Stroke Story

by Stephen McMahon

22 April 2021, 6:30 am

I needed to answer a call of nature. Not an urgent, 'must do now' sort of a call, but reason enough to get out of bed and start my day. It was a Thursday, bin day and I had to check that I had left the black bin out the night before. And the dogs would want out to attend to their bodily functions.

There was just one problem. I couldn't get out of bed. Something so simple, routine and automatic that it shouldn't require a lot of thought. Throw back the duvet, swing the legs out, sit there for a second or two and then stand up. Except it wasn't happening.

All I was managing to do was to thrash about on the bed and get nowhere.

What was required was a plan. If I could get down to the floor and onto my knees beside the bed I could leaver myself up using my arms and legs. Somehow I got to the floor without falling off the bed, but once there the edge of the bed seemed to be a very long way up. Not to worry, there was an armchair in a dormer alcove under a skylight across the room, much more accessible than the bed. I could use that. I squirmed and wriggled my way over to the armchair, which was hard work. My progress was further impeded by a random, seemingly disembodied arm that kept getting in the way. My right hand kept finding it, cold, someone else's, because when I grasped it there was no sensation of any arm that was mine being touched.

Thinking back this should have been a frightening experience. But it wasn't. I was becoming increasingly frustrated, angry even, unable to stand up and get on with my day. It was as if I was in someway detached from what was happening, like watching some improbable drama unfold on the TV without paying it too much attention - Eastenders? My situation was an annoying inconvenience, like going out in the morning and the car refusing to start. Using the armchair to help me to stand up wasn't happening either. I needed help.

We sleep in separate rooms. Linda, my long-suffering wife of some forty-six years suffers from insomnia. She needs the freedom to toss and turn in the bed, to switch the light on, to get up and move around the room and to read without disturbing me. When my eldest granddaughter, Amelia, enquired as to why we didn't sleep together. Linda quickly replied by way of explanation 'Papa snores!' Somewhat aggrieved I quipped 'Yeah, and Granny farts!' Not true I hasten to add, well, no more than usual, but my granddaughter's curiosity was satisfied and she had a laugh.

Could I attract Linda's attention in the next room? Very often if she's had a bad night by getting-up-time she's solid gone. If I called out, would she hear? And if she did and came to my rescue how was I going to explain why I was lying on the floor, now on my back, and unable to stand up when I had no idea myself? Close to a foot was a shiny metal pedal-bin. Could I kick it against the wall? It would make quite a clatter.

'Linda, I need help!' I cried out. That sounded feeble and pathetic I thought, but mercifully she heard me. In retrospect I'm glad that I didn't kick the bucket!

Hospital

My son in law stood staring down at me, concern written across his face. Even when I'm standing up he is considerably taller than me and all things considered I was in no position to argue. My request for him to help me stand up had been ignored.

Linda had tried, but as I was unable to move, a dead weight, she had quickly abandoned the attempt.

'I'll phone Alan' she' decided 'He'll be out walking Yoshi now.'

Alan had appeared with commendable speed and he and Linda were engaged in a conversation in which I was a non-participant.

'I think he's had a stroke' he said, 'his speech is slurred, his mouth is twisted and he can barely move his left arm. I'll phone for an ambulance '

Linda was behind me somewhere, out of my line of sight but very close to me, possibly on her knees.

'Quickly!' she replied 'his speech was okay when I found him and I would've noticed his mouth. It must still be happening!'

In an attempt to lighten the mood I tried to ask if anybody had noticed if the black bin was out, but I either hadn't made myself understood or been ignored.

Alan was now in conversation with the 999 call handler and describing my symptoms.

'Yes, he's conscious and breathing and we have him in the recovery position.'

How long since you found him? he asked Linda 'Yeah, about twenty minutes, half an hour tops. Thank you, I'll do that.'

'The ambulance is on its way' he announced. 'My car's still on the road, so I'll open the gates and bring it in out of the way and yes, I'll check that the black bin's out!' before I had a chance to ask. 'I need to turn the front outside light on and where are the dogs?' 'In the kitchen' replied Linda 'Don't be tempted to let them out while the gates are open.'

She now had a pillow under my head and I was covered by the duvet 'Just you lie there' she said as she rearranged my hair. 'They'll be here soon.'

I had nothing to do now but wait. The paramedics would get me up onto my feet and this nonsense would the be over, leaving me with nothing to do but to clean up whatever mess the dogs had made in the kitchen. They would have figured by now that something was going on beyond the normal and soon there would be strangers in the house. Excitement could well get the better of them, given they hadn't been out yet.

The ambulance appeared quite quickly and the paramedics, a man and a woman, climbed the stairs with all their equipment. They set to work with reassuring efficiency, their questions being answered by the three of us. It was good to have a little input. Once they had completed their work and satisfied themselves that not only I was still living but likely to continue doing so, for now anyway, they said that I'd almost certainly had a stroke and should be taken to hospital without delay.

There was a brief conversation about getting me down the stairs. 'If you could just help me to stand up...' 'No! You stay where you are, we can bring up a chair and get you down that way.'

Fourteen steps, straight down, no landing. If this went wrong I could be out through the front door, through the gates, past the black bin and Hillsborough bound on the A1. I was lifted onto the chair and strapped in. As I was manoeuvred out of the bedroom towards the top of the stairs Alan, chivalrous as ever, offered to take the place of the lady paramedic.

'No thanks, we're okay, we've got this' was the reply. I wished I shared their confidence, but as we made steady, undramatic progress down the stairs it became obvious that they had done this before.

Once I was ensconced in the ambulance and safely strapped in it was just a question of waiting for Linda to bring out a packed bag for me. 'I'm just going to insert a cannula while we're waiting. Is that okay? asked the male paramedic who was in the back with me. 'Just incase we need to give you anything on the way to the Royal. I wondered should I request an intravenous Black Bush? Then another thought occurred. The Royal, how long would I languish in A&E?

'Let me know what's happening' was a final instruction from Linda as she passed a carry-on suitcase into the ambulance. 'Your phone's in the bag.' The charger would have been handy, but I could forgive her for being preoccupied as she'd gathered stuff together. What was irritating was her later insistence that she had packed it.

We set off for the Royal.

'So what do you work at?' asked my companion. 'I don't. I retired in 2016.'

'Oh, good for you, so what do you do now, play golf, go fishing?' 'No, I've two Jack Russells you probably heard them!'

'Hard to miss!'

'Well, given the size of them they require an inordinate amount of exercise, so they keep me busy. And I write.'

'What do you write?'

'I've written a couple of novels.'

The day had suddenly and unexpectedly taken a turn for the better.

Once my friends and nearest and dearest had come to terms with the fact that I could construct a sentence, in fact in sufficient numbers to fill two hundred plus pages of a book, I think they understandably reached the conclusion writing was all I wanted to talk about." Don't mention the book!"

Now someone was taking an interest and I had a captive audience all the way from Dromore to the Royal. Not only that, but the stimulation seemed to have helped clear away some of the brain fog. I prattled away about characters, plots, titles, self publishing, book-jacket design, editing, proofreading, typesetting for the paperback and formatting for the ebook. It all made perfect sense to me. Whether or not it made any sense whatsoever to my companion is, however, open to conjecture. In no time at all I was advised that we would be at the Royal in a few moments and that the stroke- team were waiting for me.

It was a bit like being in a movie, all I could see were florescent lights set into the ceiling flicking past as I was wheeled along. Then I was in a room I didn't recognise as being part of A & E, a room not a curtained bay, surrounded by people peering at me over masks. A lady introduced herself to me as a consultant. Her name didn't register with me, indeed little else did, but obviously I was now in the care of the stroke team.

By this time the brain fog seemed to have engulfed me again and the sense of detachment had returned. None of this was happening to me.

I did my best to answer all the same questions the paramedics had asked and to move various limbs as instructed. 'Could I wriggle my toes?' - 'Could I feel this?' - 'What medication was I on?' That was easy. 'None' I replied. 'What, no medication at all?'

'That's right, none.' Somewhere in the background I think I heard someone being instructed to check with my GP, but it was all a bit of a blur.

Another person had appeared clutching a clipboard.

'Stephen? Can I just check your details again?' I stumbled through my address, postcode and date of birth.

'Yes, it's just that according to our records you're Frederick!'

All activity seemed to have come to a halt. Was everybody staring at me? Was I some sort of an imposter, there under false pretences?

My father wanted to call me Frederick. He was Frederick as was my grandfather and possibly my great-grandfather. My mum wanted to call me Ronald. They compromised with Stephen, but both stubbornly held onto their first choices. I was saddled with the initials F,R, and S, Fellow of the Royal Society. I could have adopted the habit of following my forename with my initials, but I've always been much more arts orientated.

On our first trip to the USA I presented myself and my passport to the immigration officer at Dublin Airport. 'First Name?' he enquired 'Stephen' I replied. He studied my passport, studied me and then my passport again. 'It says here Frederick.' I embarked on a lengthy explanation. When I was finished he drawled 'In the United States of America you are Frederick!' I could have argued and suggested what he might be known as in Ireland, but I remembered the old adage "You don't mess with Roy Rodgers." Anyway, I didn't want the distinction of being deported from the USA without actually having arrived there, so I meekly acquiesced and he pushed my passport back across the counter.

Two years later I found myself in front of the same official. What were the chances? Again he studied me and my passport. 'Oh yeah, you're Frederick who likes to call himself Stephen. Enjoy your vacation, Frederick!' How many faces, how many passports?

Having established that Frederick and Stephen were one and the same, the lady consultant behind the mask explained to me that they now needed to find out if my stroke was the result of a clot or a bleed. I was to go for a MRI scan. It was most likely to be a clot and if that was the case I would receive a clot busting injection that would restore blood supply and oxygen to my brain. I heard what she was saying, but by now I was very tired and my attitude was "whatever". Memory was starting to fade. I was still very much a spectator, not a participant. I have a vague recollection of the scan and receiving the injection immediately afterwards, via the cannula that had been inserted by the paramedic in the ambulance. Next I was taken to a ward where, I was told, they would keep a very close eye on me.

Up to this point frustration had been the only emotion I had experienced. There had been no pain, not so much as even a mild headache, no feeling of panic or fear. I remember being in the ward and recounting my story to numerous people, doctors, nurses and various therapists. I was being attended to frequently by nurses checking my temperature, blood pressure and asking me if I knew where I was. It was during one of these visits that I suddenly and without warning started to shake violently and experienced an intense throbbing in my neck. Now I was afraid, on the threshold of panic.

'You're okay!' the nurse told me in a matter of fact manner, 'Don't worry, you're just having a seizure.' As you do. The second time it happened I was equally afraid but applied the same rational as when flying. If the flight attendants are unfazed by the turbulence there's nothing to worry about. Nobody seemed to be unduly concerned ... still.

Some time later Dr Gordon, who I now recognised as the kindly and sympathetic lady consultant behind the mask, explained to me that it was just the brain readjusting itself after the stroke.

My next recollection is of being visited by two Physiotherapists. I rehearsed the events of the early morning for them, again. I was then asked if could sit up in the bed. With their help and quite an effort I made it.

'Now do you think you could sit on the edge of the bed for us?' I swung my legs out and there I was, doing what had been beyond me so many hours before. Clearly I achieved this more quickly than anticipated because I found myself sitting there awaiting further instructions. Who needs instructions? The obvious thing to do now was to stand up. Suddenly I had their full attention. 'Stephen! What are you doing?' 'I need the toilet!'

After a brief struggle I was back in bed awaiting a nurse with a bottle.

'My goodness, you needed that!' as she inspected the bottle on collection a few minuets later. Now I was up on my feet again, this time supported by a Physiotherapist on each side. We went the length of the ward and back to my bed. Once there I was warned that I mustn't attempt to get out of bed again unless I had two nurses accompanying me, one on either side. So there I was. At long last I had managed to stand up and answered the call of nature that had awoken me in the first place. All I had to do now was to get home.

Recover

I now embarked on a long series of ticking boxes. I had to be able to walk all by myself, unsupported. Once I managed to do that I had to prove that I was capable of ascending and descending a short flight of wooden steps, with handrails, that went nowhere. I needed to satisfy the speech therapist that I could swallow without choking myself and graduate from mashed potato and gravy to more solid fare. There was to be another MRI scan followed by an ultrasound scan of my neck. Of course I wasn't presented with a to do list, but this was the sequence of events over the following days.

Now that I had been standing up and walking I was convinced that I was fit to walk unaided. I'm not a deliberately disobedient person by nature, a rebel, but to quote the redoubtable Douglas Bader "Rules are for the obedience of fools and the guidance of the wise." I had to prove to myself and others that I was capable of moving about under my own steam, safely.

If two people were preparing to accompany me somewhere I would set off briskly before they were ready and have them chase me down the ward. I was not above setting off on my own if nobody was immediately available to help. This behaviour probably had me marked down as a troublemaker. One nurse in particular made it her business to keep me in check. I only had to think about getting out of bed and I was being scolded before a single toe had so much as touched the floor.

I was soon downgraded to having just one person accompany me and a day or so later allowed to go solo. Notwithstanding this I still attracted anxious looks from my guardian-angle-nurse. She was inclined to hover around in a close catching position, frowning, if I was on the move. I mastered the wooden steps successfully climbing to the small landing, turning around and coming down again on several occasions under the close scrutiny of the Physiotherapists.

Deemed fit to swallow, I eagerly anticipated the chicken and chips that I had ordered for my evening meal. Imagine my consternation when I realised that my left hand was incapable of holding a fork. This shouldn't have come as a surprise as the screen of my mobile phone looked as if it had been crazy paved, having been dropped so often, the culprit invariably being my left hand.

On the subject of my now considerably battered mobile, another frustration was the gibberish I was producing when trying to text. The endlessly patient Occupational Therapist explained to me that as the stroke had effected my left side I was frequently hitting the key to the right of the one I was aiming at. I had to have a bias to the left as I typed. Almost immediately people started to reply to my texts.

Everything seemed to be going to plan. The MRI scan had revealed that the life saving and quality of life saving injection that I had received shortly after admission had stopped the damaging effects of the stroke in its tracks.

Next I was wheeled along endless corridors and taken by lift to what seemed to be near the top of the building for the ultrasound scan of my neck. This appeared to be a routine check, no cause for concern. Talk about a false sense of security! The results showed that the carotid artery on the righthand side of my neck was over seventy percent blocked and that this had been the cause of my stroke. While there was an operation that could clear this blockage, seventy percent was on the verge of being inoperable. The vascular surgeon was doubtful.

Dr. Gordon phoned Linda to inform her of the surgeon's reservations, but of her intention to persuade him to preform the operation. In the course of a telephone conversation with me, Linda, ever the optimist, said 'Maybe there's no point in doing it!' A case of thinking out loud in the midst of a fraught conversation, but unsettling to say the least. From my bed I had a clear view of the corridor at the end of the ward.

Now every time somebody walked past I was relieved to see it wasn't the Grim Reaper.

Linda had made an appointment, as required by Covid rules, and visited me on the Sunday, bringing fresh supplies of pyjamas, clothes, my towelling dressing gown, a home comfort and my mobile phone charger. Getting dressed was now added to the difficulties I had experienced with the fork and my mobile. My venerable dressing gown had morphed from being a benign garment into an extremely complicated piece of kit which I wrestled with for ages. During the brief time we had been separated it had developed a mind of its own and was determined not to cooperate, revelling in my inability to put it on.

Sometime during the Monday morning the operation went from being off to on and was scheduled for first thing the following morning. I was to be collected from the Stroke Ward that had been my home for the last four days and taken to theatre.

During the operation my belongings would be moved to the Vascular Surgical Ward, where I would be taken to recover.

After what seemed to be an interminable wait, during which the hands of the clock in the ward seemed to be reluctant to move, I was taken to theatre. I only remember being in conversation with the anaesthetist. Next I was in an enormous area which resembled an underground carpark, accept rather than parked cars there were lots of beds occupied by people recovering from operations, myself included. Beds were constantly on the move as patients were taken off to the wards, the vacated spaces being filled by those returning from theatre. 'Is it particularly busy today?' I asked a nurse. 'No, it's always like this, twenty-four seven' she replied.

I don't know how long I was there, but it was quite a while. I became increasingly unsettled as I knew Linda would be waiting for a call and I started to worry that my mobile phone, which had been in the bedside drawer in the Stroke Ward, may not have made it to my new location, wherever that was.

By lunchtime anxiety had upgraded itself to worry. Linda had been told that I was at the top of Mr Mckeever's list for Tuesday and that I would be seen first thing. She had spent the morning not being on the phone so as not to miss a call from the Royal, a considerable achievement. Our daughter, Verity and son Andrew had been sending her messages enquiring if there was any news and around lunchtime Verity eventually suggested that maybe it was time to phone the Royal.

Linda spoke to the switchboard and after a delay was told that her request for information had been added to a list. Working on the basis that no news is good news she decided to get on with her day and advised our children to do the same.

Getting on with her day meant going to friends for a meal. She had completely forgotten an invitation to call with them for something to eat after visiting me on Sunday, so was determined to put in an appearance after a second invitation. She could take a call anywhere. It came around five in the evening. The operation had gone to plan and I was doing well. The nurse had tried contacting Linda around lunchtime, but her phone had been engaged.

In the meantime I had been reunited with my possessions and mobile in the Vascular Surgery Ward and was able to confirm that I was okay and wish her bon appétit - well for some!

It was the following morning before I looked in a mirror. The incision stretched from just below my right ear all the way to my throat and I was held together by some twenty odd staples, impressive. A nurse kindly took a photo on my mobile which I immediately forwarded to Linda. Time to play the sympathy card! Despite the spectacular appearance of my neck several people in the know declared it to be a good job. So it proved and today, some ten months later there is no visible scar.

Dr Gordon came to see me and told me I could go home the next day, Friday. I was to rest as much as possible, lie down on my bed and take a nap during the afternoon. On occasion I could feel emotional and it was okay to cry. I was to be kind to myself. I must not drive.

'On a scale of one to ten, how bad was my stroke?' I asked. 'Nobody wants to have a stroke' was the enigmatic reply.

I later told Linda of this conversation. 'Oh, she told me on the afternoon you went into hospital that you'd had a significant stroke.'

I was to spend my last night in the Royal in a ward for one, my own room, complete with an ensuite wet room, an unexpected luxury. Mr McKeever came to see me in the morning and assured me that the carotid artery on the righthand side of my neck no longer represented a threat nor would it going forward. He described the substance that he had removed from it during the operation as being like porridge. I was glad I'd had breakfast! The artery on the lefthand side of my neck was still forty percent blocked. It would clear in time, helped by the prescribed medication and no further surgery was required.

All that was left to do was wait for the pharmacist to bring my supply of medicines, blood pressure tablets, blood-thinners that also made the blood less sticky, Statins to combat cholesterol and pain killers for the pain that had never happened. Then I could phone Linda and ask her to come and collect me.

Now I could wait, relax and reflect on everything that had happened during the last week. It was hard to believe that my stay in the Royal had only been eight nights, it had felt far longer, so much had happened.

My doctor's surgery had other ideas. I've had so little to do with the surgery over the years that when we had gone for our flue injections in the Autumn Linda had been greeted like an old friend while I'd had to introduce myself. Now I'd clearly taken on a new importance.

During the week I'd been due my second Covid jab. I'd enquired if it was possible to have it while in the Royal, but the answer had been no. Now the surgery was on the phone with a reappointment for next week. No sooner had I put the phone down, or so it seemed, than it rang again and I had another appointment, this time to remove the staples from my neck. I had managed to find my pen and a scrap paper and written down dates and times, hoping against hope that I had the correct dates and the correct times. Then I got third call. This one was about an appointment for a vitamin B12 injection. I scribbled down another date and another time. But which of the three dates related to which of the three times? I was suffering from information overload. Maybe Linda would be able to make sense of it.

The clock in my ward-for-one seemed to be suffering from the same malaise as the clock in the Stroke Ward, but eventually my supply of medications arrived and Linda was on her way.

We made the long walk through the hospital to the car park. I was glad to have reached the car and to be sitting down. I was going to have to learn to adjust to my new circumstances, like being driven about by Linda. She is a good driver, but I'm a bad passenger; it's a question of driving styles. Linda doesn't like to slow down until she gets there. She could out-break Daniel Ricciardo. As we hurtled home I told her about the string of appointments and the scrap of paper that I'd left behind.

'Oh, don't worry. I've been speaking to the doctor. I've a note of them!' 'There's three of them, the Covid jab ...' I started.

'Yeah, also getting your staples out and some sort of a vitamin injection. I know!'

Home

So that was that. Home again.

It was like passing my driving test. I'd done all the lessons and persuaded the examiner that I was fit to be let out on the roads on my own. It was only then that I started to learn how to drive. I'd ticked all the boxes on the to do list and been discharged from hospital. Now my recovery could really begin.

But I wasn't focused on recovery. My first reaction was to get on with life as if nothing had happened. I was like someone who has fallen over and gets straight back up on their feet announcing "I'm okay!" But they're not okay. They've just had a fall. Something potentially life changing had happened to me and I needed time and space to take stock. Was my mindset still "This hasn't happened to me"? I wasn't ready for some period of reflection, it wasn't what I expected of myself or imagined what others expected of me. I just had to pick myself up, dust myself down and get on as if nothing had happened.

I was helped in this deception because I could walk and talk. People seeing me for the first time since my stroke had the similar reactions,

"You're looking so well! and

"You're the last person I could have imagined having a stroke!"

They seemed to be relieved. Were they expecting to find me a shadow of my former self? Yet here I was, apparently hale and hearty. The reality was, of course, rather different.

My immediate family were just happy to have me home. I had started to refer to my useless left arm as "Dead Fred", following the example another stroke victim, the late

Harry Secombe, comedian and member of the famous Goon Show, along with Spike Milligan, Peter Sellers, and Michael Bentine.

Verity's girls, Amelia, sixteen, Izzy, fourteen and Lily, eleven took to greeting me with 'Hi Papa, how's Dead Fred?'

I worried how my grandsons Perry, seven and Clarke, five were going to react to my neck and how to explain it. Andrew assured me they would be unfazed as he'd told them I'd had a fight with a shark! They weren't even slightly curious. Papa was always doing weird stuff.

Perry had worked it all out. An unusually high number of visits to our house during the week only to find I wasn't there had prompted him to ask his dad 'Is Papa in hospital?' 'What makes you think that?' Andrew asked. 'I heard mummy talking on the phone' was the reply.

My two Jack Russells are sisters, litter-mates to the pedantic. They are very different characters. Poppy, aka Ginger Russell, Pops or Poppers just wanted to jump all over me, lick my face and slip in a playful chin chomp. Petal, without any nicknames, Petal being a silly enough name for a dog brimming with Jack Russell attitude. I had wanted to call them Scally and Wag, but had been overruled by a higher authority.

Anyway, Petal is dark brown and less of a scatterbrain, more the thinking man's Russell. She had clearly decided that my absence had not been a good thing. She wouldn't let me out of her sight, following me everywhere. They had both concluded that there was something wrong with my left hand, particularly if I stroked or petted them with it. Given the chance they both licked away at the back of my hand with concentrated industry.

There was a problem with my hand. Because Dead Fred was hanging limp by my side it was pulling at my shoulder. I had left hospital wearing a sling which supported my arm at the elbow, relieving the strain on my shoulder. As a result of this lack of movement my hand had become badly swollen. Fluid was not being returned back up the arm as there was none of the natural movement which normally takes it away.

I had been instructed to frequently massage Dead Fred, working upwards from the wrist to above the elbow. I had lots of opportunities to do this as Linda was now ensuring that I got plenty of rest, sitting down. I was starting to worry that I was becoming a couch potato, addicted to daytime TV. Much later when Novak Djokovic fell foul of the Australian immigration authorities I had a very clear idea of what he was going through having watched endless episodes of Border Security: Australia's Front Line.

A week after my stroke I was in a church hall getting my second Covid jab. The first one hadn't given me any trouble, but almost immediately after the second I suffered a loss of appetite. Of course this was as a result of the vaccination. Most people reporting side effects were saying they only lasted for a few days. I assumed my appetite would return.

Wrong! I started to experience nausea and was losing weight. By the following Friday, a week later, nausea had become retching and I decided enough was enough. Linda phoned my GP who told her I was to stop taking the statins immediately. I already had an appointment for my vitamin B12 injection on the Monday, so blood tests would be done at the same time.

By the time I saw my GP appetite had returned and I was feeling much better. The statins, not the Covid jab, were the culprit, or so it seemed to me. But I wasn't out of the woods yet. On Thursday I got a call from the surgery to tell me that the results of my blood tests were in and there was concern over my liver function. It was emphasised that I was to stay off the statins.

The following Monday Linda and I had an appointment to see Dr Gordon in the Royal. I was prepared for a lifestyle lecture about my eating habits, expecting to be warned of the dangers of butter, cheese, cream, Ulster Fry's and the resulting cholesterol.

My liver was her immediate concern. The blood test results were really not good. She probed my abdomen and questioned me about various symptoms, none of which I was experiencing.

'We need to get your cholesterol down, it's far too high' Dr Gordon told me. For now I had to stay off the statins, which of course I'd been taking to combat the cholesterol.

Yes, I had to watch my diet, but alcohol was the root cause of my condition.

Sugar was the issue and of course there's a lot of sugar in alcohol. At the very least I was to cut back, stick to fourteen units a week. I was to see her again in about six weeks time at the beginning of August. She suggested that if I could stay off the booze until then that would give my liver a better chance to recover.

She told me that she would arrange for me to have an ultrasound scan of my liver and I had more blood samples taken.

On the way home we discussed our combined drinking habits and concluded that they had got out of hand. When the schools closed down because of Covid my Lily- primary-school-walks, mornings and afternoons, had come to a stop.

As we'd trekked to and from school we'd been having an on going argument. Lots of her classmates were now making the journey unaccompanied, Lily was in P7.

'You don't still need me to take you to school, do you? I could stay in bed, not have to get up so early?'

'Yes I do!'

'Do you not get teased, me having to take you?' 'No!

'I'm getting teased on the way home' I lied. 'Who's teasing you?'

'Other grandparents, mummies and daddies!' 'No they are not!'

They are! Am I going to have to walk with you to the High School?' 'No!'

'Why not?'

'Don't be silly Papa. That would be embarrassing!'

And so it went on, only for our walks to come to an abrupt stop with neither of us realising that we'd had our last school walk together, a chapter in our lives closing without fanfare.

Linda and I had started to have our main meal at lunchtime and it was too easy to open a bottle of wine. Neither of us would be driving anywhere. One glass each invariably became two each and what with top-ups we reached a point where there was just a little left in the bottom of the bottle. Then it became a recycling issue. If we finished the bottle it could go into the appropriate bin. We had become the victims of a sort of double whammy; lockdown and being retired, too much time and too little to do. We were growing old disgracefully.

I considered my options, sticking to fourteen units a week or stopping altogether. Fourteen units a week just wasn't going to work. I would always want a second glass What little willpower I had to stick to just the one glass would be dissolved by the first. That left just the one option. Abstinence! Would that work? Everything Dr.

Gordon had told me was still rattling about in my head and I decided it had to work. Was I starting to come to terms with what had happened to me? Was I becoming proactive in my recovery?

Help was on hand. Since leaving hospital I had been placed in the care of the Community Stroke Team. I'd already had a visit from the Physiotherapist. She had satisfied herself that I could get about the house without being a danger to myself or anyone else. I could also stand at the kitchen sink on one leg. She left with the added bonus of knowing that Linda could also stand at the kitchen sink on one leg.

Next was a long telephone conversation with the Dietician. That was all good until she asked 'What about biscuits?'

'I don't eat a lot of biscuits' I replied. 'Roughly how many?'

'I usually have a few chocolate biscuits with my coffee, no milk no sugar, after I've walked the dogs.'

'How many?' 'Three.'

'Three?'

'Yeah, three, two for me and one for the dogs.'

'You feed your dogs chocolate?' Obviously horrified.

'Well, yes' I stammered in my defence. 'One biscuit between them, an old fashioned chocolate digestive, chocolate on one side only. It's not as if its a KitKat or a Twix, smothered in chocolate. It's not like a dog eating a whole Easter Egg. That's not good, that can be fatal depending on the size of the dog and the size of the Easter Egg!'.

Next up Carrie Killen, my Occupational Therapist, came to see me. After a general chat about how I was coping Carrie explained that she was going to give me a series of exercises aimed at restoring function to my shoulder, elbow, wrist and hand.

Constant repetition would start to establish new neural pathways in my brain, bypassing the areas damaged by the stroke. We worked through several exercises and as we went along she told me I was to repeat these exercises daily until her next visit a number of days later.

'Some people can't be bothered to do them, but as soon as I see them again I know whether they've done them or not' she warned me. 'I'm due to see you at least once a week for the next twelve weeks but if you don't work at your exercises I'll stop coming.'

The notion of people not taking advantage of professional guidance and the chance to help themselves irritated me and I worked away diligently. Soon another Occupational Therapist, Stephen, was drafted in to help as well and I was having more than one visit a week.

Dead Fred was beginning to show signs of resurrection and Carrie and Stephen were pleased with my progress. While Stephen continued to work on the physical side of things Carrie asked me how I thought I was doing cognitively. I looked at her blankly.

'How are you managing with things you have to think about?'

'Oh, I see. Well, I've worked out to how to use the TV zappers in the right order and I'm starting to figure out left and right, so I'm not putting my T-shirt on back to front so often. Clockwise and anticlockwise are still a bit of a mystery, but I'm getting there.'

She seemed less than impressed

'Okay. So, starting at January can you recite the months of the year backwards for me?' I did. I was impressed.

'Right, starting at 'A' I want you to tell me a boy's name and then a girl's name beginning with 'A' then move on to 'B', 'C' and so on.'

I got as far as 'C', but forgot the girl's name and then inexplicably jumped to 'F'. Cognitively I wasn't doing so well.

There followed a stream of weekly puzzles, tests and exercises to be completed in time for her next visit. One day she announced that the tests that I was currently doing were "executive level" and that their purpose was to allow her to assess my progress.

'Now' she said, ‘I want you to write something for me. It doesn't have to be too long, half a page or a page, any subject you like.’

She had been asking me from time to time if I was doing any writing, I might have let slip that I'd written a couple of novels. The reply had always been negative. She emphasised that I should be as writing would be both physical, using the keyboard and cognitive, using my brain. Some of the exercises I had been asked to do involved typing. They included journey planning and listing my medications, their purpose, dosages and when to take them. I'd managed the typing, right hand, index finger, but this was altogether different. Using my left hand to type seemed like a remote possibility, but then so had tying my shoelaces, and I had eventually mastered that.

Up until now I had always done as I was told and worked away at whatever I was asked to do. Both physically and mentally I could feel the benefits. While I knew it would be good to do as she had asked I had no desire to write and no idea what to write about. But I had a deadline. Still, I was suffering not so much from writer's block as post-stroke apathy.

All my life I have loved to read, but it must have been six to eight weeks after I came home before I could be bothered to pick up a book. I hadn't even thought about writing. I had the first draft of a third novel, Beige in the USA, somewhere, but I had no interest in even looking for it far less doing any work on it. There was a great deal of work to be done. A first draft has been likened to a lump of clay on a potters wheel, waiting to be turned into something presentable, but for now it was just something intimidating in the background that I was trying to forget.

I scrolled through my files hoping I could find some passage that I could fillet out and claim to have written off the cuff. Apart from the fact that nothing leapt out at me, I concluded that I would be the only person I would be deluding, like cheating at patience.

One piece had grabbed my attention, however. It described a mini adventure I had shared with Andrew when I'd visited him in Australia during his second gap-year. I had originally included it in my first novel, Bewildered in Beige, but it had later been edited out as it was a stand alone piece and didn't move the narrative forward.

I was continuing to watch a lot of TV during my prescribed rest periods. Maybe it was a sign that my cognitive ability was improving, but I had moved on from watching Border Security: Australia's Front Line and police interceptors chasing spaced out teenagers in stolen cars. My viewing had become rather more selective.

This included a series of documentaries about Ernest Hemingway. He had agonised over what he was writing, sometimes spending a whole day over a single sentence. The thought of writing a whole paragraph really bothered him, but with the passage of time he became a master of self editing.

I set about editing my mini adventure piece, It's Like Riding a Bike...

When I next saw Carrie I explained how I had struggled. She agreed that what I had contemplated would have been a waste of time. Confession out of the way, I showed her a printout of my original piece, then a further printout with double spacing between the lines and a third, also double spaced, covered with all my changes, amendments, crossings out and highlighting. Finally I presented her with a printout of my now edited piece, 1356 words. She was suitably impressed by my endeavours and took the printout away. On the day she discharged me ehe told me she had read it, that it was very good and she'd really enjoyed it. With a smile she told me it was hers now and that she wasn't for giving it back.

I was sad to see her go. Aside from guiding me towards great strides forward in my physical recovery she had been so much more than an Occupation Therapist.

She listened sympathetically to my moans and groans, counselled me, encouraged me and helped me to be "kind to myself", never giving me a hard time if I hadn't done as well with some set of exercises as she might have hoped. Still, she could administer a kick in the pants when required.

Tying shoe laces was an example. They were a nuisance and Linda wasn't always on hand when they needed doing. Carrie told me I could manage them myself. 'No I can't' I replied. 'I've tried, endlessly.'

So she stood over me while I struggled and fumbled, becoming increasingly uncomfortable in a bending over position. Suddenly, miraculously, the laces of one shoe were tied and I was ready for a lie down.

'Now the other one' she instructed. 'How about next week?'

'Now!'

Perspiration was standing out on my brow and I could feel a sense of humour failure coming on. Somehow the miracle repeated itself and I was able to straighten up. 'See?'

'I've no idea how I did that or if I'll ever be able to do it again!' 'You will.'

And I was.

Carrie always left me feeling better than I had before she arrived. As with all the health professionals who have looked after me, I feel privileged to have been the beneficiary of her training, experience and expertise.

For a while, with the advent of Covid, our National Health workers had justifiably been treated as heroes. As time went on and Covid started to become a fact of life, the stories of staff facing the pandemic with inadequate PPE, if any, of staying in hotels or sleeping in caravans or garden sheds to protect their families while fighting the pandemic, began to be replaced by reports of ever increasing waiting lists, of people enduring long waits in ambulances before being admitted to hospital, of emergencies being declared in chronically overcrowded A&E departments and distressing stories of people not getting the care that they should.

The National Health Service is an organisation run by human beings and human beings are fallible. When they are overworked and under appreciated, under funded and under paid, and when morale is low fallibility is the consequence just as night follows day. We are told we are one of the richest economies in the world. Our politicians, whom we elect, must do better. They have to display the same commitment as do our front line health professionals and ancillaries. I, for one, like so many others, owe not just my life, but my quality of life to people like Carrie Killen, Dr. Gordon, Mr McKeever, my guardian-angel-nurse and so many others.It is not just my quality of life, but that of Linda and the rest of my family.

Getting on with Life

It is now over ten months since my stroke. It is only when I think back to how I was when I came home from hospital that I appreciate how far I have come. Everything was a challenge. I was asked prior to being discharged if there was somebody at home to help me get dressed.

Linda threw herself into this role with her usual enthusiasm, too much enthusiasm if the truth be known. She liked to hoick the waistband of my trousers as far above my hips possible before fastening them. After a series of wedgies, which she found highly amusing, I suggested that getting my clothes on was something I had to master for myself. Frustration followed, but at least it was not eye watering.

What should have taken me a few minutes became half an hour. Putting my t-shirt on back to front or letting the porridge go cold could colour the rest of my day. Linda remarked that my sense of humour failure threshold had lowered noticeably. A hitherto unrecognised law of physics dictated that if my t-shirt or polo shirt went on back to front it would take a minimum of two or more further attempts before I got it right. Zips, fastenings and buttons were all presented their own challenges. If circumstances dictated that I had to get ready in a hurry I could end up looking as if I had got dressed in the dark.

Concentration or the lack of it was a factor. The porridge would go cold because I could find myself wandering aimlessly round the kitchen wondering what I should do next. Getting up, having breakfast, getting showered and dressed left me needing a rest. Poppy and Petal invariably had other ideas. Having displayed a commendable degree of patience while I had faffed about, enough was now enough. There was no good reason why we should not be out for our walk, and they weren't for letting me off the hook.

One blessing was that there was nothing wrong with my legs. I recognised that next to getting plenty of rest and sleeping well at night, exercise and fresh air were key to my recovery. Poppy and Petal have seen to it that I have got plenty of both. We live on the opposite side of the A1 to Dromore, so within minutes of leaving the house we are out in the countryside. In less than a mile the ground to the right drops below the level of the road, opening up views across the Lagan Valley. Being County Down it is drumlin country, so if we are not going uphill we are going downhill. A mile and a half brings us to a prominent white farmhouse set on the top of a hill, a good turning round point leading to a three mile walk by the time we are back home.

I worked my way up to the three miles in gradual stages and once I was used to that returned to my habit of a further walk in the afternoon, anything up to a couple of miles. Physically I was doing well. A lot of function had returned to my left arm and my left hand was improving. I had been warned that the brain would take its time, anything from twelve to eighteen months to recover.

When people asked me how I was I pointed this out, but quickly learnt because I looked well people were quite dismissive. I was lucky to be alive I was told, as if I didn't know it! I looked okay so I must be okay. Sympathy for what's invisible was in short supply.

Quite soon after coming home I had contacted Northern Ireland Chest Heart and Stroke (NICHS) on the recommendation of both Dr Gordon and Carrie Killen. A series of six Zoom meetings was suggested where I would join in with a number of other people. Prior to Covid these meetings would have been face to face, but I was hearing a lot about people struggling with Zoom and being anything but a techie nor much of a "joiner" I was quite sceptical. The lady I spoke to on the phone, however, was very helpful and pleasant. As I was no longer seeing my Occupational Therapists and had plenty of time, I decided to give it a go. I am so glad that I did.

Running a meeting for a number of people recovering from stokes all in the same room cannot have been easy. To do it through the medium of Zoom must require a whole new skill set. Zoe Campbell and Maeve O'Hagan of NICHS made it look effortless, drawing people in and putting them at their ease with their bright, cheerful manner and good humour.

Called PREP (Post Rehab Exercise Programme) the course focused on imparting all sorts of very useful information. Meeting people who had suffered what I had and in many cases so much more was a reality check for me. The resilience of the human spirit in the face of adversity was source of admiration and inspiration. If others could overcome their difficulties so could I.

Each meeting was scheduled to last an hour and there were to be six in total. The second of the six clashed with an appointment at the Royal. With that exception I managed the rest and Thursday became PREP day. That one hour once a week became a part of my routine and something to look forward to. Those six weeks melted away very quickly, so when I learnt there was follow up course called Taking Control I was quick to register.

My only reservation was that each session lasted for two hours. Taking Control covered a lot of the same ground as PREP but in much greater detail. A weighty tome entitled Self-Management of Long-term Health Conditions accompanied the course and is an invaluable reference book going forward.

Using chat rooms, participants got the opportunity to talk directly with a couple of other course members about whatever the particular topic for the day was. Invariably the chat ranged far beyond what we were meant to be discussing. The allotted ten to fifteen minutes could pass in no time. On one occasion we were meant to be discussing "Making Decisions." We were caught out when time ran out and we were to report back to the group. All we were able to say was that our decision making had revolved around what biscuit we should have during the impending coffee break, but that we had been unable to reach a conclusion.

The inability to decide which biscuit to eat can lead to unforeseen circumstances.

A number of weeks later Andrew and our daughter-in-law Victoria had hired a cruiser on Lough Erne for the Halloween half-term break and Linda and I had been invited to spend a day with them and our two grandsons, Clarke and Perry. Our middle granddaughter, Izzy, joined us for the trip to Fermanagh.

Outside my comfort zone of familiar surroundings I was reminded of my limitations. It had never occurred to me that getting on and off the boat would be an issue, but early attempts were undignified to say the least. We met up at Carrybridge and after Linda and I had been hauled, heaved and shoved aboard we set off upstream towards the Upper Lough. We made steady progress against the current and after a while Andrew offered me the wheel as he needed to go down to the cabin.

I settled to the task and soon was enjoying myself. It was more than a while since I had steered a boat, but I remembered the principles; aim the bow at a landmark and make small corrections to the wheel as wind and current try to alter your course, simple!

Simple that is until Linda and Victoria emerged from the cabin with trays of tea, coffee and biscuits. Victoria handed me a mug of coffee and I told her she was my favourite daughter-in-law. As ever she pointed out that she was my only daughter-in- law and asked what biscuit I wanted. An original KitKat or orange KitKat? Not easy, my preference is a dark chocolate KitKat, the height of sophistication.

In the briefest of interludes between setting my coffee down and electing to throw caution to the Fermanagh winds and try the orange KitKat, wind or current, or possibly both, had the cruiser heading for the reeds. I pulled the leaver back from ahead to astern and applied full power, but all I succeeded in doing was to create a lot noise, startle everyone and spill tea and coffee everywhere, including over Victoria, We slipped gracefully into the reeds. Andrew appeared like a cork out of a bottle, enquiring 'what the f•••k just happened?' to a chorus of 'swear box Daddy!' from his two sons.

We were firmly stuck in the mud with no obvious means of escape. We could contact the boat hire company, but they were hours away on the shores of the Lower Lough on the far side of Enniskillen and rescue would undoubtably be expensive.

I was mortified. I had probably ruined everybody's day and maybe even the holiday. But I was in the midst of my family who had all supported me over the last months and that support was still there. Victoria in particular insisted that I sit down, drink my coffee, which had miraculously remained unspilt, and eat my orange KitKat while she sponged away at her drenched jeans, repeatably telling me with a smile that it would be okay and not to worry.

Maybe somewhere I do have a guardian angel. Out of nowhere a boat appeared and the two guys onboard set about towing us out of the mud. A rope was attached to the cruiser and the younger of the two came aboard to inspect the filters of the engine cooling system.

There was the possibility that they could have become clogged with weeds and mud as the engine had been run hard in Andrew's efforts to free us from the mud. If this had been the case it could have caused the engine to overheat and led to more problems later on. Once he had satisfied himself that they were clear we were all advised to sit down and secure anything breakable that could smash as we were freed from the mud with a possible jolt. While everybody else did as they were told and sat down, Linda took up a position where she could brace herself and prepared to capture some video footage of our rescue that she could use to enhance the story when we got home.

As with the paramedics who had carried me downstairs on the morning of my stroke, it became more than obvious that the two guys had preformed similar rescues before. Between the cruiser's engine and the powerful outboard motor on the workboat we were soon back in the middle of the river.

Our rescuers had been working in a boatyard a few hundred yards away from where I had left the river and joined the scenery. They had watched us round a bend in the river and disappear from view, expecting us to pass the boatyard in a few minutes.

When we failed to appear they concluded we must have a problem and set off to find us. They departed with our profuse thanks, particularly mine, ringing in their ears and the price of more than a few pints in their pockets.

I spent the remainder of the day being the butt of good humoured banter and Izzy took over the role of chief helmsman. Or should that be helmsperson? Or maybe helmspersonette? From time to time she had to wrestle the wheel back from Linda.

Some seven months after my stroke the day had highlighted to me that I wasn't doing quite as well as I had thought. I was particularly mindful that another member of the NICHS walking group of which I was a member, Craig Shilliday, had walked fifty miles in a week before his 50th birthday as a fundraiser for NICHS and was learning to fly! I couldn't even be relied upon to steer a boat moving at little more than walking pace. I had allowed myself to be distracted and had displayed an inability to concentrate. Multi tasking was obviously beyond me. Even if my left hand improved to the extent where I could confidently and repeatably grasp a gear-lever without having to look at it, was I fit to drive a car?

Taking Control was a further six weeks, and while at the outset two hour sessions had seemed daunting everybody got into the way of it. Maeve and Zoe were joined by Julie and as the weeks went by we covered a lot of ground. Positive thinking, dealing with fatigue, exercise, diet, managing medication and dealing with depression were amongst the topics dealt with.

Making an Action Plan proved to be an excellent motivational tool. Apathy is difficult to overcome post stroke. I struggled to do what had to be done and had become adept at sidestepping what should be done. The Action Plan committed each course member to a task they set themselves to be completed for the following week. This could be as simple as drinking more water, walking a little further each day or maybe reorganising the sock drawer. Taking the first step is often the hardest part of getting into something you know you should be doing, while once you have made a start it no longer seems quite so onerous. As the course progressed we all bluffed our way to a greater or lesser extent. The brick paving at my back door still requires weeding, but as we move into spring I think I'll have to make my apologies to the planet and go down the chemical route.

As the course moved towards its conclusion we were asked to come up with a longterm Action Plan to be presented at the final meeting. The group would then reconvene at some later date, maybe in about six months or so, where we could catch up with each other and report how we had got on with our plans.

The first draft of my third novel, Beige in the USA hadn't seen the light of day for a long time. Self publishing is an expensive business. Everything that a traditional publisher does has to be funded by the self publisher. My plan before my stroke had been to promote my first two novels, Bewildered in Beige and Delinquent in Beige by advertising on social media and through Kindle in the probably forlorn hope that the resulting sales would go towards funding the publishing of Beige in the USA.

My longterm Action Plan was to approach Averill Buchanan, the lady who had edited both Bewildered in Beige and Delinquent in Beige. I wanted to ask her if she thought my work was of sufficient quality to warrant my approaching literary agents and publishers. I duly put this forward as my plan at the last session of Taking Control in the knowledge that the group would reunite in the future and I would have to report back on any progress I might have made.

So I took the plunge and emailed Averill. I told her of the very little writing I had done since my stroke, my rewriting of It's Like Riding a Bike... for the OT Carrie Killen and a short piece entitled Walking and Talking for The NICHS magazine From the Heart. I asked her what she thought of my plan of approaching literary agents and publishers, letting a publisher carry the costs.

Early on in our relationship I had quizzed Averill about potential earnings from writing. Averill never pulls her punches. She told me then that at an early stage writing was a hobby. I should consider it like playing golf. Membership, inappropriate clothing that you wouldn't dream of wearing anywhere else other than on a golf course, clubs, balls and tees all had to be paid for with no expectation of a return on the investment. She went on to advise me that I would probably have to write three or four novels before they would gain any traction, if there was any traction to be gained that is. So I wasn't expecting to learn that my work was worthy of the Sunday Times best seller lists, but just like Dr Gordon when I had enquired about the severity of my stroke, I didn't get anything close to the answer I was expecting. As I said, Averill doesn't pulse punches. She wrote

I'm so glad to hear that you're making a good recovery. I can hear your old sense of fun and humour in your email and that's a reassuring sign.

Okay, I'm going to very up front with you about getting published via the traditional route (agent and/or publisher) in the current climate. Nothing will set you back more than banging your head against a brick wall ... and that's really what it's like trying to get a traditional publishing deal or an agent these days. They're overwhelmed with manuscripts at the moment (and probably for the foreseeable) because the world and his wife has written something during lockdown and wants to publish. If youngsters with creative writing PhDs and big social media platforms are having trouble getting published, I think it would be a thankless task for you to pursue that route. I hope you understand why I'm being so frank. To be honest, I'm not sure I would advise anyone to try to get published at the moment. It's a brutally competitive scene. Not good for your mental well-being at all even if you have a very thick skin.

However she continued with:

Could you do more writing for NICHS on a regular basis? Could you use your writing skills to write a (humorous) book that would help other stroke sufferers on the road to recovery -- perhaps a memoir of your stroke. Books like this could help raise money for the charity with the backing of NICHS.

The other thing that occurred to me is that you could offer to run writing classes for other stroke sufferers (again with the help, perhaps, of NICHS and/or the Stroke Association). You'd be uniquely placed to be able to help others with short writing exercises that would aid recovery and raise morale. It could be done via Zoom (no need for premises or masks!). Maybe all your students could put together an anthology of their writing and publish to raise money for NICHS.

I'm not sure how helpful this is but I do hope it plants a few seeds in your mind. Do stay in touch and let me know how you get on.

I didn't take any time to think about the above and phoned Maeve O'Hagan more or less immediately, telling her what Averill had written. Maeve came across with her usual enthusiasm and positivity and told me she would talk to marketing.

Early in the New Year Una McHugh, Communications and Marketing Officer · Northern Ireland Chest Heart And Stroke contacted me and what you have been reading, Dear Reader, is the result of that telephone conversation. Having reached this point I must commend you for your stamina and stickability. What I imagined would be measured in hundreds of words has just topped eleven thousand. If this article were fiction it could be a novella!