Rich - Interview 36

Age at interview: 66

Age at diagnosis: 62

Brief Outline: Rich was on his way to his car when he tripped. When he got into his car he found that he had no feeling in his left leg and arm. He contacted his daughter for help, and she called for ambulance. He was diagnosed with a mini stroke and admitted to hospital for several weeks. After several weeks he regained his mobility fully and has had no further episodes since then.

Background: Rich is married and has two adult children aged 31 and 27. He retired from his career in sales and marketing after his mini stroke. Ethnic background' White British.

More about me...

 Rich was on his way back to his car after a lunch meeting when he tripped over. When he got into the car and started to drive away he found that he had lost the feeling in his left arm and leg. He managed to park the car and called his daughter on his mobile phone and she called for an ambulance. The paramedics suspected a stroke and took him in to hospital where he underwent a number of scans and tests and was told that he had had a small bleed which was a TIA. He was admitted to the stroke ward where he stayed for 6 weeks during which time he gradually regained his mobility with the help of physiotherapy. Whilst in hospital Rich found it difficult seeing other stroke patients who had been more severely affected by their stroke than he had been, but it made him feel committed to making as swift a recovery as possible. Rich feels that his recovery was aided to a large extent by his optimistic and positive approach and he felt determined to do everything that he could to ensure that he could go home as soon as was possible. Thinking back over the experience Rich remembers that during the time he was recovering in hospital he had felt worried about the extent of any damage and worried that if he didn’t make a full recovery his life could change drastically, particularly in terms of loss of independence. Although he did not dwell on such thoughts he feels that this spurred him on to ensure that he did everything he could to contribute to his own recovery. His family was extremely supportive during this time and his daughter made a recovery ‘log’ to help him to track the progress of his rehabilitation. 

 

Rehabilitation continued after he was discharged from hospital and over a relatively short period of time he regained full mobility and has no lasting symptoms. Since his TIA Rich has noticed some subtle personality changes, in that his emotional responses are sometimes heightened and he can find himself becoming upset about things that previously would not have affected him. He has also been somewhat bemused to find himself using slightly colourful language at times, which he says is completely out of character and most unlike him. 

 

Rich feels that it is difficult to pinpoint the reason why he had the TIA, but understands that stress and high blood pressure can play their part and so took the decision to retire early from his job in sales and marketing because of the demanding nature of the work he was involved in. This has enabled him to adopt a more relaxed lifestyle and he has also become more aware and vigilant about maintaining a healthy diet. However, he says that he was not offered any advice or information about lifestyle changes that might help to prevent any further problems and that the changes he has made have been made at his own instigation. Rich feels that the care he received in hospital and after discharge was very good, but he does have concerns that there are not enough resources allocated to ensure that all patients are able to access all the help they need once they have returned home. 

 

Rich was about to drive home when he found he couldn't move his left arm or leg.

 

I was working in [home town]and I decided to meet a colleague of mine for lunch at my golf club as she was travelling up from [city] to go across to head office in [different town]. We had our lunch said our goodbyes but to get out of the golf club she had to go through a security barrier. So she went in front of me in her car. Stopped, I let her out. And I walked to my car. As I walked back to my car I tripped. I looked at, I don’t know what it was, did I trip on the stand, I got in the car, drove it up to the barrier, swiped the card and proceeded to drive off. Where’s my left leg and arm gone? I couldn’t move the car. It was on the brake but I managed to move it and drive out of the gold club and driving along and there was somewhere I could park. So I just parked up. Oh Christ, what on earth’s the matter with me? And I wondered whether or not it was I’d trapped a nerve because I’d actually had some back trouble recently.

 

Anyway I was slumped in the car against the arm rest. I couldn’t move. But fortunately I had hands free in the car on the steering wheel. So I dialled in and I knew my daughter was in [home town] and she’d got her own car and was about to go to work. And this was about I guess 1-ish, half past one. So I rang and I said, “I’ve got a problem. Can you come to the golf club?”

 

I rang her and asked if she could come to the golf club because I couldn’t move my arm and leg. I said, “Don’t rush, no panic, I’m perfectly OK”. And I’m talking like I am now. Anyway, she arrived and we had a bit of a laugh because we were parked, little girl, and she’s blonde looking into a car, an old boy kind of slumped, you know, lunchtime, ha, ha!

 

Anyway, I can’t move it. I’ll get an ambulance. So she rang for the ambulance and the ambulance eventually came. Two paramedics came out and “What’s the matter Mr [surname] I said, “I can’t move my left arm and I can’t move my left leg.”

 

Rich was told he needed to cut down his cholesterol levels and is now careful about what he eats, but on the whole he says he still lives a normal life

I had a word with the dietician because I was, my cholesterol was a little high. It wasn’t outrageous and I soon got it down by following, you know, following the rules for want of a, but there again it’s not as though I abused it. I didn’t smoke, I didn’t, all right there were things I, I love cheese which is a no-no. I can have it but, as a treat as they say, and, you know, fried food that I never used to indulge in, as , as far as I was concerned I don’t think I abused myself that much or my body.

 

So you adjusted your diet a bit for the cholesterol …

 

Yeah, I adjusted my diet ..

 

..side of things…

 

And there, there wasn’t many things that I had to cut out. I think probably cheese was the, the major thing. We don’t have a lot of butter, we don’t have a lot of bread, bread and butter here. You know, anything that’s cooked bacon and eggs, it’s cooked, poached or it’s grilled …

 

...you know. I’m limited to, I think its two eggs a week [laughs].

 

And did you cholesterol, has it gone down …?

 

It’s gone…

 

Right.

 

.. It’s about 5.4. They’d like to see it under 5 but it’s manageable and I’m careful. I have the occasional treat. I eat Chinese Buffet on a Sat, Friday lunchtime. You know, apart from that, no, you know. I just lead a normal life.

Rich asked to see a dietician whilst he was in hospital so that he could find out more about what kind of changes he might need to make to his diet

The only, the only thing the only preventative measures that are, I was talked to about, and funnily enough I had to ask, about a week or so before I was, I came out of [ward name], I said “What about food? Dietician?” “Oh do you want to see one?” And basically a dietician was brought. It wasn’t part of the, let’s say the checklist, he’s done this, done that because I know some of the things, I was taken into a dummy kitchen in [name] ward to see, towards the end, before I was come out, just to see my kind of, let’s say, co-ordination and so forth.

But not once was I told, “There’s a dietician coming to see you”. I had to ask for that. And we went through it all. And there’s basically three columns, you can’t have this, you can, you can have this, you, in moderation, treat. In other words, one of the things, fish and chips, you can have once a week as a treat.

 

Not that I have fish and chips because I try not, much as I like fish, but, you know, I immediately think batter, fat, oil, chips, you know...

 

So you are, starting to think …

 

… that…

 

.. a little bit more in that way then?

 

Well, you know, I do that from day one, you know. Stay away from things like shellfish because I believe shellfish is high in bad cholesterol or something.

 

Right, so you’ve done your research?

 

I…

 

You know…

 

.. yeah, I’ve still got it out there, I’ve got the list and when I was last having my MOT, last January and I thanked the nurse only yesterday when I saw her. We were in there talking and my wife went in for some kind, kind of check and came and join, and she turned round to the nurse and said, “What about curries? Rich likes curries.” And said, “Yes” and she got up and I’ve got a superb book out there and I thanked her yesterday very much for it, because it’s all the things of what you can do your own curries but you don’t do, for instance you don’t use this ghee.

 

Ghee, yeah..

 

...which is ..

 

Clarified butter?

 

… you know, clarified butter. But it’s, it’s a, it’s a healthy way to do a curry. So, there are…

 

So you can find ways round it?

 

Oh yeah, you can find ways round it.

Rich took early retirement after his TIA because it would be difficult to fit back into his job after a long absence

I took early retirement officially a year and two months after my event.

 

Right.

 

Well that, let, let’s, it’s a strange, it was a, it was a strange transition because in actual fact I retracted that and they had to let me go on a, a special agreement. They couldn’t fire me, they couldn’t make me there’s a term, there’s an in between where the company let me go.

 

Was it on health grounds?

 

Yes.

 

Right.

 

Yes, yes.

 

And was the TIA mentioned as part of that?

 

Yeah, that’s the reason I couldn’t go to work because they found out and I had various managers pop in, well my immediate came to see me and the one that called all my grief came to see me and I think [wife] almost had words with him in the ward [laughs].

 

So, were they not wanting you back at work at all? Or did they want you to make sure that you were…

 

I don’t think to be honest, I could have done the job. I think..

 

And did that …

 

I think what would have happened is that, it may not have done, it depends how much I could control myself, but there would have been at least probably 12 months before I could have get, got back on my job and the job I was involved in I think had to have somebody managing it while I was there so I think, you know, the fact that I took early retirement I don’t think I would have had a job to go back to.

Rich remembered being told that having a TIA was a warning sign that you might be at risk of having a more serious stroke

 

Now you come to say it, one of the thing, one of the things I remember being, I forget who told me now, one of the things I remember was [hammering] someone saying that TIAs a warning. If you recover from that, you’ll be OK. But you could have another stroke. I remember that particular point.

 

And yeah, TIA, yeah. It’s a warning.

 

The local stroke coordinator provided Rich with information and guidance whilst he was in hospital, and when he went home he could call her if he needed to know anything

The local stroke person used to come in and visit the, the, the ward quite regularly and she kept in touch until she retired. And she was always kind of in inverted commas ‘there’ if I wish to, would, I can’t remember, remember her name now, but she was, she was a lovely lady. Older than I was, I think she was 65 nearly 70 but she, you know, you could ring her up or get, “Oh I’ll pop round” and talk it through with her and you know, she was a good source of, “Well if you do this and contact that…” Good source of information.

 

And that was from the Stroke Association, was it?

 

Yeah, she was the local Stroke Co-ordinator, I think, but I don’t think there’s anybody in [local town] now like that.

 

And can you …

 

It’s a shame really.

 

Can you remember what kind of help she, what kind of information she gave you that was helpful?

 

Well, it was just guidance. Where to go “I think you ought to do so and, why don’t you investigate this” because basically she kind of not exactly took over from the Care in the Community- the CART team, but, you know, once the, the consultant has said, “Well, OK, Mr [surname], you can go back to work”, you know, “Well, I’m not fully mobile, what do I do?”

Rich kept a diary of his recovery during his stay in hospital which shows that he gradually regained mobility with the help of physiotherapy

 

I’m looking here now, there are no dates because, oh here we are, week commencing 3rd, about a week afterwards, there we are, week commencing 3rd April ‘actual wrist movements’, ‘finger and wrist movements’, this is the week. ‘Finger and wrist movement – now able to bend able and touch nose’. That’s within, let’s say two weeks. ‘Independently carrying out finger exercises’ ‘Stood for the first time that week’. But I, I, I remember one night terrible ankle, God, my left ankle. The pain. And they sent me from, for an x-ray because, “Did you fall over?” I was asked. I said, “No, I don’t, I tripped.” “Well we’re not sure whether you’ve broken your ankle”. So I remember that. This is almost like my notes here. And … no, ‘Within standing’, within the first week I sat out of bed for half an hour in a wheelchair. That was kind of two weeks after the event. Then I sat out for lunch. ‘He has now been sat out for 72 hours, much improvement’ ‘Has now been sitting up for three hours’, so, you know, I was like that, and so for gym session, that, this is the first week, and then the Thursday, ‘Stood for the first time

 

Rich takes medication and says he has his 'MOT' once every 12 months, but that there are no resources for more to be done to help with mobility or other problems

One of the things I remember being, I forget who told me now, one of the things I remember was [hammering] someone saying that TIAs a warning. If you recover from that, you’ll be OK. But you could have another stroke. I remember that particular point. And yeah, TIA, yeah. It’s a warning.

 

But you haven’t had anybody talk to you any more about that?

 

No.

 

No.

 

No. No. No. No.

 

But you are being monitored, you said, by your GP?

 

Once every 12 months. Once every January I go in for my MOT, for want of a word, and that’s …

 

It’s interesting that there hasn’t been a discussion about that really, between you and your GP? In terms of …

 

Yeah.

 

.. thinking about, you know, because you were, you’ve been talking about preventative measures really. And it, you know, if there is some kind of idea that it could be a warning?

 

Well, I was going to say, that, this is, I don’t know whether it’s because, you know, I’m maybe thinking about it a bit more but going back to going back to what I was saying to you what came out in this the Voices magazine, which comes from the Stroke, about ‘moving on’ campaign, there seems to be a point in time where, where your let’s say, we’ve finished with you, we can’t do any more, but they could do, because the resources aren’t there. Now I don’t know whether what you’re talking about me in particular talking to the doctors whether or not they see it as a problem, because there’s no resource that they can actually put you to.

 

Right.

 

You know.

 

But you haven’t been given any advice about how to prevent anything further happening? It’s only …?

 

The only thing the only preventative measures that are, I was talked to about, and funnily enough I had to ask, about a week or so before I was, I came out of [ward name], I said “What about food? Dietician?” “Oh do you want to see one?” And basically a dietician was brought. It wasn’t part of the, let’s say the checklist, he’s done this, done that ….

Rich feels that the support team should be aiming at getting him back to how he was before the TIA but that there is not enough support available for this

I thought the treatment and the help I had in [ward name], in the ward, in [local town] was very good. You know, the care and the help and support I had there. The thing I’m a bit concerned about is when you come out. You know, and you progress. You know, I know this part of the house wasn’t built then, when I had my stroke, but I always remember that the team were out here, the CART team (Community Rehabitlitation Team) and the physio was there and my wife came out and she saw me walking unaided. That must have been two months after, about, yeah, two months after I’d been let out of the ward, walking unaided and there were flower pots, “If he goes over…” and the physio wasn’t even kind of within two, you know, stretch, “Go and walk over there.” Well if -I could have gone through that greenhouse.

 

I feel quite strongly and I, there was this article in this stroke campaigners magazine, about - it’s when you come out of hospital and you’re let’s say discharged, you have to go and do a lot for yourself. It’s almost as though, I remembered you know, walking with a stick [hammering] up and down the road about four to six weeks after I’d come out and the co-ordinator sat down, “Well, Rich, that’s as far as we can take you. You’re pretty good now.” I wasn’t 100%. I was still walking with a stick.

 

So you could be left at a point where you feel actually you could do with some support?

 

I, yeah, I think, you know, when does one when does one know that you’re 100% again? Question to people, do every, do any, does anyone, excuse me, does anyone go back to where they came from? You know.

 

So there’s a kind of question in your mind about ….

 

There’s a question …

 

… whether there’s some …

 

I’m, I’m …

 

.. permanent changes?

 

...sure, I’m sure, is there more you can do? But what they’re saying is that there isn’t sufficient physio people in the community other than going private.

Rich still has weakness in his leg and he has to be more careful about what he does now

 

I wanted to be out and active or I pottered around, you know, did this that and the other. I had one incident up there that kind of frightened me very much I was only talking to the physio about it this morning. I stepped down off something, and this is a stroke, and I stepped down onto the bad leg which just crumpled and I went whack on the bloody floor. These two fingers, I don’t know what they hit, became as big as sausages. I got in the car and it’s only a couple of miles away, got in the car, came back here and sat down and I walked through the door and [wife]said, “What have you done?” And I just collapsed in tears. I was this colour.

 

Shock. And from that day to this day I don’t go up anything, a step-ladder or, well step-ladders, steps or anything…

 

Do you still have some …

 

… without somebody …

 

... being …

 

... being there, yeah.

 

Do you still have some weakness in your arm and leg?

 

Yes, yeah and this is funny enough has come out today when I went and the, fortunately I got the physio who actually worked with me in [name] ward. I found out she was actually in the outpatients physio and I was talking to her today and she said, “You are still weak, Rich. Your core, your core fitness here is out of balance, the back to the front”. Because I’ve had back trouble. And she said, “It will help your left leg” because occasionally left foot, I can trip.

 

So you have to be a little bit more careful and...

 

I have to be very, very careful with what I do, you know. I’m not totally whoa, like this, you know. I can go and play golf but there are certain things I have to be careful … I cannot, I mean, if I come in from outside and it’s wet, I can’t wipe my feet.

 

I can’t do it, a little kind of, you know, how you wipe your feet, I can’t do that.

 

So, it’s making a few adjustments to how you …

 

Few, yeah …

 

.. deal with things?

 

.. I have to be careful what I do. There’s not very many things I can’t do but, you know, I just have to be careful take a bit of time.

 

Rich's children reacted differently when they heard about their dad being ill. His daughter coped by helping Rich through his recovery in practical ways, whereas his son was quieter and kept his feelings inside

I’ve got two grown up children who, who helped, but, yeah, it was diff, it was a disruption.

 

And how did it impact on the rest of the family? Do you …

 

Well they were, they were upset obviously but they were all kind of mobile. I felt more sorry for Emma because she just kind of started a new job and she was going down to not far down to [town], you know, half an hour every morning on the train…

 

Does she live here?

 

She lives here, yeah, both Anthony and Emma live here and she found it a bit of a strain I think but, you know, she used to, I’ll say grin and bear it really, [researcher’s name].

 

No, a lovely kid. In the end …

 

Very supportive?

 

.. yes, very supportive. What I did is she unfortunately, various things she had to leave the job after six weeks, so she became my ‘personal carer’ for a month while she found another job. And then she found another job very quickly and she was kind of off and running.

 

Did she get upset at all or how did she cope with it?

 

I think she coped very well with it. The person I’m not sure I’m just going back now to when I was in [name] ward when the three of them came to visit me for the first time after I’d been admitted, I think Anthony was. Now Anthony, the eldest, doesn’t show his emotions very much, he’s quite, completely different to Emma. Emma’s more like me, she’ll chat to anybody for want of a word. Anthony I think keeps it in himself

Rich feels the TIA has affected his emotions. Little things can make him cry or he will lose his temper as he never used to do

I think the, the worst side of having a stroke. I don’t, I don’t know - TIA is it does upset your emotions.

 

We’ve just, you’ve just seen it. And I get, and I think you know, my language is purely and simply a bit colourful it, as you said, it could very well be through frustration. I can’t get things done, things don’t go right and unfortunately I swear. As I said to, It’s much better than, I rather swear than [laughs] hit someone , which I’ve never…

 

There’s lots of worse things, isn’t there?

 

Well, there is ..

 

Than just words.

 

.. right, all right, yeah, but, yeah, but words can be unpleasant as well at the wrong time.

 

Yeah.

 

But that, well, you know, you, your, one of the things your emotions are, you’ve just seen it. But there was a, I shall start again, I got, there’s one song, I think it’s Take That, I think it’s Take That group, came out about the time and I think the it’s sung by Gary Barlow, if I’ve got the right group Give Me Time.

 

And that used to set me off.

 

Emma I heard it on, she said, “Can I have that CD for the car?” And she deleted that one. “I don’t want you to start crying when you’re driving.”

 

One of the things yeah, in actual fact it comes to mind, one of the things that never happened, I never actually sat and talked to anybody, you know, any therapist or anything like that, you know, “How do you feel, Richard?” You know, “What, what’s your problem?” “Well I, my emotions are shot to pieces.” You know. “The little things make me cry”. “My emotions come out. When I get angry and frustrated, I swear. I’m not that sort of person.”

 

So you haven’t really had the opportunity to have any help with that?

 

No.

Rich said that looking back he realises he never had an opportunity to talk to someone about how he was feeling and that he thinks counselling might be a good idea for someone who has just had a TIA

One of the things yeah, in actual fact it comes to mind, one of the things that never happened, I never actually sat and talked to anybody, you know, any therapist or anything like that, you know, “How do you feel, Richard?” You know, “What, what’s your problem?” “Well I, my emotions are shot to pieces.” You know. “The little things make me cry”. “My emotions come out. When I get angry and frustrated, I swear. I’m not that sort of person.”

 

So you haven’t really had the opportunity to have any help with that?

 

No.

 

Particularly. Is that something that you would like to do, or would …

 

It would have been …

 

.. do you feel might be useful?

 

.. I think it could be possibly useful for somebody who’s recently had a TIA.

Rich wonders why GP's don't give their patients a regular health check or 'MOT' so that risk factors can be picked up and monitored

There doesn’t seem, as a run of the mill, they say, go, you’d go and see your doctor or something, there doesn’t appear, and I’m surprised because there’s such a focus on strokes now, you know, in the media, you know, you’ve got this, this new thing FAST that they put out. The, if you go to the doctor and you’ve not been there for a while, I’m surprised the doctor isn’t kind of prompted, “Oh, when did you last have your blood pressure? Have you had your cholesterol checked?” Because I believe those are two of the, the factors for strokes.

 

I’m surprised they don’t do it, because there are, you know, you can have a statin to help your cholesterol. And I know two or three, not the two I mentioned but one other guy he was quite poorly [hammering] and they didn’t know what was wrong with him. Eventually, after about 12 months they found his cholesterol was twice mine and he, he was being, being put on medication and hasn’t looked back. Different bloke.

 

So your, one of your messages would be for GPs to do a kind of a bit of an MOT…?

 

I, I, …

 

No and again.

 

Yeah, MOT.

 

Yeah, because basically I go and have a yearly MOT because I’m on the list, I’ve had a TIA.

 

I think yeah. I’m surprised there isn’t, you know, there’s a, there’s enough checks these guys do as doctors and I’m surprised because stroke is such a debilitating thing

 

The message that I’d give to a health professional and I would, I would definitely say, you ought, I think they ought to, if they’ve not seen a patient and they, you know, like me I was a, in good health, maybe they ought to look through their patient list and say, “Oh we haven’t seen these people in the last 12 months” and get into a process. Maybe they ought to have their cholesterol checked and their blood pressure, I don’t know, as a matter of course. Maybe, why don’t people have a yearly MOT on their health, for instance.