Last November I had a Lacunar Stroke & weeks later, two smaller ones. My Story so far: Nov 2014 – Sept 2015
Last November I had a Lacunar Stroke & weeks later, two smaller ones. My Story so far: Nov 2014 – Update Sept 2015
*LATEST UPDATE – 29/09/2015 – ‘I have to keep taking the increased medication until December to allow those drugs to try, if possible, to remould as well as stabilise, my heart’s left ventricle, which is only working at a rate of about 22% (Apparently anything under 35% justifies a pacemaker). So that will hopefully be a welcomed Christmas present.
*17/09/2015 ‘I now have an appointment on the 24th with the Heart Failure Clinic at Odstock. Hopefully a pacemaker will be fitted soon and that will mean an end to the AF which keeps sneaking up on me: That should also greatly reduce the likelihood of future strokes. Luckily so many of my stroke physical symptoms have finally gone, with only now unbelievably easy to achieve total exhaustion daily, numbness around the mouth and left eye, slightly weak left leg, pins and needles in both hands, nagging headaches, confused memory and continual feeling of trepidation, still sadly lingering. Fingers crossed for the 24th! I will keep you all updated!’
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NO STROKE OF LUCK – WHAT HAPPENED TO ME
Early November 2014 I woke with a thumping headache; somebody with lead boots was jumping on my eyes while tightening a vice between my ears and pushing an elbow into the back of my neck. I lifted a glass of water from my bedside but neither my arm nor hand seemed to be part of me. It was as if I had no control over picking it up and although I did, there was no coordination between glass and mouth, so water soon spilt down my front. My wife Emily turned on the light and we could see my face seemed frozen and my mouth had dropped. My left lips had fallen, my left eye was nearly closed, my left arm and leg felt like sponge, I was grey and speaking in a strange slurred way. Emily was fantastic, immediately calling for an ambulance, lovingly giving me a big hug and calming me down. The ambulance operator stayed on the phone until the team arrived, but a paramedic was on the scene first. They were all so reassuring, competent, genuinely caring and amazingly well trained. More alert than I would ever have been at 4am in the morning!
Rushed to Salisbury Odstock Hospital
I was scanned & given a huge dose blood thinner when it was realised I had not had a bleed, but a blockage. Probably because I was already taking aspirin as part of the medication needed after my three heart attacks, triple bypass and aneurysm removal a couple of years ago, the immediate effects of the stroke might have appeared less severe than they really were. I was diagnosed with a lacunar stroke (Scroll down the page for details) which was probably not permanently disabling and recovery could take up to a year or, who knows, maybe more. As time went on, I realised there are a lot of ’who knows‘ in the World of Strokes or Events, as they in the trade call them. Why is that word used? When I think of events, I think of fun times, celebrations, weddings, horses, sport etc.. Not a terrifying mind and body distorting, threat to life. The nursing and medical care in Odstock was terrific, efficient, attentive and very re-assuring. After tests of all kinds, occupational and other therapists’ visits, I had made enough progress over the days, to be signed out of Farley Ward.
Once home, the recurring symptoms, both sensory & motor derived, many of which must earlier have been under the surface (silent), reared their ugly heads after I had two more slightly lighter strokes 6 weeks later.
My recovery at home became a nightmare with symptoms changing radically every exhausting day. From speech, to pain, to numbness, to taste, to tingling, to pinching, to stiffening, to fuzziness, to blurring, to sight, to hearing, to headaches, to weakness, to fatigue, to excretion, to tears, to depression, to fear, to anxiety, to instability, each day this dreadful stroke played Russian roulette with my body and, frighteningly unpredictably, my mind.
MY RECOVERY AT HOME & WHAT I HAVE LEARNT
- So much is known about strokes but little is understood about them.
- You never fully recover; physically perhaps, mentally never; such an experience will always be firmly engraved on your mind.
- You find yourself saying in so many conversations; ’since my stroke‘, as if there was never a time before it.
- Every stroke is different, as are the effects on each individual.
- What you think may be a new stroke, could simply be ’sleeping‘ symptoms waking up at odd times, giving recurring effects.
- When unused brain cells, waiting in the wings to try and take over the work normally done by the stroke damaged ones, become active, your physical & mental reactions to these neural job seekers can be very confusing, bewildering, painful & extremely stressful, sometimes giving the impression that you are having another stroke.
- Always expect the unexpected in recovery; both short & long term.
- You will never ever, in your life, have felt so tired, so be prepared for total exhaustion, sometimes instantly & without cause or reason.
- Emotions become uncontrollable, thoughts & reactions unreal, & with physical movements often inhibited, it’s as if some unknown alien has taken charge of your mind & body. This post stroke you, is not the real you!
- You can get your sense of worth back & ’beat the alien‘, by planning, using what’s left of your brain, a route through the turmoil with positive thoughts, humour, love & strength of will. Negativity will simply crush you!
My Average Day
*Update – 12/07/2015
Eight months after my Lacunar Stroke (Affecting both motor & sensory system) & seven months after the two smaller ones:
Daily I still have pins & needles in all fingers, my left arm seems less weak, lips and mouth feel swollen, eyes occasionally fuzzy, speech sometimes slightly slurred, burning tightening sensation in the palm of both hands near the wrist and when I walk, my left lower leg is trying to tell me I am not its owner.
My head throbs non stop and aches above and around the eyes, but by now this is manageable.
My mouth is always dry and my tongue sore.
The intensity of any symptoms seems to depend a great deal on how well I have slept & how tired I was the day before.
Sleep & keeping hydrated with plenty of water are what spurs on the recovery process; a nap for at least an hour every afternoon is vital.
Everything looks so promising but I still have:
The lack of self confidence & dread of having a further stroke.
The uncontrollable daily fluctuation in emotions & anxieties.
The overwhelming feeling of being insular & at the same time, very vulnerable.
My day to day terrifying worries about things which will probably never happen.
*Gone: Every morning until the first week in July, I used to wake up with my lips feeling swollen & falling off the left side of my face, my chin numb, my tongue pinching tightly inwards, my eyelids & cheeks as if they have spent the night in a bed of nettles, my left elbow, arm & hand floppy.
*Gone: Up until the second week in July a vice was pushing on my head trying to crush the skull between my ears and it also felt like some stranger standing on top of my forehead with hob nailed boots on.
*Gone: Unlike up until early July, the symptoms are feeling much lighter and do not all always rear their ugly heads during the day.
*Gone: My fear of travelling too far from the safety of my own home.
*Gone: The lack of total co-ordination & the capacity to only write in an illegible scrawl.
Gone: The terrible taste of metal, in my seemingly always dry mouth, I had during January & February.
Gone: The instability, stumbles & falls.
Gone: The very blurred vision I had on & off for four weeks.
Gone: The slurred, garbled or unintelligible speech.
Gone: The frozen, drooping, left side of my face.
Gone: Thanks to riding Davina (my exercise cycle) daily, my weak left leg.
Gone: The entire numbed face, as if deadened by a dentist’s injection, I had for six weeks.
Gone: The dead lumpy feeling I had in my tongue, making me incessantly lick the inside of my cheek nearly raw.
Gone: The ferocious headaches, which seemed to throb, non-stop, every day for nearly four months.
Gone: The inability to create words from an apparent jumble of letters on the keyboard; made further impossible by only being able to see half a computer screen.
Gone: The daily feeling of nausea.
Gone: Total exhaustion felt every day, from the moment I woke up until bedtime and although I do become tired relatively easily and suddenly, it is no where near as bad.
Gone: The feeling of being of being completely isolated now I am allowed, & able, to drive once more.
Gone: The sense of paranoia & need to self destruct.
Gone: The endless nights of visiting, every thirty minutes at least, the bathroom for a stand up or sit down excrete. Neither of which I really needed, it was my brain just kidding me that I did. This went on continuously for one week; I was at my lowest during this time.
Gone: Just recently, has the fear of making conversation with more than one person for any length of time.
I Am Improving Daily But:
*Most of the time, except when I am black around the eyes, my left lip droops & I am slow, unsure, stuttering & dithering, I look & act my usual self: Also, I have, as before my strokes, great bursts of uninterrupted enthusiastic energy, which used to be sustainable, but sadly no longer are; now I become tired quite quickly and because of my exuberant trait, people I know, do not realise what lies underneath this apparently normal exterior.
While my long term memory is naturally somewhat affected, my short term memory is virtually non existent, so unless I write things down or video them, days are lost forever: Reading, a pleasure I have had for years, is now pointless because stories always disappear so quickly, meaning that whenever I pick up a book I was previously reading, even after just a few hours, nothing makes any sense, so I would have to start again back at page one.
*My left eye area, mouth and cheek still feel numb daily but no where as bad as before.
*I still have thumping headaches but they are, thankfully, less severe.
I still have hot waves running down my chest, along with strong palpitations & heavy perspiration, at least twice a week, generally in the late evenings or during the night.
*I no longer seem to have A.F. so regularly, because the medication prescribed by my fantastic G.P.s, at the brilliant Hindon Surgery, seems, so far, to be working well to prevent it triggering off another stroke. I have had A.F. since my triple heart bypass & aneurysm removal.
I take a blood thinner which unfortunately does not accept vitamin K as a clotting agent, so I have to carry a tube of super glue to use on any cut, to stop myself bleeding out. A small price to pay!
I do not know if I will ever fully physically recover, but I am determined enough to get as far along that road as I possibly can.
I cannot ever thank my wife, family & friends, enough for their tireless support and unyielding love!
I will never forget the devoted care & compassion given so selflessly by our wonderful NHS specialists, doctors, nurses, paramedics and incredible staff behind the scenes.
I hope the Tardis Trial, in which I took part, encouraged by the warm & talented Dr. Black, will help prevent future patients from having recurring strokes. Sadly the trial did not stop me from having other ‘events’, but such dedicated work is needed to make clinical progress in the strange world of strokes.
I will be eternally grateful for the amazing after-care from my terrific, incredibly knowledgeable & ‘stroke experienced’ doctors, Patrick, Julian & Sally, along with all staff at the ever attentive, unbeatable, lovely Hindon Surgery (http://www.hindonsurgery.co.uk/) in South West Wiltshire.
I will never forget the genuine warm friendship, love & care so unselfishly given by my local stroke clubs.
Thank you also Emma & Beth from The Stroke Association for your good humoured, enthusiastic help & encouragement.
The journey continues and I realise every day how much I love life & living; how much I adore my wife & daughters; how much I value my family & true friends; how much I cannot be without my faithful happy dog Scrappy (https://thescrappydogblog.wordpress.com/).
As for the future, it now looks very good indeed!
WHAT IS A LACUNAR STROKE?
Strokes can damage brain tissue in the outer part of the brain (the cortex) or deeper structures in the brain underneath the cortex. A stroke in a deep area of the brain (for example, a stroke in the thalamus, the basal ganglia or pons) is called a lacunar stroke. These deeper structures receive their blood flow through a unique set of arteries. Because of the characteristics of these arteries, lacunar strokes happen a little bit differently from other strokes.
A lacunar stroke occurs when one of the arteries that provide blood to the brain’s deep structures is blocked. These arteries are small, and are uniquely vulnerable. Unlike most arteries, which gradually taper to a smaller size, the arteries of a lacunar stroke branch directly off of a large, high-pressure, heavily muscled main artery. High blood pressure (hypertension) can lead to lacunar strokes because it causes a pounding pulse. Since the arteries don’t gradually taper down in their size, high blood pressure can directly damage these arteries. High blood pressure also can cause atherosclerosis, a condition in which fatty deposits (plaques) build up along the walls of blood vessels. When atherosclerosis is present, a clot can form inside of one of these small arteries, blocking blood flow in the artery.
Unlike strokes that damage the cortex, lacunar strokes are only rarely caused by a blood clot (also called a “thrombus”) that forms elsewhere in the body, such as the neck or heart, and travels through the bloodstream to the brain. After a clot (or any debris) begins to travel through the bloodstream it is called an embolus. It is difficult for an embolus to make its way into the small arteries that can cause a lacunar stroke.
Many of the deep brain organs that can be injured by a lacunar stroke help to relay communication between the brainstem and the brain cortex, or help to coordinate complicated body movements. In a lacunar stroke, brain cells in a relatively small area (measuring from 3 millimetres to as much as 2 centimetres across) are damaged or killed by lack of oxygen. Such a small area of brain destruction is called a lacune. A lacunar stroke involves only a small area of the brain, but it can cause significant disability.
The symptoms of lacunar stroke vary depending on the part of the brain that is deprived of its blood supply. Different areas of the brain are responsible for different functions, such as sensation, movement, sight, speech, balance and coordination.
Symptoms can include:
- Weakness or paralysis of the face, arm, leg, foot or toes
- Sudden numbness
- Difficulty walking
- Difficulty speaking
- Clumsiness of a hand or arm
- Weakness or paralysis of eye muscles
- Other neurological symptoms
In a person with prolonged, untreated high blood pressure, multiple lacunar strokes can occur. This can cause additional symptoms to develop, including emotional behavior and dementia.
The sudden appearance of one or more of these symptoms is a warning sign that a stroke may be in progress. Sometimes, the small clots that can cause a lacunar stroke interfere with blood flow only for a few minutes. If the clot dissolves before damage is done, then symptoms can begin to improve within minutes and may go away completely. When symptoms go away without treatment and full recovery occurs within 24 hours, the event is called a transient ischemic attack (TIA). Never decide to wait and see whether stroke symptoms will go away on their own. Get to a hospital as quickly as possible for treatment.
Your doctor will ask about your medical history (high blood pressure, heart disease, smoking, high cholesterol and diabetes). He or she will check your vital signs (temperature, pulse, breathing rate and blood pressure) and might order an electrocardiogram (ECG).
Lacunar strokes usually are identified by a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of your brain. An MRI technique known as diffusion weighted imaging is particularly sensitive for identifying very new lacunar strokes.
If your symptoms continue without improvement during the time you are traveling to hospital, it is best to assume that your event is a full-blown stroke, not a TIA. If a lacunar stroke is treated early, full recovery is possible. If medicines restore circulation to the brain quickly, symptoms of a lacunar stroke may go away within hours. If blood supply is interrupted for a longer time, brain injury may be more severe, and symptoms may last for many weeks or months, requiring physical rehabilitation. There may be permanent disability.
You can help to prevent lacunar stroke by preventing or controlling the risk factors for stroke – high blood pressure, smoking, heart disease and diabetes. If you have high blood pressure or heart disease, follow your doctor’s recommendations for modifying your diet and taking your medication. Exercise regularly, eat plenty of fruits and vegetables, and avoid foods filled with saturated fats and cholesterol. If you smoke, quit. If you have diabetes, monitor your blood sugar level frequently, follow your diet, and take your insulin or oral diabetes medication as your doctor has prescribed.
If you have had a lacunar stroke, your doctor may recommend a daily aspirin or other blood-thinning medication, such as ticlopidine (Ticlid) or clopidogrel (Plavix). These medicines may reduce your risk, but their benefit has been more obvious for stroke types other than lacunar strokes. If you have never had a stroke of any kind, you might lower your risk for a first stroke if you take a daily aspirin. There is strong evidence that stroke risk is reduced for women over the age of 45 who take aspirin once every other day. This benefit has not been proven for men.
If doctors are able to provide treatment within three hours after symptoms start, they probably will use with a clot-dissolving medication. Although the blood-thinning medication heparin often is used to treat strokes that affect large arteries, it does not appear to help people with lacunar strokes recover.
A person who has had a lacunar stroke usually is hospitalized so that he or she can be observed in case symptoms worsen. A person with a severe stroke may need help with self-care or feeding. In the hospital, an occupational therapist and a physical therapist can help the person to work around a new disability and to regain strength after brain injury. Commonly, hospitalization is followed by a period of residence at a rehabilitation center, where additional intensive therapy may be given. The goal of rehabilitation is to maximize recovery. To prevent future strokes, it is very important for you to control high blood pressure. It helps to take a daily aspirin or other blood-thinning medication (ticlopidine or clopidogrel).
When To Call an Ambulance
Call for emergency treatment immediately whenever the symptoms of lacunar stroke occur, even if these symptoms last only a few minutes. For best results, stroke treatment must occur within three hours of the start of symptoms.
People often begin to recover within hours or days of a lacunar stroke. Lacunar strokes have a better rate of recovery than other strokes that involve larger blood vessels. More than 90 percent of people with a lacunar stroke will recover substantially within the first three months following the stroke.
‘Before my strokes, here I am with Scrappy Dog, both of us being ‘Purpled’ for Charity at 2DorzDown – Hairdressers In Tisbury High Street.’
‘My experiences on the road to recovery from my lacunar stroke in November, two smaller ones in December & January, up until June 2015 have been posted. More later on in 2015.’
‘Here I am above, in April, looking good at the same hairdressers, on my road to recovery.’
As A Stroke Survivor I Know The Following Is Also Important
Click on all images to enlarge & zoom in.
1 – Recognising the symptoms & quickly acting on them is essential. Speed in getting medical help is vital: Remember F.A.S.T. Face-Arms-Speech-Time.
- Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped.
- Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
- Time – it is time to dial 999 immediately if you notice any of these signs or symptoms.
2 – No two strokes are exactly the same! We are all different, so are our strokes, their symptoms, reactions and recovery processes. Depending on how severe the stroke is, our wonderful NHS medics, ambulance attendants, hospital care, nursing, doctors and medication can keep us alive: Only our individual coping mechanisms, self determination, true love and often selfless care will define the outcome.
3 – Once you have had a stroke, you change, never to be the same again! So make sure that change is positive and gives you a new insight to a post stroke life. It could make you a better, more tolerant, positive, nicer person.
4 – Blood starved and useless brain cells cannot be repaired; whenever possible, lively unused ones, hanging around waiting for work, try to take over their jobs. These suddenly employed cells and their neural jobseeker mates give this a real go whenever they can, and the effects can feel very strange and hugely confusing.
5 – The Brain is an incredibly remarkable bit of kit and more resilient than one could ever imagine. It doesn’t give up easily: Neither should any stroke survivor, family, friends or carers.
6 – Talk to others who have had a stroke, as soon as possible. You will realise you are not alone and this is incredibly important to help gain lost confidence and attain a feeling of worth once again.
7 – Tell your GP everything as soon as you feel your recovery may be going in the wrong direction.
I know it well
Not a swimming mode
Not a batting hit
Not a cane’s thrash
Not a clock’s tick
Not a bit of luck
Not a soothing hand
Not a way of pleasing
Just a nerve bending
Terrible trip to hell
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‘We call ourselves stroke survivors, not patients – that’s very important’
Jim Whyte was forced to give up work after having a stroke, but he’s proved that there is life after stroke.
Jim was getting out of a van when he suddenly felt his left leg turn to jelly. “I fell down, and my workmates got me a chair,” he says. “They brought me a cup of tea, but I couldn’t work out where the handle was to grasp it. Somehow I knew I’d had a stroke and asked them to take me to hospital.
“By the time I got there, I didn’t have any feeling in the left side of me. I felt like a lump of meat. I could hardly get out of the car.”
Doctors confirmed that Jim was right; he’d had a stroke. He spent the next 27 weeks in hospital undergoing rehabilitation and physiotherapy. “Luckily, my speech was still all right, though I’m sure my kids and grandchildren sometimes wish I’d be quiet!” he says. “During my time in hospital I regained around 85% use of my hand and arm. I’m actually very lucky.”
Jim had high blood pressure and was diabetic, which are both risk factors for stroke. However, he had never smoked and, due to his diabetes, was already following the healthy diet recommended for stroke survivors.
“My wife was a chef and she made sure we ate properly,” he says. He was put on tablets for high blood pressure and now has regular checks. “When I had the stroke, I had no idea I had high blood pressure,” he says.
Jim had his stroke more than 10 years ago. Although it forced him to give up work, he makes a point of leading an active, healthy lifestyle. He attends his local stroke survivors club every week, which includes exercise sessions, talks from experts and a blood-pressure check.
“It’s also a great place to share advice and make friends,” says Jim. “It’s good to talk about any problems you’re having with people who have been through the same thing. I’d recommend any stroke survivors to contact the Stroke Association to get information on their nearest club.” He also visits stroke survivors in hospital.
Jim believes there is life after stroke. “We call ourselves stroke survivors, not patients; that’s very important. When you’ve had a stroke, the most important thing to do is accept it. Unless you do that, it’s difficult to move forward. But once you do, you’ll realise that you can live a very happy, active life. I certainly do!”