Celebrating Christmas after a stroke

http://news.bbc.co.uk/go/rss/-/1/hi/health/8418326.stm

Version 0 of 1.

By Jane Elliott Health reporter, BBC News

Daniella has written 10 Christmas cards

Daniella Gonzalez has been planning to spend Christmas day on the ski slopes.

'I won't be tackling the black slopes, but I do want to have a go at the easier blue runs," she said.

No mean achievement for the 36-year-old who just three years ago this Christmas had a massive stroke, which left her unable to talk and paralysed down one side of her body.

"It was a severe stroke and there was a clot. I don't know what its size was, but the doctors told me that if it had been in my lungs I would have been dead, so that is scary.

Hughes Syndrome

"The stroke was on the left side and so it affected my right side. My face was all down and my legs and arms would not work properly. I could not talk and had to signal everything with my left hand.

"I was in hospital for three months as they could not diagnose what had caused my stroke."

My stroke could have been prevented with a simple blood test Daniella Gonzalez

Tests eventually diagnosed Hughes Syndrome - commonly known as sticky blood syndrome - an autoimmune disease which can cause abnormal blood clotting in any blood vessels.

Daniella feels her symptoms could and should have been picked up.

"I find that my stroke would have been prevented if they knew more about the syndrome and I am still angry GPs know little about it," she said.

HUGHES SYNDROME Hughes Syndrome - antiphospholipid syndrome - is sometimes called sticky blood syndromePeople with it have an increased tendency to form clots in blood vessels (also known as thromboses)Any blood vessel can be affected including the veins and the arteries

"I had many of the symptoms for about four or five years.

"I had visual disturbances, pins and needles all over my body. Numbness in my fingers in my toes, legs and ears and migraines. These symptoms came and went but they were recurrent.

"I went to see several GPs and they diagnosed me with hyperventilation. I thought I was becoming a hypochondriac.

"But my stroke could have been prevented with a simple blood test."

Spotting symptoms

Professor Graham Hughes, Head of the London Lupus Centre, who first spotted the syndrome in 1983, agrees that there are still a lot of people being placed at unnecessary risk.

"I think anyone with recurrent migraine or unexpected angina (because they are young), anyone with unexpected neurological symptoms or miscarriages should be screened," he said.

"It affects one in 100 so you are talking a large number. You don't know how many are going to go on to have a clot, but if they have a positive test we tend to put them on baby aspirin."

He said it could count for as many as one in five strokes in the under-45s.

Daniella is relearning flamenco dancing

Daniella, from Bath, who is now on warfarin to thin her blood, said her recovery had been slow, but that she marked each Christmas as a milestone.

She finds her mobility has improved dramatically over time, enabling her to take up activities she enjoyed before the stroke, like dancing and skiing.

But she still finds writing a challenge, as her arm has not yet fully recovered from the stroke.

"This year I set myself the target to write 10 Christmas cards, with just a few lines in each," she said.

"My hands were more clumsy last Christmas, but my handwriting has been slowly getting better. You have to retrain your brain again.

"Even though I find it very tiring to write, I am determined to put a few short messages in cards for those special friends and family."

Power of song

Daniella also celebrated Christmas by taking part in a concert with the Bath Chorus.

She loves singing and explained that her singing voice had come back long before her spoken one.

"They told me to go home to Spain to recover, because if I recovered the Spanish, my mother tongue - which is stronger and deeper in the brain - the English would come gradually.

POSSIBLE SYMPTOMS OF HUGHES Headache, migraine or giddinessMemory loss, visual disturbance, skin disorders and thrombosis - DVTs Heart attack, stroke, pulmonary embolism, multiple sclerosis-like features, gastrointestinal disorders and pregnancy problems

"Singing is what recovered my speech. I could not utter a word, but I could sing.

"I just remembered songs that I had learnt as a kid."

Daniella is also relearning flamenco dancing.

"I am struggling. I know the steps but I am a second slower than the others, that it is how my brain works. It is frustrating for me."

She also volunteers for the Stroke Association in their Life after Stroke services network.

Dr Martin Fotherby, who is a stroke expert, said that Daniella's story showed a good recovery was possible, even after a big stroke like hers.

"Recovery is very variable but does depend on your initial presentation," he said.

"It is often said that if you haven't recovered within six months, you never will - but it is not the case.

"The speed of recovery tends to be greatest in the first six months but recovery carries on, certainly for 18 months to two years."