Tuesday, 15 February 2011

Brain flakes

On the morning of Sunday 6 February I went to my computer to look up the route to my son's lunchtime football match on Google maps. I reached for my cup of tea and found that my arm felt heavy and weak, and I did not quite trust it to carry the cup over the keys without spilling it.

I felt a numbness in my face - around the mouth and on the right side of my jaw. It tingled as it does after being given anaesthetic at the dentist. There was a long moment of refusal - of refusal to accept that this was happening to me; a pathetic attempt to mentally run away from the reality of it.

Then I got up and went downstairs. My wife walked towards me in the kitchen and what I wanted to say was 'Don't panic. Don't freak out. But there's something wrong with me and I think it may be serious.' But what came out was slurred and garbled by my anaesthetised tongue. I couldn't speak.

My wife rushed to ring 999 and they told her to get me to lie down and wait for the paramedic who seemed to arrive within seconds of the call. He examined me and I think it was he who first let the word 'stroke' float out into the air like a black balloon, though it had been with us all the time.

The ambulance arrived whilst the paramedic was still running his checks. My speech had mostly returned while the paramedic was there, but had gone again by the time I was leaving the house and getting in the ambulance. This transience was somehow more frightening. My wife came with me and we left our poor, startled son back at the house on his own.

I lay on the bed in the ambulance watching the trees and rooftops going my, trying to keep a mental note of everything. It was a strange, dreamlike view of a route I knew so well. I tried to fill the awkward silence by chatting to the ambulance men, but I just could not form the words. My wife mouthed the words 'Don't talk,' and I gave up.

I was moved from ambulance to wheelchair and we waited in the reception at A&E until someone came to collect me . The emergency doctor in A&E was exactly the kind of person you want in a situation like this - he was kind and thoughtful, making sure that he made eye contact with me and my wife and explaining every part of the process, and he gave off a comforting aura of being very, very good at his job.

I was back in a bed now and now and had a cannula put in my arm. Pads were stuck all over me and wires connected to them for the ECG. The first of many blood tests and blood pressure checks were taken. I was given a large dose of aspirin and swabbed for MRSA.

The doctor went through a whole set of strength, coordination and spacial awareness tests. I had to push against him with my fingers, with my clenched fists, with a bent arm, with a straight arm - and then I had to pull against him. I had to do similar things with my legs and toes. I had to follow his moving finger with my eyes and he checked my peripheral vision by waggling his fingers above my head and down at his sides and checking if I could see them. He tested my reflexes with a rubber mallet and ran the point of the handle down the soles of my feet (which is excruciating!). I had to point to finger clicks with my eyes closed. I had to touch my nose with my eyes shut with alternate fingers. I had to touch my thumb rapidly with alternate fingers of the same hand and 'play the piano'.

And there was a definite difference between the two hands. My right hand - the hand I use - was slower, weaker, clumsier. The doctor told us that some sort of mini stroke seemed the likeliest explanation, but they needed to take a CT scan to confirm.

The CT scan involved lying on a moving bed with a socket for my head to rest in, that rolled me into tube. I closed my eyes on entering the scanner - as instructed - but wasn't sure whether I was allowed to reopen them, so kept them shut. All I could hear was an escalating hum or roar - like a kettle coming to the boil beside my head.

I was then warned that I was about to have water injected into my arm via the cannula I had been fitted with in A&E. A small voice inside the machine said that the injection was about to start and then I felt warm water go into my arm, spread up my shoulder across my head and chest and then down my abdomen and thighs until I felt as though I had just wet myself. One of the strangest sensations I have ever experienced.

A neurology consultant came in to see me and went into the booth to look at the scans. I was taken back to A&E and to my wife who was still waiting there. The consultant followed me down and we had a chat about what may have caused what they could now see was definitely a stroke.

In someone of my age and fitness, one of the probably causes of such a mini stroke is a carotid dissection, or tear to the arterial wall, resulting in the production of clots that are sent up into the brain. It could also be the result of a narrowing of the artery and depending on what caused the stroke, I was told that I may have to have surgery to replace the artery or to put a balloon inside it to widen it, or I may get away with the condition being controlled by drugs. To find this out, I would need an MRI scan.

And so I took up residence in my hospital ward. I was in a bay with two other men, both of whom were neurosurgery patients and in far worse shape than me. The night was filled with noise: the voices of the nurses as they went about their tasks and chatted and laughed outside my door, the shriek of monitors followed by the sound of running feet, the door alarms set off by a tagged patient and his frequent attempts to leave and his angry protests at being prevented from doing so.

I was wakened at six the following morning by a nurse saying, 'Where are you?' This threw me completely.

'I'm sorry?'
'What is this place,' she said. 'Are you at home or in a hospital?'
'Sorry - I have no idea what you are talking about,' I said.
'This hospital,' she said. 'What is the name of it?'
'Addenbrookes,' I said. I felt like I had tumbled into a Kafka short story.

She smiled, satisfied. She had simply been checking that I was not confused. By confusing me utterly. In fact I thought she was confused and was beginning to be concerned that she was in charge of the drug trolley.

The dreaded routine of the hospital kicked in. Six o'clock and I would have the first of my blood pressure and pulse checks. They would be repeated every four hours during my stay. Cleaners swept and mopped. I was given my morning dose of aspirin and then the breakfast trolley arrived. Nurses did their handovers at seven. The clock on the wall would have seemed broken had it not been for the blood red second hand juddering round. Time dragged.

'What would you like?' said the Polish lad who delivered the breakfast.
'What do you have?' I asked.
'We have cornflakes, Weetabix, brain flakes. . .'

Brain flakes? Did he really say 'brain flakes'?

'I'll have bran flakes,' I said. How could I resist?

He went to get them and handed them to me.

'Here are you brain flakes,' he said - then shook his head and hurriedly corrected himself. . .'Bran flakes.'

Was he simply mispronouncing the word or was he trying so hard not to say the work 'brain' that it blurted out? I don't know, but it cheered me up immensely every breakfast time.


  1. What an utterly horrible experience, Chris. I sincerely hope you won't have to go through that again!

    I'll never be able to eat brain flakes now without thinking of this anecdote. Thank goodness for comical silver linings:)

  2. Ah Chris, the warmth and humanity of reading this is so reassuring - so, so glad you are on the mend x

  3. How frightening. So glad you're on the mend.

  4. Absolutely terrifying, Chris. So glad you are recovering, and hope all is done to prevent this from happening again. Love the 'brain flakes'!

  5. A very moving piece of writing. Thank you. And I do know what that bottom of the foot test is like, after sciatica they often do that test on my feet. Even on the numb one it is excruciating. My toes are curling thinking about it. Or they would if they could :-)

  6. Thanks everyone. I'm slowly adjusting to the new me - the one that has to 'take it easy'. I still can't quite accept that it has happened to me and just wish it hadn't. But it did and I have to get used to it. A week in a neurology ward is a good place to see that many people have it a lot worse.

  7. As everyone says - an extraordinary piece of writing about a horrible experience. Wishing you well, and hoping that no more treatment is needed.

  8. My father had a major stroke in 1998. It was a horrible time, from the weeks in hospital when he didn't know who he was to the time afterwards - he and my mother spent years waiting for the next one, refusing to plan ahead, never booking a holiday in case he died, basically holding their breath.
    If you met him now, you'd never even know he'd had a stroke. His memory isn't great, but then, he's always been rubbish with names.
    It sounds like technology has improved even since then and I hope you never have to experience something so awful again.

  9. Thanks Keren. Loved your piece on Martin Amis by the way. And Bryony, I think I am the beneficiary of a change in thinking about strokes and of a drive here in the UK to alert people to the difference it makes if you catch a stroke early. People can ignore a mini stroke because it is transient and then suffer a bigger one later. I was very lucky. I am so pleased to hear that your father has come through his experience so well.

  10. It's a horrible thing, it happened to my hubby a couple of years ago, but slightly differently. He lost the ability to speak, but didn't seem to realise. Scared the s***t out of me, I thought he'd gone gaga as he was wandering about going 'raa, raaa, raaa'. It took 24 hours before he could speak again. Then we had to bust him out of hospital, but that's another story.

    Take it easy and you'll soon be back to normal.

  11. Actually Mary's husband here. After a heart attack I can see and feel everything you have been through. From here there is only up although at times you may feel the opposite - I promise it will all lead up. I connected with a friend who had had a stroke and I unloaded when I needed to - it helped me no end.

  12. Good to hear that your husband is OK now, Jackie. I think it's scarier for spouses and children and friends. And thanks too, 'Mary's husband'. Thanks for the positive thoughts. And I hope things are good with you now.

  13. I'm so glad you're feeling better, Chris. I'm sending lots of positive vibes your way, in the California way. :)

  14. I'm picking up good vibrations. . .Thanks!

  15. You are a lucky chap. A mini stroke and immediate and expert care. I'm so pleased that things are looking very good for you, Chris.
    But how very alarming it must have been for ALL of you.
    God Bless the NHS, say I!

  16. Only just spotted these posts...hope all is as good as it can be and that the things that need to get better start getting better soon :)

  17. my god! what a dreadful experience. i hope you are doing much better