No two strokes are the same

We mark World Stroke Day on 29 October – close to the second anniversary of my own stroke.

It has not been the easiest of times, to realise that a healthcare professional can be struck by the syndrome caused by a major event, which many among our present and past patient population have had. The cause is not always clear, but a stroke causes the trillions of neurones in our central nervous system to be either starved of oxygen in an ischaemic stroke or poisoned by blood in the case of a haemorrhagic stroke.

As physiotherapists, we are aware of the visible symptoms of stroke and we aim to approach patients with full courage to show them our support, encouraging them to reach beyond their body awareness and set neuroplasticity into motion by moving the body parts they may have lost control over. 

In children, this neuroplasticity can happen much faster as a growing nervous system will benefit from good modelling.

But the invisible symptoms of stroke are much harder to grasp. There have, among my support group, been some reports of poor practice where their rehabilitation was made difficult due to a lack of understanding about their symptoms. In some cases they were told to just push through their tiredness or to lift a limb they didn’t even feel they had any more due to lack of sensory awareness.

I have been lucky that I was surrounded by an excellent team who understood my invisible symptoms, such as the pain and the brain fog and most importantly the fatigue, of which I did not have any understanding prior to my own stroke. Yes, I knew the word related to many other conditions but I would not have connected it with stroke. 

Central post-stroke pain syndrome has been my worst enemy, along with the fluctuation of symptoms, occasionally cropping up so high under the influence of fatigue that it nearly felt as if I was having another stroke. 

Not every stroke apparently presents with those typical symptoms that one sees in television adverts and therefore even a healthcare professional can be in denial about having a stroke themselves, when confronted with a slow onset of atypical symptoms of dysphonia, dysphagia, tingling sensation on one side of the body and drooping face on the opposite side. 

In my case the symptoms then gradually worsened to show ataxic gait, nystagmus and extreme dizziness; by that time I was feeling pretty rough, but was still not acknowledging that this was a stroke. I felt like a fraud right up until my diagnosis. But an MRI confirmed I had Lateral Medullary syndrome (Wallenberg Syndrome), caused by a clot in the medulla oblongata.

The invisible symptoms of stroke are much harder to grasp. There have among my support group been reports of poor practice where the rehabilitation was made difficult by lack of understanding for their symptoms.

In the last 21 months since my stroke, I have been able to pick up my professional and personal life and piece it back together. I have warmed to using my lightweight wheelchair with my four-year-old son sitting on my lap and my partner standing by me and stopping me from tipping back, when taking a kerbside, literally and figuratively speaking. 

I have been fortunate to find a welcoming employer who saw the potential in me even when I was interviewed about three months post-stroke. 

Having survived the event shines a different light on my identity as a physiotherapist. I am determined to spread the word among colleagues and patients that I feel with them and that my stroke makes me more of a physiotherapist, rather than less of one.