Ned O'Byrne is a 51-year-old married carpenter who was admitted to the stroke unit of Tallaght Hospital, Dublin, in March 2001. Earlier he had suddenly developed a severe weakness in the left side of his body and face and was unable to swallow. It took all the efforts of his wife Kay and two ambulance men to transfer him to the ambulance stretcher, such was his loss of mobility.
A CAT scan showed a large area of the right parietal lobe of his brain had been affected by a clot. This part of the brain is responsible for allowing us to recognise the left side of our bodies, which explains the admitting doctors' finding that Ned was unable to "sense" the position or function of his left arm and left leg.
He had few risk factors for a stroke. Although an ex-smoker, he was not overweight and his cholesterol levels were normal. However, an ultrasound of the main arteries in his neck confirmed a complete blockage of the right carotid artery, indicating that it was the likely source of the clot which caused Ned's stroke. Unfortunately, complete blockage of an artery means that it is not amenable to corrective surgery.
The team in the stroke unit began extensive rehabilitation to restore Ned's functioning and independence. However, he had a number of setbacks. Because of his swallowing difficulties, he aspirated some food into his lungs, resulting in pneumonia and, in the middle of his rehabilitation, he developed a clot in his lung (a risk associated with prolonged immobility) which also slowed his progress.
After a hospital stay of three months, Ned was discharged home, with an arrangement to attend the community stroke unit in the old Baggot Street Hospital. Here he continues to receive physiotherapy, speech therapy and occupational therapy.
A social worker is also part of the team. One of Ned's main aims was to start driving again; 18 months after the severe stroke he has passed a driving test allowing him to get back on the road in an adapted car. He is back cutting the lawn and says he looks forward to "doing a bit of carpentry" and restoring a vintage car. Obviously proud of him, his wife Kay especially admires the fact that Ned "never got angry" during the slow process of rehabilitation.
Prof Des O'Neill, under whose care Ned made such a good recovery, notes that while the three months inpatient stay was unusually long, due to the skills of the specialist unit Ned has avoided permanent placement in a nursing home.
Prof O'Neill adds: "The first two weeks of treatment are crucial, offering the best opportunity for neurological repair. And the combined availability of specialist nursing care, occupational therapy, physiotherapy and speech therapy in a specialist unit reduces both the disability and death rate for stroke patients."
