Interview Section : Healthtalkonline

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What happened? The first few days after a stroke :
The event: A stroke or transient ischaemic attack
Getting medical help
Getting a diagnosis
Early care experiences
A doctor speaks – an introduction to stroke

What problems did I have, and why? :
Changes to movement
Changes in sensations
Changes to vision
Continence and cathererisation
Eating and drinking
Speech and communication
Thinking, understanding, memory and fatigue
Emotional Impact of stroke

Why me? Why now? Reducing risk of another stroke? :
Causes and risk factors
Medication to prevent another stroke
Surgery
Preventing another stroke: Changes in life style

What happens now? Rehabilitation & care :
Stroke recovery: daily activities and personal care
Stroke recovery: physical aspects and mobility
Stroke recovery: communication disorders
Leaving hospital

Life after stroke. What is the long-term like? :
Major disability
When stroke is coupled with other health problems
When stroke happens at a young age
Coping strategies and resilience
Continuing care at home and institutional care
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Stroke

People's stories

Age 21-45

Interview 51

Interview 51

Age at Interview: 44
Sex: Male
Background: He is a married father with 1 child. He works as an accountant. Ethnic background/nationality: Srilankan/English.

Brief outline:He had a stroke due to a clot aged 38 which caused severe aphasia and right paralysis of his leg and arm. Medication: dipyridamole (blood pressure), aspirin (antiplatelet), simvastatin (cholesterol).

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Our Story
Print This man is interviewed with his wife because he has some speech problems. He had a stroke at the age of 38 he is now 44. His stroke was due to a clot in the left hand side of his brain and was due to high blood pressure that he later found out runs in his family. He now takes dipyridamole to control blood pressure, aspirin to prevent a further clot and simvastatin to reduce cholesterol. His stroke happened when he was studying hard for professional exams and was very stressed. The first signs were loss of speech. His wife initially called a member of the family who was a doctor and he came out, however her husband recovered and it was not until later that night when it happened for a second time that he was rushed into hospital. The stroke caused paralysis of the right side of his body. He also suffers from severe aphasia and can only communicate with a few words of English. His mother tongue Tamil is however better preserved and he can still sing and pray. He was in hospital for several months and was helped to get mobile again and had some speech therapy. His wife also found out about an alternative rehabilitation centre in Kerala in India which provided massage and yoga type exercise in a hospital setting. They have been twice both feel that he has made big improvements. He is very keen to remain independent and has refused help from carers. He does however attend a day centre one day a week. He also attends a support group for people with aphasia and finds it helpful communicate with other people with similar problems. He travels in and out of London independently which has been a huge achievement.

He was given sheets of cartoon drawing to help him communicate.
Print Husband: Uh huh. Cartoons, car. Wife: Car Husband: Yeah. Wife: Yeah. This is really helpful. Husband: TV. TV… cassette, CD. Can you hold it up to show the camera? Wife: Do you want to show it to the camera? So you can use the, the cartoons to… Husband: Yeah. …to point out? Husband: Mmm. Floppy. Floppy… Wife: For the disk. Husband: Disk. Wife: CD. Husband: C mmm computer… And where did you get the cartoons? Wife: From? Where did you get it from? Husband: [The local hospital] speech therapy. From the speech therapy? Husband: Yeah. Uh huh.

Her husband initially had problems recognising their daughter which she found upsetting but it eventually passed.
Print Was there, you said earlier that there was maybe a problem with your memory to start with? Wife: Yes, it was, he wasn't the beginning when he had a stroke, nearly three weeks, you know, one day it was the saddest time for me my, because my brother was asking, “Where is your child?”, “I don't know”. He says, “You don't remember the child, you don't remember me” It was the saddest time. After three weeks, slowly, slowly he was improve.

He was frustrated because he could not speak and sometimes was impatient with his young daughter.
Print Wife: Mm hmm. Only thing is before the stroke, [my husband] was such a wonderful father. He never letting sit on the floor, always he is carrying and giving, you know, and teaching her, you know, like Tamil, English and taking her to the park and everything. Husband: Library. Wife: Library, park, every day the library, park and things. After the stroke, he doesn't like the screaming noise, you know, child sometimes playful, sometimes screaming, you know. He doesn't, he said, “Take the child away from me” [laughs] and he was so angry. When he says that, then I took, took my daughter to upstairs in the room and I play with her. My mother-in-law staying with him downstairs to talk to him and giving tea, cup of tea or whatever. I play upstairs with my daughter. After few minutes later, he will be fine or after one hour later because I think the mood will swing, you know, time to time, you know. Husband: Speech Wife: That's the reason. Husband: Yeah. Yeah. Angry… speech. Angry. Ah. That made you angry? Husband: Yeah. Yes. With everybody and your daughter? Husband: Yeah. That's hard.

His wife explains that he can still speak Tamil and uses this when he talks with the family but he wants to be able to speak English again so he can be independent.
Print And do you find that it's easier to talk in Tamil than it is in English? Husband: Yes. Yeah. Tamil go-good Wife: English is hard. Second language is always hard. But he, now he's more anxious to know, he wanted to talk English more than Tamil because he thinks he's OK with Tamil, communicate with me and the child. Then he go out or he want to be more independent, he wanted to go out and do the shopping or he wanted to go himself anywhere, he wanted to talk to other people but he need English. So he's thinking if someone could help me or some, or somehow I have to talk English, and he's, very anxious nowadays. It's really hard for him. Between the family, do you mainly talk in Tamil? Husband: Yes. Wife: Tamil, yes. Husband: Hmm. Wife: Mm hmm.

He was still able to sing and pray as these long established functions of language are controlled by a different part of the brain than normal speech.
Print Wife: But what he says, he always the, says the prayers all the time. The prayers comes one by one. He used to sing in, in the temple festival, he used to sing. All the prayers come one by one but he couldn't bring the words, you know, sentence clearly. Then I ask the doctor why it's like that. Then they said the prayers in the different part of the brain, like singing prayers is different speaks. You have to bring words together. That's part of the brain is damaged for him they say. So with the prayers, can you still speak the, the prayers? Husband: Yes.Yes. Wife: Clearly. And you can still sing? Husband: Yes. Wife: Yes.

High blood pressure and high cholesterol run in her husband's family and other family members have been advised to get themselves checked because they are at risk of stroke.
Print Wife: Yeah. I think it is hard. Before we, I would tell the other people, before something happens, you have to be look after your health first, you know. You have to help, at least you have to go for the regular check-up. Like [my husband's] family, they all have this cholesterol problem or high blood pressure. It's a family hereditary. My brother advises as a doctor, he advise every 6 month his family need to go for the check-up, every 6 month they have to have a blood pressure test and a cholesterol test as well. So something happen after that, we can't bring him back as 100 per cent as we possible but we try to avoid other stroke. We can prevent but we can't do anything about it, yeah, and we have to be, whoever look after the person need to be patient. Time is the healer, I think so.

Part of their culture is to help the less able when they are struggling, but the rehabilitation team encouraged her to let her husband be independent.
Print Initially how did you manage? With a… Wife: Having a bath and all? Husband: Em. Wife: Bath. Husband: Hospital Wife: They, they help. Husband: They. Yes. Wife: The four month rehabilitation, because I can't stay with him, I only go for a certain time and sit with him and talk to him and when he was sleeping and all this, they said I know your feelings but try to be independent, you know, don't help him a lot, you know, he need to be independent. That's the way they treat him, you know, they, they want him to do many thing as possible, you know. So I always, because in our culture, we always, you know, as soon as somebody is struggling, we trying to help them, if he can't drink so I, we are feeding, we are trying to feed him and they said, don't treat him like a child, let him do it, you know, and I remember that. So you were encouraged to wash yourself? Husband: Yeah. Yes. And was that good? Husband: Yeah. Yes. Yes. Husband: Hmm. Wife: And still when I go to the festival or wherever I go, take him, people said he's going to fall, you know, why can't you go with him but the thing is he doesn't like to treat him as a child, you know, somebody is behind me, it's irritate for him, you know. So I remember his feeling the beginning I was behind him all the time but he doesn't like it at all, you know, when I walk behind him and we I try and help him, he doesn't like. So nowadays I be calm and sit and I let him do whatever he wants but people think I'm not interested to help him or what, why can't you go and help him but I know his feeling. He doesn't want help, you know, it's irritated for him, isn't it? Husband: Mm hmm. Wife: He doesn't like it at all [laughs].

His stick gives him confidence for longer distances because he knows it is there if he stumbles.
Print And how is your walking now? Husband: Walking, I… walking road… slowly, slowly. So you can walk? Husband: Yes. In the house? Husband: Yeah. Library. Library… Walk. Wife: Around 20 minutes he can walk round. And do you use a stick at all? Husband: Yes. Yeah. Stick. Yes. Yes. And what's good about the stick? Husband: Balance. Balance stick. Wife: Confidence. Husband: Confident. Wife: Without, without stick he is… you know, stumbles sometimes. But with stick, he is more confident. Husband: House stick not… me walking sticks. Wife: Outside of, you know, he need it more. It's like glasses nowadays, you know, it's very important for him. One day he will forgot to take the stick and he was so upset. We went to Switzerland to see my family and he was so upset. We forgot, early morning flight, it was early morning, 5 o'clock or something, so we left the stick at home. It was so, he was so upset, then my brother bought it, stick over there and after that he become calmed down. It's like glasses, you know, it's like one of the part, one part of his, part is like that, you know. It's very important.

They felt the speech therapy had been excellent are encouraging their daughter to train as speech therapist.
Print Wife: He had a, yes, the therapy, you know, he had a speech therapy, is wonderful, you know, the lady was so, so nice with him and then, you know, they tried their best, you know. I know it's really hard with stroke people, you know, they get angry quickly, you know, they very patient with [my husband] and it was, yeah, it was, you know, they start from 1, the numbers and little, first they start with signing, you know, he signed, you know, he forgot the signs so they said start from the beginning, so they started the sign, how to sign [my husband], so he started slowly and after that numbers slowly one by one. It was wonderful. Respect the speech therapy more than the doctors, you know. I was sitting with him and I will see how they, you know, bring the words out from the people, you know, who cannot speak, you know, very patiently, so this, is not, this is not, because we try and help him but they are trying to bring the words from, you know, them first, you know. It was wonderful, this is really. I respect them and that, you know. Really amazing job speech therapy I told my daughter one day if you could, you could become a speech therapist. Yes.

Finds it helpful to go to Connect meetings to discuss news and other issues and to share experiences with people who have the same problem.
Print And how about Connect? Can you talk about Connect? Husband: Yes. Wife: Yes. Husband: Speech. English speech… Wife: Mainly he want to know the paper, newspaper, what's going on, he want to know all the newspaper, what they say and I think he likes the communication group or news. Husband: Uh huh. Wife: And I think they sit together and the tea speech therapy explain about one topic in the paper, you know. He's quite, quite interest in sports. He loves cricket and sports or anything they pick about some time with medical, about stroke or something or, yes, he's quite, he said it's worth it to go there. And is it helpful to meet other people with communication problems… Husband: Yeah. …at Connect? Husband: Mm hmm. Good to share your experiences? Husband: Mm hmm. Wife: I think after the stroke he likes to be mingle with the people who have the same problem I think so. He likes to go these. Husband: Register. Wife: OK. He used to register the people who attend the class [laughs].

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