My Stroke – Anniversary (2)
My Stroke Now In this post I want to explore how I feel now about my stroke, how it affects my life and what the future holds. There are 5 main areas that have been affected by my stroke. Vision I have double vision because my stroke weakened the muscles to one eye. That is corrected by having a prism in one lens of my glasses. The vision is blurred because of the nature of the temporary prism. Day to day I have normal, if blurred sight. The trouble is without them I still have double vision, so showering is difficult, waking up I cannot see the clock clearly and activities like swimming are difficult. The prognosis? Originally, I was told that I could have an operation that would tighten the muscles of my right eye. To be honest, I really did not fancy being awake while the surgeon operated on my eye. Over time, the limitations of having a prism in my glasses became obvious. I came to feel that an operation was the way forward. It now seems that my eye muscles have become stronger and that the operation may not be an option anymore. My double vision may be something that I have to live with. The other big effect that my stroke has had had on my vision is loss of depth perception. That means that although that can see that I am walking up to a curb I have no idea whether the curb is 4 inches high or 1. I tend to stumble, a lot. Still an issue, and probably always will be. Walking I could only walk with a stick after my stroke. I really did not want that to be the case. Supported and encouraged by Lauren from the Occupational Health team I practiced walking, with the stick. Together we walked miles through the corridors of the hospital, and I began to get pretty cocky, it would not be long until I ditched the stick. Lauren kept reminding me that the corridors in hospital are flat, no curbs, no uneven pavements, no potholes. I should have listened more. Leaving hospital, I decided that I would walk a few miles each day in order to be able to ditch the stick. The first few times I walked into town, which I did every day, were difficult. Yes, there were curbs, uneven pavements, and potholes. Each day was a new challenge. However, 10 days after my stroke I ditched the stick! Success!! Leg and Knee Problems Immediately after my stroke I had sensory problems down my right side, you can read about them in my previous post. The issues resolved themselves relatively quickly for my upper body, but my leg and foot have taken longer and the problems persist to a lesser extent. I still have nerves firing when I put on socks and shoes, but at least now it is not painful. My foot sometimes tells me that it is hot, but it no longer feels like it is on fire. One aspect that came to the fore a couple of months ago was the loss of strength in my right leg. I began to have pains in my knee. They were not related to my stroke; most likely it is arthritic in origin. The upshot is that I have begun to exercise to build up the knee muscles and reduce the pain. (Which is going very well, thanks for asking). What has been revealed to me is that my right leg is way less strong than my left, as a result of my stroke. I would not have known this or that I was favouring my right leg unless I had started to exercise. The benefit is that future leg and hip problems may well be avoided Another success! Speech After my stroke I had speech problems. One side of my face did not work so explosive sounds like “b” or “p” were almost impossible. I rang my boss at work from the hospital to say that I was still alive and to say that I had some bananas in my desk drawer and that he had better move them before the went off and smelled. You can imagine how difficult that conversation was, if only I had to tell him that I had something else, like chocolate or sweets in my drawer! One odd thing, or not, was that I could never hear that my speech was affected. To me, I sounded normal. As the left side of my face decided to work again my speech started to be clearer. There were issues, for example, about a month after my stroke I rang the doctor’s office to ask for a repeat prescription. The woman on the end of the phone was very curt and impatient. She said that she could not understand me to which my reply was “I am not bloody surprised; I have just had a bloody stroke!” Her attitude changed. Even now I have some issues when speaking but no where as bad as they were. A partial success! Mind , Memory, and Depression after My Stroke The problem with mind and memory issues is that they are internal and not obvious to others. When I “ditched the stick” it was obvious to everyone and Jane and friends all complimented me and said how well I was doing. With mind and memory issues it is so difficult to gauge progress, if any. One result of my stoke, as for many who suffer a stroke, was I descended into depression, again. I had only just come off the medication and I was pleased that I was recovering. Over night I was in that dark place, again. I have written about depression here. Since my stroke I feel that I have been recovering and quietly stopped the medication a couple of weeks ago. I have not told anybody. Why not? Because when I stopped before I paid too much
My Stroke – Anniversary (1)
Was My Stroke Really a Year Ago? On this day last year (13th June) I suffered my stroke which started as I drove to work. You can read about it here, here, here, and here. Looks like I am beginning to become a stroke bore when the truth is that I rarely think about my stroke during normal life. However, I wanted to be able to spend some time reviewing where I am, where I think will go next, and how I view the past year. This photo was taken, I think, 3 days after my stroke. Not a pretty sight with one half of my face sliding down and declaring UDI from my brain. It was the left side of my face that slipped, in case you can not tell…. My Stroke was Unusual My stroke was of a variety called Lateral medullary syndrome. who knew that there were different types of stroke? I thought that a stoke was a stroke. If you want to you can read about Lateral medullary syndrome here. Here is a bit from that article; “This syndrome is characterized by sensory deficits that affect the trunk and extremities contralaterally (opposite to the lesion), and sensory deficits of the face and cranial nerves ipsilaterally (same side as the lesion). Specifically a loss of pain and temperature sensation if the lateral spinothalamic tract is involved. The cross body finding is the chief symptom from which a diagnosis can be made. “Patients often have difficulty walking or maintaining balance (ataxia), or difference in temperature of an object based on which side of the body the object of varying temperature is touching.[2] Some patients may walk with a slant or suffer from skew deviation and illusions of room tilt. The nystagmus is commonly associated with vertigo spells. These vertigo spells can result in falling, caused from the involvement of the region of Deiters’ nucleus.” What did that mean? Well, one very odd effect was that although it was the left side of my face that fell it was the right side of my body that was affected. For me it meant that although I could feel pressure if someone poke my right side it would feel the same if they stuck a needle into me, i.e. I felt no pain. To me hot felt cold on my right side. Imagine how that felt when I showered. My left side felt the water as hot, my right felt as if I was having a cold shower! Later, my right side felt as if all the nerve endings all fired whenever my right leg and foot touched anything. For example putting my sock on my right foot was painful because all the nerves fired at once. putting a shoe on was a slow and painful experience and so on. A couple of moths later I went on holiday and fell over when I walked into the sea because I could not cope with all the sensations from my right leg and foot! The next post will cover the 5 main areas where I have been affected. Not all stoke sufferers are affected the same way, as I now appreciate. Shame that it took me having my stroke to open my eyes! For more information about strokes visit http://stroke.org.uk
My Stroke 4 – The aftermath
It is 6 months, to the day (13 June 2018) since my stroke. There are a couple of niggling outcomes from my stroke, like not being able to drink a cup of coffee without there being a small drip down the side of the cup. (My mouth does not form a complete seal). On the other hand the day after my stroke I could not even swallow coffee without choking, so it is all relative. Of more concern are my eyesight and the feeling in my right leg and foot. If you want you can read the full story starting here. My Eye Sight. My stroke left me with double vision. As everything else improved after my stroke I hoped that my eyesight would as well. There has been some improvement but I still have double vision that is corrected by a special, temporary, prism that is added to one of the lenses in my glasses. For day to day life this is fine but whenever I take my glasses off the double vision returns. Swimming on holiday was difficult, so is getting out of bed in the morning before I find my glasses! There may a resolution to the double vision problem. I am due to see the consultant on 14th December. I hope that he will agree that an operation is possible. The operation involves tightening muscles at the back of my left eye to correct the vision. I talked to a doctor about it a couple of months ago. He said that the good thing was that they can ask you if the vision is fixed and if not tighten or loosen the muscle as required. When I asked what he meant he said, ”well, obviously, you will be awake while they do the operation”. WHAT!? As if having a stroke was not bad enough, they are going to be fiddling with my eye, with scalpels and things, while I watch? Bloody Hell! My Right Foot and Leg A couple of days after my stroke the doctor took me to a wash basin and put my left hand under the running cold tap. “What does that feel like?” “Cold.” Then my right hand under the same cold water. “What does that feel like?” “Hot!!” Very odd. That was not all, while I could feel pressure in the whole of my right side from the neck down I could not feel pain. I could stick a pin in my shoulder or pinch myself, and all I could feel was a vague feeling. I would know that something was pushing against my skin but that is all. Over the next few weeks the numbness retreated until it was only my right leg and foot that was numb although the difference in heat perception remained. Imagine being under a shower and half of you feeling scolding hot and half of you icy. It does make showering interesting, especially if you test the temperature of the shower with the wrong hand, the cold hand. You step into a shower that is hot enough to take your skin off! THis effect is typical of a lateral medullary stroke. It seemed to please the doctors no end as they kept bringing their friends to stick pins in me and put my hand into cold water. Apparently this type of stroke is quite rare and they all wanted a go at pin sticking! Numb but still painful! The numbness has gone but it has been replaced by overactive nerve endings in my foot and ankle. This means that whenever I put socks on or shoes all the nerve endings in my foot all start shouting at the same time. Not exactly painful but nearly. Stepping on uneven ground in thin soled shoes is like some form of non marking torture! As for going on to the sea on holiday! I went on holiday a month or so after my stroke. Going into the water was very difficult. The hot sand was refreshingly cool (if I hopped on my right foot). The water was nicely warm, for one leg. Then all the nerve ends in my right foot and leg decided to announce that they were surrounded in water, all at the same time and continuously. The first time it happened I fell over! I have no idea what the other people on the beach thought. I was wearing an eye patch and falling over in the water while trying to hop on the sand. No wonder I was given some odd looks! The future I am pleased with how things have gone after my stroke, It could have been so much worse, and is for most people who have a stroke. I am not belittling the issues and problems that some people experience after a stroke. They can be life affecting and limiting. I realise just how lucky I have been. I am only marginally incompasitated and still feel that glad to be alive feeling every morning. How to cope with a loved one who has has a stroke.
After My Stroke – The First Day of My New Life
The First Day of My New Life My stroke was on 13th June 2018. My new life started on the 14th. I did not sleep well on male stroke ward B2 in Blackburn Royal Infirmary that first night. There were a lot of thoughts going round and round in my head, of course. Then there was the noise, the groans and the ramblings. It was a small, modern, ward and there were 5 other stroke patients. The nurses did not stop attending to first one and then another patient. As I lay there it was obvious that they were in a lot worse state than I was. Perhaps Lauren was correct; perhaps I did have the “good” type of stroke. As the following morning dawned I realised a couple of things. Firstly, I still had double vision. Second, I had been incredibly lucky. Initial Stroke treatment The first treatment for a stroke as a result of a clot (an ischaemic stroke) is to give the patient a blood thinning drug. The treatment is called thrombolysis. It thins the blood and so “dissolves” the clot. It is very effective if given within 4 hours of the onset of the stroke. After thrombolysis, 10% more patients survive a stroke and live independently. Despite its benefits, there is a risk that thrombolysis can cause bleeding in the brain. This happens to about one in 25 people within seven days of thrombolysis, and this can be fatal in about one in 40 cases. The sooner someone is treated, the better their chances of improvement, and the lower the risk of harm. The risk of a bleed in the brain is the reason that I was not allowed out of bed for 24 hours of the treatment. I would be unsteady on my feet after the stroke and could easily fall over. Knocking my head would mean that there would probably be a bleed in my brain, and I would die. With that sort of reasoning I was happy to spend 24 hours in bed using a bottle. Well, not happy, but using a bottle was preferable to dying. Onwards and Upwards When I was in the A&E I had said to Carol that I would be back to work in a couple of days. At that time I had no real appreciation of just how ill I was. One thing I did know was that this bloody stroke was not going to beat me. I would get better, I would return to work, and I would put this inconvenience behind me. It sounded so easy. I must say that the early days after my stroke were some of the most life affirming of my life. Every day, every morning and afternoon seemed to be marked with an improvement, (apart from the double vision). June 14th, 1 day after the stroke The day after my stroke I had a number of issues; I had double vision. My left eye would not close. My face had dropped on the left. I could not swallow. My speech was badly affected. Super sensitivity to noise. Panic attacks. I was unsure whether my cognitive abilities had been affected. I suffered from dizziness. Apart from that I was OK. None of these symptoms are unusual for stoke victims. It could have been a lot worse. Objectively I could see that I was in a far better place than most of my neighbours, either physically or I was more positive. Double Vision and my Left Eye Not Closing The double vision was the worst thing. It meant that I could not read, or see what was going on around me clearly. The solution to that was to tape my left eye shut. I was given a gel to put in my eye to moisten it to keep it from drying out and being scratched. With the left eye shut I was able to see clearly. I could read, type messages, and recognise who was talking to me! The solution to my eye not closing did present me with another issue. Taking the tape off my eye resulted in a loss of eyelashes and eyebrows! Still, that they would grow back was reassuring. Gradually, my eye did begin the close. I can remember the first time I was able to wink at someone after my stroke and how good I felt being able to do something so simple. It took me about a month before my eye would close. My Dropped Face Even before the Occupational Health team descended on me I decided that I would need to do something about the fallen side of my face. In my mind the best thing that I could do was to rub my face to stimulate it and to remind my brain that it should be controlling that side of my face. As it happens that is one of the exercises recommended to stroke victims so I got a head start. Improvements began within a few days. Swallowing and Speech Problems Swallowing and speech impediment were connected. Half of my mouth and throat did not work. The day after my stroke I called Paul, my manager, to say that I was still alive. I also wanted to tell him that there were a couple of bananas in my desk and that he should remove them before they went off. The trouble was that I could not make the explosive “b” sound. It took hours – well, it seemed like hours – until I could make Paul understand what I was saying! All explosive sounds were impossible. The best way to improve the situation was to practice talking, so I did, I talked to anyone who would listen. The swallowing function is something that often suffers after a stroke. For me it left me unable to swallow. The best I could do was to use my tongue to shovel the food or drink to the right of my mouth and, with my head tilted, swallow.
My Stroke – I Have Had Better Wednesdays – Part 2
My Stroke, no It wasn’t a Bad Dream…. So, the story of my stroke, where was I? Oh yes, I had arrived at work after having a couple of episodes of double vision and I did not feel terribly well. I obviously did not look too good as Victoria, a colleague, said that I looked pretty dreadful. As I was having a stroke, I suppose that was fair enough, although it is not a comment that boosts one’s ego. Geoff the first aider came to check me out and immediately asked for an ambulance to be called. The paramedics arrived and I was still hanging on to the hope that they would say “go home and rest, it’s fine”. I was hoping that but I kn ew that it was a stroke. Oddly I could still hold my arms up, there was no weakness in my limbs, but the other symptoms were there. I could feel my face slipping on one side (at least I think that I could, it is hard to remember now). I also knew that my speech was becoming more and more indistinct. On the other hand my brain still felt sharp. If I had thought about it I would have expected someone having a stroke to feel their brain slipping away. The problem was making other people understand. After a few minutes the para medics loaded me onto a wheel chair (I wanted to walk to the ambulance, but they were adamant). The only time I felt fear that day was when I was taken down the stairs on the wheelchair. I was strapped in to the chair and if I had been dropped I could have done nothing to protect myself as the chair and I bounced down 2 flights of stairs. Of course, the para medics did not drop me. It did not seem odd to be worried about the wheelchair being dropped but not about having a stroke, just goes to show what tricks the brain plays on you at times of stress. The Ride to the Hospital and My Stroke Buddy. If you could plan to have a stroke my main suggestion would be to have a “stroke buddy”, someone who goes to the hospital with you and helps you make sense of what is a confusing time. I had Carol. Carol is a colleague who suggested that I should have someone go with me to the hospital and volunteered to go with me. She stayed with me in the ambulance chatting and not letting me dwell on what was happening. She also acted as a buffer between the para medics and me, helping me understand what they were saying and helping them to understand me. I am not sure that I thanked Carol on the day but she was of immense help to me. From sharing a secret look and smile when we both saw the nurse with the unusual hair colour, to laughing at my pretty weak jokes, to explaining what was being said when I was distracted she helped me stay calm. I remember thinking that I was calm and being surprised. Looking back I do think that the quiet competence of the para medics and Carol’s presence helped a lot. The paramedics were great. When I asked about having the flashing lights on because it was the only opportunity I was likely to have they said “yes” and the lights were on, for no reason other than I wanted them on. Top Guys. The ride to the hospital was a time for me to take stock. I realised that my left eye would not close and that the left side of my face was dropping more. Although I knew that I had had, or was having, a stroke I did sort of think that I would be going home that day. I was still holding out for a couple of days off work and back in the next Monday. Carol said that she did not think that it would be that simple. The A & E I had never been in A & E before. My experience of A & E was gained from television and Ealing comedies. From the cheeky, heart of gold Barbara Windsor nurse, to the dedicated doctor who has “issues” of Holby General. Judging from my limited experience the truth is that the staff in A & E are professional, a bit cheeky, but they hide any personal issues very well. There were no meaningful looks between the nurses and doctors that I could see, no sly touching or innuendos. (But then was I in any state to notice? Probably not). Carol kept me going. For some reason I felt the need to appear cheerful in front of her, no idea if I managed. I did not want to let the side down. She was being so supportive I owed it to her not to descend into self-pity. After all people get over strokes every day, right? So, with the nurses being calm and professional into my life walked Lauren. Lauren was with the Occupational Health team. She was there to tell me what was going on and ( as I found out later) to observe me, gleaning what she could of my disability before I moved to the ward so that the OT team and the Speech and Language Team had an idea of my issues. She often attends a stroke patient that comes into A & E. If not her one of her team does. It was not until later that I appreciated the importance of her being there. It was Lauren that explained to me that there are 2 basic types of stroke. One that is caused by a bleed into the brain and could need surgery and one that is caused by a blood clot in the brain. I had the latter. As Lauren said that is the good type of stroke. The term “A good type
My Stroke – I Have Had Better Wednesdays – Part 1
No One Expects the Spanish Inquisition, or A Stroke. My stroke. Wednesday 13th June 2018. A perfectly normal day. I was looking after Meg, a golden Labrador for her mum, Di, had gone on holiday with Jane. I had fed Meg, given her a walk, and then taken her to her house for the day. It was 7.45 and I had half an hour before I had to start work. Just time enough to buy food the evening meal. I was going to have Lamb with smoked aubergine and minty broad beans. I was looking forward to making a new recipe. Driving away from Tesco I suddenly had double vision which cleared after 10 minutes. Although I did not know it, my stroke had started. I drove on to work, feeling none the worse for the double vision episode. Was I worried? Not at all, I had experienced double vision before. That I put it down to one of the known side effects of Sertraline, my anti depression medication. I drove into work and parked up and the double vision started again. Again, I waited for a few minutes and when it passed I clocked into work, 8.20 5 minutes late, BUGGER! My Wednesday, it gets worse. Up the stairs and into the office. “Mornings” all round. Victoria looked up and asked me if I was OK. I said something about me having one of my dizzy and double vision episodes and that it would pass, as it had in the past. Then the double vision returned and I knew that I could not stand up without falling over, this was going to be a bad day. Victoria kept looking at me, obviously a bit concerned. By this time I was as well. I held my arms out in front of me, no weakness there, so I knew that it wasn’t a stroke and I said as much, laughing, to Victoria. However, the words did not come out properly. I stopped for a few seconds and said to Victoria, ” Is my speech slurred?” She said yes and I said I think that you had better phone the first aider. Even as I said it I knew that it was a stroke and there was nothing I could do to alter what was about to happen. Everyone Else Looks Worried Geoff, the first aider was with me within a couple of minutes and almost immediately said “call and ambulance”. He knew that it was a stroke and confirmed that when I asked. He stayed with me, asking all the right questions and keeping me calm. Although I already felt calm. There was nothing that I could do. Besides there were enough worried people in the office without me adding to the number. I wanted to stay calm so that I could tell the para medics exactly what I was feling. They needed to have the right information as quickly as possible. It actually did not occur to me that they probably could not understand what I was saying….. One of the many bad things about having a stoke is that your brain works (or you think that it does) but holding a conversation can be impossible. The upshot was that I had a list of symptoms and observations in my head but could not make anyone understand. I also thought that it was all rather unfair. I had stopped smoking (with a couple of slip ups) 10 months previously. Very unfair! At some point I realised that this was going to be a seriously bad Wednesday. For more information about strokes visit http://stroke.org.uk Be sure to check out how to recognise when someone is having a stroke and what tom do here.
Phil’s British Heart Foundation Donation – you know it makes sense
