Interview 17

Age at interview: 68
Brief Outline: He had a stroke owing to a blocked left carotid artery aged 66 which caused aphasia and reading and writing problems. Medication' amlodipine, bendroflumethiazide (blood pressure), simvastatin (cholesterol), aspirin, dipyridamole (antiplatelet).
Background: Is a married father of 2 adult children and a retired industrial training manager. Ethnic background/nationality' White/English.

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This man had a stroke at the age of 66 he is now 68. The stroke was due to a block in his left carotid artery which carries blood to the left hand side of the brain. There was no definite cause identified and he was not suitable for the surgery which is sometimes used to remove blocks in the carotid artery. He now takes amlodipine and bendroflumethiazide to reduce his blood pressure, simvastatin to reduce cholesterol and aspirin and dipyridamole to prevent further blood clots forming.

He was driving and had a car accident at the time of the stroke, which he understands was quite an unusual. The experience was traumatic for his wife who was in the car and his son and family who were following them. Fortunately no one was badly injured.

His main impairments have been with speech, reading and writing. He had speech therapy in hospital and when he returned to his home town after the accident. He also used his own techniques to improve his speech including reciting nursery rhymes and bits of Shakespeare and playing a game with his grandson where they challenge each other to say long words. Although his speech is much better he still has difficulty finding words. He struggles to take part in the normal flow of conversation and finds reading to his grandchildren difficult. 

Shortly after the first stroke he had a problem with his vision where a clot lodged near the nerve to his left eye. He now has a V shaped patch in his vision. Initially this stopped him driving but after visual tests he was cleared for driving.

Since the stroke he has been an active member of a support group for people with aphasia (speech problems following stroke) and enjoys talking with people who have similar difficulties. 

Describes the carotid Doppler scan which measures blood flow in arteries of the neck. He had a...

Describes the carotid Doppler scan which measures blood flow in arteries of the neck. He had a...

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Can you describe how they used the Doppler scan on your neck? Some people might not know.

Oh no. Well, it was like it, it's like a little microphone and they put it against here like that phew, phew, you know, it, its obviously picking, they're measuring the blood flow through there and what you hear is phew, phew, phew, phew, phew, phew and of course that is transmitted to the monitor and you can see where the whole thing, it's, I don't know how when they actually a camera of sorts and then you can certainly feel, you can see it going through like that and she said to me, 'Oh yes, that's blocked that's clearly blocked it's not getting round. We'll try in different positions like that', and it's there apparently here (pointing to neck) and she said, 'Yes, that's blocked' and I'm told that you think, well if, I'm told if you if you can get it quickly, they can give some sort of a drug that will disperse it but I think in my case, it was totally blocked. 

Now, one doctor came to look at me and he said, 'Well', he said, 'Sometimes it isn't a block in the, in the actual arteries. It's sometimes there's a piece of the artery gets flakes off, not flakes off but it, it sort of comes off like a flap on the artery and, and it then comes across like that and blocks like a non return valve of some sort' He said, he said, 'It could be that' he said. Because there's no reason why I'd had a block in, in there at all, he said, because it seems to me as, he said it could be the reason why it did that, it was a flap'. But there again my own doctor said he said it may be the case but there again they had the eye later which suspects that probably there's something floating around in the actual system so I, we said OK, well, it might be a thought, I thought, maybe a thought but I don't think it was the case. It was something blocked but what it does, although it's blocked the blood has to go somewhere and it, apparently it finds other ways round to get the, into the brain, you know, it gets in the and, and that's what happened. So that's why you get a bit better but I know no more than that at all, that's all I know.

He wouldn't tell people that he had problems with speech and would struggle. Others from a...

He wouldn't tell people that he had problems with speech and would struggle. Others from a...

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You get better but you, I don't know, I can only say, you can't sort of understand why things are the way they are, you know, we're all the same I suppose and that's were it is. And I also read that one, one of the reasons why a lot of people consultants go into it or the doctors go into because they can't put their finger on it because we're all different. And it's not something you can give someone and say, 'Well, you do that and you'll get better' because you don't and I've found that. 

After 2 years, I've realised now, this is the best it's going to get, you know, and I, and I think you say to yourself, 'Well, I've got to get on with it, get on with it and battle on, you know and don't worry about it' and I got to a point where I wouldn't tell anybody I'd had a stroke at all. I go into a shop and I'll, I would just bash away, you know. Other people have said to me, 'Well, why, why do you do that?' because we all had a card, we're all given a card. I said, 'I can't say that I've had a stroke, please be careful with me' or something. I thought, 'I wouldn't do that' I'd bash on, 'Oh no', they all said, 'No, no, you, we found that if you tell people that you've had a stroke, people are quite set have you ever thought of that' and I thought, 'Well right yeah' so I did say that and people did. And when I was on the telephone and got myself in trouble and I wouldn't try to tell them that I'd had one I'd just bash on with it and, you know, I'd come away perhaps thinking, 'Well that's a mess' but when I found people now, everybody's kind and I think, 'Well that's good' so that's something that I've learnt you know, I was a bit proud or pride, proud I suppose, I was you think, 'Well why do you do that?' and they all say that. 

So if I go in now and I get in real trouble, I'll say, 'I'm sorry, if you bear with me I've just had a bit of a stroke'. 'Right, oh yeah, what is it?' 'Great' and you feel your confidence gets a lot better but all the time it is a funny thing.

His grandson will often pick him up on things he says and he does not like him reading to him....

His grandson will often pick him up on things he says and he does not like him reading to him....

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Our, yes, my grandson sometimes we're talking at some, or maybe he's reading something or I'm reading to him or worse still is when my wife's reading him and (is my wife alright? Is it?) yeah. She'll be reading something to him and then she'll say to him, 'Do you, do you mind grandpa just reading for, can he read a bit while I go and make the breakfast or something?', you know, 'Oh no, no, no, stay with me, stay with me nana' because he knows I make a mess, I'm going to make a mess of it, you see. So sometimes he will, he'll say and reluctantly he will start doing it. But once whilst we were looking through the, when we've got the book, he very quickly will tell me things that I've got wrong, you know, or words, 'Grandpa, you said that, why did, you know, you said that grandpa' 'Oh yeah, sorry."

I can't do that, I'm going to do it, so I'll bash it away and, but it's, it, I think with me, it's mainly the confidence you think and once you get, feel you can better, and my grandson here from [town] he's quite sharp and he'll say to me, 'Grandpa, you, you keep saying this' you know or 'Why did you say that?' and I, 'Oh, I'm sorry, [Grandson's name] I don't know.' So we started words I could do and I couldn't understand why because we, I think it was it, Mary Poppins, the supercalifragilisticexpialidocious. Now, that was the one. Now I can say that. When we first tried it, [my grandson] said, 'You say it, you say it grandpa, supercalifragilisticexpialidocious and I had no idea. And what I can't understand about the stroke is that once you've practised it, I can do it, I can get it right, I can get it right every time I think now.

He was told that an operation would not help because the blockage in his carotid artery had...

He was told that an operation would not help because the blockage in his carotid artery had...

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With the blockage in your neck did they ever discuss options for surgery?

Yes. Well, no. Because they all said you couldn't do anything about it. They all say that and several and [the hospital at home] said the same. They said, 'No, you can't do anything about it now because it's dangerous if they open it' I believe I was told if you do it very quickly after the stroke, the they can, as I said, medication sort of drug, I don't know, but they can do it, but I don't, they can I, I nobody's ever told me they can, they can do it. Everybody's said the same thing, once it's blocked, it's gone, you know, you've lost it, it's gone. And I assume that, you know, because basically when it's blocked I think it means all those blood, blood vessels are dead, you know, sort of like my eye. You know, they will never move again. They said, 'We can't do anything about it' because those, those vessels are gone, you know, they've just been dead not dead but whatever the word is not dead its' So all, so I don't know but nobody's ever told me they can do anything about it, no. No.

Did less exercise than prior to his stroke but balances that with a healthy diet and taking...

Did less exercise than prior to his stroke but balances that with a healthy diet and taking...

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I think in terms of health, I did swim and I used to jog, I told you that before but no, not more, no. I don't think so. Partly because I've had a problem with my knee as well. Which has caused some sort of a problem with that and it's not been able to as much now but we, no, and of course my wife can't too much walking. She can walk a bit, so we don't sort of go out, you know, long hikes if you like, we don't do that because that's too much, you know, and even to go to [the local town] sometimes I'll walk down with her or sometimes I'll take the car down there and she'll walk down and I will wait for her down there, you know and perhaps if she feels good, she'll walk back. If not we have the car, I know its only a mile and a half, a mile and a bit from here but with walking round there and duh duh duh sometimes it's too much so we don't. No, I don't do enough in terms of exercise, I know that and I keep saying, I'm going to go back swimming, because swimming even though my knee's got a slight problem here I could still swim, so I'm going to try and do that. So I'm trying to look after it in terms of food. She my wife always gives us good food, decent food, and we don't have any rubbish, you know, sort of junk food, junk food, we, I think we, pretty well in terms of that. But health wise, I think I'm alright at the moment.  
 

A speech therapist suggested he practice speaking in time with a metronome but he didn't find...

A speech therapist suggested he practice speaking in time with a metronome but he didn't find...

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One of the things that, one thing, it didn't really help me but what, the sort of thing they come out with, we had one therapist, these 3 therapists in the hospital, she said to me once, she said to me, 'Well, you quite quickly don't you, speak quickly, don't you?' I said, 'Well, the trouble is I do think like that. I do think quickly and because I can't explain speak in the, the same way I get problem, a problem with it, so', I said, 'Can, you help me?' and she said, 'Well not really, you see, because short of trying to, trying to speak slower', I said, 'Well, yeah, I can't do that because I, when I'm speaking slowly, I lose my concentration and couldn't, couldn't bleugh, bleugh so I'm, I'm trying to do it that and I'm thinking quicker than, so it didn't work. She said, 'Well, one, you could try to', she said because somebody was had the same problem and he used to sit, this chap, he sat with his hand on the chair, the table or something and he would be speak like that and he kept like a metronome, you know. And that way, so for about a week, I tried that and it didn't work but the sort of thing that, that, that might help somebody clearly somebody, she said that this chap, you know, sat and he got used to it, speaking like the metronome and I think that's a bit strange but that's the sort of thing that they come out with, things like that and I pick those and I think, oh I'll try that. Yeah. No, it doesn't work.

He was given help with reading and comprehension and writing cheques and letters.

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He was given help with reading and comprehension and writing cheques and letters.

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Can I ask you to tell me in a bit more detail about the sort of things that you did with the speech therapy?

Oh yeah. They she used to, she did things like sentences mixed up and she'd write them down and she'd say, 'This today, this today Romsey going shop with until Tuesday' or something like that and maybe something, oh, I've not been to, I'm not, I'm not going there until Tuesday but when I'm going to shop in Romsey.' Something with, and that was quite useful because all, some of those I couldn't work, you know, some of them are quite straightforward like 'You birthday have at year last year' some, something like that and 'My birthday was in April last year', something like that, you know, and she's very good, very good [laughter] but at first that was useful and she'd give me tests like that, you know numbers as well. Sometimes numbers. And you know, quite straightforward and I think I think, I think at first, she was trying to find out what I could do and what I couldn't do. I think she was trying to work where, where I was. But as I say, she was very good for around 6 or 7 weeks. She'd come with different ones like the cheque book, the cheque book, she realised I couldn't do that and then when she realised, when I realised or when I was told that I couldn't work, work simple arithmetic things, she did give me those, you know, so things like that. 

What else? Oh and a bit of comprehension where she'd give me a story and then questions at the end and make notes, we used to have at school and that was quite useful and what else did we do? And a bit of writing because that's something that I still can't do. I can't do writing and the, I know what I'm trying to say, to write a letter I'm better, I'm getting better now but a low, I had to wrote, I had to write to somebody what was it? About 2 months ago, I wrote something about a complaint I had. What was it about? I don't know. And I battled away at it and I, I couldn't, I couldn't do it right, I wrote it again and I did it, I did, I get, I think in the end it was alright and [my wife] said it was it was alright but.

Gains a lot from the two support groups he attends where he enjoys the friendly and non-...

Gains a lot from the two support groups he attends where he enjoys the friendly and non-...

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But I say I'm very comfortable when I've got my, my groups, my group. We have 2 groups. One is the stroke, stroke association, that's, what we have a, there's about 20 of us and 4 of us in little, one table and we all, we're all given little tasks, the task is something like perhaps a topic, what you think about this and the idea is that we just talk and of course we have a helper. These, they're not, they're not trained other than just trained, trained that way. They're not sort of professionally trained, just good helper, helping and they just help us and the idea is that they will just sort of get us going, you know. So of course we're all trying to do that and I really enjoy that because it's 2 hours, we have a cup of tea and we have a raffle and we have a good laugh really. It's great and we've got a good helper and we are, I find that's fine. So I come away after about 2 hours and boosted by it, you know.

I think back to the groups, you know, the groups I go to, they really, all the time, they're really, they're smashing. That's really enjoyable that where you can you can get the attention and they'll listen to you and you'll listen and you tell them the same story again, it doesn't matter. It, it's terrific and there's no, there's no judgement, you know, everybody's sort of friends together, you know, that's really nice, good.