On an otherwise ordinary Bank Holiday Monday, Tanya von Ahlefeldt was having a shower ahead of a day of chores.
Then suddenly she found herself in a re-enactment of that familiar public health message you see on TV.
‘It was a carbon copy of the warning about strokes and it dawned on me immediately what was going on,’ says Tanya, a healthcare communications executive from Berkhamsted, Hertfordshire.
‘I started getting dizzy, enough to think I urgently needed to get out of the shower. Then I realised half my body wasn’t working. I looked in the mirror and saw the left side of my face looked like it was hanging off.
‘My daughter, Alexa, was waiting to use the shower. When she knocked on the door, I wanted to say: ‘No, I’m still in here.’ But I couldn’t speak.
On an otherwise ordinary Bank Holiday Monday, Tanya von Ahlefeldt was having a shower ahead of a day of chores. Then suddenly she found herself in a re-enactment of that familiar public health message you see on TV
‘She poked her head round the door, screamed and ran off to call 999. The paramedics were there in ten minutes.’
Tanya had developed a major clot in her brain, causing a stroke. Every year around 100,000 people in the UK experience a stroke, with around a third dying. A quarter of cases are, like 57-year-old Tanya’s, in the ‘low risk’ category of younger people, from children up to the age of 65.
Tanya has been lucky. ‘The paramedics asked if I could walk, and I could. But by the time we were in the ambulance I couldn’t move my left side at all,’ she recalls.
‘It was completely paralysed, which was kind of terrifying, but I had already been through the life‑threatening experience of advanced endometrial cancer, and it somehow wasn’t as scary as that,’ recalls Tanya.
There is no doubt she is a fearless sort. The goddaughter of former South African president Nelson Mandela, her late father was James Kantor, a white South African lawyer and anti-apartheid campaigner who helped defend Nelson Mandela on charges of sabotage and ended up in jail with him.
James moved to England after his release in 1963 but died aged 47 when Tanya was nine.
Despite being half-paralysed after the stroke, Tanya wasn’t overly alarmed. ‘Nothing phases me,’ she says. ‘Being in the healthcare business meant I was armed with more information than most people.
‘I knew what was happening when I had my stroke — I knew that there was a way for them to sort me out with thrombolysis,’ she says, referring to the clot-busting drugs designed to unblock the blood vessels in the brain.
Clot-busting can only do so much, though. Daily physiotherapy is key for anyone hoping to build new nerve pathways and compensate for damage done to the brain.
Normal blood pressure is regarded as below 130/80. Tanya’s systolic blood pressure was a dangerous 180 after the stroke, but four months on is now 125/80 thanks to medication
Speed is of the essence in stroke treatment but there is concern many cases are being missed.
During the pandemic the number of people going to hospital with stroke symptoms fell by 12 per cent, according to Public Health England (PHE). A study published in the journal Heart last September showed that, as a result, there were 2,085 extra deaths from stroke and heart disease in March to June 2020 alone.
To counter this, in March PHE relaunched the television stroke warning campaign FAST — the acronym used to remind people of the symptoms of stroke, with ‘F’ for facial weakness, ‘A’ for arm weakness, ‘S’ for speech problems, and ‘T’ indicating it’s ‘time’ to call 999 if you see these symptoms.
Acting fast is key, says Clare Perkins, head of the cardiovascular disease programme at PHE. ‘Around 1.9 million nerve cells in the brain are lost every minute that a stroke is left untreated.’
The longer treatment is delayed, the greater the risk of paralysis, and death.
Stroke is linked to undiagnosed and poorly controlled high blood pressure and it’s now emerging that younger women may be at greater risk than previously recognised.
A study in June from the British Heart Foundation showed that thousands of women are at risk of a stroke in later life because of high blood pressure in pregnancy.
Earlier research in the European Journal of Preventive Cardiology found that women with slightly raised blood pressure at the age of 41 were at greater risk than men of developing heart disease in the ensuing 16 years.
Tanya doesn’t drink, has a healthy diet, did daily yoga and has a slim 10 st physique (she is 6 ft).
‘I would say I was 100 per cent not at risk of stroke,’ she says. ‘I don’t eat processed food and I never eat red meat.’
She did smoke up to ten cigarettes a day for 40 years, but Tanya believes undiagnosed high blood pressure was the real reason for her stroke.
Blood pressure is given as two measurements. The first number is the systolic pressure of the blood as the heart contracts and pumps it out; the second number, the diastolic blood pressure, is the pressure in the arteries between beats.
Normal blood pressure is regarded as below 130/80. Tanya’s systolic blood pressure was a dangerous 180 after the stroke, but four months on is now 125/80 thanks to medication.
‘I’d never had my blood pressure measured,’ says Tanya. This is despite undergoing extensive treatment for cancer.
Five years ago, shortly after the breakdown of her relationship (as well as her own 27-year-old daughter Alexa, she brought up three stepdaughters, now aged 26 and twins of 20), she was diagnosed with advanced cancer and spent six months recovering from the removal of her uterus, cervix, ovaries, fallopian tubes, several lymph nodes and part of her stomach.
‘I had check-ups every three months for the first two years and then every six months after that,’ she says. But no blood pressure check took place.
‘High blood pressure is one of those silent killers,’ says Tanya. ‘There are absolutely no symptoms and you just don’t know you’ve got it — although with hindsight I realise I had been having killer headaches for the previous six months.
‘It felt like my brain was oozing out of my ears and would last one or two minutes and then go. I assumed it was a migraine.’
An extraordinary 9.5 million Britons already take high blood pressure pills. But most of the population would, too, if they had their blood pressure checked, says Pankaj Sharma, a professor of neurology at Royal Holloway, University of London.
‘The level at which high blood pressure is considered in need of treatment is going down all the time as we find out more.
‘At the moment it’s anything above 130/80. Ten years ago it was 160/90 and it’s likely to go down to anything higher than 120/70. The vast majority of the population have blood pressure higher than that.’
This is because the main risk factors are obesity — with nearly three-quarters of the population estimated to be overweight or obese — and smoking.
‘Blood pressure in the Western world goes up as you get older as a result of poor lifestyle and diet,’ says Professor Sharma.
‘Most people in the UK are overweight but attempts to change lifestyle through public health intervention have been an unmitigated disaster over the last 40 years. I believe smoking rates in females are actually going up.’
Tanya is now taking daily blood pressure readings using a £19.99 monitor she bought over-the-counter and doing punishing daily physiotherapy, designed to rebuild nerve pathways in the brain.
Despite a remarkable recovery, Tanya is still working to regain fine movements that control typing with her left hand. She is also battling the fatigue that’s common in stroke survivors. But it’s the fear of another stroke that ‘terrifies me more than anything’, she says.
To reduce her risk, she gave up smoking straight away. ‘After ten days in hospital and rehab I hadn’t had a cigarette and I didn’t want another one,’ she says.
differentstrokes.co.uk
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