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Have a low probability of complete recovery after stroke? Here are 5 major sequelae and treatment you can try

See what treatment is available after stroke.

A stroke takes place when the blood supply to the brain is reduced or interrupted, resulting in brain damage. The chances of being able to recover completely after a stroke depends on a myriad of factors, such as the severity and location of the stroke, and the age and general health of the patient.Unfortunately, the probability of complete recovery from a stroke is often rather low. Many stroke survivors experience permanent or long-term disabilities, known as sequelae. Below are five common sequelae of stroke and their treatments:<h2>1. Weakness or paralysis</h2>Stroke survivors experience weakness or even paralysis on one side of their body. They can improve their muscle strength and coordination though physical therapy and rehabilitation.<h2>2. Speech problems</h2>A stroke can result in difficulty with understanding, speaking or writing a language. Going for speech therapy could help to improve communication skills.<h2>3. Cognitive impairments</h2>Suffering from a stroke can also affect one’s cognitive function, which includes, problem-solving skills, memory, and attention span. These functions can be improved through cognitive rehabilitation.<h2>4. Emotional problems</h2>Experiencing anxiety, depression and other emotional problems after stroke is very common. Taking part in support groups, engaging in counselling and taking medications can help to manage these symptoms.<h2>5. Swallowing difficulties</h2>A stroke can affect one’s ability to swallow, which could result in aspiration pneumonia or choking. Dietary changes and speech therapy can help improve swallowing function.Receiving appropriate medical care and rehabilitation as early as possible after a stroke is key in increasing their chances of recovery.

<h2>Stroke Rehabilitation Golden Period1</h2>In the unfortunate scenario where you suffer from the sequelae of stroke, you should seek rehabilitation treatment as early as possible. It is generally believed by the medical committee that the golden period for recovery is three months after a stroke. During this period of time, brain ischemia gradually improves, brain edema, haemorrhage and pressure slowly returns to normal. In fact, there is still a lot of recovery happening in brain conditions after the first three months. The first six months after a stroke are also a critical period for recovery.During this stage of stoke treatment, the focus is to help restructure the brain’s internal structure and function, as well as teaching patients to relearn how to use their limbs. For stroke patients with more serious conditions, significant improvement can still be achieved with a longer training period.<h2>Stroke Rehabilitation Treatment2,3</h2>Our brain has a self-remodelling characteristic, as such various trainings and stimulations can help rebuild the damaged brain neuron connection network, thereby restoring the stroke patient’s ability to take part in activities. One key method of stroke rehabilitation involves engaging in physical therapy. Physical therapy can help stroke patients to improve self-care abilities, relearn limb control skills and integrate back into their work and daily social life. Some examples of physical therapy include walking training and gait correction.On top of physical therapy, stroke rehabilitation treatment also includes occupational therapy. This focuses on targeting training of cognitive abilities. For instance, selecting and designing suitable assistive equipment according to the patient's needs can improve their autonomy and independence in their daily life. Another stroke rehabilitation treatment is speech therapy, where it focuses on training various muscles in the oral cavity, helping to improve speech clarity and reduce swallowing difficulties.<h2>Do you have enough financial protection in case of a stroke?</h2>It is likely that stroke recovery requires a large amount of time, which could be a major impact on your work. Having a critical illness insurance plan can provide you with financial support, relieving you of your financial burden so you can focus on your recovery.

<ol><li>Source: Doctor Now, “[Stroke rehabilitation] Understanding post-stroke difficulties”</li><li>Source: Rehabaid Society, “Storke rehabilitation physiotherapy”</li><li>Source: Hong Kong Adventist Hospital, “Head stroke”</li></ol>The above information is provided by FWD Financial Limited ("FWD Financial") for reference and educational purposes only. It does not constitute an offer to buy or sell any insurance products outside of Hong Kong. Before purchasing any insurance product, you should understand your needs and affordability, read the policy carefully, and select suitable product. FWD Financial is an appointed insurance agency of FWD Life Insurance (Bermuda) Company Limited (incorporated in Bermuda with limited liability) (“FWD Life”). FWD Financial, FWD Life, their subsiding companies or their respective directors or employees make no express or implied representations, statements or warranties as to the accuracy, completeness or suitability for any particular purpose of the information provided. In no event shall FWD Financial, FWD Life, their subsiding companies or their respective directors or employees liable in any way for any consequences resulting from the use or reliance upon this article, and shall not incur any legal liability (including third-party liability). Users should evaluate all the information contained in this article and seek independent professional advice.

【中風】完全康復機率微？5大後遺症及治療 | Managing stroke with low chance of complete recovery

Managing stroke with low chance of complete recovery | FWD HK

Think you are suffering from an enlarged prostate? Here is a quick self-assessment check

Do a self-check with a simple questionnaire.

As men get older, particularly over the age of 40, they may experience trouble urinating or more frequent urination. These symptoms, which could be associated with an enlarged prostate, may occur more frequently. In the following article, we will go through some symptoms of an enlarged prostate as well as go into the details of the procedures for doing a self-examination.<h2>What is the prostate?</h2>The prostate is a gland that is very important to the overall health of a man's urinary system. It oversees generating sperm as well as facilitating its movement from one place to another. With the appearance of a walnut, its surface is segmented into three distinct zones: the central zone, the transition zone, and the outer zone. The transition zone encompasses the urethra. If the prostate is irritated or enlarged, it can put pressure on the urethra, which can lead to urinary problems in males1.<h2>What are the symptoms of enlarged prostate?</h2>Males over the age of 40 have a greater risk of developing an enlarged prostate than younger men. According to a survey carried out in the United States, fifty percent of the male participants between the ages of 51 and 60 years old had an enlarged prostate. This percentage further soared to approximately 90 percent for men over the age of 802. Although the size of a typical prostate is comparable to that of a chestnut3, the cause of prostate enlargement is still unknown. However, it is possible that age and changes in hormone levels in males are some causes of this condition1.Urinary problems are rather prevalent in those who have an enlarged prostate, and it is essential to be aware of the following symptoms1:<ul><li>Having difficulty starting the urinating process</li><li>Sluggish discharge of urine</li><li>The act of urinating is followed by dribbling</li><li>A feeling that the bladder has not been completely emptied yet</li><li>Problems with keeping urine in the bladder</li><li>Frequent urination</li><li>Nighttime urinating that is far too frequent</li></ul><h2>Here is how you can assess your own prostate health</h2>The American Urological Association's "International Prostate Symptom Score questionnaire (IPSS)," analyzes an individual’s monthly urinary patterns, and can be used to assess the condition of one’s prostate. On top of visiting the doctor for a prostate examination, you can also use this self-assessment below to assist you in learning more about the condition of your prostate4.

<table><thead><tr><th></th><th>None</th><th>Less than 1/5 of the time</th><th>Less than half of the time</th><th>About half of the time</th><th>Almost every time</th><th>Incomplete emptying</th></tr></thead><tbody><tr><td>Unclear urination</td><td>0</td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td></tr><tr><td>Frequency of urination</td><td>0</td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td></tr><tr><td>Intermittent urination</td><td>0</td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td></tr><tr><td>Urgency of urination</td><td>0</td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td></tr><tr><td>Weak urine stream</td><td>0</td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td></tr><tr><td>Difficulty urinating</td><td>0</td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td></tr><tr><td>Number of times urinating at night</td><td>0</td><td>1 (Once)</td><td>2 (Twice)</td><td>3 (Thrice)</td><td>4 (Four times)</td><td>5 (Five times)</td></tr></tbody></table>

The severity of prostate health issues can be estimated using self-assessment scores as follows:<ul><li>Mild prostate health problems are indicated by a score of 0 to 7.</li><li>A significant prostate health problem is indicated by a score of 8 to 19.</li><li>Severe prostate health problems are indicated by a score of 20 points or higher.</li></ul>

<h2>Prostate examination methods</h2>As prostate enlargement is typical in males over the age of 40, it is advised for these individuals to have regular hospital check-ups in addition to self-evaluation. The following are the examination techniques employed1:<ul><li>Digital rectal examination (DRE): A finger is inserted into the patient's rectum during a DRE, during which the doctor looks at the prostate's size, shape, and texture.</li><li>Urinalysis: Looks for indications of urethral hemorrhage or infection.</li><li>Prostate ultrasound scan: A prostate ultrasound scan involves looking at the prostate's size, the bladder's capacity, whether stones are there, and whether malignancies might be present.</li><li>Urine flow rate measurement: Measures the rate at which urine is discharged while utilizing a device to look for prostate enlargement.</li><li>Blood test: With a blood test, the prostate-specific antigen (PSA) level can be checked to see if the patient has an elevated level.</li></ul><h2>Treatment methods for an enlarged prostate</h2>It is advised to routinely monitor the possibility of suffering from an enlarged prostate through checkups for those at risk or those who only exhibit modest symptoms. Significant prostate enlargement can be treated with medication, but severe cases may require surgery, including minimally invasive procedures like transurethral resection of the prostate and transurethral incision of the prostate1. While the latter relaxes the urethra by creating an incision at the bladder neck, the former immediately removes the enlarged prostate portion using a charged metal coil.Open surgery, in which the doctor creates an incision in the lower abdomen to remove the enlarged prostate tissue, is appropriate for people with significant prostate enlargement or problems such as bladder stones.It might be difficult to prevent prostate issues, and any man is at risk of getting them. Some serious consequences of an enlarged prostate include prostate inflammation and even prostate cancer. Bacterial infections are the main cause of prostatitis; minor cases may have no symptoms, whilst severe cases may result in excruciating pain and other consequences5. The incidence of prostate cancer increases with age, making it the third most frequent cancer in men in Hong Kong6. Early signs of prostate cancer may not be obvious and could also be mistaken for prostate enlargement. However, when cancer cells move to other organs, it can produce other signs such as bloody coughing fits and back pain7.In the unfortunate event that you are diagnosed with a prostate issue, it is important to go for regular checkups and have long-term medical care. The financial burden of hefty medical bills might be reduced with comprehensive cancer medical insurance coverage.

<ol><li>Source: HK Urological Association, “Benign prostatic hyperplasia”, 2014</li><li>Source: National Institute of Diabetes and Digestive and Kidney Disease, “Prostate Enlargement (Benign Prostatic Hyperplasia)” ，2014</li><li>Source: The Family Planning Association of Hong Kong, “Prostatic hyperplasia”</li><li>Source: HK Urological Association, “International Prostate Symptom Score”</li><li>Source: HK Urological Association, “Prostatitis”, 2014</li><li>Source: Centre for Health Protection, “Prostate cancer”, 2022</li><li>Source: HK Urological Association, “Prostate cancer”, 2014</li></ol>The above information is provided by FWD Financial Limited ("FWD Financial") for reference and educational purposes only. It does not constitute an offer to buy or sell any insurance products outside of Hong Kong. Before purchasing any insurance product, you should understand your needs and affordability, read the policy carefully, and select suitable product. FWD Financial is an appointed insurance agency of FWD Life Insurance (Bermuda) Company Limited (incorporated in Bermuda with limited liability) (“FWD Life”). FWD Financial, FWD Life, their subsiding companies or their respective directors or employees make no express or implied representations, statements or warranties as to the accuracy, completeness or suitability for any particular purpose of the information provided. In no event shall FWD Financial, FWD Life, their subsiding companies or their respective directors or employees liable in any way for any consequences resulting from the use or reliance upon this article, and shall not incur any legal liability (including third-party liability). Users should evaluate all the information contained in this article and seek independent professional advice.

【前列腺肥大】小便無力？排尿困難？自我評估檢查 | Do you have symptoms of an enlarged prostate?

Do you have symptoms of an enlarged prostate? | FWD HK

Understanding kidney diseases and the common methods of kidney dialysis

Kidney disease is one of the most common chronic diseases in Hong Kong, ranking sixth among the top 10 fatal diseases in Hong Kong in 20201. Many people tend to ignore the early signs of kidney disease and the early symptoms are usually not obvious. By the time they realise that they have kidney disease, the disease may be so serious they are required to undergo dialysis. What are some treatments for kidney disease? What are the different ways kidney disease patients can choose for dialysis? We will share some comprehensive information on dialysis in this article.<h2>Do all kidney disease patients require dialysis?</h2>The kidney is said to be the regulator of our body. It is responsible for cleansing the blood of toxins and helps transform the waste into urine. The kidney also coordinates and balances the body's blood pressure, water, electrolytes, and so on. If the kidney function is damaged, it could lead to other diseases such as high blood pressure and hematuria. Kidney failure can be divided into acute and chronic kidney failure. Acute kidney failure can cause the kidney function to deteriorate suddenly in a short period of time, within hours to days. If the condition of the kidney is not improved after finding the cause, emergency dialysis will be needed. Chronic kidney failure occurs when the kidneys are damaged for more than three months.Patients suffering from early chronic kidney disease can turn to medication or dietary control to slow down the disease. However, if the condition worsens and the kidney function continues to decline, dialysis may be required. In general, if the kidney function drops to less than 15% and complications cannot be controlled by medication, dialysis may be required. The severity of chronic kidney failure is divided into the following four levels according to the kidney function index2.

<table><thead><tr><th>Degree of kidney failure</th><th>Kidney function index</th></tr></thead><tbody><tr><td>Renal insufficiency</td><td>51% - 80%</td></tr><tr><td>Renal impairment</td><td>25% - 50%</td></tr><tr><td>Renal failure</td><td>15% - 25%</td></tr><tr><td>End-stage renal failure</td><td>10-15%</td></tr></tbody></table>

The symptoms of kidney disease are usually not obvious in the initial stages. Many patients with kidney failure often only discover their illness in the end stage when their kidney function index is less than 15%. At this stage, their kidneys are no longer able to effectively cleanse their blood from toxins properly. As kidneys are unable to recover after losing their function, a common treatment method for end-stage kidney failure patients is kidney transplant.<h2>Methods of kidney dialysis</h2>Kidney dialysis refers to the treatment of kidney failure, which is divided into: hemodialysis and peritoneal dialysis.<h3>Hemodialysis</h3>Hemodialysis, also known as "blood dialysis,” refers to the use of a dialysis machine to extract blood from the patient's body, guiding the blood to an artificial kidney on the hemodialysis machine. Toxins or waste in the blood that were unable to be removed due to kidney failure are filtered out using dialysis fluid. The blood will then be transported back into the body.<h3>Peritoneal dialysis</h3>Peritoneal dialysis, also called "belly wash", is a treatment that can be performed at home. A permanent peritoneal dialysis catheter can be surgically implanted into the abdominal cavity. By injecting dialysis fluid through the catheter, the peritoneum can be used as a replacement for the kidney to remove excess waste and water from the body. The peritoneum is a thin membrane that covers the organs in the abdominal and contains many small blood vessels.<h2>Is hemodialysis or peritoneal dialysis more commonly used?</h2>According to data from the Hong Kong government since 2014, the number of people receiving hemodialysis or home peritoneal dialysis in public hospitals has continued to rise. In 2019, the number of people receiving hemodialysis reached 1,570, while the number of people receiving peritoneal dialysis was 4,5433.Both kidney disease treatments have their own pros and cons. Below is a rough comparison on the pros and cons of the two treatments

<table><colgroup data-width='647'><col style="width:21.947449768160745%"/><col style="width:78.05255023183926%"/></colgroup><thead><tr><th>Haemodialysis</th><th>&nbsp;</th></tr></thead><tbody><tr><td>Duration</td><td>Patients will need to head down to the blood dialysis centre at least three times a week. Each dialysis runs for around 3 to 4 hours.</td></tr><tr><td>Pros</td><td>It may be quicker and more effective in removing water and toxins from the blood as compared to peritoneal dialysis.</td></tr><tr><td>Cons</td><td><ul><li>Haemodialysis is a more complicated process and requires professional nursing staff to operate. Patients will need to go down to the centre to receive treatment which could affect their daily life.</li><li>Additionally, blood must be drawn from the patient before each haemodialysis session, causing more pain for kidney disease patients.</li><li>If dehydration takes place too much and too quickly at once, it could cause complications such as headaches and muscle spasms during haemodialysis.</li></ul></td></tr></tbody></table>

<table><colgroup data-width='657'><col style="width:24.65753424657534%"/><col style="width:75.34246575342466%"/></colgroup><thead><tr><th>Peritoneal dialysis</th><th>&nbsp;</th></tr></thead><tbody><tr><td>Duration</td><td>The dialysis will need to be performed 4 to 5 times a day, each time for about 30 minutes.</td></tr><tr><td>Pros</td><td>Patients and their family members can perform peritoneal dialysis at home by themselves after being trained by a nurse. They have the flexibility to choose the time for their dialysis, which can effectively reduce the physical and mental burden on patients and caregivers caused by frequent visits to hospitals or haemodialysis centres. Patients generally do not experience pain during this process.</td></tr><tr><td>Cons</td><td><ul><li>Performing peritoneal dialysis at home could run the risk of an infection if the environment at home is not clean. If bacteria were to enter the abdomen through the dialysis tube, complications such as peritonitis could arise.</li><li>If dehydration takes place too much and too quickly at once, it could cause complications such as headaches and muscle spasms during haemodialysis.</li></ul></td></tr></tbody></table>

<h2>How do you do kidney dialysis at home?</h2>Many kidney disease patients hope to be able to do dialysis at home to save some time travelling to the dialysis centre. Two types of peritoneal dialysis can be done at home2: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD).CAPD costs less, but more time and effort are needed to do the dialysis. The patient will need to manually inject approximately 2 litres of dialysis fluid into the abdomen and leave it in the abdomen for 6-8 hours before draining out the used fluid. The draining out of fluid would take about an hour and needs to be repeated 3-4 times a day.On the other hand, APD is more convenient. The patient can connect to the APD machine before going to bed, and the machine will automatically drain the dialysis fluid when the patient is sleeping. This allows the patient to perform dialysis while resting without disrupting their daily activities.<h2>How much does an APD machine cost?</h2>APD is the most convenient treatment for chronic kidney failure patients compared to other methods. The popularity of home dialysis has also increased in recent years. There was an increase of approximately 14% of kidney patients receiving APD at home3. However, the cost of an APD machine is not cheap. According to the Hong Kong Kidney Foundation, it can cost as much as HK$84,0004, which is likely to be unaffordable for most people. Although some hospitals have rental programs for dialysis machines, the quota available for rent is limited. The cost of renting from private dialysis centres is also not cheap and can cost up to tens of thousands of Hong Kong dollars per month. Therefore, purchasing or even renting a dialysis machine can be a long-term financial burden without purchasing medical insurance. Some medical insurance plans in the market cover the cost of renting a home dialysis machine, such as FWD vPrime Medical Plan5, which fully covers the kidney dialysis benefit and allows reimbursement for the rental cost of the home dialysis machine.

<ol><li>Source: Centre for Health Protection, "Mortality rate from leading cause of death, 2001-2020"</li><li>Source: Smart Patient, “Chronic renal failure”</li><li>Source: HKSAR government press release, “LCQ19: Financial support for patients of end-stage renal failure”, 2019</li><li>Source: HK Kidney Foundation, “Home automatic peritoneal dialysis”</li><li>FWD vPrime Medical Plan is a Flexi Plan certified by the Hong Kong Special Administrative Region Government (the “Government”) under the Voluntary Health Insurance Scheme (“VHIS”) (Certification Number: F00045) and is underwritten by FWD Life Insurance Company (Bermuda) Limited (incorporated in Bermuda with limited liability) ("FWD Life/ FWD/We").</li></ol>The above information is provided by FWD Financial Limited ("FWD Financial") for reference and educational purposes only. It does not constitute an offer to buy or sell any insurance products outside of Hong Kong. Before purchasing any insurance product, you should understand your needs and affordability, read the policy carefully, and select suitable product. FWD Financial is an appointed insurance agency of FWD Life Insurance (Bermuda) Company Limited (incorporated in Bermuda with limited liability) (“FWD Life”). FWD Financial, FWD Life, their subsiding companies or their respective directors or employees make no express or implied representations, statements or warranties as to the accuracy, completeness or suitability for any particular purpose of the information provided. In no event shall FWD Financial, FWD Life, their subsiding companies or their respective directors or employees liable in any way for any consequences resulting from the use or reliance upon this article, and shall not incur any legal liability (including third-party liability). Users should evaluate all the information contained in this article and seek independent professional advice.

【腎衰竭就要洗肚？】洗腎原因及常見洗腎方法比較 | Understanding kidney diseases and the common methods of kidney dialysis

The ABCs of kidney disease and dialysis | FWD HK