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Majella Cassidy

Majella Cassidy was driving to work when she recognised the F.A.S.T. signs of her own stroke in her rear view mirror.

One the 20th of September 2018, Majella Cassidy from Navan in Co Meath, suffered a serious stroke at the age of just 36.

A Senior Neuro Occupational Therapist (OT) who worked with stroke patients at The Louth County Hospital, Dundalk, Majella recalled that she had been feeling unwell for a few days before her stroke with a chest infection and bad cough.

“I had been living with my parents at the time and so when I got up that morning my mother was in the kitchen. She took one look at me and told me to return to bed as I looked really unwell. I have always been that person that never misses work and powers on through no matter how rough I am feeling. Also, my colleague was on annual leave and there was no one to cover if I was off sick. So, I got myself ready and headed on into work in my car.

In one way I look back on this decision and say thank god for being a stubborn mule and going into work, otherwise I would have returned to bed, my parents would have left for work and I would have been on my own and god knows how having a stroke in that situation would have panned out,” she said.

On the drive to work Majella began to cough heavily and felt that she was going to be sick, so she pulled her car over to the side of the road. She recalled that before opening the car door she said something out loud to herself and realised that her speech was slurred. She then looked at herself in the rear- view mirror and saw that her face had drooped on one side.

She then looked at herself in the rear- view mirror and saw that her face had drooped on one side.

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“This is when I started to think “could I be having a stroke?”. But the irony was too great…My main experience since qualifying as an OT over 12 years ago has been in neuro rehabilitation but particularly stroke. Despite knowing young people can have strokes, I remember saying to myself in the car, “you can’t be having a stroke, sure you are an OT in stroke rehab, plus you’re really young”.

Sadly, however Majella’s first thought was correct and she was indeed suffering a stroke alone on the side of the road.

She somehow managed to get out of the car and onto the road however realising that she needed help, she tried to reach her phone which was still in the car, but at that point her left side was completely paralysed and she couldn’t move.

“I remember just lying there on the ground but not feeling any panic for some strange reason, having a feeling of calmness. It was as if I was oblivious to the significance of the deficits I was experiencing from the stroke. I knew I was having one but just kept saying to myself you can’t be, don’t be silly. Its like your brain is divided in two, literally. One part is very logical and working to an extent so it’s telling you “yes, I’m having a stroke, you have all the symptoms, you need to get help” and the other side is just in la la land and you say to yourself “ah sure you’ll be grand,” she explained.

Thankfully two women who were passing by saw Majella on the side of the road and called an ambulance.

Majella said she remembered hearing the ambulance dispatch caller asking her rescuers to check if she was F.A.S.T. positive – Facial weakness – can the person smile? Has their mouth or eye drooped? Arm weakness – can the person raise both arms? Speech problems – can the person speak clearly and understand what you say? Time to call 112 or 999 for an ambulance if you spot any one of these signs.

Majella said that with her slurred speech she tried to tell the ladies not to fuss, and that she was fine however, they too recognised the FAST signs and confirmed that she was indeed F.A.S.T. positive. They also called Majella’s mother to tell her that she was being brought to hospital and that they believed she was having a stroke.

Majella’s first thought was correct and she was indeed suffering a stroke alone on the side of the road.

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The ambulance brought Majella to the Emergency Department of Our Lady of Lourdes Hospital (OLOLH) Drogheda. When her colleague Fiona, a Clinical Nurse Specialist in the stroke team met the ambulance, as she did for all suspected stroke patients, she got a massive shock to see that her next patient was her colleague.

When it was confirmed that Majella had suffered a stroke she was given thrombolysis treatment in record time – just 23 minutes from the time she reached the hospital.

She was then assessed as meeting the criteria for a thrombectomy, and rushed to Beaumont Hospital in Dublin when just hours after her stroke Majella underwent the procedure to remove a clot on her brain. Almost immediately after the thrombectomy all of her paralysis disappeared.

Thrombectomy is a radiologically guided interventional procedure where doctors use specialist equipment to mechanically remove the clot from the brain and restore blood supply. The procedure is carried out in two specialist centres in Ireland at Beaumont  Hospital in Dublin and Cork University Hospital in Cork.

“The most amazing thing with having the thrombectomy is the almost immediate return of function. I remember being asked to lift my left leg in the air and I could do it. By the time I had returned from Beaumont, I had a small party of professionals including my family waiting for me in Drogheda and apparently the first thing I did was wave at them with my left hand. I had my stroke at 8.15am and had returned from Beaumont with almost all function by 12.00am. That’s the power of thrombectomy,” Majella explained.

After just six days in hospital Majella returned home and said she was extremely grateful to all of her friends and family for their unwavering support.

Majella continues to advocate for thrombectomy, a treatment which she said: “saved lives.”

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As a Stroke OT Majella said that her experience has made her even more empathetic in her treatment of stroke patients particularly when it comes to post-stroke fatigue, something that she continues to struggle with.

Now working with patients with acquired brain injury, Majella continues to advocate for thrombectomy, a treatment which she said: “saved lives.”

While physically Majella made a complete recovery, she was left with the after-effects of a very frightening experience and through the Irish Heart Foundation, she accessed special counselling to help her come to terms with her experience.

For Majella, it was a few weeks after her stroke when she asked to see her own brain scans, that the enormity of the situation really hit home.

“ I could see the clot, you can see the discolouration on the scan…you realise you are looking at your own brain, and it kind of hit home then,” she said.

Majella was off work for six months mainly due to post-stroke fatigue; something that she still struggles with to this day. Today she is back working four days a week with patients with acquired brain injury and she tries to remember to take her own advice when dealing with fatigue.

“Having the stroke is probably the worst thing that has ever happened to me but also the best thing. People describe me as a new woman but I like to think I’m a better version of the old Majella. I appreciate things a lot more, I don’t let things stress me out as easily as before and I would have a more positive attitude, I’m eating more healthily and I exercise a lot more.”

Majella paid huge tribute to all the medical professionals involved in her care both in OLOLH Drogheda, and Beaumont and believes that the speed at which she was treated as one of the main reasons she has made such a good recovery.

“The speed at which they worked and the overall care and attention I was given cannot go unmentioned. Without their expertise, timely work, and good communication between them and the team at Beaumont, thrombectomy may not have been as successful as it was. We all know the saying “time is brain” and this surely should resonate with all the wonderful professionals involved in my medical care,” she said.