Scot suffers life-changing disability after missing out on stroke treatment
John Watson, Associate Director for the Stroke Association in Scotland, said: “Stroke is the third biggest killer in Scotland, and the leading cause of complex adult disability. But the latest official figures show the ongoing failure of health boards to make stroke the priority it needs to be.
“The failure is most striking in thrombectomy, a life-saving, life-changing treatment that should be a normal part of any modern healthcare system. Thrombectomy also saves the health and care system £47,000 per patient over five years2, potentially providing part of the solution to the current NHS and social care crisis.
“A Scotland-wide, round-the-clock thrombectomy service was promised years ago, yet less than a fifth of eligible patients get the intervention1 that could transform their lives. The thrombectomy rate elsewhere in the UK3 is more than double that in Scotland.
“Today we highlight the harrowing story of one man who was unable to get treatment because he had his stroke in the wrong place, at the wrong time of day (see Graham’s story below). Last year over 1,000 people were similarly let down by health board’s who offer thrombectomy in some places, at restricted times.
“We work closely with stroke teams and recognise the tremendous efforts made by staff on the ground. But they can’t sort this on their own. It is political decisions, from the Scottish Government and health board leadership, that determine the resources, equipment and staff available to them.
“Small sums of money, such as investing in new operating suites to perform thrombectomies, would remove an existing bottleneck, save lives and quickly pay for themselves.
“But more than anything this requires political leadership.
“Oversight of the thrombectomy programme has now been passed to the NHS Planning and Delivery Board – it needs to own this problem and make it the priority it should have been all along.”
Graham McGowan, 53, from Aboyne, Aberdeenshire, suffered left-sided paralysis when he was unable to have a thrombectomy, for a stroke he had in 2022, due to restricted availability of the procedure.
The former performance improvement consultant, trail runner and skier was rushed to Aberdeen Royal Infirmary on the evening of 20 May 2022 with a brain scan revealing a blood clot, which doctors advised should be treated with a thrombectomy.
Thrombectomy is a medical procedure that removes blood clots in a large artery, which can otherwise cause disabilities such as paralysis, blindness and communication problems.
However, Graham was told he couldn’t be transferred for the procedure because he arrived at hospital outside “office hours” at around 9pm. Otherwise, he would have been air lifted to Ninewells Hospital in Dundee, which is one of Scotland’s three specialist thrombectomy hubs.
Ninewells is only able to perform thrombectomies from 9am-7pm, Monday to Friday. The Stroke Association is calling for a 24/7 Scotland-wide thrombectomy service, which it says has been a Scottish Government commitment for years.
Instead, Graham had thrombolysis, a drug which is used to try to disperse clots and help restore the blood supply to the brain.
Three years later, Graham lives with life-limiting disability including total immobility on his left side, and is keen to raise awareness of the importance of 24/7 access to a national thrombectomy service to prevent future stroke patients in Scotland missing out on the procedure and all the positive outcomes it can bring.
He said: “I don’t want to dwell too much on the ‘what ifs’ and the cost of me not getting a thrombectomy, as it doesn’t help me mentally.
“But if you take me as an example, I was working and had an active, healthy lifestyle before I had a stroke. Now, I can’t live independently. I can’t work. I can’t drive, ski, run or mountain bike. My wife is now also my carer and there has been a dramatic change in our circumstances.”
Graham’s stroke was caused by a carotid arterial dissection – a tear in the carotid artery, which leads to a blockage or formation of a blood clot. The clot had broken up and travelled to Graham’s brain, causing the stroke. He stresses: “I’d been running the day before I had my stroke. I was fit and healthy – there were no signs that I could have a stroke, I had no risk factors.”
The immediate effect was paralysis down the left hand side of his body, leaving him unable to sit up, stand or walk, which Graham describes as, “disturbing”.
He continues: “It was difficult to deal with, but even then I thought it was temporary. I thought I would be treated and I’d be OK again.”
His rehabilitation and life since have proved otherwise. After four days of constant sleep and “unbelievable pain in my head”, Graham’s four months of hospital recovery and intensive physiotherapy began.
He returned home to his wife, Heather, and their two dogs in September 2022.
He says the support he received at Woodend Rehabilitation Hospital in Aberdeen was invaluable.
“The physio team helped me take my first, single step and taught me to walk again. But there were significant challenges at home. Heather has always been so upbeat and supportive but I can’t really do anything around the house anymore. It puts a lot of responsibility on her.”
Initially, Graham relied on a wheelchair, with Heather or a retired neighbour pushing him around the village or the woods to experience a little of the outdoors he loves so much. With perseverance and patient support he is now able to walk around the same places.
Graham now aims to walk 50km every month and is applying the same determination to volunteering with the Stroke Association’s Deeside Stroke Group.
Graham found the group online and was delighted to find it had an exercise focus. He says: “Heather pushed me in my wheelchair along to my first group session that autumn and I walked the few steps into the hall where it was held.”
In March 2024, Graham was appointed chair of the group and has found a renewed sense of purpose in using the knowledge and skills he gained in his 26 years of work to help the group thrive and welcome new members.
Deeside Stroke Support Group currently has around twenty five members, meeting weekly in Aboyne and Banchory for exercise sessions and monthly for social get-togethers. For more information, contact engagementteamscotland@stroke.org.uk.
John Watson, Associate Director for the Stroke Association in Scotland, said: “Graham’s story pulls the need for a 24/7 Scotland-wide thrombectomy service into sharp focus. Getting the best stroke care shouldn’t depend on where or when your stroke happens.
“We are enormously grateful to Graham for sharing his story to help us campaign for better stroke treatment and remain indebted for the wonderful job he is doing at the Deeside Stroke Group.”