A forwarded message arrived on WhatsApp recently. It was about detecting early symptoms of stroke – the FAST way. FAST stands for Face, Arms, Speech and Time: Face may be drooped; Arms cannot be raised; Speech may be slurred or confused; and Time is most critical in stroke detection.
You probably got it too, and deleted it even without reading! Because let’s face it – there is an overabundance of info coming in on our devices, and also because of a strong belief, however incorrect, that these are things which happen to others, not to us.
In reality though, over 60,000 Australians suffer a stroke every year, making it the second most common cause of disability in our country. More than half of those who survive a stroke require help with normal daily activities. There is no cure for stroke, nor any forthcoming. Rehabilitation is the only method to recover movement of stroke-affected limbs.
A stroke occurs when part of the brain loses its blood supply. About 80 per cent of strokes are from a clot blocking an artery (ischaemic stroke), and 20 per cent from an artery bursting (haemorrhagic stroke).
But what if neither is the case, could you still get a stroke? The answer is YES.
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I did not have the slightest idea when I woke that morning with a dull headache, that I was going to get a stroke.
I went to see my GP for the seemingly innocent problem of blurry vision. The GP failed to recognise the symptoms and referred me to an ophthalmologist. The ophthalmologist quickly recognised the symptoms. She gave me a referral and packed me off to Emergency. Later I learnt that she had even called ahead, requesting them to do an urgent MRI.
However, the neurologist at the hospital did not think the MRI was urgent – it took place later in the evening. I was admitted to hospital for further investigation. The neurologist treating me recommended periodic neurological observations. However, I was apparently looking perfectly normal, so the nurse on duty ignored these instructions.
I suffered a massive stroke the next morning in the early hours. It was a brain stem stroke, also known as killer stroke.
I collapsed on the floor. I frantically pressed the call button. A nurse came. She told me she did not have the manpower to help me back to bed.
I had significantly deteriorated by the time my wife came to visit hours later. She raised the alarm.
The neurology team rushed in and decided to move me to a bigger hospital. I went in an ambulance with lights and siren, the head of neurology accompanying me, straight into the operation theatre.
I woke hours later in the ICU, hooked up to a mess of wires and tubes – ventilator, IV fluids, blood infusion.
Gradually, I progressed from ICU to High Dependency to Ward to Rehabilitation. I was being fed through a tube in my nose and later through a tube surgically inserted in my stomach. It formed part of my body for almost four years, during which time I could not eat or drink even a drop. I had a hole in my throat for tracheostomy, and an artificial nose called Swedish Nose.
I could not speak at all.
All this was due to brain stem stroke, where nerves cross over. Apart from affecting limb function on either or both sides, it affects the vital function of the body like breathing, heart beats, swallowing, speaking etc.
When I got back home from hospital, an entire year had passed.
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* * *
It was a slow, uphill task for me, and still is, six years later.
Rehabilitation took up most of my days.
First, I got rid of the ventilators. The next to go was tracheostomy, then Swedish Nose. They said the hole in my throat will close by itself – it did not, and had to be closed surgically.
Then, I was able to make some sound. With long-term speech pathology, although not very clear, I can now speak.
Swallowing was another skill to be relearned, with guidance from the speech pathologist, who introduced me to a doctor who had done significant research in the area. He had devised a method which could potentially help people like myself with swallowing difficulty. Only he had a small problem – the method was never tried in Australia! Some operations had been done overseas, he said, but there was no history of success.
He gave me two options. Stay as I was for the rest of my life, or allow him to do this experimental operation. I chose the second.
Today, the plastic tube protruding out of my stomach has disappeared. I can enjoy almost all type of food orally, although much slowly.
* * *
Now, thinking about it, I wonder if there was something I could have done differently.
First, the ophthalmologist. She suspected I was likely to get a stroke. She did everything right. But I did not ask her the reason why she was sending me to Emergency. I could have asked what was in her note, or whether I could get a copy of that letter. I should have asked her what her next plan was.
If a doctor had asked for an urgent MRI, I should have pushed for it.
I learnt later from another neurologist, that there is a scan available at the hospital. It takes only a couple of minutes and tells doctors if the individual is likely to get a stroke or not. I wish I had known this before. Doctors are only humans. They can make mistakes. That is when technology comes to their rescue, if they use it.
Again, if neurological observations had been recommended for me, I should have checked, who is supposed to do these and when? When they did not get done, I could have asked why.
Time surely is the key factor here!