I would say it was an early start at 6am with nurses entering our room but I am not sure I managed to get much sleep the night before as several of the other Stroke patients were not as fortunate as myself and either clearly did not know that they were in hospital let alone why, with dedicated nurses sitting beside their beds caring for them 24/7 or other patients were fully aware what was happening to them but not able to communicate very well.
The “crash” alarm went off a couple of times in the night with patients requiring urgent assistance and every two hours there was the interruption for blood pressure and oxygen level checks needing to be taken from everyone. One crash alarm will remain firmly in my mind as I heard a lot of noise and what seemed like a patient punching and kicking his bed, the nurse called for assistance by pressing the alarm button which meant the lights went on and around 8-10 doctors and nurses entering the ward, on calming the patient down it transpired that he was very frustrated that he was unable to articulate that he would like a coffee rather than a tea. Being able to communicate is something we all take for granted but to suddenly lose this capability must be one of the most frustrating things to experience. Something I am grateful to have only personally experienced for a very short time after my Stroke but to witness someone’s frustration first hand will be something I shall never forget.
I remember managing a couple of hours sleep, however by 05:30 am (and for those that know me food is reasonably dear to my heart) the smell of breakfast was fast starting to reach my stomach. My thoughts were on a full English but the nurse had other ideas as the board behind the bed said liquids and soft food only which ended up as tea and soft Weetabix for me.
After breakfast it was like a whole new world opened up to me as I do not think I have met so many medical professionals in one morning! By 9am I had seen the Stroke Consultant, Doctor, Nurse, Physiotherapy, Speech and Language Therapist and Occupational Therapist.
The Stroke Consultant visited with a Doctor, to discuss with me that I knew and understood what had happened and to answer any questions that I have. He confirmed that the CT scan of my brain showed a Right Cerebellar Infarct (Right POCS) which correlated with my symptoms of slurred speech and balance issues and that if it was not for my Doctor making sure an ambulance came for me and arranging a CT scan that my Stroke may well have been misdiagnosed as Vertigo and sickness. So I had my new Doctor to thank who I had not met or even spoken with previously.
The physiotherapist wanted to check my strength and coordination first followed by a separate balance test. Strength and coordination was a series of gripping and pressure tests along with touching your nose and then touching a moving finger of the therapist as fast as you can, running your right heel down your left shin and vice versa. It was not until the therapist said follow my finger that she stopped and said she would come back later, I asked why and she said “I lost you then, your eyes went all over the place” so I lay back down a slept for a short time.
The physiotherapist returned later and asked if we could try going for a walk to the end of the corridor and back. So I sat up on the edge of my bed and put my feet to the floor which all seemed great, however I then noticed that if I did not focus on directing each part of my body to stand up from the bed and keep focused on the process of walking, it did not feel like it was going to be an easy task and I grabbed the wall and physiotherapist for some stability and then proceeded to instruct my legs that they were to walk one foot in front of the other. I was a bit wobbly to start but my legs seemed to pick up the idea fairly quickly and as long as I did not change my focus to something else I was good to slowly walk up and down the corridor and eventually without support from someone or reaching for the wall.
I had an extra incentive to walk unaided and make sure all therapist were happy as the Stroke Consultant had told me that medically he was happy that there was nothing further he could do in hospital that could not be followed up with Outpatient care and so there was a good possibility that i could be home for the evening subject to the physiotherapist and occupational therapist being happy.
My speech had stopped slurring and had fully return however it was clear my brain was recovering as I had to pause to consider any response to a question as my mouth was using words which had absolutely nothing to do with the conversation which became even more evident when I sat down with the Occupational Therapist and tried disusing my Stroke experience.
The first task given to me by the Occupational therapist was to go into the kitchen and make a cup of tea! how easy is that I said to myself? Well before the Stroke everything was spontaneous and what I did not realise was how clearly all the stages the brain goes through from hearing a question or instruction to answering or performing a function became.
1) Hear it
2) Remember it
3) Understand it
4) Find the words
5) Put a sentence together
6) Tell your muscles how to move
7) Say the words or Perform the function
If you apply this to making a cup of tea you have to pick the kettle up, take it to the cold water tap, open the kettle or take the lid off, turn the tap on and fill the kettle up, close the kettle lid and put back on its base or plug it in, switch the kettle on, find a cup – remember these are in a cupboard, find a tea bag – remember these may be in a pot or box, get the milk – remember this is in the fridge, Once the kettle has boiled, pour hot water into the cup and over the tea bag, allow the tea bag to steep, remove the tea bag – find the bin, add milk and sugar and then stir the tea. Tea made? I remember my brain breaking down the full process stage by stage until the tea was made. With tea made I thought excellent job done! until I went to drink from the cup!
I found I could pick the cup straight up but I could not bring it to my mouth to drink from it. When I then focussed on trying to bring the cup to my mouth my hand would shake like it was in spasm and the tea would go everywhere, so I had to steady the cup with my left hand and using both hands I managed to bring the cup to my mouth and drink it. We all take for granted the process of making a cup of tea but now it was clear to me that I was only able to focus on the one thing at a time and so any action was broken down by my brain into each individual stage, stages that from birth I had learnt to simply do spontaneously .
Moving my hand to the cup was first, I then had to focus my effort on grabbing the cup, if I did not raise the cup straight up my hand would shake like crazy. So picking the cup up was fine but bringing it to my mouth was not possible without the assistance of my other hand. The therapist explained that it was great that my brain had worked out how to achieve bringing the cup to my mouth and that in time my right hand may well recover but it was also fine to use two hands if that gained the desired result. All ready my brain was realising my issues and working with me to find a new way.
The therapist then produced the Oxford Cognitive Screening test. Wow having sat a Mensa Exam in the past, you will not believe how difficult the cognitive screen questions are after having a Stroke. If you think about the process the brain goes through to actually answer a question then you might appreciate why the most basic questions are hard to answer.
I was pleased to be able to answer that 3 + 6 = 9 but when I was asked what is 36 – 17 my mind went completely blank, not only could I not think of the answer I could not think of how to work it out. I understood the question and knew I should know the answer or at least how to work it out. Then my brain said to me that two 18s equals 36, as 17 was one less than 18 it must mean that the other missing number would be 19 as it would need to be one more than 18?. So I said 19 not really knowing that to be the answer or really knowing why. Again it was clear that my brain was trying to learn new ways to achieve the end result. The therapist said at this stage it is not how long or how you arrive at the answer it is that you can understand the question and find away to the answer. It may be your brain might need to reprogram and work things out in a different way.
I was then given pictures to name and other cognitive and memory tests to achieve.
If you would like to see more of this screening then take a look at the below You Tube video.
I had a break after all this and then another physiotherapist turned up at my bedside to ask if we could do some balance and stability tests, which involved me walking in a straight line , move around the room and operate as best I could. We went to the physiotherapist room which had stairs with rails either side, walkways with handrails and benches etc. All the test were to check my balance and ability to walk in a straight line, up and down stairs, stand then bend down to pick up a pen amongst lots of other tests all of which were to check my ability to function on my own and it was ok if something was a challenge that my brain recognised this and I worked out a way to achieve the end goal.
By 4pm all the various departments had given me the green light to return home and continue my recovery with the help of lots of booklets, guidance from the team and Outpatient check ups.
My wife collected me from hospital and we returned home for some sleep………….