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Mike - Interview 38

Age at interview: 63
Age at diagnosis: 53
Brief Outline: Mike had a small episode one evening where he found himself unable to speak for a short while. As it was out of surgery hours he saw a locum GP who advised him to go home and see his doctor the next day, even though he had very high blood pressure. However, the next morning he had a more serious episode which was diagnosed as a stroke. He is fully recovered now, although he finds sometimes he has some short term memory loss, and is speech is slightly slurred at times.
Background: Mike and Debbie married 10 years ago. He is a retired accountant and publisher. Ethnic background; White British.

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Mike returned home from work one evening and found that he was unable to speak coherently for a short while. His wife Debbie said it was if he’d had a few drinks and was slightly inebriated. As it was during the evening they went to see a locum GP from the out of hours service, who did not mention the possibility of it being a TIA but advised Mike to see his GP the next day even though his blood pressure was extremely high. The next morning before he had a chance to visit the GP he had a more serious episode in which his speech became more confused than it had been the previous time, and on visiting the GP was diagnosed with a stroke. He was immediately referred to the TIA clinic at the local hospital where the consultant suggested that he should be admitted for tests. Over the course of the week that he spent as an in-patient Mike underwent an MRI scan and an ultrasound of the carotid artery amongst other tests, and gradually his speech returned almost back to normal. Initially he found swallowing and eating food difficult but gradually he was able to eat normally again. Since that time he had some help from a speech therapist and finds that he can generally live a normal life, although his words are sometimes slightly slurred at times. He has been left with some residual side effects one of which was diagnosed as cough syncope - occasionally he has a coughing fit that leads him to black out and he later has no memory of the event. He also sometimes has short term memory loss.

Looking back Mike remembers that he experienced two episodes earlier that year in which he felt slightly unwell but had not felt it important enough to see his GP about. He now thinks these symptoms may have been a warning sign or small TIA event. It seems as though the initial episode he experienced on that first evening was probably a small TIA and he feels let down that the locum doctor did not advise him to start taking aspirin straight away that evening instead of leaving him to his own devices until the next day, particularly as he now knows that may have prevented him from having the stroke the following day. Mike and Debbie feel strongly that it’s important that people who experience these types of symptoms should insist on getting medical attention as soon as possible during or after the event because they now understand that the sooner treatment begins, the better the outcome.

Since his TIA and stroke Mike has taken aspirin, Lisinopril, Bendrofluozide and Fenofibrate on a regular basis but it came to light that Fenofibrate was affecting the protein levels in his kidneys. Although his GP felt he should remain on the medication to avoid a further stroke taking place, he was sent for an ultrasound scan on his kidneys and it was found that he had a malignant tumour on his bladder. This was totally unrelated to the medication, but Mike feels fortunate in that if he had not been taking Fenofibrate and been having regular checks this may not have come to light until much later. He was also prescribed Citalopram for a short while to help him cope with the reactive depression that he experienced for a short while. He still finds that he sometimes feels more emotional about things than he used to.

Mike and his wife Debbie both feel that stress may have played a part in contributing to his risk factors for stroke/TIA as at the time his blood pressure was particularly high. Since he had his stroke Mike took the opportunity to retire and take life more slowly. He feels lucky that he has no significant lasting effects from his stroke and is able to live a happy and normal life.
 

 

Mike was advised to stay in hospital and have his tests done rather than wait for them to be done...

Mike was advised to stay in hospital and have his tests done rather than wait for them to be done...

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We went to see our GP who knew exactly why we were there. She had a fax from him and after about two minutes of being with her, she said, “Right, you’re off to the, another hospital to a TIA clinic”, which we took ourselves off to and we went in there and saw the chap very quickly. And within five minutes I was having an MRI scan [clears throat] A, a few minutes after that we saw the consultant again and he said there had been a small bleed in the brain and that I’d had a stroke. And he said, “If you want you can go home but you would, you’ll not be able to have the tests that we want to do on you. You’ll have to, you’ll have to book up, book up for them and wait, wait, it could take weeks. So I suggest that you do come in and we do it much more quickly.”
 
So I said, “Well, if I’m having a stroke then I ought, I ought to be, be here under some sort of control”. So I did that.
 
I was in for a week having, well having all these tests that he’d been promising me and the team were absolutely magnificent. What the one I remember, it was a while ago now, but I remember the young chap every morning he’d come in, always before breakfast and say, “What’s your name? Where do you live? Where are you? Can you say ‘British constitution’?” And of course when, at the start of all this I didn’t say anything at all, I didn’t make sense of it but by the end of it I kept, kept saying yes, and it was all, all good practice. And for some while afterwards I’d try and say these things which improved my speech, although it’s not perfect now. It’s miles, hugely improved. Hugely improved. And now I’m just, I’m more, more or less, more or less living a normal life and perfectly, perfectly happy.

 

 

Mike saw a locum doctor in the evening who told him to go home and have a large whisky and see...

Mike saw a locum doctor in the evening who told him to go home and have a large whisky and see...

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I was just wondering, when, when you saw the GP the first time and he sent you off, he didn’t mention taking aspirin at all or giving you any…?
 
Mike' No, no.
 
...thing like that?
 
Mike' All he was worried about was to get me out of, out of the room and some,…
 
Debbie' And he was the one that told you to go home and have a large whiskey.
 
Mike' Yeah.
 
And it, I mean, it sounds like at that didn’t sound very satisfactory. How did it make you feel when that happened?
 
Debbie' I, well I felt he knew what he was doing. In hindsight I should have taken him straight to A&E. But …
 
Mike' Yes, it was…
 
Debbie' You know.
 
Mike' ..should, should never have gone to see him at all.
 
Debbie' No.
 
And what do you think might have happened differently if you had of acted differently?
 
Mike' Well I would have been in the care of the hospital immediately rather than on, on my own not knowing what was going on. We did not know what was going on. And I could have had a much worse stroke. But without any medical care around at all. So it would, it would have been more sensible to, if we’d known, if we’d thought about it, or known to go straight to the hospital and be sorted out there and then.
 
Did you know anything about strokes before all this happened?
 
Mike' No I didn’t.
 
Debbie' No, I mean, as I say, I went through, ‘Did he have chest pains? Did he have a pain in his arm? Did he have a splitting headache?’ because I knew that might be a sign of a heart attack. But no, no we didn’t So
 
Can you remember how you were both feeling during that evening when things were a bit up in the air and you didn’t know quite what had happened?
 
Debbie' I was very worried. But I took, you know, I suppose as you do, you think if you’ve been to see ‘an expert’, in inverted commas, you take their advice and we went home and I rang the GP first thing the next morning to get an appointment. And they’d asked us to come straight in. So, as I say, they obviously knew …
 
So you felt like you were in good hands?
 
Mike' But by then …
 
Debbie' Yes.
 
Mike'.. by then, yes.
 
Debbie' Yes, but …
 
Mike' Yes.
 
Debbie'.. I could tell that our GP was not happy when we got there. And I did say, and I did mention it to the consultant as well. Now, what happened after that I don’t know. We didn’t take it further. In some ways I regret now we didn’t. But [uh] I would imagine that he was fairly quickly removed from the locum list.
 
Mike' Yes.
 
You felt like, it sounds like you felt quite let down.
 
Debbie' Very let down.
 
Mike' Yes, yes, yes.
 
Debbie' Yeah.
 
But presumably that’s not an experience you’d had prior to that..?

Mike: No, no …

Debbie: No, and our GP was brilliant. But it was in the days when they’d just recently gone onto this new everybody signs up to a locum service in the evening and so many locum GPs cover so many practices and…

So do you, I mean, do you feel if you’d have, if it had been your normal GP, your regular GP that …?

Debbie: Oh, we would have been in hospital.
 
 

Mike goes to see his GP regularly for blood tests, as he also has another condition that needs...

Mike goes to see his GP regularly for blood tests, as he also has another condition that needs...

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Mike' I do think about it and well, whenever I can, which perhaps is not as often as it should be but I would, would, whenever I go to the GP, she always takes my blood pressure... whenever. And I should perhaps do more often than I do now, but I do, I do try, and try and go, go, go down say once every three months, three or four months and have my blood pressure checked. And it’s been, it’s been like...okay, disrupts you a little bit but currently it’s quite, quite good, quite good.
 
Debbie' You have six monthly blood tests as well, don’t you?
 
Mike' About six monthly blood tests, yes, that’s right.
 
So you’re still being monitored?
 
Mike' Oh yes, yes, yes, yes.
 
Debbie' Yeah.
 
Mike' Yes.
 
Debbie' And I think you, I think he always will be and, and as for the bladder he’s going to be monitored because it’s a, apparently it is a cancer that can return. So he’s always having somebody sticking needles or tubes or something into you, aren’t you? [Laughs].
 
Frequent MOTs?
 
Mike' Frequent …
 
Debbie' Frequent MOTs.
 
Mike' Frequent MOTs.

 

 

Mike thinks everyone should go to their doctor more often for an ‘MOT’

Mike thinks everyone should go to their doctor more often for an ‘MOT’

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Debbie' And so I would say definitely have an annual, you know, have an annual, annual check up. You know, just go and ask, ask them just to do the run of the mill screen and check your blood pressure.

 
Mike' Hm. Hm.
 
Debbie' Because if he’d had it checked more often, you know, who knows. I mean, you can’t say it, it could have happened, it could have happened even with you taking pills but on the other hand as it was blood pressure related then probably it wouldn’t have done. You know. But you can’t, you can’t stop everything happening to you

 

 

The locum doctor that Mike saw initially didn’t seem to take his symptoms as seriously as he...

The locum doctor that Mike saw initially didn’t seem to take his symptoms as seriously as he...

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I was just wondering, when, when you saw the GP the first time and he sent you off, he didn’t mention taking aspirin at all or giving you any…
 
Mike' No, no.
 
...thing like that?
 
Mike' All he was worried about was to get me out of, out of the room and some,…
 
Debbie' And he was the one that told you to go home and have a large whiskey.
 
Mike' Yeah.
 
And it, I mean, it sounds like at that didn’t sound very satisfactory. How did it make you feel when that happened?
 
Debbie' I, well I felt he knew what he was doing. In hindsight I should have taken him straight to A&E. But …
 
Mike' Yes, it was…
 
Debbie' You know.
 
Mike' should, should never have gone to see him at all.
 
Debbie' No.
 
And what do you think might have happened differently if you had of acted differently?
 
Mike' I would have, I would have been in the care of the hospital immediately rather than on, on my own not knowing what was going on. We did not know what was going on. And I could have had a much worse stroke. But without any medical care around at all. So it would, it would have been more sensible to , if we’d known, if we’d thought about it, or known to go straight to the hospital and be sorted out there and then.
 
Did you know anything about strokes before all this happened?
 
Mike' No I didn’t.
 
Debbie' No, I mean, as I say, I went through, ‘Did he have chest pains? Did he have a pain in his arm? Did he have a splitting headache?’ because I knew that might be a sign of a heart attack. But no, no we didn’t So...
 
Can you remember how you were both feeling during that evening when things were a bit up in the air and you didn’t know quite what had happened?
 
Debbie' I was very worried. But I took, you know, I suppose as you do, you think if you’ve been to see ‘an expert’, in inverted commas, you take their advice and we went home and I rang the GP first thing the next morning to get an appointment. And they’d asked us to come straight in. So, as I say, they obviously knew …
 
So you felt like you were in good hands?
 
Mike' But by then …
 
Debbie' Yes.
 
Mike' by then, yes.
 
Debbie' Yes, but …
 
Mike' Yes.
 
Debbie' I could tell that our GP was not happy when we got there. And I did say, and I did mention it to the consultant as well. Now, what happened after that I don’t know. We didn’t take it further. In some ways I regret now we didn’t. But I would imagine that he was fairly quickly removed from the locum list.
 
Mike' Yes.
 
You felt like, it sounds like you felt quite let down.
 
Debbie' Very let down.
 
Mike' Yes, yes, yes.
 
Debbie' Yeah.
 
But presumably that’s not an experience you’d had prior to that..?

Mike: No, no …

Debbie: No, and our GP was brilliant. But it was in the days when they’d just recently gone onto this new everybody signs up to a locum service in the evening and so many locum GPs cover so many practices and…

So do you, I mean, do you feel if you’d have, if it had been your normal GP, your regular GP that …

Debbie: Oh, we would have been in hospital.
 
 

Mike had a TIA one evening, and although the symptoms subsided relatively quickly, the next day...

Mike had a TIA one evening, and although the symptoms subsided relatively quickly, the next day...

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Mike' I came home one evening about six o’clock of the evening and sat on the sofa and start, started talking to my wife [creaking] having, having driven home perfectly happy and then, sorry, suddenly, suddenly I found I really couldn’t, couldn’t, couldn’t speak at all. And I found this very,  a little bit unnerving. I was accused possibly of being in the pub earlier on before I came home and I said “No, No, nowhere near. Didn’t touch the pub.” And so Debbie, Debbie will have got, managed to get on the phone and tried to speak to the surgery with, by then of course had closed. So she then rang NHS Direct.
 
Right.
 
Mike' Is it all right?
 
Yeah, yeah.
 
Mike' And they suggested that we rang the local hospital...
 
Debbie' No, no we didn’t …
 
Mike' No?
 
Debbie'.. we rang the …
 
Mike' Right.
 
Debbie'.. local GP, we had to then go back to the …
 
Mike' Oh sorry.
 
Debbie'.. because we went to see a locum GP.
 
Mike' Locum GP, sorry.
 
Debbie' It was an out of service it was an out of service, out of hours service which happened to be based at a local, our local hospital. That’s why.
 
Mike' All right, sorry, sorry.
 
Debbie' But I had already gone through had he …
 
Mike' Yeah.
 
Debbie'.. had a, had he, did he have a headache, did he have …
 
Mike' Aha, pain in the arm.
 
Debbie'..pain in the arm and all these things, pain in his chest. So, that’s why I didn’t ring an ambulance.
 
Mike' And so we, we, after we discovered the, the name and place of this, this doctor we went, went off and, set off and managed to see him, I don’t know what time of day it was by then probably half past seven eight o’clock.
 
Debbie' Yeah.
 
Mike' We managed to get in, get in to see him. And he took my blood pressure which was 250 …
 
Debbie' Yeah.
 
Mike'… over 150.
 
Debbie' 140
 
Mike' 140, hundred and
 
Debbie' 140.
 
Mike' 140. 140. By that time my speech was beginning to return and I felt perfectly all right. Perfectly all right. So I thought, “Well, let’s, let’s go home and forget about it.” But no, he said, “No, what I want you to do is promise me that you will go and see your GP in the morning.” So I said, “OK, fair enough.” And thought not, not a lot of it after that. We were, we, we got home and did we have supper? Maybe, might have a bit of supper.
 
Debbie' You had a large whiskey.
 
Mike' I had a large whiskey did I? Right, large whiskey. Which may not have been the, the best medicine but and then eventually we went to bed Come, come the next morning I had had what would seem to be a stroke. My face was all skew-whiff. My mouth was at an angle and again I don’t think, could I speak?

Debbie: No.

Mike: I couldn’t speak. Or make anything not of any sense anyway.

Debbie: No sense at all.

Mike: Could I speak at all?

Debbie: No. Well… 

Mike: No.

Debbie:..yes, but you were talking gobbledygook.

Mike: Talking gobbledygook. OK, fair enough. And so we, as promised this doctor the night before, we went to see our GP who knew exactly why we were there. She had a fax from him and after about two minutes of being with her, she said, “Right, you’re off to the, another hospital to a TIA clinic”, which we took ourselves off to and we went in there and saw the chap very quickly. And within five minutes I was having an MRI scan. A few minutes after that we saw the consultant again and he said there had been a small bleed in the brain and that I’d had a stroke. 
 
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