Interview 06

Age at interview: 54

Brief Outline: He had his stroke at the age of 53 during an emergency heart operation. His stroke caused partial right-sided paralysis and vision loss. Medication' bisoprolol (blood pressure), simvastatin (cholesterol), aspirin (antiplatelet).

Background: Is a married process operator with 2 adult children. Ethnic background/nationality' White/Scottish.

More about me...

This man had his stroke during an operation on his heart for an aortic dissection. He was previously very fit and had run, cycled and hill walked regularly. He sees the stroke as the least worst outcome as there could have been other severe consequences from the surgery.

The stroke was due to a clot lodged in the left hand side of his brain. He initially had paralysis on the right hand side of his body and has some loss of the peripheral vision on the right. 

To start with he was in intensive care, then a heart ward in another hospital and there was a delay moving him to stroke rehabilitation locally which he found frustrating. In stroke rehabilitation he managed to regain function in his leg and arm. After initially using a wheel chair he started walking and is now setting himself goals for walking and running. He has attended a cardiac gym which has given him a great boost and he advises others to find similar programs to help with fitness after their stroke. Although his hand function has improved he still feels it is weak and is wary of carrying things in that hand. 

He was hoping to return to work and was being helped by a community occupational therapist to find the best way to do this. The occupational therapist has also helped him to get back to helping his wife around the house particularly feeling safe cooking a meal.

He had recently started driving again after attending a special centre to have his driving assessed which he is very happy about.

His leg and arm were initially paralysed and had no sensation. He recalls the shock of realising...

Can you tell me a little bit more about the sensation and the movement coming back, how that was?

It seemed, it seemed to be at that time, I mentioned my leg in bed, earlier. That was, the third week of the illness' I tried to turn over in bed and I felt this lump, a virtual lump, if you like. It was like a lump of wood and I got such a shock, you know, it really was. Once, once you realise, 'That's my leg'. It was totally dead and I remember, again in the early days, the doctors used to come round and say, 'Move your left toes', you know, the toes in your left foot. And I moved them. 'Move the toes in your right foot' and I thought I was moving them and it was just days later, I'd think, you know, the doctors were saying, 'That's good, that's good', you know. And I'm saying to myself, 'Did these toes move or was it my left toes that moved again?' you know. So there was absolutely no feeling whatsoever. I had no control... reading a book. I couldn't read a book. You know, I've loads and loads of books and I'll read anything, magazines, papers, you know. It was such a chore to even turn the pages. I had no control what, no control whatsoever in turning the pages. Even a paper lying in my lap on the bed. My right arm used to lie across the page and I couldn't work out why I couldn't turn the page, you know, because I couldn't feel, to me, my right arm wasn't lying there. Now, a really, really queer sensation, you know. To me, my right arm wasn't lying there and it's just when you realise, again, it's a shock. It's a real shock to your system, you know. You think, 'God, my right'', it was because my right arm was lying across the page that I can't, I can't turn it, you know. It seems so simple but, it's hard to explain, you know, its. But the bottom line is it's a real, real shock to your system when you realise exactly what's, what's wrong. 

Described the symptoms of urine infection after catheterisation and that it was the lowest point...

I really, really felt, the worst, the worst thing that I really, really felt, was when they took the catheter out. I had a catheter in obviously for [sighs] about 3 weeks and they took the catheter out and 9 times out of 10 you get an infection, you see. And it makes you feel as if you're needing the toilet all the time but you're not really. It just feels that way. And there was one day they took me down to have an x-ray. Now, normally, I'd been getting x-rays in my bed. They'd put the plate behind me, the camera was in front of me and they took the x-ray there and then, you see. But this day they took me down by wheelchair to the, the x-ray department and going down in the wheelchair in the lift was a long, it seemed a long journey going down in the lift. I had to wait for an x-ray being taken, got the x-ray taken and I had to wait on the porter coming back and I felt as if I was wetting myself and that was really, really humiliating. I really felt, I felt the pits, you know, and it was before my wife came in and she said, 'What's wrong with you?' and I didn't explain, you know. I said, 'It's just this catheter', you know. But that must have been the lowest, lowest point. I was so, I felt, I felt I was wetting myself, you know. There was nothing I could do. I had been to the toilet before I went. I knew I was going to need, you know, and I felt, so humiliated. I really felt so low, it was ridiculous. It really, really was. That was a low point. The lowest point I would think, I would think possibly the lowest point. 

Collapsed with a heart condition whilst out training on his bike. Had a stroke during an...

And then, as a result of the operation for the aortic dissection...

Mm hmm.

...was that' You had the stroke then?

The stroke.

Had they given you any warning that was a risk factor?

No. No. I was lying, on the, on the trolley from the ambulance and having had the tests done, the scans done and that, you see. And the nurse was explaining that you might need to stay in overnight. My wife had, had been called by that time, she was explaining about not getting any meals until midnight and I'd get out a day, you know, 24 hours later, kept in for observation. And it, it transpired that it were a phone call down, you know, 'Get this guy transferred immediately, his aorta was leaking', and the blood from the heart instead of going back through the valves, back through the, you know, the valve, was leaking into my chest cavity. And I was taken to the' [another city] to have an operation. Transferred for the emergency op and that was the Tuesday night and the next thing I remember was the Saturday morning. 

Half past 8 on Wednesday morning it was about, when I got back into Intensive Care and it was explained to my wife and family that I might be left with brain damage, kidney damage, liver damage and a stroke. But that was never explained to me, which was maybe a good idea, you know but certainly my wife and family knew of the possible risks that I might be left with these things, including the stroke and it transpired luckily enough it was the stroke I was left with. 

His doctor explained that there are two types of statin but the one he was taking needed to be...

And how do you manage with taking your medication? Do you have to take it at a regular time or..?

Out of the 4, I take 3 in the morning and the simvastatin, I'm told there's two types, two types of statins. The type I've got is simvastatin and that's to be taken at night because that's when it fights the cholesterol. That, again, has been explained to me [laughter], that the cholesterol is formed at night when you're sleeping and I usually take this simvastatin it's called. The reason I take it at night is because the cholesterol is formed at night. So that's why but again, it's no problem. It's just remembering. Remembering that you've still got a pill to take before you go to your bed, you know. But apart from that, it's fine. Aye, it's fine. 

Describes how he tries to prevent another stroke by increasing his fitness, watching his diet and...

Sort of thinking about, you know, the future and perhaps the possibility of having another stroke, have you thought about that? Is that something that worries you at all?

Mmm. Mmm. Aye. Thought about it. That's why I'm working hard at the fitness level of things. Really, really a lot more conscious about diet. You know, my diet wasn't bad anyway. My diet was not bad. Fairly healthy diet. Moderate drinker but I've cut out a lot of sugar. In fact, I've cut out sugar entirely. I use a sweetener now, as opposed to sugar, put it that way. Very, very conscious about 5 portions of fruit and veg a day things. That kind of thing. Very, very conscious about sugar on the likes of shortbread and things like that. Biscuits, you know. I'm a great lover of chocolate biscuits, which I'm struggling to cut out, you know. But I'm very, very conscious of that and trying to, and this has all come through, through the hospital, through the, again, the talks we get from dieticians, pharmacists, these kind of people, you know. It makes you so much more aware, it's made me so much more aware of how things works, how your body works how your, your, your arteries can clog up, you know. I've always been pretty fit and I'm, that's what I'm working towards again, allied with a healthier, healthier diet, healthier than was the last time but it's, as I say, it wasn't bad before. It wasn't bad at all but it's better now and it's going to be better. Aye. 

He could see the importance of exercise to improve strength and things like lifting small pegs...

Can you perhaps tell me about some of the things that made it helpful for you to get back to being independent?

I really, really think just about everything. That's, that's not going to help you but I think, honestly, I really think almost everything has helped me from' the very, very start of the physiotherapist therapy, lifting the wee pegs. It sounds daft but it's been great. It still impacts on the home when your, imagine making a cup of coffee, you know, lifting the spoon, which again, it's no great control but I can lift coffee and stirring it, you know. And that is, it brings into effect your wrist and your arm movement all these types of exercises. 

The occupational therapist has obviously worked on these kind of things, which has been a great, great help. It really has been a great help. One of the things that we done which is, it sounds daft but it's really, really simple was lifting a kettle, a jug kettle. I couldn't lift a jug kettle because... if you can the imagine the handle coming at the side and my hand was going through at an angle and I couldn't see it but the occupational therapist said, 'If you adjust the plane of your hand to go through the handle, then you tighten your grip, you know. And it made such a difference. It's amazing, you know. Lifting a cup. Lifting a cup. I couldn't lift a cup without the cup going forward and spilling, you know. I spilled a bowl of soup within the early, early days because of my control of the spoon and I knocked the bowl, it's a horrible feeling to think, 'I can't even have a plate of soup without spilling it, you know'. But it's these kind of things but between the physiotherapist working on stretches and strengthening exercises, various push-ups, like strengthening various parts of your body, and the occupational therapist working on these type of exercises, if you like, in the kitchen and these kind of things, you know, it's come together to the physio's getting you stronger, the occupational therapist is getting me working at the actual operations, you know, and it's the cardiac rehab gym. 

Again, I've got to keep saying, it brings out the confidence to try these things anyway, you know, because I was finding, I didn't have the confidence to try these things because you're thinking, 'God, I've not got the strength, you know, I've not got control, so I'm not going to try it', you know, but, to me, it all worked part and parcel, you know. Occupational therapist, physiotherapist, the gym, confidence building up, strength building up, your ability to do the actual operations is building up, you know. And it's absolutely, absolutely superb. I can't speak highly enough about the, the help I've had. I really can't.
 

He was worried about cooking a meal at home because of the safety but the occupational therapist...

Hence the result of the illness was, it meant I couldn't do too much about the house and I know my wife realised that, so there wasn't any problem that way but, at the same time, without saying anything to her, I felt, I felt kind of, you know, I should have been doing more, you know. Normally I would have but, as I said, events decreed otherwise. 

But I certainly did feel, and now, again, thanks to, and it's only been within the last, last 6 weeks, thanks to the occupational therapist that she said, 'Is there anything now', and this was the start of December, she said, 'Is there anything now that you feel you'd like to do, that you, you, that you were doing before your operation?' And I said, 'Well, actually, I miss cooking'. And she said, 'Right, next week'. And she said, 'Why have you not been cooking?' and I said, 'Because I feel the health and safety aspect, you know, lifting hot pots, hot pans, woks or anything like that' and she said, 'No, I think, I think you're ready enough. I think your balance is good enough to stand there and I think your grip's good enough and your, your control is actually good enough to do that'. She said, 'Next week, we'll prepare a meal. Just pick a meal and we'll prepare it. Something you've, you've to chop, peel, that kind of thing', you know. So I said, 'Right.' So the next again week, we prepared a meal and she said, 'What have you got?' I said, 'Well, I've picked a meal that I've got to prepare and chop and peel and scrape.' It was a stir fry. A chicken stir fry. Right? And it involved chopping peppers and peeling bits of potatoes and, you know, things that go into a stir fry. And she stood and watched and now, and since that day, I've cooked the Christmas dinner, you know or helped, you know.

And it's been, it's just one of these things that since then, I've really, really felt a lot more confidence, I was talking about the confidence thing and this has really, really helped because now I don't feel that, I don't feel there's anything I can't do now that I was doing pre-operation. Granted, it takes me slower. It takes me longer but I give myself longer, you know, I give myself more time to prepare the meal. I'll give myself an hour longer, just to make sure that I've got things prepared and I can get things in, in the pans in the oven, or whatever, you know.

When he first got home he found even getting washed and dressed very tiring and was very...

So the weekend visit went very well and I spoke to the occupational therapist on the, on my return on the Monday and she cleared it for the Wednesday. And it's been fine ever since. Obviously things the very early days, it used to take me an hour from getting up in the morning, getting showered, getting washed, getting showered, getting changed, coming downstairs. I had a battle, a real battle to take my pills out the foils because of my lack of control and the first 2 or 3 weeks, my wife used to leave them lying for me in the morning and that was, took about an hour to an hour and a quarter from getting up to getting down before I started making my breakfast. So that was, you know, it was quite taxing, both mental and physically because at that time I was, obviously you've been in hospital for about 2 months and you're very, very weak, you know. And I used to come here and sleep, lie along here and sleep, you know, and I was very, it was very tiring, very tiring at that time. It really was. 

But, like everything else, like, like the speech coming back, your throat's getting stronger , my muscles got stronger, physically got stronger and things became easier and easier and easier and you've just got to keep doing it and doing it and doing it and doing it, you know. Sorry, I was going to say I was very, very dependent on, on my wife because I couldn't make coffee, I couldn't make tea, I couldn't make soup, I couldn't make you know, meals or anything. I couldn't do anything about the house or, you know, once I was dressed, I could, manage, just manage to dress myself. It was the devil's own job trying to put a pair of shoes on socks or slippers or anything like that, you know. It was really, really difficult and I was totally dependent.

Getting his license and driving again was a big confidence boost after the stroke and he is now...

How do you go through the process of getting your license back?

They told, they told me initially when I left the hospital that I wasn't to drive for 3 months and I think most heart attack patients are told this, you see. So it was, once the occupational therapist started coming out, she asked about the driving and I said, 'Well, I've been told not to drive for 3 months.' 'Right', she said. And I was advised by the therapist to advise DVLA in Swansea of my condition and the fact I had been advised not to drive for 3 months in what was the' order of events, you see. So, with the stroke, my peripheral on my right side has been affected as well, you see, slightly, which means you've got to scan, scan wider than normal. So I was, I was advised to go for a visual field test, eye test, which checks the peripheral vision. So I done that, got the prescription and the print-out and sent it to Swansea. A month later, Swansea sent forms back to me which had to be filled in by, a 3 part form, one to be filled in by myself, one by the hospital and one by my work and send them away back to Swansea with the, the prescription and the print-out. So that was sent away back and a month later, they came back giving me the, the OK to drive. 

So thankfully, I got the OK from Swansea and it was a big, big step getting back in the car, I can tell you. Psychologically again, confidence thing again, you know. It seems to be, just building back this psychological thing, you know, jumping the psychological barrier and getting the confidence going because the first time I sat in the car was like, it was like the first time I had ever sat in the car, you know. Where's the clutch, where's the brakes, where's the indicators, you know. And you've just got to sit, well, I had to sit anyway and take my time and go through the controls of the car without actually switching on, you know, just familiarising yourself with, as I say, indicators, brakes, clutch, you know, light switches, things like that . But again, I've been in the car a few times now and each time, it's been getting better and getting better and getting better and it's actually, again, it's this thing, you're building up confidence. I think I most, that I think, with the effect of the stroke was that I've got a lack of feeling between my right foot and the pedals. But again, it's like, it's like driving and braking on instinct. It's, not quite that but it seems as if that's how it's doing, you know, and the lack of feeling, it's not 100%, I can feel, you know, I can feel it but it's the awareness is it's less than it was, you know. So that's another thing to get used to but, again, as I said, I've been out in the car 3 or 4 times now and it's, each time it's, it's been, it's been getting better, you know. But I think again that's a confidence thing.

He felt guilty seeing his wife go out to work and then come home and do the house work.

How did it feel having to be so dependent on your wife?

Again, I didn't like it because with' to let you understand, how my job worked, I worked 4 days on and 4 days off. So the 4 days off, I have the house [laughter] I'm no saying tidy but I can do, I can do ironing, I can do the hoovering and all the rest of it and the meals were always made, you know. So when my wife was coming in, she had to start from scratch at 6 o'clock, you know, which meant we were getting our meals later, which, you know, it was, and my wife's had a hard day and she's coming in, as I said, normally the meals were made, and I felt, you know, it wasn't really my fault but it was my fault, you know, and you start to feel, you know, [makes snorting noise] I didn't like it. I felt guilty again. I didn't feel guilty because I realised it wasn't my fault and there's nothing I could have done about it, you know, about the illness, you know, that kind of thing. Hence the result of the illness was, it meant I couldn't do too much about the house and I know my wife realised that, so there wasn't any problem that way but, at the same time, without saying anything to her, I felt, I felt kind of, you know, I should have been doing more, you know. Normally I would have but, as I said, events decreed otherwise.

Apart from a couple of members of his wife's family his only contact with people who have had...

I was wondering if you'd had any contact with any support groups for people that have had a stroke at all or looked up any information about strokes?

Well' apart from actually speaking to people, there are 2 or 3 members of [my wife's] family have had strokes, actually died from strokes. It seems to be kind of, inherent, if you like, you know. Her mother had a bad stroke 2 years ago and that left her with no speech the only other people really I've come in contact with is, has been at the cardiac gym the rehab gym, and not just stroke patients but all kinds of patients but stroke patients have been there, you know, and it's very, very interesting to speak to, you know, people that's had the same kind of injury as yourself, you know, it really is, it's very enlightening, you know. And the likes of, you get a talk after the cardiac rehab gym, you get a half hour, half hour talk, be it on diet, be it on stress management, what causes stress, how to beat it , heart problems, what causes it, how to beat it, you know, strokes, what causes them, how to beat and they're really, really interesting. Really interesting. And you get a talk, we had a talk from a, the pharmacist in the hospital and explained how, the difference between heart attacks and angina and strokes, all that kind of thing, you know, and it's very, very, educational, you know. And it's been a great help. It's been a great help with, with diet and your exercise and drinking liquids and stretching various parts of your, your legs and, you know. Aye, it's been very, very education. Very, very good.