Stroke – Risky business

Feb 18 2013

Stroke survivor and father-of-seven Tony Bailey appreciates – in 20/20 hindsight – the value of a new genetic finding by HMRI researchers that may eventually provide a forewarning of inherent stroke risk …

In what is akin to finding a needle in a haystack, a recent genetic discovery is helping HMRI researchers take a further stride towards pre-determining the risk factors for stroke.

The team from the University of Newcastle and Hunter New England Health detected previously unknown signals on Chromosome 6, which are associated with stroke. It came during a meticulous, two-year genome analysis.

Professor Chris Levi, Director of Acute Stroke Services at John Hunter Hospital and head of the Priority Research Centre for Translational Neuroscience and Mental Health, said there were strong associations with large artery atherosclerotic stroke.

In our scanning we looked at 1200 cases and there were 610,000 variants per person analysed,” Professor Levi said. “We compared that with a control group comprising healthy people from the Hunter. It represented an enormous statistical challenge.

“Once we learn enough about the genetic factors we’ll be able to profile people, even from birth, and if they’re at risk of stroke advise them to be conscious of leading a healthy lifestyle.”

Next step for the research team – comprising Dr Elizabeth Holliday as chief analyst, Dr Jane Maguire, Professor John Attia and Professor Rodney Scott – is to return to the laboratory to explore what is actually happening in blood vessels.

“I call it reverse translation, where you discover a genetic signal then go back and find out what it means,” Professor Levi said.

For former pool paving contractor Tony Bailey, from Merewether, the finding is good news … in hindsight. Nine months ago, the father of seven was left incapacitated and on the verge of financial ruin by a sudden stroke, and he wouldn’t wish a similar fate on anyone.

“If I’d known there was a genetic test that warned me I was a candidate I probably would’ve taken it up,” Tony said. “Stroke was never really on my radar – there’s no family history of it – but in hindsight I ticked every box because my diabetes was out of control, I was stressed, I was smoking and drinking.”

The day of Tony’s stroke began at 4.30am, as usual. He hopped into his work ute, bound for Mayfield, but after two blocks his right hand fell off the steering wheel. Then, as he slowed for a roundabout, the brakes locked.

“No alarm bells were ringing yet – I’m thinking there’s something wrong with the car’s brakes. I went to take off again and spun the wheels. Obviously I was losing feel in my right leg, so I’d lost my finesse with the brake and accelerator,” he said.

“I kept driving with my left foot on the accelerator and steering with my left hand, still determined to pick my mate up for work.

“By the time I reached the house I knew something was seriously wrong. I rolled out of the car, onto the road, pulled myself up and staggered to the front door. I said to my mate’s wife, ‘I think I’m having a stroke’.”

An ambulance was immediately called and they hit the sirens on the way to John Hunter Hospital. Tony was whisked into Emergency, where a stroke nurse checked him.

“I had an MRI scan and by the time I got back I was paralysed on my right side. My speech was deteriorating as well. They gave me a drug to dissolve the clot.”

Fortunately for Tony, the stroke team is also renowned for its ground-breaking research work on MRI scanning and clot-busting therapy. He couldn’t have been in safer hands.

“I was in the G2 Ward for three days, being monitored every half hour, and by the last day I was onto them about getting to rehab. I was absolutely determined to go. G2 was treating the symptoms but not helping me get back to walking and doing what I had to do.

“Rehab was a totally different environment and experience. It gave me the incentive to get better. I told the doctors I’d be out in two weeks but they advised me not to get my hopes up … In so many words they estimated I could be there for up to three months.”

Tony was wheelchair bound initially but soon progressed to a walking stick, which “was like winning Lotto”. Every moment he wasn’t doing physical exercise he’d visualise himself walking and using his hands.

“Whether or not that helped retrain my brain I can’t say, but little by little my dexterity returned. Within that two-week period I was allowed to go home.”

Today, he spends his time writing a book about his experience and tending a veggie patch in his backyard. With five kids still under their roof, and two living away, it has meant a complete role-reversal for Tony’s wife, Jenny.

“Financially, Tony was the major breadwinner of the household but that came to an abrupt halt – one day he was earning the money and next day he wasn’t. That meant I had to step up to the role and look for fulltime employment,” she said.

“I was very fortunate that the club I work at gave me extra hours, understanding my circumstances, but of course I’m not home as much. The older girls had to take on a greater responsibility in maintaining the house because their dad is only able to do a minimum.

“That very first day I can honestly say I needed God … I needed a piggyback ride because I didn’t know what I was walking into. And when I did walk in, after speaking with Professor Levi, the shock of seeing Tony deteriorating and being unable to speak was really difficult.

“He’d been the strongest, biggest person in our lives and I could see him in a really vulnerable state. I couldn’t cope with his not coping. He just cried – I don’t know whether it was fear, frustration or disbelief – but I looked at him and thought ‘he’s only 50’.”

Jenny asked Tony’s doctors if the effects were going to be permanent but they couldn’t predict.

“If I’d know there was a predisposition to stroke I definitely would’ve encouraged Tony not to smoke or drink as much. We’d have looked at his health in a different light because I thought he was strong as an ox, and it’s just not like that.”

Tony agrees: “My business was spiralling and I was incredibly stressed. The way I was going it could’ve been something worse. I’m the luckiest bloke alive because the stroke could’ve taken me.

“On the morning I left, little Charlotte got up, gave me a cuddle and said ‘I love you Daddy’ as I walked out the door. Those could’ve been the last words she ever said to me.”