Heart of the mat­ter

When stroke strikes young

The Irish Times - Tuesday - Health - - Front Page - Ar­lene Har­ris

Al­most 10,000 peo­ple are af­fected by stroke every year in Ire­land and as Septem­ber sees the start of Ir­ish Heart Month, the Ir­ish Heart Foun­da­tion (IHF) is hop­ing to raise aware­ness about the con­di­tion and ed­u­cate peo­ple about the need to look af­ter their heart health with the cam­paign “Let’s Strike Be­fore Stroke”.

Karen (28) ‘I am now back to good health’

Karen Donoghue from Dublin is well aware of the dan­gers as while the stereo­typ­i­cal im­age of a stroke vic­tim is older and in­form, she was af­fected when she was just 28 years old.

Ini­tially be­liev­ing she was ex­pe­ri­enc­ing the ill-ef­fects of a hang­over, Donoghue ig­nored the symp­toms un­til her mother per­suaded her to go to the doc­tor. “One night in Au­gust 2011, I went out for a few drinks with some friends,” she re­calls. “The next morn­ing, I felt aw­ful and thought I had a hang­over even though I didn’t drink much. That evening my left hand started to feel a bit numb and I still wasn’t too con­cerned, but the next day I had pins and nee­dles in my left leg and felt dizzy. I be­gan to think that it was more than a hang­over and rang my Mam, who took me to the doc­tor.”

Un­aware that she was show­ing early signs of stroke, Donoghue wasn’t con­cerned when the GP asked her to un­der­take a few ba­sic tests – but although she passed them all, he re­ferred her to ca­su­alty as a pre­cau­tion.

“The doc­tor thought I should go to hos­pi­tal for fur­ther checks, so I had some tests and a CT scan,” says Donoghue. “But shortly af­ter­wards I be­gan to de­te­ri­o­rate, so I was ad­mit­ted and booked in for an MRI the fol­low­ing morn­ing – by which time I was com­pletely paral­ysed down the left-hand-side of my body – it was ter­ri­fy­ing.”

The MRI re­vealed that Donoghue suf­fered a mild stroke, which luck­ily was caught early, and af­ter two weeks in hos­pi­tal, she was re­ferred to the Na­tional Re­ha­bil­i­ta­tion Hos­pi­tal (NRH).

But then things took a turn for the worse.

“Af­ter a week at the NRH, I went home for the week­end. Sud­denly I be­gan to feel re­ally sick and the left side of my head went numb,” she says. “I was rushed to hos­pi­tal and not long af­ter­wards I slumped over – this is when my sec­ond stroke hap­pened.

“I couldn’t talk or move prop­erly and the left side of my face had crum­pled, so I couldn’t move at all. I was put into the High De­pen­dency Unit where I was mon­i­tored closely as there was the risk that I might have an­other stroke.”

Un­able to move, Donoghue was un­der con­stant ob­ser­va­tion un­til she was well enough to be re­ferred to the NRH to be­gin the long road to re­cov­ery.

Thank­fully, a com­bi­na­tion of de­ter­mi­na­tion and phys­io­ther­apy has paid off and her lengthy or­deal is now a dis­tant mem­ory.

“I have im­proved greatly and am al­most com­pletely back to nor­mal,” she says. “My cog­ni­tive side is 99 per cent re­cov­ered and thanks to the quick ac­tion of my doc­tor and all the sup­port I re­ceived, I am now back to good health.”

Tr­isha (42) ‘I couldn’t speak or see prop­erly’

Tr­isha Kier­nan also knows too well the dam­age a stroke can cause. Just 42 years old, the mother of two has al­ways been an ad­vo­cate of a healthy life­style – she doesn’t smoke or drink, ex­er­cises reg­u­larly and has been veg­e­tar­ian since she was a teenager.

But an in­jury caused dur­ing a yoga work­out tore an artery in her neck and caused her to have a stroke.

“I lead a very ‘clean’ life­style, have al­ways looked af­ter my health and have been told I look younger than I am,” she says. “So when I pre­sented to hos­pi­tal with se­vere headaches, no one thought I could be a stroke can­di­date and I was told I prob­a­bly had a trapped nerve in my neck and should go home and rest.

“But the headaches per­sisted and a week later, when vis­it­ing my mum, I got out of the car and felt a strange feel­ing down my left side and then tum­bled into the house and my speech be­came slurred. My mum called an am­bu­lance and when it ar­rived she asked paramedics if I was hav­ing a stroke, but they said no as I didn’t have a droop­ing mouth.”

Tr­isha, who works as a beauty ad­viser, was taken to the emer­gency depart­ment, where she was placed on a trol­ley un­til she was fi­nally seen by a doc­tor, who re­alised she needed ur­gent at­ten­tion.

“I was left on a trol­ley for 72 hours and couldn’t even get off it to go to the toi­let,” she re­calls. “The staff thought I had a mi­graine and were treat­ing me with parac­eta­mol un­til a doc­tor walked by and knew from my hugely swollen left arm and the fact that I couldn’t speak or see prop­erly that I was suf­fer­ing from some­thing a lot more se­ri­ous.

“I was rushed for an MRI where it was dis­cov­ered that I had suf­fered a stroke. So I was im­me­di­ately trans­ferred to the acute unit and treated with med­i­ca­tion and even­tu­ally, when I was well enough, I started phys­io­ther­apy.”

The tear in Kier­nan’s artery was prob­a­bly caused by a yoga work­out, but con­versely, it was also her love of ex­er­cise that helped her to re­cover as this, com­bined with sheer de­ter­mi­na­tion, has seen the Dublin wo­man back on her feet in less than six months.

“It’s likely that my stroke hap­pened as a re­sult of do­ing head­stands, which is some­thing I will never do again. Nor will I lift weights as, while I was in hos­pi­tal, a young wo­man pre­sented with stroke symp­toms

The av­er­age stroke kills two mil­lion brain cells every minute, so the quicker a per­son can get emer­gency treat­ment, the more of their brain can be saved

that had been caused by lift­ing ket­tle bells,” she says. “How­ever the fact that I was so fit and healthy has re­ally aided my re­cov­ery, and a month af­ter I was ad­mit­ted, I was al­lowed to go home.

“This is be­cause while in hos­pi­tal, I was ut­terly de­ter­mined to get bet­ter and af­ter the physio helped me to take my first few steps, I re­fused the aid of a crutch as I didn’t want to be­come re­liant on it and I also did squats be­side my bed – some­times for the whole day.”

Once dis­charged, Kier­nan made it her mis­sion to get back in shape and re­turned to the gym as soon as pos­si­ble – this along with a healthy diet and mind­set is what she cred­its her re­cov­ery to.

“I got back into the gym as soon as I could and even though there were days it was so hard, I kept push­ing through,” she says. “A lot of peo­ple are put on anti-de­pres­sants af­ter some­thing like this, and although I have had plenty of dark days, I am de­ter­mined to deal with it my own way with ex­er­cise, a healthy diet and plenty of fresh air – I be­lieve that this is the best way to re­cov­ery.

“I still have some is­sues from the stroke which ac­tu­ally af­fected both sides – I have no sen­sa­tion in my right side and con­stantly feel cold there, while on my left side, I fre­quently get a burn­ing sen­sa­tion. My short-term mem­ory is also dam­aged but I hope this will im­prove with time and I of­ten ex­pe­ri­ence a fuzzy, con­fused sen­sa­tion.

“I have an MRI this month which will de­ter­mine where I am on the road to re­cov­ery and while I am not out of the woods yet, I am do­ing well. But I think it is very im­por­tant to ac­knowl­edge that stroke can af­fect any­one of any age and doesn’t al­ways fol­low the clas­sic pat­tern – so my ad­vice would be to get help im­me­di­ately if any­thing seems wrong.”

Dr Angie Brown, con­sul­tant car­di­ol­o­gist, agrees and says de­spite the im­age that stroke af­fects only older peo­ple, one-third of strokes hap­pen to peo­ple un­der 65. And, as the av­er­age stroke kills two mil­lion brain cells every minute, the quicker a per­son can get emer­gency treat­ment, the more of their brain can be saved.

“The re­al­ity is that a stroke is a med­i­cal emer­gency and it’s vi­tal that as many peo­ple as pos­si­ble can recog­nise the signs and call 999 or 112 with­out de­lay,” she says. “A lot more lives could be saved and a lot more suf­fer­ers could be spared from se­vere dis­abil­ity re­quir­ing long-term in­sti­tu­tional care if more peo­ple acted on the warn­ing signs by call­ing 999.”

And while stroke is at the fore­front of this year’s cam­paign, there are also many other is­sues that cause heart prob­lems.

Ap­prox­i­mately 10,000 peo­ple die each year from car­dio­vas­cu­lar dis­ease, which is the most com­mon cause of death in Ire­land, ac­count­ing for 36 per cent of all mor­tal­ity.

Chris­tine ‘The pain is a 10’

Chris­tine Mc­Grath is aware of this statis­tic as in June 2014 she felt ter­ri­ble pain through her left arm and her chest. Although she didn’t visit the doc­tor reg­u­larly, she de­cided to make an ap­point­ment as the pain was in­tense. But on her way to the surgery, she felt a “heavy dead pain” in her arm and rang an am­bu­lance which took her to the emer­gency depart­ment and she was then ad­mit­ted to hos­pi­tal.

For­tu­nately, she was in the right place as, the fol­low­ing morn­ing, she be­gan to ex­pe­ri­ence in­cred­i­ble pain, was shak­ing un­con­trol­lably and be­gan to lose her speech: she was hav­ing a heart at­tack.

“The nurses kept ask­ing me what the pain was like and I kept gasp­ing and say­ing it’s a 10,” she re­calls. “My whole body went into shock and the nurse gave me an in­jec­tion which made me feel bet­ter im­me­di­ately. Later that day I had two stents in­serted: it was all a big shock.”

Mc­Grath spent 10 days in hos­pi­tal and found it dif­fi­cult to walk upon re­turn­ing home – but has re­cov­ered well over­all, apart from a con­stant pain in her lower back.

Every day hun­dreds of peo­ple in Ire­land are di­ag­nosed with heart dis­ease and Chris­tine comes from a large fam­ily with a his­tory of the con­di­tion – her mother has angina, her fa­ther un­der­went a quadru­ple by­pass and her brother also has had stents in­serted.

She also smoked right up un­til a few days be­fore her heart at­tack so is now a to­tally re­formed smoker. For­tu­nately, 80 per cent of this dis­ease is pre­ventable and quit­ting smok­ing is just one of the ways in which risk of heart dis­ease and stroke can be min­imised.

PHO­TO­GRAPHS: DAVE MEE­HAN, MARK ST­ED­MAN

Left, Tr­isha Kier­nan, who had a stroke at the age of 42 and will never do head­stands again; be­low left, Karen Donoghue with her mother, Mar­garet, who brought her to the doc­tor; be­low right, Chris­tine Mc­Grath, who had a heart at­tack and still has con­stant pain in her lower back.

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