It’s 10 o’clock in the morning and my husband, the broadcaster Andrew Marr, has just finished yet another strenuous physiotherapy session. It’s more than two years since he had a major stroke, at the age of 53, but the long, slow path to recovery seems endless. With four sessions a week, every week, he makes small advances, though he still walks with a splint and a bad limp, and can barely use his left arm.
He is fortunate, being a broadcaster, that he can still work, waving just one arm around now instead of two. Not an hour goes by when Andrew isn’t acutely conscious of what happened.
There are bad days, but mostly he insists he has been lucky – above all because he can do what he loves. Had he been a plumber or a surgeon, the story would be very different.
The news that strokes among men of working age have shot up comes as no surprise. In the last 15 years, strokes among men aged 40 to 54 have rocketed by nearly 50%. For women of the same age, the figure is 30%.
We had always assumed that strokes were a problem for the elderly – that’s why, at first, we couldn’t believe that a fit and seemingly healthy man in his early fifties could be having a stroke.
Yet the hospital wards where Andrew spent many months in the immediate aftermath of his stroke were certainly not restricted to the over 70s. He recovered alongside working men, women who had just given birth, and even teenagers. Many were quickly doing well; many weren’t.
Stroke can affect anyone, and the results are shattering. Every stroke is different. A quarter of strokes are fatal. Half result in permanent disability.
Part of the reason for this alarming increase in strokes among younger people can be put down to a sedentary lifestyle and a bad diet. We all know that as a nation, we are becoming increasingly obese.
But that’s not the whole story. The most obvious predictor of a stroke is high blood pressure, something that ought to be picked up in a routine visit to a doctor. But for those who are otherwise fit and well, and who take regular exercise, there may be no reason to check blood pressure. In Andrew’s case, he regularly ran eight miles round Richmond park, and was not overweight, so it never entered his head to check his blood pressure.
For him, it was over-exercising that caused the stroke. An intense session on a rowing machine caused a carotid artery to tear. And this is a surprisingly common cause of stroke.
We have met people who had a stroke after turning the head too quickly while reversing a car; who suffered a carotid tear at the hairdresser’s while leaning over the basin; and, of course, who over-exerted themselves in the gym. This isn’t to say that we need to fear a stroke in normal, everyday activities. But it’s certainly worth getting the blood pressure and cholesterol checked regularly.
What, though, are the implications of stroke becoming a disease of the active middle aged as well as of the elderly? For too long, when an elderly person suffers a stroke, there’s an attempt to help them back on their feet but a general acceptance that perhaps the time has now come for life in a wheelchair.
For people of working age, it is even more essential to regain as much mobility as possible rather than face 20, 30 or 40 years without being able to get back to work. Yet the resources available are painfully scarce.
Most stroke survivors are lucky if they receive any help at all after four months, and some get much less than that.
Some excellent charities, notably Arni (Action For Rehabilitation Following Neurological Injury) and the Stroke Association do their best, but they can’t reach everyone who is in need. Physiotherapy and rehabilitation have been at the sharp end of cuts to the NHS – a false economy, surely, when people can be helped to become active again, needing less care and ultimately returning to employment.
I’ve become evangelical about this: yes, I admit it, a bore. Check your blood pressure; check your cholesterol, I tell friends – particularly those fit young gym bunnies who think it can’t happen to them. Get checked. Regularly. And if there are any symptoms, such as a numb arm or leg, a drooping mouth, speech difficulties, or a “dizzy spell” and bad headache, I tell them: get help, fast.
The reason I bore on is that some illnesses are part of the lottery of life, but strokes are different. A few small checks really can save a devastating stroke. The latest statistics are depressing, if not surprising. But with just a little more public awareness, the figures for strokes among working-age people could be going down by 50%, rather than up.
