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Stroke - the hour that struck

ABC radio All in the Mind

Professor John Bradshaw is from Monash University in Melbourne. He spoke on the radio about how his life (and that of his wife Judy) has changed forever - Judy had a major stroke during a hiking trip in the Grampians in Victoria (Australia). John can clearly remember the conversation he had with his wife "Bring out the black bag", she said "Which one?" I asked. This conversation took place while they camped in a remote valley at the foot of a mountain. They had planned to climb the mountain that day. John says It was the very last conversation we were ever destined to have. Judy had started taking a double dose of her medication for rheumatism. She took her first ever double dose at 7pm on the first night of the holiday - after they had set up camp and had their evening meal. They went to the same place every year to see the orchids in bloom. The next morning Judy seemed unable to answer John. She looked like she was having an epileptic fit. John asked her to grasp his hand with her right hand she could not do so. He knew it was a major stroke the stroke was in her left

hemisphere which controls speech, hand movements and the opposite right side of the body. It was the worst possible scenario. Luckily, Judy was in her sleeping bag on the bed in their 4WD car. John could not find his mobile. He found his wifes mobile but there was no reception. He left all their camping gear and drove to a ridge to use the phone. He knew that from then on their lives would be totally changed. Emergency Triple 0 put him in contact with medical services - they arranged to meet an ambulance at Halls Gap, about 40 minutes away. They were there and waiting. John has little memory of that terrible drive. He knows that he broke the speed limit. In maybe 30 minutes they reached the nearest bush hospital. He remembered that there was there was a special drug a clot busting drug. This can help save some of the brain cells it has to be given within 5 hours of the stroke. He found out later it was within 3 hours. He noted exactly when it had all happened. He decided to ask for the drug to be given to Judy he worried it would not be available in country areas. To his surprise, the bush hospital did have a small dose this was given to Judy. an hour away. away. The rest of the dose was three quarters of It came by taxi, the minutes continuing to tick

It has to be given slowly - when the last drop was in, it

was close to mid-day, outside the important time of three or five hours.

Judy was taken by light plane back to Melbourne while John drove back alone. He remembers looking hard and long at the Grampian mountains. He thought that this would probably be the last time that they would both have seen those ridges the mountains had been part of their lives for nearly half a century since they arrived in Australia. Judy and John had researched stroke and its effects at the very hospital she went to. She also had six months of intensive therapy in a rehab centre. John says that he does not know how he would have survived, let alone coped, without the support, advice, help, meals, and country walks from the doctors and other staff these were people that he had worked with before. He has found it wonderful and inspiring. He has got to know and get close to them in ways he would never have done otherwise. For relatives or carers of stroke victims there is a nightmare of paperwork. There seemed to be so many organisations providing care, funding, assistance, therapy and lots of red tape. Sometimes you begin to think that you could do it all quicker and better yourself. John found that costs are horrendous - a month's supply of just one drug costs $140. A wheelchair seat cushion, filled with gel to ease pressure, costs $764 - it goes on and on. He felt lucky that he knew the hospital system (from his work) and he had friends in high places. Also, his daughter is a doctor. John

thinks that the system needs to be re-designed from the bottom up. Judy was an athletic 72 year old, with no risk factors, normal blood pressure, cholesterol and exercising daily all her life. She was a bush walker, ever mindful of her diet. Somehow her arteries were blocked on the left side of the brain she had aphasia and a paralysis on the right side of the body. John is now her sole carer, 24/7, for every bodily function. His own scientific research career has had to end. Judy is locked into a life of pain, discomfort and humiliation she has difficulties in thinking, speaking and walking. She can follow simple conversation but she cannot contribute anything useful. She can do none of those things which we all take for granted and enjoy. Her life is restricted by her wheelchair and where John can take it there are also the visits of rehabilitation specialists and carers. How meaningful is her life for her? Would she have preferred not to have pulled through? Should we dare ask such questions? John knows that he could not bear such a life. In the meantime he does everything possible for his mate of 45 years, who still knows and loves him, even though she is largely helpless. Judy has lost a lot of brain tissue - at least one third of the whole. It is amazing that her personality is largely unchanged.

Though slow, she can even work out the right money to give someone. John still feels that this is a personal tragedy. John wonders if there be some slow continuing improvement or is she now as good as she ever will be? Will there be a slow decline? Now Judy has had a fall and an epileptic fit. Is it good to be so very well informed of what's going on when you're severely ill? Is it better to know the truth?