Surviving Strokes And Avoiding Them

No-one's indestructible

Stroke Of Fate – Stress, Booze, Smokes & Parties

The work hard, play hard mismatch that almost cost Newk the game of his life. At 58, John Newcombe was revered as one of Australia's greatest tennis legends. With a swag of multiple Wimbledon, US Open and Australian Open singles and doubles crowns under his belt, Newk was living the 'good life'. Success in business, the love of family and friends, and known for his enthusiastic appreciation for a good time, the larrakin lover of a wine and late nights was invincible.

He was partying as hard in late middle age as he was in his 20s. Life was great and he had every intention of living forever. Then, one evening in March 2003, Newk was relaxing with a glass of wine after a day's work when he was felled by a stroke.

Following is Newk's own account, taken from his new book 'No-one's indestructible', which details his treatment and care at Dalcross Private Hospital in Killara, NSW.

I'd been a medical disaster waiting to happen for years. But in my fifties – an age when your body is not what it was in your twenties or even thirties – business and sporting stress and overindulgence were my everyday companions.

I'd always lived my life to the max

I had my companies, investments and board memberships, charity work for the Starlight Foundation and other organisations, and a tennis ranch in Texas.

I was captain of the Australian Davis Cup team. After decades of playing tennis all over the world, I was also trying to make amends by devoting myself to my family: Angie, my wife, and our grown-up kids Tanya, Gigi and Clint, and their partners.

All I was doing was adding to the stress, and the pressure was building up.

With each blow-up with the difficult champion Mark Philippoussis, each win-or-die rubber, and the often unreasonable expectations of the press and the public, I knew it was all getting me down, but I thought I was coping.

I was fooling myself

In January 2003, I noticed a slight shaking in my right hand. But did I have the uncontrollable tremor checked' Of course I didn't. I was invulnerable; Superman had nothing on me. Serious illness only happened to others.

I didn't even mention it to Angie.

Had I seen a doctor about the shaking, most likely I'd have been given tests that could have saved me a lot of grief.

Instead, I rushed off to Texas to work at my tennis ranch for a few weeks before throwing myself into the next big project: my daughter Tanya's wedding to Gian Arpino at the beach house at Copacabana.

I wasn't about to let my gorgeous daughter move on to her new phase of life without a memorable wedding ceremony and a damned good party, where the noisiest, most raucous bloke present would be…guess who?

Holding court

I danced, drank, smoked, ate, made speeches and held court like Don Corleone until 5.15 in the morning.

I was having too much fun to know it, but I was punishing my body mercilessly. As I partied like a 30-year-old, my system was at breaking point.

The following Thursday I flew to Brisbane to host a function at the Powerhouse Museum. At 7.30pm, my official duties over, I joined colleagues on a verandah to chat as waiters poured wine and offered finger food.

It was there, as the lights of the city's office towers switched on and the Brisbane River lapped gently below, that my life changed forever.

Suddenly I felt a strange sensation in my head, like an electric shock and as shocking as a lightning bolt. I felt dizzy and was aware of a tingling on the right side of my bottom lip and on my tongue.

There was a bitter, metallic taste in my mouth. My right foot also felt oddly uncoordinated. Bloody hell! I thought. I must've eaten some crook food.

I put my drink down, excused myself and stood alone in the shadows, trying to work out what the hell was happening.

After a few minutes, I composed myself and returned to the group, talking and drinking for another 30 minutes as if nothing had happened.

Typically, I was doing my best to deny that anything had happened, while acknowledging a prickle of dread in my vitals that it could well have been something awful. Sanity prevailed, and instead of kicking on into the night, I called a car and returned to my hotel.

In my room I ordered room service, and watched TV. I wondered what in God's name had gone off in my head, that strange, lightning-strike sensation. Something's not right here, I said to myself. I'm not sure what, but something's not right. Then I nodded off to sleep.

I woke at 6am. Lying in bed, I was relieved that while the tingling in my mouth and the numbness in my limbs were still there, they didn't seem to be as pronounced as they were the night before.

In an hour a car would pick me up and take me to Brisbane Airport for the 90-minute flight home to Sydney. Hoping against hope that last night's episode was just a 24-hour bug, I took a shower. So far, so good.

Then I tried to shave – and I knew I was in trouble. I couldn't control my right hand. It was missing my face altogether.

I must have looked like Norman Gunston when I went to check out. I spoke to a young woman on the front desk and thought, That came out a bit funny.

My words were slurred. She looked at me knowingly, as if good old Newk had had another night on the booze.

In the car on the way to the airport it occurred to me that I may have had some kind of stroke. If so, I thought – getting panicky now – should I be flying?

My mind was filled with the deeply unpleasant prospect, for both myself and my fellow passengers, of my stricken brain popping like a grape in a pressurised cabin.

I considered going straight to a Brisbane hospital, then thought I'd be better off flying to Sydney and seeing my own doctors.

I've done some dumb things, but that decision ranks with the dumbest. I went to the Qantas lounge and ordered muesli and yoghurt, hoping that if I ate something, I'd feel more confident. I then prayed for the boarding call and that I'd make it home alive.

I sat on the plane telling myself, Stay calm, John, stay calm. I closed my eyes and put myself into a trance, trying to keep fear at bay. For the seemingly endless flight, I sat immobile, breathing slowly and deeply.

At Sydney Airport, I collected my car and powered up the expressway. Just near Moore Park, I called Dr John Yeo, former head of the spinal research unit at Royal North Shore Hospital, said I had some kind of allergy and could he see me straightaway.

John's a good friend and has offices at St Leonards, just over the Harbour Bridge from the city.

Beetling along an expressway with trucks travelling at more than 100 kilometres per hour on either side, I suddenly realised I was dicing with death. Another attack like last night's could see me lose control of my car.

Somehow I made it to St Leonards, where John was waiting for me outside his office.

He motioned for me to pull in, even though it was a no parking zone. I wound down the window and protested that I might get a ticket, but, certain after hearing my slurry tones that it was no allergy I was suffering from, John snapped: "Tough! Park it, get out of the car!"

John performed a series of neurological checks, such as getting me to close my eyes and touch my nose with my right hand. I could hit my ear, my cheek, everything but my nose.

It was obvious that my motor controls were impaired, and my speech was still a little off. My facial features were asymmetrical. By now John was almost certain I’d had a stroke. He put me in the care of neurosurgeon Professor Michael Morgan.

Rushed to Dalcross

As I was driven to Dalcross Private Hospital in Killara, I figured my blood pressure was bound to be high. It was. When we arrived at Dalcross at about 2pm, I was tested and my blood pressure was 180 over 100. My cholesterol was also dangerously elevated.

Professor Morgan wanted to perform an angiogram, an X-ray examination of your blood vessels, but when I tried to sign the release form I was horrified to discover that now I was unable to write or even print with my right hand. "It won't work!" I exclaimed.

Now I knew I’d had a stroke. I was among the 48,000 Australians who each year suffer stroke, the third-largest cause of death and a major cause of disability in this country.

The Dalcross specialists grilled me on my medical history, whether I had high blood pressure and cholesterol, heart disease or diabetes, whether I was a smoker.

They checked my temperature, respiration and pulse.

They lowered my blood pressure and cholesterol to safe levels and gave me medication to dissolve any lurking blood clots, thin my blood and help me relax.

Outwardly, I was calm

All that practice at never appearing flustered on the tennis court came in handy. But I wasn't scared. I know that in life terrible things happen to us all – to ourselves, our family, our friends.

My time, perhaps, was right then. People died all the time, so why not me? I told myself there was no point worrying. Panic would get me nowhere, and may even cause that dreaded second, fatal, stroke.

"I knew I was in the best of hands"

I knew I was in the best of hands, and I was strong and fit for a man of my age.

I had a CT scan of my brain: the right and left hemispheres (or halves), the cerebellum, and the brain stem. The angiogram, however, would still have to wait, due to my inability to sign the form.

A patient's written permission is necessary because if you have a blood clot, the angiogram dye can push it up into your brain, with fatal results. So we all had to wait until Angie arrived to sign the release on my behalf.

I can't guess what Angie was feeling on the long drive down from the Hunter Valley.

I'd called her twice now, and slurringly told her what had happened. When she arrived, she seemed in shock.

Hopefully, my calmness helped her and Gigi, and my son Clint when he came a little later, to keep their composure too, during what must have been a harrowing experience. I prayed I wouldn't have another stroke right in front of them.

I was wheeled down to the angiogram room. It was a scary, intimidating experience. Professor Morgan, the doctors and a nurse laid me out on a long table and put a band across my head to keep it completely still. Any movement can abort the angiogram.

I was given a local anaesthetic and a catheter tube was inserted into an artery in my groin. X-ray dye was injected through the tube and into my bloodstream.

The dye made the blood vessels visible. Doctors watching it all on a screen gauged how well the blood was moving through my lungs, abdomen, arms, legs and brain.

As I lay there wide awake for the unnerving four-hour procedure, trying to be still and calm while the doctors discussed my body and why it had failed me, I knew I should have seen this coming.

All this was the end result of decades of stress, booze and cigarettes.

Professor Morgan described what had happened

"Something very, very serious could have happened to you if we hadn't acted immediately," he told me.

"We've two issues – deciding whether the stroke you've had is a warning sign of a second, catastrophic stroke that will hit you within the next 24 hours or further down the track, and treating you to ensure that doesn't happen; and we also have to find out more about the stroke you had last night."

He explained that the CT scan showed no sign of bleeding and the angiogram indicated that no major blood vessels were blocked.

All the signs were that Id been pole-axed by a lacunar stroke, which occurs when the blood flow to the brain through a system of tiny arteries is blocked by a blood clot. The clot forms inside the artery because the artery has been damaged or narrowed by high blood pressure, smoking, eating too much fatty food and drinking too much alcohol. (I was guilty on all counts, except for maybe the fatty food – though I did enjoy frankfurters and cheese).

When this blockage occurs, nearby brain cells are damaged or killed from lack of oxygen.

Depending on which part of the brain loses its blood supply, different areas of the brain – such as sight, speech, balance and coordination, sensation and movement – are affected.

Some of the symptoms he listed had become terribly familiar to me over the past hours: lack of hand or arm coordination; weakness or paralysis of the face, arm, leg, foot or toes; numbness; a tingling sensation; difficulty in speaking and walking; and weakness or paralysis of eye muscles.

In extreme cases, bizarre behaviour and dementia can take place. Luckily, I was spared that.

In the next days, the tingling and numbness remained in my lips and tongue, and my right-side foot and hand, but I gradually recovered my ability to write.

Said the professor, "You've been an athlete, but you've also been, and still are, a smoker and a drinker. You've bashed yourself about a bit. And your cholesterol is way too high. John, you've got a number of stroke risk factors."

He added, somewhat unnecessarily, that I was bloody lucky to be alive.

The stroke had allowed the doctors to diagnose my problem before things got even more serious. If I'd continued the way I was going without it occurring, then I could very easily have gone on to sustain major blood vessel damage, which could have resulted in a fatal stroke.

It's the difference between a boiler letting off pressure via an escape valve or the boiler blowing up.For two days that redefined for me the term long weekend, I lay at Dalcross, trying to think positively and stay strong.

On Monday I had an MRI, a magnetic resonance imaging brain scan, to identify exactly what had happened and predict the potential of impending strokes. It confirmed that my stroke had indeed been caused by the blockage of a small artery on the left side of my brain.

The doctors explained to me the places in your body and brain where cigarette smoke reaches, and the damage it does. I'd always thought it only affected your lungs. Not so. I knew I'd never have another cigarette.

Having a stroke was a rude shock to my self-esteem. My body and brain had taken me to the heights of sporting success. They'd never let me down before, and for a time I resented their treachery.