'I had a stroke - at the age of just 46'
Niamh Malone - herself a stroke nurse - has developed an app to help fellow survivors on their way to getting back on track
As an experienced clinical nurse specialist in a busy stroke unit, the last thing Niamh Malone expected was to end up in an intensive care unit after suffering a stroke herself.
Malone's job at the rehabilitation unit in St Mary's Hospital in Phoenix Park was one she enjoyed - in fact she'd helped establish the facility some seven years previously.
So when she felt suddenly and inexplicably overwhelmed around noon one busy Friday in February 2013, the then 46-year-old, who had also been closely involved in the creation of the national Stroke Strategy, knew something was very wrong.
But she could never have predicted what was about to happen.
"In a split second," says Malone, "things seemed to build up. I felt overwhelmed; I didn't feel right."
Although her shift wasn't due to finish for another two hours, she went home - and it was lucky that she did.
If she'd waited until her shift was over, she'd have been driving through heavy traffic at the time the stroke hit - because the mother-of-one was about to have a sub-arachnoid stroke; an aneurism, in which a blood vessel in the brain ruptures, causing significant damage.
However, because Niamh had left work early, the brain injury occurred when she was safely at home in Blanchardstown.
"I'd made a cup of tea after I got home as I felt very rattled," she recalls.
"But when I was drinking the tea I felt a sensation; a kind of 'squelch' in my brain," says the Dubliner who will be speaking at the Irish Heart Foundation Stroke Survivor Conference at Croke Park on Thursday.
"I suddenly got a terrible headache and went upstairs and lay down because I thought it was a migraine.
"Then I suddenly felt a cold rush coming down the back of my neck.
"I sat up. I didn't know what had just happened but I saw my face in the mirror and I was white as a ghost."
Suddenly she experienced projectile vomiting.
"I was very frightened," she remembers.
She tried to contact a friend to ask if they could collect her daughter, Alison, then aged 13, from school, but found she was unable to use her phone. "The numbers and images made no sense," she says.
"I had to work out how to dial the number."
However, when she finally managed to contact her friend, the woman was unable to collect Alison.
"In the end I had to go myself," she recalls.
Frightened, cold and deeply unwell, Malone drove slowly and cautiously, and with much stopping and starting, to her daughter's school.
The journey took more than twice as long as normal, and after collecting Alison, she drove straight to her GP, whose practice was nearby.
"I went in the door, collapsed and started vomiting. They said I'd had a sub-arachnoid haemorrhage.
"I was put on an oxygen mask and they rang for an ambulance."
After being brought to Connolly hospital, where staff carried out a CT brain scan which confirmed the GP's diagnosis, Malone was transferred to the intensive care unit at Beaumont Hospital.
Malone was now one of the 50,000 stroke survivors in Ireland - we have, on average, about 10,000 strokes per year in this country, which result in some 2,000 deaths annually.
Although a procedure called 'coiling' stopped the aneurysm from leaking further, Malone had to cope with the severe, long-term consequences of brain injury.
"I couldn't go back to work because the stroke caused cognitive deficits," she explains now.
"I have problems processing information and with concentration and attention, so I might miss out on bits of a conversation, which would significantly interfere with my work as a clinical nurse specialist," says the now 49-year-old.
Because she now also gets dizzy spells and becomes very tired, she must schedule regular rest periods into her day.
It has been a huge upheaval but she has coped - Malone has now started her own business BraineyApp, after inventing an app to help people with brain injury establish a healthy routine to get them back on track.
The app is based on a motivational programme the determined mum devised for herself about two months after leaving hospital.
"I developed techniques to deal with the insomnia I was suffering and to structure my day and set out monthly goals," she explains.
Initially the goals were simple; getting up, getting dressed and even moving from room to room.
However, the goals became more challenging and she found her techniques worked.
"It forced me to take control of my own recovery and find ways to compensate for the cognitive deficits which resulted from the stroke.
"People suggested that I make an app of my recovery programme for others," says Malone, whose Recovery After Brain Injury app focuses on achieving day-to-day goals and setting up and maintaining routines which help patients get themselves back on track
Three years on, she's come a long way.
"When I look at myself now and compare to how I was a year ago I can see how much I have improved. It's a case of small steps, which over a year lead to big progress," she explains.
Alison's life has changed too.
"There's a bit of role reversal now, as Alison has to be a little more mature than your average 16-year-old; she has to take on a little more responsibility because although I've improved, I can still be forgetful or lapse in concentration," Malone explains.
Malone now gives regular talks to stroke support groups, brain injury support groups, multi-disciplinary journal clubs, physiotherapy conferences and specialist groups.
She will be giving presentations at the Stroke Survivor Day and the Stroke Study Day in Croke Park this week.
"I have a good quality of life compared to what I might have had so I consider myself relatively lucky," she observes.
For further information about the Recovery After Brain Injury app email firstname.lastname@example.org
Stroke: The warning signs
Symptoms of a person who has suffered a stroke include:
Numbness, weakness, or paralysis on one side of the body
Slurred speech, difficulty thinking of words or understanding other people
Sudden blurred vision or sight loss
Being unsteady on your feet
Here's a simple test to check if someone has had a stroke:
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 999 for an ambulance if you spot any one of these signs.