Stroke, also known as a cerebrovascular accident (CVA), cerebrovascular insult (CVI), or brain attack, is when restricted blood flow to the brain results in cell death. Of course prevention is always better than cure as treatment after an attack may be limited in its effect. The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including high blood pressure, cigarette smoking, atrial fibrillation and physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. But this is a real story about my experience of a stroke attack, not an impersonal medical explanation, but an account of what may happen to you. I had just started on a long-haul flight and reading a book as my usual time-waster. I became aware that my left hand had become numb and lacked feeling.
That was a bit strange; shaking the hand and flexing my fingers had little effect. After contemplating this dilemma for a while, I attempted to stand. I say ‘attempted’ because I soon found myself collapsing back to the seat. The weakness in my legs (mainly on the left) was overwhelming. During this time there was no pain or other trauma, just no control over these limbs; helpless. It was another 6 hours in flight plus ground transport and the usual waiting time before I was home. Managing the disembarkation from the various forms of transport was a bit bizarre, culminating with me on hands and knees on the footpath before the final taxi home. I was waiting for someone to accuse me of public drunkenness (‘legless’) ………… if only! Then to hospital, but maybe too late. I now know there is a 4 1/2 hour window when blood vessel dilation medication can be effective. This is the time limit for dissolving a clot and improving blood flow to the effected part of the brain. I could see the disappointment on the doctor’s face when he learnt of the time delay. In hindsight I was feeling ‘strange’ a couple of days before the main event, so maybe my error in not seeking a medical opinion then.
Next tests, tests, test and still more tests. X-rays, cardio scans and multiple blood pressure and heart function assessments. The focus during this phase was clearly about the possibility of a further stroke, not treating what had happened. Overnight in the Intensive Care Unit was a part of that concern. The most memorable part of the story was the Magnetic Resonance Imaging (MRI) Machine experience. Just imagine being on your back with your head held motionless by a fixed ‘Darth Vadar’’ helmet before sliding into an enclosed tunnel with the walls less than 100mm from your face ………………… for an hour! You are also bombarded with electronic sounds; sometimes similar to those colourful ‘disco buses’ or maybe a new age hydraulic drill. This is a claustrophobic’s worse nightmare and for some a sedative is required. After an initial phobic attack, I decided that pressing the panic button would be ridiculous.
However I needed a strategy, a psychological diversion and I couldn’t read a book. My answer was to start writing this story in my head as a way to let everyone know how wonderful it was …………………………………… when it was over! The MRI experience alone should be a big enough deterrent when you are about to break the lifestyle rules. It’s the stuff of nightmares. The good news was that there was no unexpected bad news. I am now home with my hypertension drugs and I’ve purchased a home blood pressure monitoring machine. I have an appointment with the neurologist at the end of the week when I hope to understand more about the test results. Then maybe some physio to get my pathetically weak limbs to obey instructions.
We’ve all read the life-style causes of stroke in medical warnings and I cannot really add to that. However monitoring blood pressure at home and proactively seeking hypertension medication is often not on the radar. A home monitor is simple to use and inexpensive (around 2,000 THB). It may be a very wise investment. Note: If your sober friend can’t raise an arm or walk anymore, take him (or her) to the hospital NOW!