Beth Browning (Smashing it after stroke)
This podcast was created and is hosted by Paul Burns, a young survivor of stroke. This podcast series is part of Stroke Foundation’s Young Stroke Project.
Special episode - Smashing it after stroke
Episode 5, 14 July 2022 (Duration: 1:00:21)
Host: Paul Burns
In this episode Paul talks to Beth Browning, who has a strength and determination that has seen her to go on to smash it after the stroke she suffered when she was 19 years old. She’s organised a major fundraiser for the Stroke Foundation. She has also completed her studies in Nursing and has just begun her first role in the industry.
Beth chats about how she accomplished all this whilst dealing with post stroke symptoms such as fatigue and navigating the associated changes to her social life that an event like a stroke brings.
Announcer: This podcast was created and is hosted by a young survivor of stroke. This podcast series is part of Stroke Foundation’s Young Stroke Project. Find out more by visiting youngstrokeproject.org.au.
Paul: Hi there. My name's Paul Burns. I'm a young stroke survivor and I am on a mission to talk to people that have suffered strokes and other traumas and have gone on to absolutely smash it in their chosen field. We'll chat about how they approach life, manage their shortcomings, and get a few tips and tricks along the way. My guest today is Beth Browning. Beth has a strength and determination that has seen her to go on to smash it after the stroke she suffered when she was 19 years old. She's organized a major fundraiser for the Stroke Foundation. She's also completed her studies in nursing and has just begun her first role in the industry. We chat about how she accomplished all this whilst dealing with the post-stroke symptoms such as fatigue, and navigating the associated changes to her social life that an event like a stroke brings. So please enjoy this chat I had with Beth.
Paul: Thank you so much for making the time to chat with me today.
Beth: That’s alright! Thanks for having me, I’m excited.
Paul: No worries at all. So, I guess to get straight into it, nursing – has that always been a thing for you?
Beth: I think it's funny because mum's a nurse, so I think that a lot of people kind of assumed or thought that that would be something I went into, but I honestly didn't really consider it until I took a six months out straight after school and I worked and I started a different degree, it was like sport science. I think I always had this idea like, oh I really want to do something that involves me and helping people or working with people. So, I then didn't really think about it until then, and when I started it I was like, oh yeah, like I should have done this straight out, this is definitely what I’m meant to do.
Paul: It just clicked?
Beth: Yeah, yeah. It kind of just like clicked. I think a lot of people around me and my family and stuff were like, yeah, like we knew. But yeah, it's definitely, I've definitely chosen the right thing for me, I think.
Paul: Okay, so what, I mean apart from the family connection, I mean, what really drew you to it? Like, is it, I mean, just purely helping? I mean, there's plenty of, I guess plenty of occupations where you can help people and nursing’s hard graft.
Beth: Yeah, I think I was always definitely interested in like the medical side of things. You know, growing up, I watched all these medical shows and you know Grey's Anatomy and like A&E and all those things like that. And then when I, I think one of the other things was when I was 18, just before I started, I think I was kind of going towards that direction, and then one of my best friends was diagnosed with cancer and, you know, she's been battling it for the last few years, and she's okay, she’s going really well. But I think that was also one of other thing that kind of influenced it a little bit. You know, I had someone close to me and I saw what she was going through and, you know, hearing the good, the bad, the ugly about the people that were looking after her. And that was one other thing that kind of just switched on like, yeah, I think I can do, I think I can do that. Like, I think I could do, not a better job, but I think I'd be able to tell how to look after someone.
Paul: I guess there's nothing wrong with saying, hey, l want to go out there and, you know, I mean, not to say that I want to be better than everybody else, but to leave your mark. I reckon that's a great thing to do, yeah?
Beth: Yeah, yeah. So, yeah, it's definitely something that I'm very passionate about now, so.
Paul: So when you said, I mean, I remember some of my experiences and I guess we'll dig into some of yours, but in the hospital with nurses and jeez they have to have broad shoulders. I mean, I have to say that because both my mom and my stepmom have nursing backgrounds, but it's, I mean, what were your some of your experiences, like some of your stories from your friend that, you know, you sort of alluded to the good, the bad and the ugly. Like what kind of things did she tell you about the profession?
Beth: She was like, a lot of people, the hospital's a very busy place. And you can’t stop and talk to every single patient, some days it's just not possible. But it was just the small interactions that made a difference. And I think it was like, you know, instead of just walking in, dropping off the medication and running to the next patient, just literally just stopping to be like, how are you going? How are you feeling today? Like it's the basics you’re just supposed to do is a nurse, but I think sometimes people just do it as like check off the list rather than get to know the person a little bit. And when you're in there for a long time and you're going through a really crappy time, really, it's, you know, it just takes one person to stop and have a chat, to make a difference and I think, you know, when I was in hospital as well, you just there's one or two people that will stick with you.
Beth: It could have been so basic as just to be like, hey, how are you actually going?
Beth: Yeah. So, I think it was those parts that I was like, it takes 2 seconds to, you know, just take that tiny bit of extra care you know.
Paul: Yeah, and I think, not to take away from anybody else in the medical profession by any stretch of the imagination. But nurses, and I guess I'm biased, but nurses are especially pragmatic people, you know, they call a spade a spade. You never have to be in any dispute on where you stand with a nurse because they'll tell you. And I mean, I think that's refreshing, too. I mean, doctors, doctors can be different. I mean, their motivations and their training and that kind of stuff is different. But I guess nurses are just sort of immediately relatable to everybody. I mean, they've got that background, but they also come across as real people. I mean, yeah, I mean, not to sorry, I guess I'm hedging my bets here, but not saying that other people aren't real people, but they but you know, they're especially relatable.
Beth: I think a lot of the time they're the link between the patient and then maybe the surgeon or the doctor, and they’re the person you're dealing with 90% of the time. So, it helps to have someone that you relate to and someone that you can be like, hey, you know how we're chatting about this before? You know, like I think having that relationship with someone that you can trust and that you can talk to, and not saying you can't with the doctors, it's just, not there a lot of the time so it's you know, having that person that can be that link and that advocate is really important. So, there's one part that I do like about it is you get that connection with the patient, and build that relationship and stuff like that.
Paul: So is that did they, I mean did they cover that off or any of that sort of aspect off in the training in nursing? Or is it very much a science, you know, medications? I mean, do you get that exposure?
Beth: Yeah, I think you're, you know, in classes in theory. It's very much like, you know, this is what you're doing is how it works. But I do cover the more like therapeutic relationship. I guess that kind of, they try and encourage it obviously. But then when you're on prac placements that you're actually working in a hospital, those are the times that you pick it up from the nurses around you and the people that are caring for the patients around you. And you know, you learn from them and you kind of you observe a lot and you pick up your like, I guess your own style. Like in a weird way, you kind of pick what works for you and how you can kind of like have a chat to a patient or. Yeah, and yeah, you're sitting back and watching it like your preceptors and you know, your other senior nurses and how they kind of work is where you definitely learn the most.
Paul: And I guess it's those, yeah, interpersonal relationship skills have to be, you know, so important in that space, I mean, without getting too much into my background. But you know, my profession is technology and you learn all the technology, but if you can't talk to people, you can't apply that technology. So it's so so key.
Beth: Yeah. And I guess finding that common ground with someone that is in hospital, because a lot of the time, you know, people could be in there and it's like the worst moments of their life. And yeah, it could be someone who you would never normally relate to, like. And you have to kind of build that relationship and be like, hey I know I'm like this, you know when I started I’m this 18, 19 year old girl that I'm just learning how to be a nurse. Do you mind if I look after you? You know, you it's this weird, like, especially when you're a student. It's like, hey, like, I'm a student. Is it okay with you if I'm here and is it okay if I kind of like, help you with this and stuff. It's just kind of like learning those boundaries and still kind of learning for yourself as well. It's a weird in-between, but I'm glad that I'm, you know, at the end of the student phase now. But I learnt a lot.
Paul: And you're still I mean, you're still very excited for it even at the end of the student phase, because I mean it’d be so easy, particularly after, you know, your issues and, you know, couple of years of pandemic, you know, it would be totally understandable if you're a bit sort of hesitant, I guess. I mean, you still got the burning passion there?
Beth: Yeah. Like I think that even though, you know, you go through some times when you're a student and you know, just through uni in general, that you're like, am I doing this? Like, am I really keen to be a nurse, you know, people along the way are like, well, okay, like you go and especially with the pandemic and things, I think everyone's like, alright, you’re a tough one. And I know it will be at times, but at the same time, I couldn’t picture myself doing something else. So I'm still I'm still nervous. I start, I've got my orientation next week, so I'm still nervous, but at the same time I'm like excited to just get into it and, you know, keep learning and stuff like that. Yeah.
Paul: Yeah. Okay. Well, that sounds I mean, it sounds like you've been pretty, now that you've found your space, is it fair to say, you’re, you’re pretty damn focused. You're willing to get in there and give it a good a good crack.
Beth: Yeah, definitely. Yeah.
Paul: Yeah, that's cool. Okay. So, I guess to sort of go into a little bit of your situation, you know, you've, as you said, you've just finished uni, but in amongst that mix somewhere, I guess the wheels kind of fell off. Fell off a little bit. So, you were 19 when you had your stroke? Is that, is that right?
Beth: Yeah. So I would say it was like a year or so in almost halfway, I guess in my degree, I was 19. Um, and yeah, I guess things changed quite quickly for me.
Beth: Yeah. So I had, I had my stroke, um, you know, I was in the midst of exams and all that sort of stuff. So it was, it came out of nowhere.
Beth: But I guess like I, the most of my recovery and dealing with the stroke was came afterwards and learning how to kind of figure things out but still be able to do the studies and do the things that I wanted to do.
Paul: So yeah. So I guess with regards to that, that stroke, that event, because you had some complications around that point too. So I mean, can you tell me a little bit or share with, you know, a little bit about. I guess you've had this event, you're in the hospital. I mean, jeez what were you. when you could think, because I remember, you don't think too much in your early days, but when you could actually start to piece it together, what was your take on this?
Beth: I guess I was just like confused more than anything. Like, my speech was the only thing that was kind of affected and that came back to, I guess, kind of full swing between 15 and 24 hours of me being in hospital. But I think that like that moment when I just started to think about it, I was like, what is happening? Like, yeah, you know, why? You question like, why is this happening? And at that stage, like the early stages of me in hospital, they were kind of like, we don't know why this has happened yet. We're going to try and figure it out, but we might not find out why. Well, I guess it was just those first few days were horrible, just kind of like, you know, you're in this haze of, I was so confused still and I was like, you know, you've got 1,000,001 people coming in and out of your room. And I was told by accident that I had the stroke, like someone kind of was like, oh, so, you know, you had the stroke, and Mum and I were like, wait, no no no, like, no one's actually said that word to me yet. And they were like, oh, okay, well, you know, here is your MRI.
Paul: So, this was how long post-event?
Beth: This was, I'd say, like, when did I go in? It could have been like 24 hours, ish, it was like I think, ish. It was kind of like I went in late at night and I kind of found out, okay, maybe less in the next day, but I was I think it was just like that moment when I found out and someone said stroke for the first time.
Beth: I was like, you know, I didn't really, I kind of considered it before because, you know, they were doing the FAST, you know, stroke test and things like that. And, you know, but no one really, guesses that I guess for a 19 year old.
Paul: And all this during the period where you couldn't speak?
Beth: Yeah. So by the time they told me I'd gained like most, you know, most of my speech back.
Beth: There were little points where I was kind of, words weren’t quite making sense. But you know, I was understanding everything and I could mostly communicate by that point. I think there were a few times where I would just kind of stop because I was like, I think I'm messing up my words here.
Beth: Yeah, it was an interesting few days. The first few days before figuring out why it happened. And then, you know, I started getting tests that explained that you know, we're going to do some tests on your heart, because a lot of the time in young stroke, you know, this could be one of the reasons why. And they found a hole in my heart, an atrial septal defect, that they assumed I'd had since birth but hadn’t found, didn’t know about. And they just explained to me in the most basic way that, you know, you've got the little hole, blood kind of flows through when it's not supposed to. And a little tiny clot formed around the edge of the hole and somehow, flicked up and went to my brain. So that was the explanation I eventually got, and I was like sitting there like, what? So now my heart's involved?
Paul: Jeez. Did your background in nursing help you, kind of, I don't think anyone could ever be prepared for news like that, but at least you'd be able to kind of... Did it help you contextualize it a little bit?
Beth: A little bit. A little bit. Because we'd almost covered stroke like not even a week or two before in one of my -
Paul: Oh wow!
Beth: It was used as like a case study in one of my labs. And it was just like, you know, Bob, 70 years old, has had a stroke.
Paul: Bob 70 years old, yeah.
Beth: Yeah. So that was, you know, that was kind of like I knew what a stroke was and I knew kind of like some of the other side effects that can happen. And I was like tossing that up in my head going, okay, like this is what had happened for me, but I was...it helped in a way.
Paul: That was my next question. Do you think that helped or hindered knowing what could come down the track? Is ignorance, bliss, or did it sort of?
Beth: Honestly, I think it was a bit of both. Part of me was like, hold on. Like, can this, it was always the can this happen again? Is this going to change for me? Like, is my speech affected first and then is somewhat something else going to happen and come from it? Like, I think, I think anyone would have those questions as well. So I think it was a little bit of both. In a weird way, it helped, but it also was kind of like, oh dear, like I kind of knew at that point it was pretty serious.
Paul: And I guess you can start what-if-ing with that little bit of knowledge as well or what if this happens, or what if that happens where as..
Beth: Which is not great when you’re laying in a hospital bed, and you’ve got a lot of time thinking.
Paul: Yeah, yeah. So did the I mean, did the professionals around you give you kind of any, any insight outside of what already knowledge that you and your mum had? Because I've spoken to your mum as well. But did they, did they give you a bit of a flavour of what could potentially come down the line?
Beth: I guess it was I think my, my memory and my experience of that time would be that I didn't feel I got the information that I know now. And, I think that because I was so young, 90% of what I heard was, oh, you're very young. Like, you know, it was just, oh, wow, more than... it wasn't exactly the most reassuring.
Beth: You're going wait so am I like the only person... you know like you go so this doesn't happen often, do we know what's going on sort of thing. And then there were a lot of questions that I would ask about, hey, so like what's happening now? Like, you know, like, can I go back to normal life? Like when I get discharged, you know, what's the plan for me? Because I know nothing. And a lot of the people would kind of be like, oh, yeah, you know, and handed me off to someone else, maybe check with the neuro team. But then the neuro team would be like, oh you know, maybe, maybe check with the cardiologists. And, you know, there was this weird in between. And eventually, it was like, oh, you're going to get this surgery to repair this hole in your heart because, you know, that's the cause that we've got. And then you then you'll be good to go. But, you know, that's going to happen in like two months or a month and a half.
Paul: Oh, wow.
Beth: And I was like, okay, but what happens in the in between, you know, like you've given these blood thinners and they're like oh you'll be okay, here’s the blood thinners, and then you’ll have your surgery and then you’ll be good to go. And there wasn't, apart from getting the stroke pack, the book, apart from that there wasn't a whole lot of clarity for me about what was going to happen after. And I think that knowing now that the support that I could have got or the answers I could have got, it's a bit frustrating since like there's so many amazing supports out there, like the Stroke Foundation and like, you know, there are other people out there that are like me.
Beth: But at that point, I didn't feel like I knew that at all.
Paul: Because the last thing you want to hear is, oh, well, you're young. What you’d probably prefer to hear, and I know that I felt this, is yeah, we've had five of you in last week, we know what we're doing. I mean, not that I would say it like that, but, you know, everything will be cool. You know, you jump through these hoops and you’ll get to this and everything will be hunky dory. And when there's that lack of oh, well, you're quite young -
Beth: Yeah, what am I like this weird anomaly, are there other people that you've dealt with that have had this situation. I think I felt like I was like the first person coming through that was 19 and had this stroke. And yeah, you know, don't get me wrong, between there, there were people that were amazing and there were like people that maybe I could have pushed to talk to more, but at that point in time, I was very much still like, not in denial but in shock and like, oh my goodness, like what's, what's going on sort of thing.
Paul: Yeah, decisions. I mean, I remember my time, decisions aren't really sort of...your ability to make good decisions, much less I mean, your ability to maintain a decent mood, your ability to be civil to people after you've had a stroke, let alone make good decisions, let alone, you know, try and work out and interact with the right people that are going to give you the right help...
Beth: And I acknowledge now, like I maybe could have gone through that booklet and actually like gotten past the fact that I assumed it was all old people, and pictures of old people. And I could have, you know, I could have maybe like pushed for a bit more help, but I was just not in the mental state to be able to be like, okay, now I'll go google who I can talk to. I was not, not ready for that at that time. Um, so yeah it was very, it was a very blurry, I think I was in there for ten days in hospital and it felt like a lot of sitting around and, you know.
Paul: A lot of sitting around. A lot of unknown unknowns.
Beth: Yeah, pretty much, yeah.
Paul: When did you start thinking, oh, jeez, what's this, how is this going to impact on my future? Did that come up in the, in the mix?
Beth: I think they came quite early, yeah. Especially considering the fact I was supposed to have an exam or two the next day, and you know, I was like getting mum to help me email people, someone at uni to try and be like, I don’t want to drop out. I don't want to like, I just need a break, I guess for a week and then can I please reschedule to do these exams. I think it came quite quickly because I was like, I don't -
Paul: Sorry, Beth, I don't mean to laugh, but I look, I just need a break for a week and then I'm going to, just cut me some slack for a week. You know, that's something I'd say for a cold!
Beth: Yeah, I guess it was kind of like, I wanted to. I wanted to not go I'm going to be off for a long time. I was like, I'm just trying to figure out what's going out right now, going on right now. Like, this is what's happened. I don't know what sort of a deadline I'm on I guess. Like I didn't want to risk having to repeat that semester or anything. So, I think in my mind I was going, but what if I do like what? I don't know why uni was so important at that point in time, but I was like, I don't like, what's this going to mean for my future? Like, am I going to be able to like comprehend uni and write essays and things? Because at that point when I didn't know whether I could sit down and write a big paragraph of information, like I had my speech and you know, I wasn't sure whether there was deeper things that were going to kind of pop up. So that was a big worry for me as well, I guess.
Paul: Ah, so you sort of didn't have the... Well, it's funny, I always sort of, you know, when you're missing cognitive abilities, you don't have the cognitive abilities to try and work out how good your cognitive abilities are.
Beth: Yeah! So I think for me it was, because when I was initially having my stroke, my words, my understanding was there I knew what I was saying was completely wrong.
Paul: Oh, okay.
Beth: So I was, I could hear myself saying it like saying the wrong words, sentences. But I just couldn't change it. And I did try and type like messages, like a message on my phone. That's how I figured out, I was by myself in my room. That’s how I figured out to try and talk to myself was because I was typing, replying to a message and all of a sudden it was just like completely muddled words.
Paul: So, you were nutting this process out by yourself in a hospital room with a phone in your hand?
Beth: Oh, so this was when I was having my stroke.
Paul: Ah right. Okay.
Beth: Yeah, so I was at home and I was like about to go to bed and, you know, I was replying to some messages and all of a sudden it was just didn't make sense anymore. So that's how, and I was like, okay, if I can't type, should I try and talk. And I tried to say a sentence out to myself and that's when I was like, okay, that's not right.
Beth: After that, when I was in hospital and you know, my speech was back and, you know, I could type to my friends and my phone and all that sort of stuff. I think that's when the questioning came. Like, what if there's like a deeper element to this that I can't test by just sitting here talking to people, like is my processing and my like ability to write long sentences and paragraphs and essays and things for uni, is that going to be affected? I don't know why.
Paul: No, but I mean, it sounds like you've got a really structured mind. I mean, to actually have the presence of mind to sit down, well, okay, let's go through a little mental checklist about stuff that I may or may not be missing. Yeah, I mean.
Beth: I think I kind of, because I had so much time sitting in a bed in hospital, I was like thinking about like a lot of things and like a lot of like what I'm going to be able to do in the future. And like a lot of the future that I was and the things I was going through at that point in time was uni, and was assignments and essays and being able to do exams and memorize things for exams and that was like a lot of what was going on. So I think that's why it took up a lot of my thoughts at that time I guess
Paul: But you'd be well within your rights as someone that's in a high pressure studying environment in right smack bang in the middle of your exams to be sitting in a hospital bed staring at the walls, just internally screaming. I mean, that's probably what I would have done. But you're still like, well, okay, well, let's get this out and all right, that's to you credit, that must've, I guess that mindset that you've got that okay, let's take, you know, one step in front of the other student and, you know, it must have also stood you in good stead in, you know, prior to that with your studies. I mean, have you always been a bit like that? You've always been quite methodical in the way you approach stuff.
Beth: I wouldn't say, I don't know. I think if I actually, maybe not in normal day to day life. I think if I sit down and I'm with my studies and it's just me and my laptop and my notes, learning to do, I guess there's a process, you know, prioritising, and I think you have to do that when you're studying anyway. So I think I just got into the habit of that like, knowing what needs to be done when and I guess that came into it with my thought processing, alright, well this is the next step, I guess, like figuring out what I can do. And I wasn't really getting a whole lot of guidance from everyone else. So I think it was like okay, so, you know, I want to figure out this and I was discharged and I went to a really amazing OT, but it was, for me it was, it wasn't a huge amount of deep, assessments, I guess. It's hard, like, what am I going to do, sit and write an essay?
Beth: You know. So a lot of it came into knowing I was back on track was when I actually did get back to uni and I did have that first big assignment that was due, you know, that was like, that was the first time that I was kind of like, okay, I'm getting back into the swing of things and, you know, getting the result back for that assignment. That was like the clarification that, okay, you know, it did make sense.
Paul: Yeah, you must have had a, and I guess all survivors when they take a hit to, you know, whether it's physical or cognitive, you know lose a lot of confidence. I mean, particularly, you know, if you've got speech things and I mean, I, I say, you know, weird stuff all the time, particularly if I'm in a really relaxed environment. So, it tends to really impact your confidence in yourself.
Paul: Did you find that when you were going that first hurdle, like how's this going to go?
Beth: Oh yeah, I was so nervous and like, you know, I was sitting there writing. I think it was an essay on...I can’t remember what it was, some unit that was like pretty tough. And I was just like questioning like, oh my god is this going to make sense to anyone? Like am I actually doing this essay, like is this, is this making sense? And what if what if I get this back and I failed and, you know, I've gone through this whole hurdle and then I failed it at the end when I'm actually back at uni. I mean, like there was a lot of those things, where until I got that result back and until I kind of finished off those exams and things that I was like, oh ok.
Paul: That's a gutsy move. Like to, like to actually, you know, I'm going to know that if I'm going to move forward or I'm going to take, you know, a bit of a hit to the confidence based on a mark that someone else is going to give you. I mean, jeez Louise that's...
Beth: It was yeah, it was an interesting time. I think that just because I was so, like, determined not to miss a semester or like miss a prac placement a few months later, like I was so determined I didn't want to be behind. It wouldn't have mattered honestly it wouldn’t have made, I would have still graduated, you know, just afterwards, you know, I still would have had the same opportunities. But I think to me I was like, I want to, I want to keep...
Paul: Did you did you want it even more in some respects post injury than you did before?
Beth: Yeah, I think so. I think it was because I was like proving it was more proving to me...
Paul: Got something to prove?
Beth: I think to me I was like, all right, you know, that happened and you know, this is part of it. And yeah, I think but it also was a really good distraction in a way, in a weird way, like having something to focus on and to like, be like completely like, ok uni uni uni. Let me finish this, you know, I had like a timeframe of my semester and I think that helped a bit.
Paul: Yeah, structure.
Beth: Yeah, yeah.
Paul: Just yeah. So at least you had that the bouncing ball to follow whereas yeah, without that structure. Wow. So did you, so when you came out of, sorry jumping around a little bit, but when you came out of hospital and you sort of started to think about it reapproaching uni again, did you I mean, everyone walks away with a few temporary I call them souvenirs but you know, things like, you know, memory and your speech and that kind of stuff. Did you get, did you get the fatigue?
Beth: Yeah. So the main thing even now two and a bit years on, that I was kind of have had to learn to manage was, is fatigue. You know I say sometimes I'd muddle up my words you know, when you get really tired and -
Paul: Oh yeah.
Beth: It's become like a joke in my family. Like, you know, we joke about it because I notice it, but sometimes I want to like, you know, everyone does that now and then, but I think I do it a little bit more than I probably used to. Apart from that, my main kind of deficit, I guess, is the fatigue. And I just I didn't really understand what it was. Like people did tell me, you know, like in the hospital, you know, you may be a bit tired, may be a bit fatigued.
Paul: That’s like the understatement of the year.
Beth: And that was like the first time that word fatigue was kind of thrown at me and I was like, oh, okay, like, I understand. And then it wasn't really until I left hospital, and, you know, that first week I was like, oh, I'm exhausted. But I was like, but that could just because I got no sleep in hospital, like, and then it kind of carried on a bit and I just had to have like naps all the time, and I still do like there, it's just I had to kind of structure a nap into my day and I felt like a toddler. I was, I'm like, how am I not making it? You know, I could sleep in. I could have a huge sleep and have a massive sleep in.
Beth: And still, by like the afternoon, I'm not going to make it to dinner and past dinner if I don’t have a sleep. Or if I don't, obviously, like, I think that was a big thing. And, you know, it took a long time. Even now, I'm still learning to not push myself and to just listen to my body and just feel like I'm exhausted now. And it's just a different type of tiredness and the main, like another thing with that was just like explaining to people around me, and like explaining to my friends and you know, like the people that mattered in my life like, yeah, I can probably catch up and do something in the arvo, but can we just, I'm exhausted today I just need to have a bit of a rest soon.
Paul: How did they take it? Did they I mean, not that anyone would take it negatively I guess, but did they understand?
Beth: I think yes and know. I think a lot of people would be like, oh, yeah, that makes sense, like you're pretty tired. But I think people probably didn't take it as like just physical exhaustion. It was more like, oh yeah, she's a bit knackered, you know.
Paul: Yeah. Well, we all get like that.
Beth: Yeah, and like, oh you've just had this big thing happen to you, I guess like not a lot of people probably around me knew what it kind of entailed. And it was like friends was the main thing because I was like, didn't want to, I was trying not to be a drama queen. Like, I didn't want to be like, oh, you know, woe is me like I’m tired all the time, and I had this thing and, you know, blah, blah, blah. Like, I wanted to do the things I wanted to like still go out with my friends and still like, you know, do nice things and stuff. But I had to just pick how to word it to them and be like, this is like it's nothing, like if I have to cancel and like, if I can't catch up anymore, it's not because I don't want to and it's not because I'm just being lazy, it’s genuinely because my body is not going to function. I'm not going to be able to like, do anything if I don't just have a sleep and I don't have a rest.
Paul: Do you find you get that fatigue regardless of how much you've done or is it just, you know, regardless of, you know, you can, you know, move a pile of bricks or, you know, you can just sit around watching TV. You've got the same amount of fatigue every day.
Paul: Or does it really flex and flow depending.
Beth: I think now, I mean definitely like initially for the first I reckon year or something, it was like, doesn’t matter what I did, doesn’t matter how much sleep I got, I was always going to have that same amount of, like, tiredness and like, yeah, I could have a massive day or I could have a day where I'm literally doing absolutely nothing, and still be just as tired. I think now, it still kind of would be the same yeah, but I think that it’s just exaggerated when I have had like a massive day of like, you know, things, waking up early and then all day, that's when like the next day after -
Paul: I was going to say, is it the next day? Yeah. Yeah, that's what got me.
Beth: Yeah. It's the next day, really. You like and like recognizing that at first that like hey I might be feeling all that like, fine, all day. But then tomorrow you’re going to be exhausted, so don’t do much.
Paul: It's, it's the feedback loop is so long. Like you used to, like you know, if you do some exercise, you know, you come out of exercise, oh, I'm, you know, prior to injury, I'm ruined. So, you know, you’ve pushed yourself too hard. Whereas post stroke, I mean for me, and it sounds like for you it's push yourself hard the previous day and you go, oh yeah, I'm feeling fine, I must be getting better. And then the next day you fall off a cliff.
Beth: Yeah, pretty much. And then there's some days where it's like, even if I just had a few lazy days, like I’ve had a bit of time off and you know, I've been on holiday and stuff before starting my grad and I've had a few days where like, you know, I feel a bit guilty for doing nothing, but I've not done much. And all of a sudden, one day in the middle where it's just like, I feel like I've just run a marathon or something, like I'm exhausted. I'm like, I'm thinking I'm like, I've done nothing. Why is this like, why am I so exhausted? Like, I feel like I could just fall asleep, like, instantly. Like, I think, like, that was one thing. Just throughout out the whole thing is like I say, aw yeah, it's just, you know, yeah, fatiue I've dealt with that. But it's just it, it's a weird thing to have to deal with when you're going through like, you know, 20, 21, 22, like, you know, I'm, it's a weird thing to have to like.
Paul: I mean, fatigue is something that happens when you're 19, when you've been out till 4 a.m. in the morning, after, you know, a few pubs and a couple of nightclubs back in, you know, back in the day, you know, not, oh, well, jeez, you know, studied for a bit and now I need to sleep for 4 hours. So, I mean, so people did eventually sort of get their heads around it?
Beth: Yeah, yeah. Like my closest friends that like I guess when I was talking about it and, you know, explaining it, they kind of understood it. But I think like, you never really understand it fully 100% unless you've like experienced, like, yeah, the proper like exhaustion I guess, and just being able to be like that's not just me being a little bit tired, that’s like I'm fatigued. It's, it's a little bit different. But everyone around me has been like super supportive and like wanting to understand and to like, you know, want me to talk about it a lot and be like ok, you know, what's with this fatigue? What is it sort of thing?
Paul: So it sounds like even though they may not necessarily understand, they're definitely supportive.
Beth: Yeah, yeah. 100%. I think that was a lot of everything even when I was in hospital, like a lot of friends, you know, people find out and you tell certain people and you know, you want people to know why you’re missing in action I guess. And yeah, a few people found out and they're like, hey, like obviously, you know, they didn't understand fully what was going on. And I didn't even at the time, but everyone was super supportive and was like, you know, we're here. And when you do want to talk about it and you know, when there is more to talk about and you feel comfortable to, you know, we're here. And I did. Everyone was really like good and has been like the whole way through, I guess.
Paul: Has anyone, have any of your close friends actually seen you quite fatigued?
Paul: Yeah. I don't know about you, but I turn into a two year old.
Beth: Yep I’m exhausted, and I like zone out and I'm just, like, grumpy and, it's like, I don't know, like, there's a few of my very, very close friends that have spent, like longer times with me or like if I've been, I've been on holidays with friends and things like that, so people have seen me at that time, but I think when I'm with my family, it's a lot worse because I don't kind of like mask it like, with my friends I’m like you know, like they’re my friends they’re not my family, you know you try and kind of, not pretend, but you go I'm just a bit tired, you know and you try not to be grumpy. But my poor family, have definitely seen the worst of me throughout the years, my days where I'm extremely tired and fatigued. So yeah, my friends have, but definitely more my family.
Paul: Do you have any physical injuries from your stroke, like to I mean, walking down the street, you know, apart from, you know, fatigue and if you start bumping into things. But is this an invisible injury for you?
Beth: Yeah, it's completely, you know, invisible. And I've never you know, from the moment I was having my stroke, you know, there was no like, drooping, you know, the classic drooping of the face or the weakness of the arms. Like, there was nothing for me. It was purely just my speech processing. Yeah, so it's like the whole time it's just been invisible. So that's, it's a weird thing to have to navigate. And I guess like when you're telling new people, you're meeting new people and it comes up in conversation kind of or like they'll see something on Facebook. Or it’s a new mate, or you know, like starting a new job. And there's a lot of things that it's like, oh, like you should probably know or like I have to declare like, you know, on like a health form, you know, my history, like, okay, something that's happened to me, I am okay. But it happened, and it was big, and now I get fatigued, but I'm managing it. It's like this whole weird cycle of things that, like learning how to tell people was a really weird thing for me. Like, I think I just didn't until someone maybe found out or it came up in conversation, but you know, Perth’s a small place and there are things that I have on like my Facebook, for example, or doing volunteering stuff. And there's things like, you know, I don't hide it. And, you know, I've been doing things with the Stroke Foundation. I've had like meetings and calls and stuff, so, you know, that comes up. But yeah, it is. It's an invisible thing for me and that was something that I had to just learn to, kind of deal with I guess.
Paul: So, I mean, apart from filling in forms because you have to, is there, is there something in your head where you go, oh, are you forever balancing, you want to be come across as you don't want to be high maintenance and you don't want to be drawing attention because you know, everybody's got their dramas in life. You don't want to be seen to be drama farming I think was what you said. But by the same token, you know, you've got a balance that with well I need to give some people an explanation for the fact I fall off a cliff at 2:30 in the afternoon. When do you, how do you balance that disclosure versus not disclosure in an informal setting? Or is it you just shoot from the hip and if it feels right, you do it?
Beth: I guess it's kind of like in like if say if it's something like meeting someone new, like a new friend or like not to do with work and things like that. I guess it's just kind of I would just go with like if it comes up, of if there's like just a random time where it's like, oh yeah. Like you'd be surprised at how many times, like history and health and yeah, random things like that come up in conversations or like volunteering. You know, sometimes it's like, that's the in that I use. I guess it's just, I have this little thing in my head, like, you know, if it's someone in my life, it's like are they important, are they going to be in my life, are they can find out any way and are they maybe going to be exposed to, yeah me being super fatigued. Most of the time, it's yeah they probably will. So that's when I guess they come down to like that checklist of how do I put this into the conversation, how do I, I don't want to tell everyone. Because I don’t want to worry people, like that's another thing. I don't want to just be like, like it's okay. Like it's, you know, like I'm okay. And like that happened that it was 2 and a bit years ago now, but it was a big part in my life. And it still it still is. So, I don't know. It's a weird thing to navigate. And I think that was one thing that, like, I just figure out on my own, you can't really ask people so how do you do that, how do you hide that or not hide that? You know, it's like, you kind of just have to figure it out as you go.
Paul: It's something I still struggle with. It’s like do I, don't I and yeah, it's, it's a tough one, but it's, to be honest with you it’s the reason why I asked the question, because I still have a great answer.
Beth: And like when it came down to work and stuff, you know, for this grad program, my new job, you know, I’m working as a nurse and like you have to, you have to put down you know, your medical history and your previous work assessment. And, you know, I'm writing it down. I'm like, what if they just assume that I can't do things like, what if this hinders me? Like, what if this? You know, they look at that and they go, oh, like, is she going to be, like, capable enough to do? Like I just always almost feel like, let me just clarify.
Paul: Yeah, almost unconscious bias. Like, well, they’ve had a stroke. It's not their fault. But, you know, we have to be sure that we can do the things that we can do when people think of...
Beth: Yeah, and on paper as well. You don't you know, there's a lot of things on paper like maybe they haven't met me yet, and they haven't, you know, sat down with me. They can't like, judge me for me. And yeah, people wouldn't, you know, there's always people are going to give you a chance to be like, okay, so like what, what's the go with this? You know, how do we kind of manage this? Like no one's going to, like a lot of people won’t discriminate, it’ll just be like, okay, so, like, what do need to do with this? Is there anything?
Paul: Okay, so they're happy to work with you in a certain sense and -
Beth You know, have a chat. But it's just that initial thought of like, oh, what, what if?
Paul: What if? Yeah, yeah.
Beth: So it's a weird, that's a weird thing to navigate and, you know, learn how to...
Paul: Yeah. Well, so how do you manage your fatigue? I mean, what tips or tricks do you have for fatigue management?
Beth: For me, it's just like honestly, just like listening to my body. Like, if I'm feeling like exhausted, just to be like, all right, you know, you can be lazy today. Like, have a sleep, have a rest get up and then see how you feel. And I think a lot of, at first I wasn’t very I think I would try to push myself maybe a little bit more than I should have or I felt guilty just being lazy and just for sleeping and like having a huge sleep in and then needing to go sleep again. Even now sometimes I get that like I'm like I'm being so lazy, but if I wasn't, then I would just be like a wreck anyway.
Beth: So I think now it's just, I don’t have, you know, the best routine and like the best, like tips. But it's honestly just like learning to listen to my body and just to be like, okay, like that's a bit, much like, you know, don't book in too much stuff to do this week.
Paul: Yeah. Okay, so more of a proactive, so, I mean, do you get proactive about it? I mean, because you sort of said I'll be, you know, when I'm feeling down, I, you know, I look after myself and that sort of stuff. But do you really sort of think, you know, for example, today's a Tuesday. I've got 10 hours worth of, zooms or whatever, maybe that's not a good idea?
Beth: Yeah, I think like the last few months it's been more, I guess social. I've had a bit of time since graduating, but when I was kind of in uni and when I was doing a lot of different I guess more like study academic type things, I just had to put like a limit on it, sometimes. Like it just came down to it look like, yeah, I've got this essay to finish, yeah, I've got this assignment that I need to work on, I've got some study to do, but like nothing's going to happen if I stare at the screen for another hour. Like, I'm not going to be able to intake it because I'm just exhausted, like, you know. So, I just had to kind of you know put a little bit more of a limit on it. And be like, alright. Tomorrow, like, you know, there were some days where I know I had a choice to go into uni are not to go into uni and sometimes alright tomorrow you can do it like, do it from home. Like, you know, you’re still going to get the same stuff done, but you're going to, not, I think you don't have that social interaction of like that extra added exhaustion. A lot of that like at uni for me, a lot of the days that I got back, you know I'd spoken to heaps of people, I was in class, I was like super stimulated and like all the lights and like all the people around you, you know, it's different to if you’re sat home on your laptop and you can you know, go have something to eat or have a drink, or have a coffee or, you know, stop for a bit and go have a nap. So, I just decided, like, which things were important and which things I had to just be like, alright, you know, this is how it's going to work today because of how I felt.
Paul: Did, did that require a lot of trial and error or were you quite, again that methodical sort of problem solving approaching things? Did you nut it out pretty quick?
Beth: I figured it out quick that like fatigue is like a serious thing. Like it's not it's not something that, like, might happen. I figured out, all right, this is happening for me. And yeah, I have to, like, not push myself. I think there were still times where I was not methodical. I was very much like, no, I need to do this. Like, I didn't want to miss out or I didn’t want to like, you know, change my plans or something. But I think eventually I figured out that like, you know, it's not, it's not something that I can just shove to the side and you know be like, oh, I'll deal with that fatigue later. It's something that I have to, like, think about now and something that I have to just kind of like work into like every day.
Paul: But comparatively, I mean, I still get it wrong. I still overbook myself and do dumb stuff and go, no, I'm going to do that and carry on like a two year old, usually when I'm already fatigued. So the fact that you've got on to that, I mean, it sounds like when you're sitting in, you know, in hospital, you know, working things out, you know, and then even now you're sort of applying that same sort of methodology to managing your things. I mean, you know, that combined with your very clear vision of where you want it to be, I'm going back to nursing by hook or by crook. I'm going to finish this damn thing and I'll do it in a smart way. I mean, would you say to those two things have stood you in the best stead to get where you've got to?
Beth: I think. I think so, yeah. Like I don't get it right 100% of the time.
Paul: Who does?
Beth: I wouldn't say like, that It's been like the most smooth sailing I mean, learning, you know, what's right and what's wrong. I think that, you know, I'm still two years on or something, so I, you know, it's taken time to, yeah know what to do and how to do it. But I think that yeah, I think having that motivation of uni and knowing not to push myself has definitely gotten me to kind of where I am and you know, how I see things I guess now.
Paul: Okay, so I think this is probably a question that, you know, a few people would want to hear about, you know, you've got through you, you did university, had a stroke, finished university and now you’re about to start nursing placements. And again, we know in Pandemic Town that, you know, nurses work a hard shift it's hard graft. How, how are you going to you know match that requirements from that and your fatigue? Is it just a case of being open and honest with people and setting expectations early?
Beth: Yeah, I think, like I learnt how to do it I guess when I was doing my prac placements, even though they were three to five, six, weeks, they were shift work, and that was like I had to be there. Like I have to get signed off, and like I had days where I was like, oh my God, why am I here? Like, you know, but I was a student at that time, so, you know, you can be not on your A-game I guess, because you've got the support there the whole time, and you can be just like hey I just need a minute, you know, can I take my break early sort of thing. But I guess, you know, you still and you can step away from something like if someone goes, do you want to do this one, you're like, oh, you know, I'll let you do that injection you know for now. Like, I'm going to go have a break and you know, like, I think you can manage it more, but I think that it's going to be a big thing of just, you know, it's just learning how to kind of, I guess, communicate it is a huge thing. I've already I've already kind of like spoken to the managers and they even suggested before they knew anything about like my stroke or probably even got my history on the paper, they were like oh as a new grad, you know, we give you the opportunity to drop down to like 0.8 or 0.9, which is like eight shifts a fortnight or nine shifts a fortnight instead of ten.
Beth: So they were already giving us that option and I was like, ok, I clocked that and I was like, alright, probably be like, good to start off with like four a week or something, you know, eight a fortnight. And then if I felt up to it, I can always pick up extra shifts because god knows there's always like extra shifts that they need covered and stuff. So I think it will definitely just come down to, you know. I know I will be all right. And that like now the fatigue that I get now versus where I was before and you know, how I managed on prac placements versus, you know, not having that experience, I guess that like I'm just going to have to just listen to my body and you know, it's still a job and it's still, you know, you can't just.
Paul: But you've got to try.
Beth: It's people's lives and you know, it’s a big job. But at the same time, like, I know that I would never kind of go into a day being like completely like should not be there because I’m so tired. And like, you know, even just being like, okay, I'll just take four shifts a week instead of the five or the three or, you know, like I think even just starting with that is probably how I'm going to be able to learn to manage it. And it's just like anything like I learnt how to deal with uni sitting in front of a laptop all day. I learnt how to deal with my prac placements and get through them. So I think it's just another step in that just, you know, learning what works.
Beth: You know, like I might figure out that oh morning shifts work for me or afternoon shifts work for me and then, you know, it's just the process of maybe putting in those requests and being like, hey, it actually works really well for me to have a sleep in in the morning and then do the 1:00pm till 9:30pm shift, you know, like it's just kind of learning what sort of a routine works and just being able to talk to people about it.
Beth: Because most of the time everyone's very supportive and you know.
Beth: You're there for a reason, and they’re there for a reason. So I guess it's like just asking for that help. So I never really was good at that before. But I want to ask for help when I need it or when you know, when you need that extra little bit of guidance or clarity and stuff.
Paul: But I guess it does take, I mean, just standing here listening oh, sitting here listening to the story, you know, it does take a certain amount of bravery to give this a go. I mean, it could be very easy to go, I don't know if I can make this work. You know, I've got this fatigue thing. I don't know how it's going, whereas it's either, you know, sitting in a hospital bed going, how am I going to do my exams and planning for that? And just, you know, or even sorry after the, after the fact, when you were talking about sitting that exam and going, I have to try, I have to test myself. And, you know, I guess you're putting it all on the line. And I think that's pretty that's pretty awesome. It's yeah, that's that's an amazing thing. I mean, I guess just one last question I'd like to ask you, and, you know, knowing what you know now, you know, couple years down the track and with all your experience and, you know, your nursing experience now and, you know, even with your mum's nursing experience now, I mean, what do you I mean, do you have any advice for people? I mean, firstly, you know, carers slash, friends slash, social circle, you know, if there’s anyone listening that's got a friend that's in this situation, do you have any advice for them?
Beth: I think it's just, you know, off offer your help or your ear more than you think you need to. Like, just, not push, but check in. And yeah, it's always nice when you just kind of like get asked, you know, like, okay, well, you know, it's so easy, how, how are you going with things like, you know, if it's if you know, it's fatigue or physical rehab or, you know, it's always nice when someone just stops for a second and goes, you know, like how are you actually going, even if on the surface, it's like, oh yeah, they’re managing they’re back at uni, they're like, you know, they’re fine like they had the stroke, they’re good. A lot of that for me was like, oh, she's out of hospital. I had the surgery and on the surface I'm fine. A lot of it was like I was still struggling. There was a lot of stuff that, you know, it wasn’t all easy breezy. There’s all the things you have to deal with. And I think, like, it's always just kind of offering that support, even when you think they're having like a very easy time or, you know, oh they're going so well with, you know, the rehab or, you know, with work, uni, I think it's just kind of being there more than you think you need to for a bit longer than maybe you think you need to. Because I think I was very much like, oh, yeah, I'm fine, I'm fine. And there were just some days where all it took was like mum to be like, I can tell that like maybe you're not. And I was like, okay, but you know, you have those moments of like, you know, you put up a wall for a long time and then someone would just have a little poke and it's like, okay, you know? So I think like for people around someone that has gone through such a big moment in their life, you know, remind them, you know, that was huge.
Beth: That was a big thing that you went through and like it's still affecting you, you know, and just have chats. Like I think for me it was a big thing was like talking, being there physically and being like, oh, like, you know, helping with meals, or, it depends on the person. It’s all important and it helps a lot. But I think just being there to actually talk is just like the biggest thing.
Paul: I think that's great. That's great advice. A lot of people don't sort of know what to say. They get a bit awkward about it too. Yeah, look I don't want to pry, but you know.
Beth: I think if it’s someone that's close to you. But a lot of people that I've spoken to, you know, it's through the Stroke Foundation and stuff, that have had strokes, everyone is extremely open. And it’s because you learn to be, and it’s because you go, oh, yeah, it happened, but you know, it becomes part of your life and you know, something you've been through and like so a lot of the time it's like, yeah, you might feel like you're overstepping and you learn boundaries and you learn, you know, what's a yes and no for different people, but just yeah, just asking them what they're comfortable with, talking to like do you want to talk about this? Like, do you want to talk about what happened or what you're going through right now? Like offering it up I think is very useful.
Paul: Yep. So what? Okay, I'm sorry, sorry, say it again?
Beth: So it is a very hard thing to navigate.
Paul: Yeah, it's, t's really hard. I think a lot of people struggle with it because they, you know, people come out of these events radically different as well. I mean, personality changes and then there's effect with families and yeah, it's a big thing, but I think that's a great tip. You know, make the attempt and be guided by the person that's having the issue.
Beth: Yeah. Yeah. I mean, it’s simply said, but you know, it is a challenge either way. But yeah, it's just, you know, trying to gauge off that person what they want to talk about and how they want to talk about it.
Paul: So, this one might be a harder one then. Again, knowing what you know now, what would you say to Beth that's just had the event and, you know, starting to, you know, get her capabilities back a little bit, but is asking questions of what future is going to look like. Uncertainty, you know, with all the experience you've got now, what what's a key piece of advice that you give, um, you know, survivors that are very new to the experience.
Beth: Yeah. I think a huge thing would be like for me when I came out, I was trying to be very independent. Like when I came out of hospital I was like, I was trying to be like, I'm okay. You know? I didn't want help. I had so many appointments, everything that I just didn't want to search for people to...I wanted someone to come to me and be like, hey I’ve had a stroke, we can talk about that. Like, all I wanted to do was talk to someone that had been through the same thing, but I didn't actively go out and search for it. And even though it was really hard at that time to be like, okay, I want to sit down, research it more, put more time into acknowledging I've had a stroke that was a big thing. I wish I did. And like, I wish I kind of maybe realized that there were like so many resources out there, like so many people out there that were in the same boat as me.
Beth: And, you know, like I would say that, like, if there was someone that went through the same thing as me, I'd want to go and talk to them in a heartbeat, because that's the only thing I wanted at that time, because everyone was like, Oh my goodness, you know, wow, you know, no one was like, oh, hey, you know, if you search this up, you know, you know, I had that stroke foundation book but I didn't maybe go and look as much as I should have. And even though it was the last thing I wanted to do it would have been amazing to talk to people that were like in the same boat as me.
Beth: I think that, you know, through things like Genyus and, you know, Facebook groups and Young Stroke Project and just going on to the Stroke Foundation website, I think that's something that maybe I wish I looked into a bit more. And I guess on top of that, like just asking for help.
Beth: Admitting that like, hey, I'm not having a good day or hey I'm struggling a bit, I’m really exhausted. Like, it's okay to ask people to help you and ask people to be there for you and that and it's ok to talk about it and talk about what happened and yeah, I think, I guess those are like those would be the main things for me, like asking for help and just listening to my body as well. Like I think at first I tried to push myself more than I, not should have, but I guess like just learning how to be like this is the new normal and this is how you got to manage it. And yeah, so there’d be a few things. But I think yeah, my main thing would be like, I wish I kind of searched sooner, I found people eventually, but I wish I searched a little bit sooner.
Paul: Okay. Well, that's great advice. Thank you so much. So now, thanks again thanks for your time Beth, that was that was that was an amazing chat. Yeah I always do these chats with people and I always walk away with something. But yeah, I think you've given a lot of good insight and good advice today, so thank so much for your time.
Beth: Thank you for having me. It's been nice to kind of talk about it and have a different perspective on questions and things as well.
Paul: Ah, no dramas at all.
Announcer: This episode is part of the Young Stroke Podcast Series, created by Stroke Foundation’s Young Stroke Project. Find out more by visiting youngstrokeproject.org.au. You can listen to dozens of other podcasts on our Stroke Recovery website, enableme.org.au. StrokeLine’s allied health professionals can help you manage your health and live well.
StrokeLine is a practical, free and confidential service. Call 1800 787 653, Monday to Friday, 9 a.m. to 5 p.m. Australian Eastern Standard Time or email email@example.com. The advice given here is general in nature. Discuss your situation and needs with your health care professionals. The Young Stroke Podcast Series is presented by Australia’s Stroke Foundation and funded by the Australian Government Department of Social Services.