'I've been left paralysed by stroke - because treatment wasn't available at 9pm'

A man says he didn't receive the right treatment for a stroke as he went to a hospital outside 'office hours' and he has been left paralysed.

Graham McGowan, 53, says the time he fell ill prevented him from accessing much-needed care when he suffered a stroke and was rushed to Aberdeen Royal Infirmary (ARI). Doctors carried out a brain scan which revealed a blood clot and they advised he should be treated with a thrombectomy - a procedure to remove blood clots in a large artery.

But Graham, from Aboyne, Scotland, was told he would be unable to receive the procedure, because he arrived at hospital outside "office hours" at 9pm.

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And the hospital's closest specialist thrombectomy hub, in Ninewells Hospital in Dundee, only offers the procedure from 9am-7pm, Monday to Friday. Graham, a former performance improvement consultant, trail runner and skier, was instead treated at ARI with thrombolysis, a drug which is used to try to disperse clots and help restore the blood supply to the brain.

Graham remains totally immobile on his left side, and is sharing his story in an attempt to raise awareness of the importance of 24/7 access to thrombectomy services in Scotland. 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".

"It was difficult to deal with, but even then I thought it was temporary," Graham said. "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," he said.

"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 nearby 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 said: "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.

Graham is now working alongside the Stroke Association in Scotland to push for a national 24/7 thrombectomy service, to give stroke patients the best possible chance at a full recovery.

John Watson, Associate Director for the Stroke Association in Scotland, said: "Graham's story pulls the need for a round-the-clock 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."

An NHS Grampian spokesperson said: "Access to thrombectomy treatment doubled across Scotland between 2022-2024. We understand work continues to further improve access to this vital treatment, which we are fully in support of."

Public health minister Jenni Minto said the Scottish Government was "focused on ensuring people who have had a stroke receive the best possible care as quickly as possible to enable them to live longer, healthier and more independent lives".

She said: "We will continue to work with health boards to drive up standards of local care. We know there is more to do but it is pleasing to see a rise in the number of patients receiving thrombectomy treatment. We have invested more than £51 million and are grateful to teams across Scotland for helping to expand the thrombectomy service."

The Stroke Association supports all stroke survivors and their families online, by phone and in the community.
Anyone affected by stroke can find out more at www.stroke.org.uk/scotland, or www.stroke.org.uk for services across the rest of the UK.