Strokes and Suicide

Is there a typical stroke victim?

In current discussions or articles on strokes great emphasis is put on lifestyle. In order to minimise the risk of a stroke we are all encouraged to give up tobacco, moderate alcohol intake, eat healthily and take regular exercise and watch our weight. All of this is sensible advice if we want to live a long and active life but unfortunately strokes cannot discriminate between those who do and those who don't follow this advice. Strokes can affect anyone regardless of the above and in my case it was my husband who suffered a stroke. Here was a man who never touched alcohol, gave up cigarettes 30 years or more ago, had a very healthy diet with plenty of vegetables, fruit and fibre and was still working in his own business and riding his horses at the age of 77. He looked a picture of health, enjoyed a great holiday last August when he went back home to Ireland for a family reunion, visited all his friends and had a thoroughly good time. I was happy for him to go and I stayed at home to look after the livestock and the business. Little did I realise what was ahead. When he came back he was very tired, which we put down to trying to do too much when he was away, and never gave it alot of thought. One month later while he was at work he spoke to me by phone as usual around 9.30.a.m and was in great form. Less than 2 hours later he collapsed with a clot on the brain.

Fortunately the girls working for us recognised the symptons and called the paramedics and he was hospitalised immediately, given a CT scan of the brain to confirm whether it was a clot or a bleed, it was clot, and because they had acted witin the crucial 2 hour time frame he was thrombolised and the clot dispersed. At this time he could not remember his own name and did not recognise me and did not know where he was and also had a slight palsy of the face and some slurring of the speech. It was a worrying time but when I visited the following day he seemed physically better but was still having memory problems, especially with names and the time and day.

Two days later a further CT scan showed a deep infarct on the left side of the brain in the cognitive area and the staff explained to me that although he presented well he did have problems. He was allowed home a week later but could not drive or go out alone as he may become disorientated but he appeared to settle into a different routine and it was, for him, a novelty not getting up early and going to work at the stables. We did go out to work but I had to accompany him and he tired quite easily but was happy to come home and rest in bed all afternoon. This was a godsend for me because it gave me time to do other things because I was noticing that he was wanting me to stay with him all the time. I had been warned by the stroke team that depression may occur post stroke and as he was already on medication for this the doctors did not consider that his depression would become worse.

As there was very little physical disability no care package was in place but he did have a weekly visit from an occupational therapist which he seemed to enjoy although could not appreciate why he had to play 'silly games and draw clock faces' . He could not understand that this was a way of opening new neural pathways in the brain to circumnavigate those that were damaged. As the weeks went on the occupational therapy sessions ceased, I suppose due to pressure on the health services and the fact that he appeared to be coping. Three months after the stroke he began to change in his outlook and started to become withdrawn and lose interest. Theses changes were so subtle at first and I did not notice them until someone who had not seen him for a while commented on this change. Admittedly he had said some strange throwaway comments that I just thought 'what a strange thing to say'. Within 2 weeks I saw that he was not taking any interest in television and the expression 'the lights are on but no-one is at home' described how he had become so I decided that he should see his doctor. At the surgery he became a different person, laughing and joking and telling the doctor that I did not know what I was talking about!

Monday 17th December last we went to the stables and saw the horses but unfortunately the landlord upset him and I realised that every minor problem ( and this was a minor problem) had become a huge insurmountable object in his mind. I was able to pacify him and we went to see another friend who had horses and who had been very kind and helpful when he was in hospital. We had an enjoyable time, a cup of tea and great chat, wished them a Merry Christmas and went home. We had lunch and he went to bed to rest and during the afternoon his daughter rang from USA. She had been having marital problems which had upset my husband and I went to tell him that I had been talking with her and that she was OK. That seemed to trigger the outburst that followed and he became very agitated and named all the little problems, money flow etc and culminated in the outburst that he could not work and therefore he was useless and this was a terrible world and he wanted out of it.

Again I calmed him down and asked him to come downstairs and have something to eat . After 5 minutes I heard him come down and he put his dog Paddy in the living room and I heard the door slam.I thought I knew what he would do as in the previous couple of weeks when he got agitated through his lack of independence I was happy for him to walk round the block to cool off because I knew that he was aware of his surroundings in the immediate neighbourhood. After 30 minutes I began to worry and set off in search but to no avail. Within the next hour the police and a dozen of the neighbours were out searching but he had vanished. Police dogs and the helicopter were used and the following day mountain rescue teams also joined in the search but he could not be found.

Christmas, his birthday and New Year came and went and still no sign. I accepted in my heart that he was no longer alive as he was diabetic and on Warfarin and statins. Twenty three days after he walked out his body was found in the river about 1 mile from home. At least we had some sort of closure but because he was missing for 23 days I was not allowed to see him and say good-bye. I have to console myself with the thought that he is now at peace because only now do I realise what a dark place he was in and his mind must have tipped that day.

If this article strikes a chord with any reader I urge you to note any changes, however small, and if possible let your loved one be seen on a regular basis by a health professional. I realise now that the stroke robbed my husband of his personality from the day it happened but I was just happy that he had no physical disability andt did not understand, or perhaps even did not want to understand, the severity of his cognitive problems. The weeks since his disappearance and death have in a way seemed unreal and only when I visit his grave does reality dawn. I will never know what actually happened on that day but I have to accept that in his right mind he would not have put us through the heartbreak and so if the sharing of my experience alerts just one person to what can happen after a stroke then he will not have died in vain.

Eleven weeks after his disppearance I have had to wind up the business and sell the horses and I signed off the stables on 4th March which made the next day, 5th March the start of a new way of life for me. Quite strange really because 5th March this year was exactly 35 years since I was first widowed at 32 years old but God is good and I am still here and coping.



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