You
know, if you're not going to go you should do it
properly. Anyone can just not go. But doing it with style
takes skill and preparation.
First:
lose your job several months before. A year would be handy (it can be done).
Then
go on a break to a country you rate highly. You know, like
Come
back refreshed with ideas, contacts and a stack full of job-related literature;
newspapers, corporate brochures etc.
Then,
when you're back home, then is the time.
Collapse.
You
may have been having breakfast or lunch, remembering isn't important - or
possible - but it is important to finish eating first. It’s bad to collapse on
an empty stomach. You don't know when you'll eat again. And in fact you won't
remember having the first few meals after this one anyway.
So,
collapse. Landing in the recovery position gains extra marks. Especially if it's under a table and chairs.
Then
wait. Hallucinate a bit if you wish, even have a few moments of lucidity.
That's fine. Bear in mind that it pays to be patient here.
Eventually
get found by, say, your landlady. To the question "Have you been taking
drugs" answer "No" even if you haven't.
The
waiting won't be over yet so patience is still important. Just lie there and
wait. An ambulance has to be called. When they arrive they'll have to do all
their usual things, whatever they are. You’ll be taken to the local hospital.
At some stage your T-shirt will be cut off and discarded and your trousers and
underwear will also be removed. They'll dress you in a standard gown and put
around your body a large number of electrical pads and an intravenous drip in
the back of your hand. Complaining, or even noticing, is rude so don't.
They'll
also put on an oxygen mask then ask lots of questions – in that order. When you
remove the oxygen mask to answer they'll tell you not to touch it. That's
standard. Remember, when you're conscious, to speak with a very heavy slur,
very slowly.
One
of the question they'll ask is for next of kin. That's
the parents. The initial response should be that there's no need to disturb
them. When they persist - and they will - give them the number. I know that may
be difficult to remember these days with mobile phones and selecting numbers by
name. So it may have been years since you actually dialled their number but
persevere with recalling it.
After
a while you'll get transferred to another hospital. They'll be more equipped to
deal with this sort of case - n.b. you won't have
realised what's wrong but so what? Just lie there and go along with their
plans.
At
this new hospital they'll do a couple of noteworthy things. First a lumber
puncture.
Now, I don't really know what
the fuss is about lumber punctures. Years ago there was a student at University
who was permanently in a wheelchair. Funnily enough his surname was "
Despite
your problems with memory, and indeed consciousness, you'll remember these
thoughts. You'll find them comforting as you lie there waiting for the
puncture. And there will be a lot of time between being told about the puncture
and actually having it. Nice one medics.
But
when it actually happens you find it no worse then having blood taken from an
arm. In fact you could even be disappointed. It's actually better than having
blood taken as you can't see what's happening.
The
next noteworthy test is the MRI scan. There are stories about this as well. One
of my friends is an American for whom XXXL is too tight. He went for a scan in
the
After
this, at some time, a phone will be brought to your bedside. Your parents are
on the line having a chat with you. Tell them that funnily enough you're in a
hospital near them and they'll tell you that actually you're not. You're in the main neurological hospital in
The
next day your parents will turn up in intensive care to visit you. And then
some consultant doctors will turn up. They'll explain that you've had a stroke.
Yes really. A few infarctions in the brain stem They'll
also explain that one of the nerves controlling your left eye has been
affected. Which is why it has been looking downwards all the
time.
This
is the first time you realise you've had a stroke. It's also the first time you
realise you have double vision.
Anyway,
stay in intensive care for a few days. Whilst there have
showers every day. During one shower - not the first - notice the
electrical pads still stuck on your body. As soon as you notice rip them off
ignoring the pain this causes. The more hairy you are the more effective (that
is painful) this will be.
Also,
don't worry about personal issues like going to the toilet. Number Ones are
easy. There'll be a bottle near you. Use it without regard to whose there
around you. Number Twos ... well it's best not to
remember anything about them.
Several
times a day a nurse will check your memory and reflexes. When they ask you what
day it is, look at the date displayed on your recently purchased watch and tell
them. (This is why preparation is so
important: you need to be wearing the watch when you collapse.) Notice that
when they ask you to recall where you are you really don't know which hospital
you're in. That's because no-one has actually told you yet.
The
neurologists will question your lifestyle. By this they'll mean more than the
occasional visit to Ikea. Tell them about your diet (healthy), regular exercise
(three times a week) and technically moderate consumption of alcohol. They'll
work out for themselves your relative youth.
So,
you're unlucky as far as the neurologists are concerned. Now, I know some
people would argue (because they have) that actually you are lucky. Sure, you
could have been confined to a wheelchair for months or even life, lost
intellectual and memory powers, or even left hospital in a wooden box. In fact
a stroke to the brain stem could have by-passed all this by killing you
immediately. But my definition of good
luck is different. It involves being offered highly paid jobs, chocolate cake
and sexually adventurous blondes.
As well as being unlucky (or as we can see lucky according to some
people's view) you'll also find it's a patent foramen ovale. "A
what?"
That's a natural hole, more a
tunnel really, between the two upper chambers of the heart. It's there before
birth so that the pre-born baby's blood circulation can bypass the lungs. It
should close and seal in the first year of birth; often within a few days of
birth. But not in your case, oh bloody no. Nor, depending on which medical journal you read, in 1/5 to 1/3 of the population.
Blimey. Sometimes it can cause heart murmurs or other irregular rhythms. It
certainly gives divers even more things to worry about. But often there’s no symptoms.
In
your case it probably allowed a clot to transfer from the body to the head and
cause the stroke.
Finding
this PFO won't be fun. You'll be transported by car and wheelchair to the
There,
they'll do a few things. First they'll ask you to wait. Not too long. Then
they'll squirt anaesthetic in the back of your mouth. You are reminded of Pernod. They'll allegedly sedate you. Then they'll pass a
camera down your throat, down your oesophagus. Whilst using it to photograph
your heart you’ll be asked to squeeze a few times as if you are constipated.
In
all, you’ll find it the most unpleasant thing since your admission to hospital.
You'd much sooner have a lumber puncture. In fact, after this test remember to
ask the cardiologist if he'd actually sedated you. He'll assure you that he
did.
So
for the first time in 37 years you discover you have a PFO. Something you've
had all along. And it'll need to be closed. But not yet.
This is why patience is so important. Having been made
redundant months before you've lost your private healthcare so you have to wait
for the NHS wheels to grind. They'll put you on a priority because of
your relative youth - still being called young will please you - but that still
means a wait of months. Just for an appointment with a cardiologist. The
procedure to close the hole will happen much later, if
at all.
So
meantime the doctors put you on an anti-coagulant. Although they and the
literature always refer to the generic name - i.e. an anti-coagulant - you'll
find the drug is invariably Warfarin. All your
friends know it because their older relatives or parents will be on it. Having
the drug used by your friends’ parents doesn't please you.
Another thing. Every doctor involved with this tells you to limit your alcohol
consumption whilst you're on anti-coagulant. No more than two units. That's two
glasses of wine, one pint or half a litre of beer. "But ...". But "but"doesn't
come into it. Really, you may as well open a flower shop. But you don't and you
stick with this limit. After a little while, say three months, you find that
you get pretty drunk on two glasses of wine anyway. Going to an event where everyone is drinking
several litres of very strong beer may not be a good idea after all. You decide
not to go to the Munich Bier festival.
© John Chaudhry 2002