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Tony Saunders: Stroke survivor

6 Sep, 12 | by BMJ

One afternoon, 12 years ago, I was doing some gentle exercises in the local gym. I was adjusting the rowing machine when, suddenly, my vision blurred and I fell sideways hitting my head on the floor. The woman on the machine next to me shouted “don’t move.” “Stupid idea,” I thought “I must get up,” only to find that I was unable to move.

The trip in the ambulance and my passage through casualty to the ward are a blurred memory. I woke in a side room and became aware of a weakness in my right side and being unable to speak. No matter how hard I tried to talk I had lost the ability to do so. I was very distressed and panicky as a result, particularly when I had visitors and was unable to communicate with them.

Over the next few days I had regular physiotherapy, and the weakness in my arms and legs gradually improved. Finally I regained my strength and was able to drive again.

My speech, however, was problematic. The speech and language therapist was very helpful, encouraging me, and setting me tasks. What I found worked best was to think about what I wanted to say, practice saying it in my mind, and then to attempt to say it out loud. It was a slow process. One of my colleagues said that I sounded like a Dalek! But with continued practice, and focusing on rhythm and cadence, my speech improved.

After the stroke I felt very tired, and found it easier to let people talk to me—a skill useful in my role as a psychiatrist. My speech was worse when I was tired, anxious, or after a drink. Luckily, I can now drink again without the dreaded effects.

My MRI scan showed a partial dissection of my left internal carotid artery and an infarction of my left middle cerebral artery. It so happened I had been visiting an osteopath for severe headaches, and had had vigorous manipulation of my neck a couple of weeks previously. This probably triggered my stroke.

Through contact with “Different strokes” and the “Stroke association,” I learned to think of myself as a stroke “survivor,” and not a stroke “victim,” which was helpful in regaining my confidence.

I had sessions of acupuncture and reiki. Did they help? At the very least they made me feel that I was doing something active towards my recovery. I have taken omega 3 capsules since my stroke. Many of the parents of children I was treating with ADHD, conduct problems, and dyslexia, swear it makes a difference to their children’s behaviour. I keep taking them, I think that they have made a difference, but it may be just a placebo effect. There could be scope for a research project here.

I was surprisingly desperate to return to work as a child and adolescent psychiatrist, believing I would make better progress and feel more normal. In the event I went back after five months. It was too soon and I struggled at first. I found myself hesitating to talk at meetings, and sometimes stuttering, and envying colleagues I had previously thought rather garrulous.

My recovery has taken place over several years, with the maximum progress being made in the first few weeks and months. I am now left with a small false aneurysm at the level of C1 in my internal carotid artery, and an intermittent problem with my spelling.

I wanted to be able to share my experiences, but at first found that when I gave a vivid account of my stroke I imagined myself back in the ward and becoming anxious, stuttering, and losing my place in my narrative. A form of post traumatic stress disorder I eventually realised. Time and distance from the event has stopped this from happening.

I have given regular talks to medical students about what it was like to have a stroke, what helped in my recovery, and the rare, but significant, risk of neck manipulation. I think that they listen because I am a doctor as well as an ex-patient.

I was asked by Ann Ashburn, professor of rehabilitation at Southampton General Hospital, to talk at the second UK stroke forum. After that I was invited to speak at the launch of the results of the Royal College of Speech and Language Therapists nationwide this took place in the House of Commons. I had an extremely dry mouth during my talk.

I know that I am one of the lucky ones, to have been able to return to work after a stroke. I try to celebrate survival on birthdays, anniversaries, or whenever there is any cause for a celebration.

Tony Saunders is a retired consultant in child and adolescent psychiatry, Southampton child and adolescent mental health services.

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  • Pamela Ashurst

    Brave and helpful to share an informed insider’s experience. Doctors need to know what it feels like to recover from debilitating episodes of illness, and to live with the consequences. This is an antidote to the recently stated view that speech therapy doesn’t have much to offer in stroke rehabilitation.

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