Interview 01

Age at interview: 58

Brief Outline: He had a stroke due to hemorrhage aged 57, which caused left paralysis, left neglect and some early problems with speech. Medication' atenolol, ramipril (blood pressure), levetiracetam (epilepsy), paroxetine (antidepressant), omeprazole, (gastric resistant tablets).

Background: Is married with two grown-up children. At the time of his stroke he was Head of News and Current Affairs, Channel 4 Television and is now a Visiting Professor at City University. Ethnic background/nationality' White/English.

More about me...

This man had a stroke due to haemorrhage in the right hand side of his brain at the age of 57 he is now 62. His stroke was due to high blood pressure which was not checked regularly before the stroke.  He now takes atenolol and ramipril to control blood pressure.

He was with a friend at the time and is very grateful that she acted quickly and phoned an ambulance. He was admitted to hospital where an emergency operation was performed to remove the blood from his brain. He woke up a few days later but remembers a considerable amount about the stroke.

His stroke caused paralysis of his left leg and arm. He had intensive physiotherapy in hospital and private physiotherapy on his return home. He is now able to walk short distances with a stick but still uses a wheelchair for longer distances. He feels that he is still seeing improvements 5 years after the stroke and thinks that he saw most improvement once he got home. He realises this is unusual as people usually see most improvement in the first few months. He still has very limited use of his arm but hopes that this might improve with time.

He has also experienced some problems with his vision on the left and in addition had a condition known as visual neglect that means that he was unaware of things on his left hand side.

Since the stroke he has developed epilepsy which was initially a problem but is now well controlled with medication.

He has been very motivated to recover and thinks it is important to keep setting and working towards goals and reflecting back on things that he has achieved. One of his major achievements was getting back into work after his stroke.

Describes how he chooses things that are easy to eat with one hand if he goes out to eat.

How about, you know, going out socially, going out to eat, perhaps with the problems with your arm, you know, do you have any issue with that at all?

No, but I, people know that they have, they have to expect to cut my steak, I can't cut my steak.

Does it have any influence over what you choose to eat or?

Mmm, it does, it does. There's a particular, there's a steak and kidney pie on offer at a gastro pub fairly close by which can be eaten with a spoon [laughs], and so I don't have to get. I mean knife and fork are my great bugbear. Chopsticks aren't so bad, knife and fork really quite tricky [Laughs]. 

[Laughs] Not many people would say that about chopsticks [Laughs].

Well if you can manage chopsticks in the first place you only use your right hand after all and so it's easier for me. And obviously I haven't given up from every being able to use this again [slapping sound].

Describes what it was like to have an unexpected seizure after his stroke.

I was virtually unaware of what happened the first time, was almost like going to sleep in the middle of, almost in the middle of a conversation really, and I must have sort of passed clean out really. But presumable shook the while, I mean the first time I did have a seizure was admittedly a [my previous work's] party, an anniversary party, tenth anniversary. When I was as yet, well all I was doing was, I had a glass of champagne which didn't see eye to eye with the, the pills which are there to bring down my blood pressure. So I had a bit of a seizure then but that was a very different matter. The time I had the seizure in the last hospital I was in, was without any, any role played by alcohol at all. It just happened out of absolutely nowhere, I, suddenly became, well I didn't become aware actually that I was shaking, I now realise that must have been what happened, but I was in the middle of a conversation with a researcher in fact at the time. And, then everything is erased after that, I don't, don't have any memory of what happened after that. When I got home I was still, still having these seizures and, found that if I got at all fatigued particularly by talking at any length, I might have a seizure like this. I was later told that it could have been as a result of some new pathways being built in my, in my neurological system and that might have been what activated these seizures so long, long after I was ill, might have been. Anyway I'm now under medication which is specifically designed to arrest the seizures and as I say, it is now, it's pretty much a year, and I think more actually since, since I had them. 

He was very appreciative of a friend because she phoned 999 quickly which meant there was little...

Well, my stroke was in fact a brain haemorrhage. And, it came upon me without any warning. And I think the most extraordinary thing about it was that it wasn't as if there was any activity I was doing which was likely, or would have been thought likely, to endanger me. I was working very hard. I was approaching my sixtieth year and I wasn't working any harder particularly than I had over a long period of time. But one day I travelled to the North West of England and broke my train journey in order to see and old friend. 

I was sitting in her kitchen drinking a cup of coffee and suddenly in the middle of drinking this cup of coffee I became aware that I was loosing my ability to articulate. I didn't know what had happened. In fact I was completely confused and bemused by it. But, the friend of mine who I was sitting with immediately got on her mobile phone to the emergency services and said that, she thought, she was very sorry, but she thought that the person she was just sitting with was having a stroke. And it was at that moment that I thought, 'My goodness, is this what's happening to me?' 

Anyway her quickness and her general speed and alacrity of response helped me enormously because it got me into, onto an operating table much faster, I think, than is normally the case. But it think what I take away from that myself is that it is possible to be very ill indeed, suddenly without, even looking back on it, without any warning sign. And I suppose the reason is that what I had wrong with me was very high blood pressure which I now realise having examined this many times doesn't necessarily have any tell tale symptoms. You know, no sort of, no heart flutters, no things like that, no, you know, no obvious precursors to what in the end was a very severe illness. 

Although he is not back to normal he stresses that he has achieved more than he originally...

And I think one of the critical things I'll say is this; there's a time immediately after your illness when you can't imagine that you'll ever be back to normal again. I remember saying to my consultant neurologist, he asked me what my ambition was and I said, 'My ambition is to return to a point when no-one will ever know that I've had a stroke,' and he looked at me slightly gravely and said, 'I think you have to, you may have you reduce your ambition a little.' And I see now what he means. But at the same time it's true to say that, you will find, if you are of the right mind to find it, that there are things that in your immediate, in the immediate aftermath to your illness you could never imagine yourself being able to do. You'll think to yourself, 'Well I might just about walk with a stick but I'll never walk without one,' all you, you have to answer that by thinking back to what you can now do that you once said you would never do. And then think forward from this point and there's no reason why the same distance can't be achieved as between this point and a future point that would be equidistant with the point that you once said you would never reach from a point immediately after your illness.

He describes the tests he had for a severe hemianopia. He also suffers from visual neglect and...

Initially I was very, very neglectful of my left side. If I for instance was sitting here and somebody would sit next to me on that settee and they would ask me a question, I would address my answer to you and to pass the camera to you, and they would start to get extremely jumpy about all this and wonder why I was cutting them dead. 

Of course I wasn't I was just, I was just unable to cope with my left side. I've done hundreds and hundreds of tests on paper since that time to try and improve my left neglect as it's called. What they do is they give you a whole load of designs on a piece of paper and you have to cross the one's which are maybe zeros or threes or twos or fours or whatever and of course. What you tend to do is cross out those examples on the right hand side of the page and when you get the hang of it you start to cross out the left hand side as well because in the beginning you look terribly proud of yourself for having found all these twos, threes and fours on the right hand side and the person doing the test looks at you with a sort of rather sympathetic gaze and says 'well what about the ones on the left hand side'. 

Well after a while you do get used to this test and you really start correcting it and you come to realise that what's on my left side there is this, this and this but I, I'm still not too good at it, I have corrected it up to a point. I had to really work at it very hard, and I suppose that's one of the reasons why the DVLC say's 'well you've had a stroke, I don't know whether you should drive. How are you in the side mirror, how are you in the driving mirror indeed. Do you see things through 360 degrees and how long will it be until you do'.

He describes the tests he had for a severe hemianopia. He also suffers from visual neglect and...

Initially I was very, very neglectful of my left side. If I for instance was sitting here and somebody would sit next to me on that settee and they would ask me a question, I would address my answer to you and to pass the camera to you, and they would start to get extremely jumpy about all this and wonder why I was cutting them dead. 

Of course I wasn't I was just, I was just unable to cope with my left side. I've done hundreds and hundreds of tests on paper since that time to try and improve my left neglect as it's called. What they do is they give you a whole load of designs on a piece of paper and you have to cross the one's which are maybe zeros or threes or twos or fours or whatever and of course.

What you tend to do is cross out those examples on the right hand side of the page and when you get the hang of it you start to cross out the left hand side as well because in the beginning you look terribly proud of yourself for having found all these twos, threes and fours on the right hand side and the person doing the test looks at you with a sort of rather sympathetic gaze and says 'well what about the ones on the left hand side'. 

Well after a while you do get used to this test and you really start correcting it and you come to realise that what's on my left side there is this, this and this but I, I'm still not too good at it, I have corrected it up to a point. I had to really work at it very hard, and I suppose that's one of the reasons why the DVLC say's 'well you've had a stroke, I don't know whether you should drive. How are you in the side mirror, how are you in the driving mirror indeed. Do you see things through 360 degrees and how long will it be until you do'.

He doesn't remember his operation but understands that they cleared the blood and repaired a...

Was there talk about a defective artery that bled. I mean when they did the operation, did they actually tie something off or did they just mop up the blood, do you know?

My understanding is that the operation that was performed on me was pretty much to clear the blood out of my brain and then to mend the blood vessel that had burst. I don't think it extended beyond that into the arterial body, into the arterial system. I think it was simply a matter of repairing a blood vessel, however you do that, I don't know.

But anyway it was done and the blood has to be drained off because if your brain is flooded no doubt, that does account for a complete collapse in your ability to articulate and probably do a whole load of other things mentally as well. 

So I'm extremely grateful to that surgeon who, who performed what must be a pretty, a pretty terrifying operation when. Now all operations presumably are terrifying to that degree but I don't know how you get into the skull in the first place, thank goodness I wasn't awake when it happened because I'm pretty, pretty awful when blood is involved.

Was very impressed with the knowledge and attitude of physiotherapists he saw in hospital and...

I think the, when I look back to my time in hospital the, the medical, the medical discipline, the medical profession which I had never really understood the full and complete worth of before, but now realise absolutely what they do and how well they do it and to what effect it is physiotherapy. I've been very fortunate but I doubt I've been unduly fortunate to have some very good physios and I think the standard of physiotherapy in this country from my experience is extremely high. I've had so many different physios because they rotate round often in different hospitals and, I have never met a bad physiotherapist. I've only met caring, supportive, intelligent, knowledgeable physios right through. And I've also had one extra advantage that since leaving hospital, my last rehabilitation unit, when I didn't have the, any ability to walk, I didn't really have much use in my left leg, I have been guided by a final physio who has treated me privately at home. Now that I realise is, because not everybody has private health insurance, that is an enormous advantage which I've had over perhaps the majority of people but I've shared with virtually everybody going through the NHS, the enormous quality of physiotherapy that exists in this country. And, they are, they're a great bunch of, of people. And they, they quite rightly keep you up to the mark, they don't let you slack, they, they always explain to you what they are doing and why they are doing it and what they hope will be your benefit from things. So, I think, both in temperament and in their whole attitude to their work and their knowledge of their work, I'd put them as overwhelmingly top of the tree. 

Records his progress in a diary and encourages other people to do the same.

How do you, do you have any way of keeping a record of your progress at all? You were saying that, you know, you can look back and see how you've moved on, how, how have you recorded that?

I try and record in a diary what I'm doing and what I'm up to at any particular moment. And at one stage I used to time myself going around the park and seeing whether I could increase the speed, in fact, I've stopped doing that now because it isn't a matter of speed so much as technique. Because now I, you know, I probably shouldn't do it too fast, I should simply do it more accurately and more proficiently. But yes, I mean, I would advise people to keep a good record of their own as to where they've got to and where they've from arrived at any one moment. For one thing it'll do them the power of good to be able to set a marker on where they are now and then become increasingly aware of how they've travelled from one marker to another to another again. And by projecting that marker forward you can become more and more confident that one day you will reach the very same distance forward to the distance that you arrived from a point behind. 

The speech therapist gave him speech exercises to help regain the muscle strength in his face...

Did you have any help from speech therapy at all?

Oh I did, I had quite a lot of help from speech therapy. Particularly in the last hospital I was in before going back home. And, I was able to do quite a lot of mouth exercises, speech exercises, with them. At one stage I was asked by one of them to read, read her my favourite poem [laughs]. So, there was, there was quite an incentive in there.

Can you, people might wonder what sort of speech exercises you do after a stroke. Can you describe the sort of things you were doing?

Quiet a lot of, speech exercises you do are quite, some of them quite simple in trying to redevelop your muscles where they seem to have gone flat or flabby. And in my case it appeared to most of the left side of my mouth. But quite a lot of 'ee', 'oh', 'ah,', 'ee', 'oh', 'ah', quite a lot of that to sort of, almost like an orchestral musician warms up to be honest or a brass player anyway 'ee', 'oh', 'ah', 'mm', 'mm', and to get those muscles, relearning their strength, re-acquiring their strength. And in fact even now if I do get a quiet moment, sometimes, I look in the mirror and' see whether I can reinforce some strength, particularly on the left side. And I think the left side went with all the mobility problems that I was initially having in my left leg. Still have to a degree in my left side, but I don't seem any longer to have the same sort of problem now with articulating consonants. 

Enjoyed meeting people from different backgrounds in hospital and admired the determination of...

Yes, I met some, I met some smashing people actually, we, we were very sort of, I mean, we were right across the class range, I mean, you know, very different bunch.

Did that help in any way to, you know, motivate you to, to get better? Was there any competition or anything like that?

I don't think it was that exactly, there was every so often, we had little, sessions for people who could stand and, we would sort of, we would play, sort of routine tennis, you know with bats and balloons back and forth. So that was quite a bonding exercise but it wasn't competitive as such. No most of the people, I'm talking now about the [the hospital]. Most of them were, were a good lot, good fun. And we had, we had a few laughs, bit like a kind of grown up boarding school really. 

How about, good examples, you, you know you mentioned about the guy at the gym who was a very good example of'

Oh yes, oh yes he's' Now he was, he would put me to shame to be honest. He because the sheer amount of physical exercise he did and was determined to do was so great that in the end he decided he, he ought to become a gym instructor and was a good one too. And he'd had, if anything I think, a worse condition than mine in that he'd lost a lot of speech ability as well has having lost a lot of mobility. But he'd obliged himself to get rid of his stammer or his, you know, his speech difficulties. And had really, really, really worked hard at it. Younger than I am, only in his thirties. Very, very admirable guy. Really amazing.