Paralysed at thirty six You are never too young to suffer a stroke. Take the case of this young office-goer

Two years ago, Sudhakar Sawardkar was a healthy 36-year-old, who worked as head of administration at a tech-manufacturing firm. 

    It seemed like a regular morning on August 9, 2010 until he ambled out of bed to get to the bathroom in his Matunga home. His left hand felt a shade heavy, which he thought was the result of a weird sleeping posture. A look into the mirror before he reached out for his toothbrush, revealed a face twisted to the left. He rushed out to call his wife, but was unable to speak clearly. His speech was a series of slurs. 
    Sawadkar had suffered a stroke in his sleep, which was unfortunate because 10 hours had passed before he sought medical attention. The sooner a correct diagnosis is done, the less likelihood there is of long-term impairment, say experts. 
    Sawadkar's experience is proof that strokes, once an ailment associated with those aged 60 plus, can occur among young people. "A pressurising work schedule and unhealthy lifestyle are chief reasons," says Dr Rahul T Chakor, neurologist at BYL Nair Hospital,Mumbai, who treated Sawardkar. "30 per cent of all stroke patients we treat are aged 30 to 40," he says. 
    In March this year, the seventh national congress of the Indian Stroke Association that was held in Pune discussed stroke among young Indians. Dr Shirish Hastak, director stroke services, Kokilaben Hospital and a member of the executive committee of the Indian Stroke Association, who was a participant, says, "High blood pressure and glucose levels are directly linked to strokes since they lead to increased fat deposits along blood vessel walls, restricting blood flow. Both, hypertension and diabetes are increasingly seen among young adult Indians." 
    A WHO report released in May 2012 confirms Hastak's claim. Twenty four per cent men and 22.6 women in India — aged 25 years and above — suffer from high blood pressure. Recent figures by the International Diabetes Federation put India second to China (90 million diabetics) with 61.3 million diabetics in 2011. India is likely to cross the 70 million mark in the next two years. 
WHAT IS A STROKE? 
The human brain depends on the arteries to transport oxygen-rich blood from the heart. When blood flow to a part of the brain is interrupted due to a blockage in a blood vessel or rupture in an artery, brain cells in the region suddenly die due to lack of oxygen. Since these cells do not have the ability to regenerate themselves, it results in permanent damage in that part of the brain. 
    This damage could translate to loss of sensation in one half of the body (paralysis), vision and speech loss, incontinence or bladder problems. 
    Sawardkar's MRI revealed that a clot had formed in a blood vessel on the front half of his right cerebral hemisphere (which controls motor coordination on the left side of the body). Even if he recovered his speech gradually, there was a high chance that his left arm wouldn't function again. 
THE ABUSIVE LIFESTYLE CONNECT 
Sawardkar says he hadn't imagined that additional work load and eating junk could leave him with a useless arm. 
    In the last one year before he suffered a stroke, his company had diversified into film produc- tion, doubling his responsibilities. Instead of the usual 10 hours, he was now putting in 16 hours a day. Grabbing hours a sleep, skipping breakfast and eating a fat-heavy lunch of fried rice, biryani or pizza did him in. He'd chase the calorie-high lunch with samosas, vada pav or cream biscuits in the evening. Dinner was usually a burger that he'd order in at work. "Other than consuming junk, my biggest mistake was to stop high blood pressure medicating for six months," says Sawardkar. 
DIAGNOSIS & TREATMENT 
Strokes can be of two kinds — ischemic stroke (involving a blood clot, like in Sawardkar's case) and hemorrhagic (artery bursts inside the brain). The first can be treated within the first four hours of the attack. If diagnosed in time, the clot(s) can be dissolved by tissue plasminogen activator (t-PA), reducing the impact of the damage by 50 per cent. 
    In a hemorrhagic stroke, surgery might be required to tackle the blood spill inside the brain, and seal the leaking artery. 
    It's the fact that strokes are painless that often leads to misdiagnosis. Most are passed off as headaches or regular weakness. 
    After two months of rest, Sawardkar suffered a heart attack. Nine more clots were discovered between his head and heart. These could dislodge any time, travel to his brain via the blood stream. A bypass surgery was mandatory. Sawardkar had to change his lifestyle if he had to survive, the doctors told him bluntly. 
CHANGE OF HEART 
Luckily for Sawardkar, the brain damage was minor and the motor function controlling his left hand was taken up neighbouring portions of the brain. He was able to regain his speech and full function of the arm within six months. "Sawardkar's is a rare case. In most, recovery is never complete," says Dr Chakor. 
    Sawardkar now works no more than 10 hours, wakes up at six in time for a morning walk at Shivaji Park, and runs miles away from vada pav stalls. His breakfast consists of two oil-free parathas with tea. Lunch includes a home-cooked green vegetable and four chapatis. Aerated drinks have been replaced by fresh fruit juices, fruits and salads. Fish and daal makes up dinner. 
    Worry and stress play a key role, as is evident in Sawardkar's case. "We are a family of seven, and our 1 BHK home leaves us no space to breathe. Buying a new home was a concern since I'm the only earning member," he admits. Now, when worry creeps up, he plugs in his headphones and listens to calming music. Things will fall in place gradually," he says with a philosophic smile. 
YOUNG, INDIAN AND PARALYSED 
A 2010 report by the National Commission on Macroeconomics and Health states: Number of stroke cases in India is likely to increase to 17 lakh in 2015 (that's a jump from 12 lakh in 2005). Of these, between 15% to 30% are accounted by those below the age of 40. 
CHIEF CULPRITS 
» » High Obesity blood and pressure consumption of junk food » » Smoking Worry and stress

SIGNS THAT COULD SPELL A STROKE 
Strokes are painless, and hit you suddenly. After 
the onset, you have just four hours to act if you 
must prevent permanent damage. Due to misdiagnosis, treatment is often delayed in 40% cases. Rush to a neurologist if: » You experience difficulty in speaking and comprehending what others are saying. » One side of your face is dropping or feeling numb. » There is sudden loss of control (numbness or constant flapping) in an arm or leg on one 
side of your body. » You experience difficulty in controlling balance, movement. » You suffer from dizziness, severe headache or abrupt loss of vision in one or both eyes

WHAT DID SAWARDKAR IN 
» » Skipping 16 hour work breakfast -day » Fat-heavy lunch of fried rice, biryani or pizza » Evening snack of samosas, vada pav or cream biscuits, and a 
burger dinner » Skipping his BP tablets

A pressurising work schedule and unhealthy lifestyle are chief reasons. 30 per cent of all stroke patients we treat are aged 30 to 40 
DR RAHUL T CHAKOR, NEUROLOGIST

Burglar rapes Spanish woman in Bandra flat MUMBAI’S SPIRAL OF CRIME UNABATED

Mumbai: A bizarre night of house break-ins in a posh locality of Bandra deteriorated into a nightmare for a young expat woman when the thief turned into a predator and raped her twice at knifepoint before fleeing with her money and undergarments. 
    A police first information report has been lodged and sketches of the accused are being circulated to police stations. The 27-year-old Spanish woman, who came to Mumbai on a scholarship to learn music, also takes private classes. She was alone at home on Monday as her flat mate was travelling. 
    Around 2am on Monday, the thief first tried to enter a bungalow on Perry Cross Road, but ran away after a worker inside spotted him. The worker saw him enter the adjoining building and went back to work. The culprit then proceeded to rob a senior citizen in that building before entering the house of the Spaniard in a nearby building. 
    The thief shinned up a drain pipe and entered the third floor flat where she has been residing for four months through an open window. The man, who had partially covered his face with a handkerchief, woke her up and, brandishing a knife, asked for "gold", the victim told the police. She jumped out of bed, and managed to run out and knock on her neighbour's door. But there was nobody inside. The thief dragged her back into the flat and raped her. 
    He again asked her where her valuables were and, rummaging around, found some foreign currency. He settled down with a cigarette he found near the victim's bed and then raped the woman again. 
NIGHTMARE ON PERRY CROSS RD 
Burglar on 'house-hunting' spree at night 
Eyes bungalow, chased away by worker inside 
Breaks into fourth floor flat in adjoining building, steals Rs 5,000 from elderly woman's packed bags 
Next, enters Spanish woman's 3rd floor flat some buildings away 
Waves knife, demands gold. Woman runs out, but neighbour's door is locked 
Burglar drags her back in and rapes her twice 
As woman locks herself into bathroom and screams for help, suspect flees 
Help comes for woman only an hour later Robber-rapist didn't leave behind any evidence 
Took Away Victim's Gown, Undergarments 
    After this, she asked to be allowed to use the toilet. Once in, t h e S p a n i s h woman, whose parents are settled in Germany, locked it and began screaming for help. 
    The watchman of the building told the police that he heard the screaming, but assuming that it was coming from some other building, did not follow up on it. She screamed for over an hour before a maid, who was passing by, informed the police. 
    Roshan Reporter, secretary of the Perry Cross Road (north) Residents' Association, said around 4am she heard someone screaming in the next building, 'Help me, call the police'. "When I opened the window, several people had gathered and the police had been informed. The fire brigade came and broke open her flat door before the police could enter." 
    The thief, hearing his victim screaming, closed the main door from outside and quietly left the building. "The accused seems quite shrewd as he took care not to leave any piece of evidence behind. He has taken the victim's undergarments and night gown along with him," said a police officer on condition of anonymity. Sources said in a rape case, the undergarments are a crucial piece of evidence. 
    The police could not enter the flat as the terrified victim wouldn't come out of the toilet. After the fire brigade broke open the main door, they convinced her that they were cops and persuaded her to open the bathroom door. A special team of crime branch officers has been set up to crack the case. They are going through the list of history-sheeters and have also announced a cash reward for any information on the suspect. 
    "A person saw the accused at the bungalow but unfortunately he didn't inform the police. Otherwise, this incident could have 
been avoided. More unfortunately, the victim ran out of the house and knocked on a neighbour's door, but no one was there," said additional commissioner of police (west region) Vishwas Nangre-Patil, whose office is close to the area of the house break-ins. 
    The sketches being circulated of the suspect were made on the description given by the man at the bungalow and the Spanish woman, who saw the thief after he took off his mask. 
    After being shooed away from the bungalow, the thief had first broken into the fourth floor flat of 79-yearold Neela D'Souza, who had packed her bags and was ready for leave for her son's place in Bhopal on Monday morning, through the kitchen window. She woke up around 5.30am and went to the kitchen to make tea, but was surprised to see the window open. She had alsoseen that her bags were missing from the living room. She called up her other son who lives in a building in the vicinity. 
    Later, while searching the house, they found the bags lying on a window ledge and her belongings strewn around. Also lying were currency notes of small denominations. After the bags were retrieved, it was found that the thief had taken away Rs 5,000 in Rs 500 notes and dumped the change before raiding the Spanish woman's flat. 
    (With inputs by S Ahmed Ali) 
Robbed senior citizen to boost security Vijay V Singh | TNN 
Mumbai: Senior citizen Neela D'Souza, lucky not to be physically harmed during a robbery by a thief who raped a Spanish woman twice that same night, had never felt scared living alone after the death of her husband five years ago. The house break-in has shaken the 79-year-old and she now plans to be more careful about her security. "I am not shattered or frightened. I never expected that someone would be able to climb to the fourth floor to commit a theft. I am now more concerned about security and will adopt appropriate steps to make the house more secure," she said. D'Souza added that she had withdrawn money from an ATM on Sunday night as she was to leave for Bhopal early on Monday morning and wondered if the accused had been keeping an eye on her movements. NIGHT OF HORROR

1 A thief tries to enter a bungalow on Perry Cross Road, Bandra, around 2am on Monday. A worker inside spots him and chases him off

2 Thief breaks into senior citizen's 4th floor flat in adjoining building. Takes her mobiles and luggage packed for a trip to a ledge. Rummages through bags, leaves with 5,000

3 He climbs drain pipe of a nearby building and enters 3rd floor flat. Wakes up expat woman and asks for gold. She runs to neighbour's flat, but nobody's home. Thief drags her back, rapes her at knifepoint

4 The assailant searches the house again and finds some money. He smokes a cigarette and rapes her again. The victim goes to the toilet, locks herself in and starts screaming for help. Thief locks main door and flees

5 Around 4.30am, a woman hears screams and alerts police. Cops enter flat, calm victim and ask her to come out

The bungalow on Bandra's Perry Cross Road, near the office of the additional police commissioner for the west region, that the thief first targeted in the wee hours of Monday

79-year-old Neela D'Souza's building in Bandra