How to rebuild confidence after a stroke

Andrea Outram had a stroke aged 54 and thought her life was over. She tells Rachael Healy how she regained her confidence.

“Talking to me now, you’d never think my self-confidence had once totally gone,” says Andrea Outram, 64. “I was never going to drive a car again.  I was never going to go back to work. I thought my life was finished.”

In 2007, Andrea had a stroke. She’d been diagnosed with atrial fibrillation (AF) a few years before. It’s a condition that can raise your risk of stroke. Andrea now takes warfarin to reduce that risk.

A woman arranging some national flags

“I didn’t realise how poorly I was and that there was the potential for me to have a stroke,” she says. “I’d been a nurse years before, but I was working as a chiropodist at this point. In my day, strokes killed you.” Andrea, from Sunderland, had a bout of AF that resulted in her going to hospital. She was released after a few days, but still didn’t feel right. “I felt like I couldn’t get my breath, or that I was going to pass out,” she explains.

Back home, Andrea was making a cup of tea when a horrible feeling came over her. “I came into the front room, drooling, and my right arm was curving up towards my chest, holding this red-hot kettle,” she says. “My husband jumped up. My mouth had dropped and when he tried to speak to me, I couldn’t say anything. “He took me over to the settee. I could see him going backwards and forwards in my peripheral vision, and it was as though he was shouting to me through several panes of glass. “After that, I can’t remember anything until the hospital. I looked around. My second daughter was wailing and crying, my dad was there, and I thought: ‘What are all these people doing here?’”

Unexpected effects 

That night, Andrea was being taken for a chest X-ray, when her husband Phil told the hospital porter that she’d had a stroke. Andrea was shocked: “I thought: ‘What made you say that? What do you know about strokes?’ And then I realised I couldn’t speak.” Phil and their four children helped her come to terms with what had happened. “My family was very supportive,” she says. “I think if you have had a life-changing illness, you understand how that support makes life so much better.”

I think if you have had a life-changing illness, you understand how family support makes life so much better

They even helped her find new ways to communicate while she was in hospital. “My eldest daughter was signing to me, asking if I wanted my clothes,” Andrea says. “I put my thumbs up and then drew around my lips to say I wanted my lipstick, too. They wouldn’t give it to me in case I put it on funny. I didn’t get it for over 48 hours – I was traumatised!” Andrea soon had a better idea. “I commandeered a piece of paper and a pencil,” she says.      

She was so chatty that Phil had to sharpen the pencil three times a day. But she couldn’t find the right spellings for most words and there were other cognitive effects, too. “I had a slight bit of confusion,” she says. “If I went to wash my hands, I would wash my face at the same time.”

Seeing an occupational therapist helped Andrea get to grips with daily tasks again. “The lady gave me this brown thing and I looked at it and thought: ‘I think I’ve seen this before, but I don’t know what to do with it,’” she says.  

The therapist explained it was a vegetable and showed her how to peel it. “I realised I was peeling a potato,” Andrea says. “Then she handed me a carrot. I did the carrot in rings, but I couldn’t do it in batons and I got upset over that. You get upset a lot of the time.” Over the next few days, Andrea relearned her cookery skills. Soon, she was making cheese scones and cupcakes.“ I really felt I was on a roll,” she says.      

At the same time, her speech slowly returned, but even the names of her four children took a while to come back. “My daughter Rebecca, I called ‘Rabunkle’,” says Andrea. “Jessica was ‘J’. I could get Adam, but Leah was ‘the little bit’. Hers was the last name I could get.”

Building confidence after leaving hospital

Three women talking and making labels

After leaving hospital, Andrea attended group sessions to help with her recovery. “I went to a stroke club at the beginning and it was very therapeutic,” she says. Andrea loves working and was keen to return to her job. “After six months, I went back to nursing and I’ve got to say I did not get the support I should’ve had,” says Andrea. “I was really demoralised, so I took six months off and really recuperated. “I now work in the chest clinic. I’ve been there for six years and I love it.

I can't do the bare minimum, it's not in my nature!

I only do 16 hours a week and I work across two wards. You could say I should retire next birthday, when I turn 65, but at this moment I don’t want to. I feel well enough and it gives me a purpose in life. ”During Andrea’s sick leave, she attended a confidence course recommended by the hospital. “Your self-confidence when you’ve had a stroke is nil,” Andrea explains. “I did a self-confidence course and the woman who ran it was brilliant.“

Andrea learned to rate activities out of 10, to represent how confident she felt about doing them. By analysing her feelings and revisiting the rating, activities started to seem less daunting. The course helped her get back to work, and to swimming, which she had previously loved.

The course leader asked Andrea how she felt about swimming. “I said: ‘I used to go, but I’m not doing that again.’ She asked me to mark it out of 10 and I gave it a two,” Andrea explains. “I was about to go on holiday, so she asked me to think about going in the pool. Every week I would rate it. When it got to six, she said: ‘Next week, you’ll be a seven – then you can do anything.’” On holiday, Andrea finally felt ready to get back in the pool. Back in Sunderland, she signed up to a swimming course. “Now I go swimming every single week,” she says.

The value of work and play 

Two woman and a school boy doing crafts

Swimming isn’t Andrea’s only hobby. She loves to keep busy. “I can’t do the bare minimum, it’s not in my nature!” she says. “This morning I was in the garden digging. I’ve got hens and a greenhouse with tomato plants.”

Andrea also loves looking after her five grandchildren and runs a Messy Church for local children. It’s a craft, baking and storytelling club, which she puts on every six weeks. “Messy Church is really good,” says Andrea. “We normally have a baking table, then eight tables of crafts and 15 minutes of story time. Then the ladies in the kitchen serve the tea I have organised.”

Trying new things and keeping busy has helped Andrea’s confidence grow, but she is careful not to overstretch herself. “Do it gradually,” she says. “You have to know your limitations. On the days I’m at work, I don’t do any washing or cleaning. I leave it for another day. And if I’m going to be out in the evening, I relax during the day.“

Andrea thinks her determination has helped her through. “I’m not conditioned to sit back and retire, I need to keep going,” she says. “One of my girls said to me: ‘You’ve got such a competitive streak in you!’ Even the day after my stroke, I was never, ever going to give up.”

BHF stroke research

The BHF is currently funding more than £16m of stroke research, thanks to your donations. We’ve funded Dr Robert Ariens at the University of Leeds to look at the structure of fibrin – a molecule that helps blood clot.

Previous research has shown that fibrin has a different structure in people who have had a heart attack or stroke.

Dr Ariens is trying to find out why, and is looking for clues as to how blood clots form in stroke patients. The results could help Dr Ariens and his team develop new drugs to prevent the clotting that leads to strokes.

It is hoped these new drugs will be safer than current options, some of which can cause excessive bleeding.

 

Related publications