) and insensible fluid losses (sweating, respiration) should be considered in hydration management plans to tailor fluid intake effectively.
Types of Fluids and Hydration Strategies
Patients typically require about six to eight cups of fluids daily, adjusted to individual needs and medical conditions. Water remains the preferred hydrating fluid, but other options include:
1. Water-based beverages (milk, tea, juice with limited sugar)
2. Frozen liquids (ice cubes, popsicles)
3. Hydrating foods (soups, fruits, gelatin desserts)
For patients on fluid restrictions due to comorbidities, hydration should be closely managed with healthcare providers’ guidance.
Practical Tips During Stroke Rehabilitation
– Position fluids within easy reach of patients with motor impairments to encourage self-hydration.
– Engage caregivers in prompting fluid intake to prevent neglect of hydration needs.
– Incorporate safe swallowing techniques and fluid consistencies recommended by SLPs.
– Use hydration goals as part of personalized rehabilitation plans.
Hydration’s Impact on Recovery Outcomes
Well-hydrated stroke patients show improved short-term and long-term recovery outcomes. Proper hydration supports:
– Brain tissue repair and neural regeneration
– Reduction in secondary stroke complications such as urinary tract infections
– Maintenance of electrolyte balance essential for nerve and muscle function
– Enhanced cognitive clarity and reduced confusion or fatigue
Dehydration at the time of stroke is associated with nearly four times worse prognosis, underscoring hydration as a vital component of rehabilitation success.
Here are some Nigerian doctors and experts involved in stroke rehabilitation and their insights related to stroke care; this is what they have to say about hydration and holistic rehabilitation:
1. Nicholas Aderinto (Ladoke Akintola University of Technology, Ogbomoso)
2. Gbolahan Olatunji and Emmanuel Kokori (University of Ilorin, Ilorin)
3. Ismaila Ajayi Yusuf (Obafemi Awolowo University, Ile-Ife)
4. Anuoluwa Oyeboyin Oyelude and Faith Adedayo Adejumo (Bowen University, Iwo)
5. Emmanuel Agbo (University of Nigeria, Nsukka)
They emphasize the need for coordinated, multidisciplinary stroke rehabilitation in Nigeria, which includes physiotherapy, task-specific training, and cognitive programs. They also recognize hydration as a critical component of nutrition care in stroke rehabilitation, essential to improving outcomes and minimizing complications.
The general consensus from Nigerian stroke rehabilitation professionals aligns with global best practices: hydration is vital for recovery, cognitive function, and prevention of secondary complications. They advocate for a team approach incorporating nurses, physicians, physiotherapists, speech therapists, and caregivers to manage hydration safely, especially in patients with swallowing difficulties.
The saying that ‘There is no overdose of water intake’ is both correct and incorrect, depending on the method or manner of drinking it. Water drunk slowly and not in excessive quantities in a short period, does not result in overdose or water intoxication.
Now, there is the possibility of water intoxication or water poisoning. This occurs when someone drinks too much water too quickly, overwhelming the kidneys’ ability to excrete water. So you just need to draw the line here and be careful.
Take healthy liquids whether or not you have stroke. Those who presently suffer one should prevent a reoccurrence. Come on! It’s simple – try to hydrate to prevent setting the stage for a comeback. Will you do that? Oh Great!
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