Stroke patients in NI missing out on a ‘miracle treatment’

After collapsing at home, Paul McCausland was treated with a thrombectomy, which involves inserting a small tool into the brain to pluck out the blood clot causing the stroke and killing brain cells.

Stroke Association NI say the revolutionary procedure can save patients from severe disability or death but is most effective within six hours. Currently it is only available between 8am and 6pm, so anyone admitted outside these hours would have to wait until the following morning. Every minute a stroke is left untreated 1.9 million brain cells die, so the delay could have devastating consequences.

To mark World Thrombectomy Day, Wednesday 15 May, the charity has called on the Health Minister to honour commitments made two years ago to provide a 24/7 thrombectomy service by the end of 2024.

Paul McCausland, 39, from Hillsborough had a stroke in 2021. The morning of his stroke was like every other, a cup of tea in hand ready to wake up his three-year-old daughter and then a shower whilst she happily watched cartoons on the bed. But then the unthinkable happened.

“I was walking through my dressing room, tea in hand and I felt the need to sneeze but was conscious of not spilling my tea. After I sneezed, I sensed something wasn’t right. Uncertain of what had occurred, I reassured myself in the mirror, thinking I would feel better after a shower.

“However, while in the shower, my entire right side suddenly became limp. It felt like being shot in the leg and arm, without any pain, and I collapsed onto the shower floor.

“Thankfully, the feeling in my leg and arm came back after around 20 seconds and I got myself up and looked at myself in the mirror. Again, I shrugged it off not thinking that something seriously wrong was happening and got back into the shower. This time, however, I wasn’t as lucky, I collapsed again.

“It was the longest hour of my life with my daughter on the bed oblivious to what was happening to me as I tried to crawl with one arm and one leg to my bed, stopping off for a pair of boxers. I was like the Wolf of Wall Street trying to get into his Lamborghini!”

The dad of two considers himself lucky as his parents were staying at his family home whilst their house was getting renovated. “It’s a blur but my father came to my room at around 1hr 30 mins after my stroke, as he was wondering what I was doing and why I wasn’t up and about. Once he saw I couldn’t speak or move my right-hand side he phoned for an ambulance.

The ambulance arrived swiftly, and Paul was taken to the Royal Victoria Hospital in Belfast knowing he was in trouble and that something was seriously not right.

“When I arrived at the hospital I was brought straight into theatre where they proceeded with a thrombectomy. Before this day I had never heard of a thrombectomy, probably much like most people reading, but it’s a truly remarkable procedure.

“As luck would have it, I believe there were only two consultants that were qualified at the time to do the thrombectomy procedure in NI and they were both on call the morning of my stroke. My wife told me weeks later that she had to sign a waiver allowing the surgeons to perform a thrombectomy and that it had a 50/50 chance of working. Thankfully I was on the right side of those odds. I hate to think what my life would be like without this procedure.”

Like many stroke survivors, Paul had fatigue for the first few months after his stroke, often sleeping for up to 12 hours every night and a few hours in the afternoon.

“Thankfully I have had no physical adverse effects from the stroke. I am naturally a very positive and resilient person. Granted I have good days and bad days like everyone but I am also well aware that many people are in a far worse situation than myself. Thankfully I have a great support network around me and my wife can instantly tell when I’m having a bad day. Her support has been invaluable to my recovery.”

“Now two and a half years later I still have to manage my fatigue. I had to sell my business last summer as I physically couldn’t keep it up. I felt that I needed to give my brain a proper rest. My neuro fatigue is getting better but it’s still not where it needs to be”

Alasdair O’Hara, Associate Director at the Stroke Association in Northern Ireland, said: “Thrombectomy is a very powerful treatment that instantly restores blood flow to the brain. It can treat severe strokes that would otherwise cause multiple disabilities or death. Some doctors have called it close to a miracle treatment.

“Northern Ireland as a region currently has the highest thrombectomy rate in the UK. This is testament to the tireless efforts of our dedicated stroke teams over the past few years.

“Yet provision is still not available 24/7 due to a lack of staff, funding and resources.

“In the year last year, around 100 potentially eligible patients could have missed out on thrombectomy, resulting in some patients being left with more serious disabilities following their stroke and, in some cases, death. If we continue at the current rate, at least 500 potentially eligible patients will miss out by 2029/30, which will have devastating consequences on their lives.

“Despite previous promises, the Health Minister has said it is now unlikely the service will be expanded to 24/7 by the end of 2024, meaning even more patients will be missing out on this life-changing treatment.

“As part of our Saving Brains campaign, we are calling on the Northern Ireland Executive and Assembly to deliver on their commitments for thrombectomy expansion and give the service the multi-year investment and support it urgently needs.

“The Health Minister has recently stated that it will cost just over £5 million to expand the service to be available 24/7. Given the wealth of evidence for the cost-effectiveness of thrombectomy, we believe that it is an investment worth making, even in these times of financial pressures.

“On average, each patient who receives thrombectomy saves the NHS £47,000 in on-going care over five years. If we had delivered thrombectomy to every patient who needed it last year, that could have resulted in around £13.2 million in savings over the next five years. Money that could be reinvested in our struggling health and social care services.

“Northern Ireland must have a 24/7 thrombectomy service for stroke so that every patient who needs it can access this miracle treatment no matter where they live or at what time of the day or night they have their stroke.”

“Paul talks about being lucky to receive thrombectomy. We often hear this from stroke survivors who received the procedure. But it shouldn't be about luck. Thrombectomy should be available as a routine treatment for every patient who needs it no matter when or where they have their stroke.”

Caption:

Thankful: stroke survivor Paul McCausland with his wife Rachel