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Stroke โ€“ Risky business

Stroke โ€“ Risky business

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

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

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,โ€ Professor Levi said. โ€œWe compared that with a control group comprising healthy people from the Hunter. It represented an enormous statistical challenge.

โ€œOnce we learn enough about the genetic factors weโ€™ll be able to profile people, even from birth, and if theyโ€™re at risk of stroke advise them to be conscious of leading a healthy lifestyle.โ€

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

โ€œI call it reverse translation, where you discover a genetic signal then go back and find out what it means,โ€ Professor Levi said.

For former pool paving contractor Tony Bailey, from Merewether, the finding is good news โ€ฆ 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 wouldnโ€™t wish a similar fate on anyone.

โ€œIf Iโ€™d known there was a genetic test that warned me I was a candidate I probably wouldโ€™ve taken it up,โ€ Tony said. โ€œStroke was never really on my radar โ€“ thereโ€™s no family history of it โ€“ but in hindsight I ticked every box because my diabetes was out of control, I was stressed, I was smoking and drinking.โ€

The day of Tonyโ€™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.

โ€œNo alarm bells were ringing yet โ€“ Iโ€™m thinking thereโ€™s something wrong with the carโ€™s brakes. I went to take off again and spun the wheels. Obviously I was losing feel in my right leg, so Iโ€™d lost my finesse with the brake and accelerator,โ€ he said.

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

โ€œBy 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 mateโ€™s wife, โ€˜I think Iโ€™m having a strokeโ€™.โ€

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.

โ€œI 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.โ€

Fortunately for Tony, the stroke team is also renowned for its ground-breaking research work on MRI scanning and clot-busting therapy. He couldnโ€™t have been in safer hands.

โ€œI 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.

โ€œRehab was a totally different environment and experience. It gave me the incentive to get better. I told the doctors Iโ€™d be out in two weeks but they advised me not to get my hopes up โ€ฆ In so many words they estimated I could be there for up to three months.โ€

Tony was wheelchair bound initially but soon progressed to a walking stick, which โ€œwas like winning Lottoโ€. Every moment he wasnโ€™t doing physical exercise heโ€™d visualise himself walking and using his hands.

โ€œWhether or not that helped retrain my brain I canโ€™t say, but little by little my dexterity returned. Within that two-week period I was allowed to go home.โ€

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 Tonyโ€™s wife, Jenny.

โ€œFinancially, Tony was the major breadwinner of the household but that came to an abrupt halt โ€“ one day he was earning the money and next day he wasnโ€™t. That meant I had to step up to the role and look for fulltime employment,โ€ she said.

โ€œI was very fortunate that the club I work at gave me extra hours, understanding my circumstances, but of course Iโ€™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.

โ€œThat very first day I can honestly say I needed God โ€ฆ I needed a piggyback ride because I didnโ€™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.

โ€œHeโ€™d been the strongest, biggest person in our lives and I could see him in a really vulnerable state. I couldnโ€™t cope with his not coping. He just cried โ€“ I donโ€™t know whether it was fear, frustration or disbelief โ€“ but I looked at him and thought โ€˜heโ€™s only 50โ€™.โ€

Jenny asked Tonyโ€™s doctors if the effects were going to be permanent but they couldnโ€™t predict.

โ€œIf Iโ€™d know there was a predisposition to stroke I definitely wouldโ€™ve encouraged Tony not to smoke or drink as much. Weโ€™d have looked at his health in a different light because I thought he was strong as an ox, and itโ€™s just not like that.โ€

Tony agrees: โ€œMy business was spiralling and I was incredibly stressed. The way I was going it couldโ€™ve been something worse. Iโ€™m the luckiest bloke alive because the stroke couldโ€™ve taken me.

โ€œOn the morning I left, little Charlotte got up, gave me a cuddle and said โ€˜I love you Daddyโ€™ as I walked out the door. Those couldโ€™ve been the last words she ever said to me.โ€

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