Out of the blue, into the fan

As my ongoing ‘sabbatical’ continues to morph into something more akin to ‘retirement’, I can now look back and finally admit that maybe stress did actually play a part in ‘a stroke of bad luck’ I had fifteen years ago. For you ‘stress deniers’ out there, if you’re still struggling to balance the frustrations of corporate life with your commitments to family life, this might be a cautionary tale.

Watching the recent BBC TV documentary about Andrew Marr, ‘My brain and me’, brought the lessons from my own stroke recovery sharply back into focus.  After watching it, I ‘googled’ the keywords ‘stroke’, ‘damage’ and ‘thalamus’ and found a raft of sources where fifteen years earlier I’d found a blank screen.  Whether this currently available knowledge would have helped me back then is debatable, though I would probably have drawn comfort from the knowledge that I was neither mad nor alone.  I did publish a few random notes online at the time, but it proved as futile as Jimmy Carter casting his message into the cosmos in 1977.

One Friday evening, fifteen years ago today as it happens, I was running around playing indoor football with a group of hyperactive seven-year-old junior scouts when without warning I was felled by an explosion of pain ‘somewhere’ behind my left eye. Simultaneously, the right hand side of my body lost all sense of purpose and I collapsed to the floor in a heap. I crawled to the side of the room, relieved that a fellow scout leader was there to take over supervision of the kids.

Half an hour later, with power to the right side restored and the headache receding, I limped out to my car and drove cautiously home, already trying to deny what had just very obviously happened. For the rest of that weekend I nursed what seemed like the mother of all hangovers before getting back in my car at 6:30am on Monday for the hundred mile drive to a customer site.  During that journey, I was alarmed to find that my visual reaction time was well off the pace.  I cut the day short, got back in the car and headed home before the rush hour for an appointment with a GP.  With hindsight, two hundred miles I should never have driven.

Grounded by the GP and told to rest, I set out two days later to walk my ten year old to school.  I’d barely moved fifty feet from the house when another unexpected episode left me completely and utterly disoriented, unable to do anything other than retrace my steps to the house.  Compared to the first event, this one was relatively painless; my internal ‘sat nav’ system had abruptly and inexplicably shut down and been left confused and drowsy.  A couple of hours later I was sat semi-comatose in another GP’s surgery while my wife convinced the doctor that it must be ‘stress related illness’.  With no obvious visible physical impairment, such a diagnosis must have seemed the easy way out.  I struggled to join in with the conversation but my feeble request for an investigatory scan simply met with the retort that I’d be ‘wasting their time and my money’.

Two days later the background headache had developed into a constant migraine which, in combination with the spatial disorientation, became debilitating.  I consulted a neurologist privately and was referred for an MRI scan.  The result confused us both. With the scan showing three clear lesions in the left cerebellum and one in the thalamus, he expressed surprise that I wasn’t exhibiting any mobility issues.

For the next twelve months, chronic migrainous headache was the order of both day and night, making sleep fitful and the ability to concentrate weak.  Several attempts to get back to work crashed after only a few days.  To cope with the migraine, I was prescribed a succession of pain killers, starting with beta blockers and moving on to anti-depressants as neural painkillers. Neither category provided relief for long, and in the case of the anti-depressants, the side effects were even less tolerable than the headache was becoming.

On the plus side though, recovery was happening, just taking its own sweet time. The issue I had with spatial disorientation I could describe as being like having a busted ‘graphics card’.  The eyes were working fine, but the brain was struggling to render the image correctly, an issue we attributed to the small area of damage in the thalamus.

The usual manifestation of the problem was quite bizarre.  I could stand still in a ‘rectangular’ space, a room, a corridor, a store full of shelving, but as soon as I tried to move, my head seemed to need to constantly redraw the perspective to understand my moving position.  This process, which in normal life must surely have just been an automatic ‘background activity’, had now become a totally debilitating issue.  Around this time, I took to regular country walks, finding that the soft, undulating landscape of the South Downs with its woodlands and open skies were easy and pain free to be in. My issue with buildings and right angled structures didn’t apply.

The very worst environment, a local DIY superstore with high mounted rack shelving and narrow aisles, became my preferred benchmark.  Once a week or so, I would trudge up and down those aisles, timing how long I could take it for before my head forced me to quit.

Over time, new cells took over the lost function and the issue slowly improved, reducing the intensity of the headache to more manageable levels at the same time. Fourteen months after the first event, I made the cathartic, if inexcusable, decision to flush all remaining medication and live with the reducing symptoms undisguised. With the decreasing level of intensity, tolerance of the headache became preferable to trying to hide it.

The eventual diagnosis, having discounted all the usual factors, ended up as ‘Migraine Induced Stroke’.  I’ve never been convinced of this since the first migraine I ever knowingly suffered was the 24/7 monster which struck me down afterwards

My lifestyle and stress levels have all mellowed over the intervening years, but in the event that lightning strikes twice, then the two sets of MRI images from 2002 and 2003 tucked away in a large envelope beside the filing cabinet in my study should provide a useful benchmark.