Keith - Interview 28

Age at interview: 58

Age at diagnosis: 58

Brief Outline: Keith was sitting on the sofa talking to his wife when he suddenly found he was unable to speak properly and began to feel disorientated. His wife called for an ambulance immediately and he was taken to hospital. The next day he had a similar episode and was admitted to hospital for 3 days during which he had a variety of tests and was diagnosed with a TIA.

Background: Keith is married with one adult son who lives at home. He is a primary school head teacher. Ethnicity; White British.

More about me...

 Keith had just returned from holiday and was sitting at home having some lunch and talking to his wife when he suddenly found that he was unable to speak coherently, couldn’t formulate words properly, and felt disorientated. His wife recognised his symptoms as a possible stroke and called for an ambulance immediately. He was taken to hospital where he had various tests and was told to return the following day for a further appointment. During the next day on the way to the hospital appointment he had a further episode where he felt disorientated and his speech was slurred. This time he was admitted to hospital and stayed in for 3 days during which he had more tests including MRI scan, blood tests and a series of questions to ascertain his speech and memory. He was diagnosed with a minor stroke / TIA although he feels slightly confused about whether there is a difference between the two. He was prescribed Warfarin and Aspirin to take in addition to the beta blocker that he was already taking for a previous atrial fibulation. His medication is being monitored on a regular basis at the moment and the dosage is adjusted depending on the results of weekly blood tests that he has taken at the local GP surgery.

 

Keith was advised that he should refrain from work for 6 weeks, and during that time he found himself re-assessing his priorities in life, and making some lifestyle changes including giving up smoking immediately, taking more exercise, and eating healthily with a view to losing some weight. Although he was not given a definitive cause for the TIA, he felt that in order to avoid any further episodes or a more serious stroke that he should take more care of himself and his health. Keith felt frightened at the thought of what life could be like if he had a more serious stroke and feels grateful that he was not more severely affected. During his stay in hospital he met patients who had longer lasting or more serious symptoms and this made him feel lucky, but also motivated him to feel that he would like to offer help and support to people in that situation. He hopes to be able to do some voluntary work with stroke sufferers in the future, but in the meantime, although he has returned to work he is aware that he needs to pace himself and slow down a little. 

 

Keith had returned from a short break away with his family and found himself feeling disorientated and unable to communicate. As his symptoms were subsiding he felt a pressure around his chest.

 

I’d been on holiday to Centre Parcs of all places and, and returned in the afternoon and had a, an afternoon nap after driving back from, from Longleat and something to eat sitting on the sofa at, this very sofa, and was talking to my wife and suddenly I just couldn’t formulate words. Words wouldn’t come out of my mouth, my wife asked me a question I just simply couldn’t answer. sounds came out but it didn’t make any sense. And also I couldn’t, I knew what I wanted to say but I just couldn’t think of the words to say what I wanted to say. And that was the first sign.

 

I was feeling a bit tired because it, it had been a very good holiday really, we’d had a good time and driven back and but nothing worse than that and just suddenly couldn’t speak. So I stood up in alarm I suppose, feeling a bit leaden but nothing worse than that and couldn’t speak and, and couldn’t speak and obviously my wife was becoming concerned because she could see something was wrong.

 

I then moved to this side of the sofa and looked out of the window and it looked as if the window had slipped to the left, moved to the left, strangely, and was fuzzy round the outside. And I sat down or rather slumped down, this side of the sofa, as I am now I suppose really, and gradually, very gradually, within minutes my voice came back, I could speak again. Albeit slurred, I could speak again. But when I was standing I couldn’t put words together and couldn’t think of, couldn’t think of the words that I needed to say, which was a curious mixture.

 

Gradually the words came back.

 

In the meantime my wife and son had called the ambulance immediately. And I should imagine within, I’m not absolutely sure but with five or ten minutes they were here. It seemed quite quick.

 

As I was sitting here and my speech was gradually coming back, I could feel, now I don’t know whether this was imagination or, or, or whether it was real, but it, it felt as if, I didn’t have a pain around my heart, but certainly there was weight there. It was as if it was gradually, like the Monty Python foot was pressing down on, on my heart and increasing pressure there. Not desperately uncomfortable but just there.

 

Keith stayed in hospital overnight but was keen to get home as soon as possible. On discharge he was given an outpatient appointment for the next day.

 

And then the ambulance came and two paramedics came in who were absolutely wonderful. Walked in and, and took control and, I actually walked to the ambulance which was at the front of the house, speaking to the paramedics as I went. Lay down in the ambulance and talked to them all the way through. And then went into the hospital…

 

So I was taken to the hospital instantly taken and, and seen and the rest of the evening is a bit of a blur really. There were a whole series of tests, different people came in to see me, question me about various things. And I felt good. I felt pretty desperate to get out. I want, I didn’t want to be in hospital, you know, my natural reaction was to get out almost at whatever cost really. I didn’t want to be there. But the help I had was terrific, terrific support, terrific talking me through every stage and, and what the tests were for. And my wife and son came with me and, and kept me company while I was there and waited for about three hours I suppose, three and a half hours. I went into hospital at six o’clock the ambulance picked me up. And by half past nine I came home. Stayed overnight, felt tired, stayed overnight but with an appointment to go back to the hospital the following day at mid-day.

 

Keith gave up smoking straight after he recovered from the TIA

 

I used to smoke and that’s stopped instantly.

 

How did you find doing that? I mean, was that hard to …

 

Oh, it’s still hard, yeah. Yeah, yeah, extremely hard. Yeah. I didn’t think it would, I thought it was really, it’s a very strong motivating factor to have a stroke because I haven’t smoked since and it’s very, it, sometimes it’s exceedingly difficult but not that difficult really.

 

How long has it been since you …?

 

Well since the stroke on April 10th, so that’s well two months now, yeah. Yeah, which is a reason to celebrate really.

 

Keith plans to retire early and would like to spend some time as a volunteer supporting people who have had a stroke

I’m extremely fortunate in that most if not all of the symptoms have completely gone so I don’t need the extra support as it were. Thought I wouldn’t mind looking into support other people, you know, when, when perhaps my workload decreases. Because at the moment I couldn’t manage it with any consistency. But I, I, I think probably what I will do is when I cut back my work or retire or I will look to see if I can help through one of those organisations. There is a man, obviously he’s had a stroke at some stage in, who came in the hospital and was helping out, just general things like …

 

Was he a volunteer?

 

Yes, and I thought that’s, that’s what I’d like to do.

 

What motivates you to do that?

 

Well, it, was fascinating meeting other people who are worse off than me in, in that ward because there were people there that were severely affected by strokes. And you know …

 

So in a way that gave you a window into …

 

It did…

 

.. possibilities.

 

Well, yes, yes, I just felt extraordinary lucky that I wasn’t in that position.

Keith felt frightened because he recognised that his symptoms were similar to what he had seen in...

When I, when I stood up here I, as I say I felt distant from it but I suppose I, I was I was frightened I should think, I, I, there was fear, there was yes, it was a definite fear and a, perhaps a real anxiety, a real concern I knew what was happening though, I knew that that’s what it was, I knew it was some sort of stroke, because I knew the signs and, and we’d followed the television advertisements and, and followed the raising of the arms and all the other things and, but I knew just what it was. But it, there was a definite fear within me, yeah.

Keith underwent a series of tests including questions to test his memory and understanding

 

When the ambulance or paramedics were here, did they do any tests here before you went to the hospital?

 

I seem to remember they did but again I can’t …I think it was a blood test. But I, I can’t remember. Certainly they asked me a series of questions very carefully and methodically. But I’m afraid it was a bit hazy so I can’t, I can’t exactly remember. I think they may have taken a blood test but I’m not sure.

 

So when you were at hospital for the three hours initially on that evening, and they did some other tests…

 

A series of tests.

 

..do you know what they are?

 

Blood pressure certainly. I can remember that. They certainly took blood again. And I think they measured it, you know, heart beat testing, regularity of heart beat, after that it seemed a variety of things. And, and they did explain it. To be fair to them, they explained it clearly at the time, but I think I was not clear thinking at the time certainly.

 

And then after that you were admitted for a few days. Was, during that time, what happened? What sort of, were you doing, had more tests and things…?

 

A vast series of tests, you know, and the support given was so impressive it, it was, again clearly, clearly, clearly explained to me and people obviously knew what they were doing. I thought, I’d hoped, again I was going to skip out of hospital as quickly as possible but a consultant came in and started, asked a series of questions, count, counting back from 100 in sevens, relatively easy stuff. But it foxed me at the time. And he also asked me the date, well, in my job I do know the dates of various things and I knew the dates that I’d been on, on holidays but I was completely lost with this and he just raised his hands as if to say he’d made his point. That the, the effect was still with me and I should stay in, in hospital and but then there was a whole raft of tests after that, MRI tests and others.

 

Keith had been taking aspirin because of an erratic heartbeat which was diagnosed 2 years previously, but had forgotten to take it during his holiday

I’d had atrial fibrillation for diagnosed two years ago which was an erratic heartbeat and, and for that I’d been taking aspirin and Sotolon I think it’s called. And I, it’s a possible factor that when, I’d run out of aspirin during this holiday that I’d had previously in Centre Parcs and I’d also, because of a knee injury had only just started heavy exercise.

And, and I’d put a lot into, in search round for reasons for this happening. And it may be that it was extra exercise, it may be that I’d missed the aspirin for a few days, which is, which I had and, and that obviously, that might have caused the blood clot that caused the minor stroke.

Keith has a weekly blood test to check how well the blood thinning medication he is taking is working and if necessary the dose is adjusted

Are you having regular checkups now, what’s the position now?

 

Right, position now is, blood, blood is being tested once a week and I’m on a sort of warfarin balancing act at the moment. So I take certain warfarin tablets in different strengths of warfarin tablets and....

 

I’m on the warfarin trail at the moment, trying to balance out, my target apparently is 2.5 on the, the warfarin scale. I’m not quite sure what, what that’s called but so it means that my blood is tested once a week and I get instant feedback again from whoever analyses the, the blood and it, it is instant. It’s either the same evening or the following morning and, and adjustments are made to the strength of the warfarin that I take.

 

So how is all this accomplished? Do you go …

 

Right so I …

 

… in every day?

 

Yeah, I go into the GP once a week to the GP’s, you know, to my local practice and blood’s taken there, tested, and as I say, either that very same evening or the following morning I’m fed back by telephone and then later by post as to the adjusted warfarin strength. So at the moment I’m above the level I should be so probably to put it crudely again the blood’s too thin so they’ve reduced the strength of the tablets that I’m taking.

 

Have you had to have many alterations to this …

 

Every week, yeah. It’s gone up and down and, and changed a little bit very gradual, very minor changes, bit by bit and over the, say 10 weeks, no eight weeks that, since the stroke it, it’s gradually coming into place you know, and it’s gradually getting closer to that 2.5 level.

Keith felt he was in safe hands once the paramedics arrived and says he couldn't fault the care he received. The hospital staff were excellent.

And then the ambulance came and two paramedics came in who were absolutely wonderful. Walked in and, and took control and, I actually walked to the ambulance which was at the front of the house, speaking to the, to the paramedics as I went. Lay down in the ambulance and talked to them all the way through. And then went into the hospital…

 

I really can’t see how it could have been better. I just cannot see, I mean, as I say, the, right from the ambulance being called in the first ten minutes to and that was courteous and friendly and very efficient help to get me onto the, the ambulance and into hospital.

 

Similarly in the hospital I, I can’t recollect being kept waiting about unavoidably and every step of the way was clearly explained. Every test was clearly explained and the reasons for it. Not necessarily the results because the results might take, if it was a blood test it would take a while to analyse, but the reasons for it. And then being kept in hospital for three or four days, again everything was clearly explained and the, the barrage of tests I had was so comprehensive that. Yes, I wouldn’t have the knowledge to, to know …

 

These are like, you were taken,…

 

…if it could be improved.

 

… being taken seriously…

 

Oh yes, yeah and, and, yes it was, it was being taken seriously and that, and I could see from the way other people were being treated that just the same was happening there. I you know, they give you an evaluation sheet to fill in don’t they when you, you leave hospital and I couldn’t be more complimentary really. I was very impressed.

Keith loves his busy job as a head teacher but realises that he ought to slow down and maybe retire earlier than he'd planned to. Having the TIA made Keith reflect on how a more serious stroke could affect his life

It is busy. I, what it’s made me do is, is made me realise how much I love the job but also how much that, that I am going to pace myself and I can see retirement, whereas before I was going to go on for more years than I’m going to now. I am going to cut back. Perhaps within a year or two years rather than three or four years now.

 

Definitely fear about the impact, the impact upon my life and, yeah, I was really fearful about that because I’ve been very, I’ve led a very active life, and enjoyed sport and, and the prospect of losing all of that in one fell stroke as it were did, when I realised the implications, were, and my work, you know, I enjoy my work and that would have had to have stopped if I’d lost, if I’d lost speech and the ability to think clearly and, so there are so many implications that it would be, it would be a life changing, naturally it would be a life-changing thing that would have happened.

Keith felt frightened because he recognised that his symptoms were similar to what he had seen in adverts about stroke on the TV

When I, when I stood up here I, as I say I felt distant from it but I suppose I, I was I was frightened I should think, I, I, there was fear, there was yes, it was a definite fear and a, perhaps a real anxiety, a real concern I knew what was happening though, I knew that that’s what it was, I knew it was some sort of stroke, because I knew the signs and, and we’d followed the television advertisements and, and followed the raising of the arms and all the other things and, but I knew just what it was. But it, there was a definite fear within me, yeah.

Keith says be more vigilant about your lifestyle choices because although you never think something like a TIA will happen to you, none of us are immune

A bigger message would be to, to, to tell people that, you know, if they are smoking or if they drinking too much or are overweight or overstressed that it does happen to you. Because I genuinely didn’t think it was going to be me, and I suppose if I could get that message that, that would be a….

 

So that, is that the strongest sort of feeling that you’ve got from it really, you know, about that actually things do happen to you and it’s not other people all the time?

 

Partly, and it, also that it’s avoidable really, that’s the other thing. We’re not immune

Keith was amazed by the support and friendship shown by his friends and colleagues after his TIA

 

And how have your colleagues reacted to your …?

 

Oh, being very kind and very generous and very concerned and lots of telephone calls and cards and very, very concerned and very supportive. Yeah, yeah.

 

I mean, one of the things some people say is that it helps you to know who your friends are?

 

It does, it does and it’s been stunning the number of people that have, that have been in touch. And when, when I first was off work I couldn’t get my fingers out of it, I just kept contacting people by emails and I wouldn’t let go. And I’ve one or two very strict messages from friends saying …

 

Get off the internet!

 

Exactly [laughs] Yeah, clear off. And I did. And I’m glad I did.

 

Keith doesn't remember all the tests and scans he had at the time because he was feeling disorientated, but he does recall having his blood pressure checked regularly

So when you were at hospital for the three hours initially on that evening, and they did some other tests…

 

A series of tests.

 

..do you know what they are?

 

Blood pressure certainly. I can remember that. They certainly took blood again. And I think they measured it, you know, heart beat testing, regularity of heart beat, after that it seemed a variety of things. And, and they did explain it. To be fair to them, they explained it clearly at the time, but I think I was not clear thinking at the time certainly.