TIA and Minor Stroke

Work after transient ischaemic attack (TIA) or minor stroke

Having a TIA or minor stroke affected people’s work lives in different ways. Some of the people we interviewed experienced their TIA when they were either at work or on their way to work. Some, like John (below) tried to carry on hoping that colleagues and clients wouldn’t notice something was wrong. Clare was fortunate that she worked in an organisation where there were trained nursing staff in the building who recognised what was might be wrong and called 999 immediately. Yvonne on the other hand went into work and tried to keep going because she thought that her symptoms were due to an adverse reaction to some medication she had been prescribed (see ‘Driving’ and ‘Symptoms’).

John was at a work conference when he suddenly found he was unable to articulate thoughts and he couldn't speak.

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Age at interview: 59

Sex: Male

Age at diagnosis: 58

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My incident occurred during a conference. I was attending a one-day conference, a technical conference, and during the morning session thought that I needed to speak to a couple of characters who’d presented papers, so at a coffee break approached one of them. I had a normal conversation, turned to speak to the other character, and lost the ability to speak, which was very confusing and quite perturbing. I literally couldn’t take the thought from my brain to my mouth and articulate what I wanted to say. That lasted for a few minutes. I had to turn away from the man I wanted to speak to, managed to stumble out something to the effect of, “I’ve lost the ability - I’ve lost my words for the day”, and went back to the place in the conference hall, sat and realised that something very strange had happened. It so happened that I was sitting next to a client of mine. So I was aware that I really couldn’t speak to him, because I didn’t want him to know that there was something odd. This would have had a business impact. But I was confident that if it was serious he would – he was a good man - take care of me. At lunchtime I phoned my office and asked my PA if she could get me an appointment with my GP. And early afternoon felt very tired, very hot. So left the conference, came back home. That evening I was disturbed by what had happened, but slept normally.

Clare was at work and her colleagues could see there was something wrong but she couldn't work out what was happening to her

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Age at interview: 50

Sex: Female

Age at diagnosis: 48

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We stopped off at the shop in the morning before we went to work to pick up some breakfast. I was quite excited because I was due off … I was due to have a few days off work. We picked up a colleague from work. Got into work. And sat down all of us in the office chatting away. And I took a bite of my sausage roll. And one of my colleagues was telling a joke and I took a bite of the sausage roll and then I had almost like an out of body experience. That’s probably about the best way that I can describe it. And my colleague sort of said, “Well the joke wasn’t that funny.” And then another colleague said to me because there was about five people in the office at the time, and another colleague said to me, “Stop doing that Clare you’re frightening me.” And that was the sort of thing for me that frightened me because I knew something was going on. But I didn’t quite know it was you know, like I said an out of body experience. And then we’ve got a unit downstairs that’s for detoxification, so this nurse is there. So they came, they came up the stairs. And I, I can remember wanting to act normally because they kept looking, because everyone kept staring at me. And I had a cup of coffee on my table. And I went to pick it up with my left hand and where you automatically can pick up a cup of coffee I couldn’t do it. So I just wasn’t fazed by that, I just picked up it up with my right hand. And but I just didn’t feel like I, I wanted a cup of coffee then. And then I had some sausage roll in my mouth and my husband who was in the room with me at the time, took the sausage roll out, literally out of my mouth because I couldn’t swallow. And then one of the nurses came up and I know there were lots of people coming in at this stage. And they gave me some aspirin, 300 mg of aspirin. And then a nurse came to me and took my hands and said to me, “Squeeze as hard as you can with your hands.” And I can remember thinking, ‘I’m squeezing really hard’, but she was saying, “Well she’s not really doing it very hard.” And I can remember thinking, ‘I’m in the room. He’s saying that in the room as if I’m not there and I am.’ So it was a very weird out of body experience for me that. And then after that somebody asked me if I had a headache and it was at that stage that I had a really bad headache in the right side …

But it was the left side that I had my TIA from. This is, I’m just going from what I can remember which is quite patchy I suppose. And then they called 999 and the ambulance came into the establishment.

Yvonne experienced symptoms whilst driving to work but thought it was an adverse reaction to some medication she had been prescribed and so carried on working

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Age at interview: 54

Sex: Female

Age at diagnosis: 54

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I was driving to work, and I noticed that my vision had gone funny. It was getting very fuzzy around the edges. But I have suffered from migraines in the past so I just thought maybe that was what was starting. Then my left leg went numb. My left arm went numb. Fortunately I was driving an automatic so it didn’t really matter, I didn’t have any gears to change or anything. I was starting to get a bit worried by that stage and then I felt as if my mouth had dropped. I managed to get into the police station car park. Sort of abandoned the car really, it wasn’t really parked. Kind of fell out of it thinking, “What the hell’s wrong with me?” You know, I’m just, I blamed it on the medication, because the doctor had just changed my blood pressure medication and I thought, “Oh I’m obviously reacting badly to it.”

I managed to get to the back door of the police station and there’s quite a high step and I couldn’t get over it. And I remember thinking how stupid I was and how stupid I must look. And the typical thing of looking round and thinking, “Is there anybody watching me?” Eventually a colleague came a long and opened the door for me. I went through the back door and I thought, “I don’t think I can manage the stairs.” And actually stood against the wall thinking, “Well, if I’m standing against the wall if I collapse then I will just slump down the wall rather than, than pitch forward.”

Eventually thought, “I’ve got to get upstairs, I need to get to my office. I need to sit down.” I went upstairs in the lift. Got to the floor, went through the doors. Walked through the report writing room. And all my colleagues turned round and said, “You look awful. Why are you here?” And I said, “Oh, I’ll be fine. Don’t worry, I’m OK. Don’t worry about me. “ And I went into my office and actually worked for the rest of the day feeling awful. Having to go back over things, I couldn’t remember things. People were asking me to do things and I was thinking, “What did that person just ask me to do?” And I felt dreadful, because it’s just not me.

So, I came home and I said to my husband, “You know, I felt really strange today.” And told him what had happened. And he said, “Are you sure you’re OK?” And I said, “Yeah, I think so, I think it must be the medication.”

Felt awful the next day. But again went to work. Came back. And I was sitting here in the evening and all of a sudden I got the sensation of pins and needles in my left arm and my left leg. Passed over in a couple of minutes so I thought, “Oh, it’s definitely the medication and I’m now getting used to it.”

It wasn’t until sometime after experiencing the symptoms of what turned out to be a TIA that Yvonne stopped working because she didn’t realise that she had had one.

Yvonne carried on working until her doctor got the results of her scan and told her she shouldn't be at work

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Age at interview: 54

Sex: Female

Age at diagnosis: 54

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I carried on going to work. Absolutely exhausted. Just, I would come home in the evening and just slump on the settee. My husband would say, “Would you like to come to the pub for a drink?” “No, I’m too tired.”

Housework went, I just didn’t bother with it. I would do it on the weekend which then meant that I was tired on the weekend. And I was just like a zombie.

Were you working?

I was working, yes. I was working eight hours a day. And, although my boss was very good and kept saying, “Don’t come in for eight hours if you’re too tired.” Unfortunately I’m not the sort of person who can walk away from a job. If I start one I’ve got to finish it. So, I carried on working. And then my doctor obviously got the result of the scan and phoned me up and said, “What are you doing? Why are you at work? Aren’t you tired?” I said, “I’m absolutely exhausted.” I said, “I don’t know how I’m keeping going to be honest with you because I’m so tired.” And she said, “Well, I suggest you go home now.” And she signed me off sick there and then. And I went and told my boss and he was very good, you know, just said, “Off you go. Do you want me to get somebody to drive you home, I don’t think you should be driving.

Most people who had a job or a business to run had to stop working for a while in order to rest and recover.

Angus needs to be able to drive for his job, so having to stop driving for a while had an effect on his income

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Age at interview: 61

Sex: Male

Age at diagnosis: 60

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The kick-on from all this is that I had all these few, quite a few, six weeks or so off work because of not being able to drive etc. - not necessarily because I didn’t feel right, because I did, you know. But I was told not to drive, so I had to, and that subsequently cost me more work because I wasn’t there to follow on, and so really I’ve not had a great deal. In the last four months I’ve probably only had about a month’s work, you know.

This could have a big impact, for example on income - particularly if the person was self-employed and did not get sick pay. Some people went back to work when they felt well enough but it could be difficult to continue exactly as things had been before they had been unwell because they got tired more easily and needed to slow down.

Michelle had a TIA followed by a stroke and can now only work part-time because she gets very tired, but she hopes that she will eventually be able to work full time again

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Age at interview: 28

Sex: Female

Age at diagnosis: 26

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Now I have to stop and think of the implications like I have to know the limits, how far I can push myself and when I need to stop and rest.

When you say things, are you talking about kind of thing where you’re exerting yourself, like doing exercise or that sort of thing? What sort of things do you mean?

Everything in, in general, work-wise.

Are you back at work now?

Part-time, yeah.

Right. And how do you find working? Does it impact on your, does, does your condition impact on that at all?

I just get very tired, very easily and I suppose most people can take a lot, a lot of things and keep it there. Where for me I can only take a small bit and then I have to shut everything off because then that kind of makes me worse and then my blood pressure goes up and, so I have to know when I, you know, when to stop?

I mean, you’re working part-time, is that because of the what’s happened to you that you’re not doing full-time? Or is that just something that you wanted to do?

No, physically I can’t, I couldn’t do full-time yet because I get too tired too easily. But that is what I’m pushing for.

So you’d like to get back to work...

Yeah.

.. in a, on a more normal sort of basis?

Yeah.

So at the moment you’re kind of constrained by, still by your health condition. What, when do you, do you see that, is there sort of a time in the future when you see that happening? Or is it just all up in the air at the moment? What would it depend on? Going back to work full-time?

I’m not sure.

No. You, you said you get quite tired at the moment. I suppose perhaps …

It’s …

...is it something to do with …

... building yourself back up to being able to go for 100% all the time.

...stamina?

Yeah.

Yeah.

Hm.

Right. So is that something that you’ll do gradually? Like increased your hours a bit maybe over time, something like that? Or have, I mean, well, have, have your employers actually said anything to you about what they would expect or want you to do?

No, they’re quite flexible with my, with my hours. And I can do more if I want to. Which I have done. And then feel worse for it afterwards. So I, I know now still, it’s too much too soon. But, yeah, I do gradually very slowly, work your way up.

Yeah.

And that can be frustrating because it does take a long time and you can’t, at that time you can’t really see that you are progressing, even though you are. But you can’t just stay and do nothing because that makes you feel so much worse. You have to keep doing things.

I couldn’t just sit and do nothing. You just don’t get better doing that. You have to keep pushing yourself constantly all the time.

Clare stayed off work for a few months because she felt she wouldn't be able to cope with going back

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Age at interview: 50

Sex: Female

Age at diagnosis: 48

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I stayed off work for a, two, three months, something like that. Stayed off work.

How did you feel about that aspect, about not being able to go, to be at work and, was that something that you, you were, you were relieved not to have to go to work feeling the way you did, or did you, would you have preferred to have…?

I couldn’t have gone to work, I felt very, very vulnerable And very, I’m very funny about my neck. You know. I don’t like, somebody put their arm around me the other day and sort of went like that and I could feel myself getting really anxious without even thinking, “I’m getting anxious.” It sort of was there already.

Gilly is still waiting for a proper diagnosis after several months but in the meantime has been unable to go back to work

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Age at interview: 51

Sex: Female

Age at diagnosis: 51

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I’m walking and I’m talking so I’m fine. Well I’m not fine, I can’t go back to work so I’m haemorrhagingmoney. Thousands have gone. Which doesn’t make me unique, it happens to everybody. But thousands have gone and I haven’t got a diagnosis.

I, sometimes obviously think, well nobody, obviously they don’t think that what’s happened to me is a TIA otherwise surely to goodness something would have happened. I’m sure it’s just logistics and I, I’ve just ended up pulling the short straw in that hospital, there’s nothing we can do about it. But unless I’m careful I can end up thinking, “Well, didn’t really happen.”

Because it hasn’t …

I should be back at work.

.. do you feel that because it hasn’t almost been legitimised by …

Yeah.

... having a diagnosis.

Yeah. I’m just dossing. Why aren’t you back at work? My sister said, amusingly at the time, I think, I thought, but I don’t anymore, after a week she said, “Go back to A&E, tell them you’ve got a cracking headache and you’re seeing lights, they’ll admit you in a flash.”

Now at the time I said, “You can’t do that, because I haven’t and I’m not.” She said, “Well you’re going to be sit, sitting around waiting for ages.” Now I now, I actually wouldn’t have done it but I can see this …

Is it tempting?

Well I can see why people do it.

Some people felt that stress may have been contributed to their illness and made plans to cut back on hours, change priorities and in some cases retire sooner than originally planned.

Adrian runs his own business and has a strong work ethic but after his TIA decided to slow down and take more of a back seat

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Age at interview: 53

Sex: Male

Age at diagnosis: 53

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I look at my business slightly differently.

How differently?

Because I think I worked, I lived to work, whereas now actually in fact I’m going to work to live. So if the business goes pop, it goes pop. I’m not going to worry. That’s not the be all and end all. And for some reason I don’t know whether it’s a generation thing, but I seem to be pre-conditioned to work and think I have to work. And I’ve been looking at it and thinking well actually I don’t. And so the first opportunity I get, I shall stop. Because just think, it sounds awful doesn’t it? But I just think it’s not worth, it’s just not worth it.

John feels that the stress of working long hours may have contributed to him having his TIA but it's difficult to cut down on stress when you run your own business

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Age at interview: 59

Sex: Male

Age at diagnosis: 58

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I knew that what I do for a living requires me to work long, long hours, and always has done, which I enjoy. But that’s always been a fear, that that stress would cause something. Lo and behold, it’s caused, it would appear to have caused, or been a contributor to what has happened.

I can’t change the stress level I work under. That’s something which is self-imposed. If you run your own business, you, nobody’s told you to do that, you’re doing it, it’s your choice. I don’t have an easy answer to that. And if there’s, for other people in similar situations, I don’t know what I can say. If, unless you’ve run your own business you, it’s impossible to imagine what it’s like. People say, “Why don’t you just pack up and retire?” Well, you for all sorts of reasons can’t do that. So the stress, that stress continues.

So the changes are small. It’s something you think about on a daily basis, “What should I be doing?” And it is possible to walk away from some of the more stressful, some of the more stressful parts of the business. And I’m wary not to become overtired. I was told not to become overtired. So in summary, take the medications, measure the blood pressure, try and get fitter, and stay away from excesses of stress.

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

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Age at interview: 58

Sex: Male

Age at diagnosis: 58

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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.

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

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Age at interview: 66

Sex: Male

Age at diagnosis: 62

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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.

For some people it was difficult to contemplate the changes to their work lives. Yvonne had been in the police force for many years and enjoyed her job immensely but having been diagnosed with a heart condition a year or so before having a TIA found herself having to think about leaving her job and doing something different. Yvonne said that after her TIA she felt humiliated, ‘washed up’, because she could no longer do the things she used to be able to do and was looking for something new that would help her to feel more useful again. Most people said that they felt it was important to fill the time with doing something worthwhile and that it was important to keep busy, and a number had thought about or started doing some voluntary work. After having had this experience themselves some felt that they wanted to do something to help and support other people who had experienced TIA or stroke.

Yvonne has had to consider leaving her job and has thought about doing some voluntary work.

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Age at interview: 54

Sex: Female

Age at diagnosis: 54

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I’ve spoken to the Force doctor and given all my symptoms and all the things that have happened, he suggested that possibly it’s time to, to knock it on the head and say, you know, he said, “You’re never going to be a front line officer again.”

So were you, at that time you were on the front line or …

No, I was a front line up until I was diagnosed with a heart condition and then I …

Right.

… came off front line.

It’s been a bit of a problem thinking about it. But I thought I might start to do some voluntary work just to start with to see exactly what I can and can’t do.

And also I’m not sort of, my hours are not set if I do voluntary work because that’s where I’m finding it so difficult. And that’s where I was finding it difficult at work because I would go into work absolutely exhausted. And then I’d have to be at a meeting at eleven o’clock and that would be until two o’clock and I couldn’t just get up and think, say what, “I’m really, really tired and I’m not taking this on board and I need to go home now.” You know, because you just don’t do that do you? [chuckles]

Yeah, so doing the voluntary stuff might give you a little bit of a different set up…

Yeah.

..and scenario to be able to do that kind of more flexible...

Yeah, because if I go in and after a couple of hours I feel really … as long as I explain the situation before I go and just after a couple of hours say, “Look, I’m really tired now, you know, I’ll try and come in again tomorrow.”

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

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Age at interview: 58

Sex: Male

Age at diagnosis: 58

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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.

Some people continued to work but found that they had to make certain adjustments, for example Roger works as a pianist in quite a social environment and now feels it’s important to watch how much alcohol he drinks. Others felt that having the TIA had given them an insight into how their working life might be limited in the future if they were to have a further more serious episode.

John feels it's important that his work colleagues know about what has happened to him so that they would know how to help him if he had another episode

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Age at interview: 59

Sex: Male

Age at diagnosis: 58

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I’d certainly tell them, everybody at work, they know what’s happened. And I’ve also spoken to them about what to do if I start to behave strangely, because I want, I want them to be able to feel confident to just dial 999. You know, let’s not delay. Let’s get some help. Because I’m concerned that if I have a stroke I may not be able to explain what’s happening. I want them to recognise the symptoms and deal with it. And because I travel and work in very remote locations because of my business - I’m talking about the middle of Siberian forests, or out in the Sahara, or up on the Canadian ice fields - I need to tell the people I’m with what has happened. I need to be very honest with them and say, “Right, I’ve had this. This is my concern. And this is what I want you to do about it if these things happen.” And that’s something that just feeds into a safety culture which we’ve had as a company, as a group, for all our working time, and which we’ve inherited and learnt from the major oil companies we work with, who are very concerned about individual safety and are extremely good at it.

Last reviewed June 2017.