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Article by MOIRA PETTY
As Britain's leading
fantasy fiction writer,
Terry Pratchett
immerses himself in
an imaginary universe
where rules are bent
and the unexpected happens.
"In my world, we have a nose
for something odd. It can be a
fairly complex life," he says.
Nevertheless, he could not have
been more astonished when he was diagnosed two months ago as having
had a stroke.
He found it stranger
still that, although he was living with
the legacy of the stroke, he'd been
totally unaware he had suffered one.
Symptoms include weakness or
paralysis on one side of the body,
confusion and difficulties with
speech and vision.
But, like many people, Terry did not realise that some strokes,
classified as mini strokes, might last
only minutes and produce less
extensive symptoms, which are
often put down to other causes.
Tests revealed his stroke had been
the result of a cerebral thrombosis
— a blood clot that causes a blockage
in the artery to the brain, killing off
brain cells.
"I have dated it to two or
three years ago, because that was
when my typing started going all
over the place," he says.
Terry, 59, who lives in Salisbury,
Wiltshire, ignored this symptom,attributing his lack of dexterity
to ageing.
Although most of the 150,000
people who have strokes every
year in the UK are over 65, they
can occur at any age.
Even the fact that Terry was
treated for high blood pressure
four years ago and had heart
surgery after suffering angina
attacks a year later — both
high-risk factors for strokes —
did not alert him.
On the contrary, he believed,
and was told, these other
cardiovascular problems were
under control and no longer a
threat to his health.
Also, he has
never smoked — another risk
factor — and there is no history
of heart problems in the family.
But working on one of his
manuscripts last August, he
started to find it difficult to coordinate
his hands and brain.
"I was having a bad day and my
typing was going askew. It was
as if I was typing wearing gloves."
Terry, who lives with his wife
Lyn and has a 39-year-old
daughter Rhianna, went to see
his GP.
"After going through the
symptoms, the first thing she
asked was whether I'd suffered
any memory loss and I wisecracked
back: 'Not that I can
recall.' "
The GP gave Terry a basic
test to rule out dementia/
Alzheimer's.
The GP then
referred Terry to a specialist,
who ordered an ultrasound scan.
This would show any blockages
of his carotid artery, the principal
artery which supplies the brain
with oxygenated blood.
Terry also had an MRI scan to
check his brain activity and see
whether there were any areas of
dead tissue.
"MRI scans are damn noisy,"
says Terry.
"I got into the
groove of the bass line and
was waiting for the rest of
the band to come in.
"I wasn't
worried. I feel confident
in hospitals. I
never know what will
prove useful in my
writing so there's a
little internal editor
looking over my
shoulder."
Later that day,
Terry was shown the
scan.
"There were
grey spots where
brain cells had
turned up their toes
and died."
The right side of the brain controls handeye
coordination, so it seems
likely the stroke affected this
side of his brain.
In some ways, he's had a lucky
escape.
Strokes are the third
most common cause of death in
the UK and a leading cause of
severe adult disability.
Thankfully for Terry,
who has sold 55 million
books and just published
Making Money
—the 36th novel in the
Discworld series — his ability to
write, controlled by the left side
of the brain, was unaffected.
"My speech is no less clear
than before. I still have the lisp I
was born with," he says.
It is
likely that Terry suffered a
transient ischaemic attack
(TIA), a mini-stroke which can
last a few minutes to a few
hours and from which the
sufferer recovers within 24
hours although there will, of
course, be side-effects as brain
cells are killed off.
Like Terry, many people often
do not realise they've had a TIA,
although retrospectively they
might identify having had a
"funny turn".
Terry responds
waspishly: "My whole life is a
funny turn."
While he says he finds it difficult
to tell the symptoms of the
stroke from the signs of ageing,
a TIA can have serious implications.
Those who have suffered
one are ten times as likely to go
on to suffer a major stroke.
He has since been put on
statins, to lower his cholesterol — as high levels are associated
with stroke.
He has also given
up cheese and cut down on
red meat.
Is he worried about further
attacks?
"Yes, there could be
worse to come," he says.
"But
there could be worse to come
for all of us.
"To be honest, I'd
always associated a stroke as
having a much more deleterious
effect on the victim.
"And since being told what is
wrong, my typing has started to
improve.
"My consultant told me
other parts of the brain may, in
time, take over the work of dead
brain tissue."
Terry's other main symptom is
that he can no longer knot his
tie.
As the writer's style is more
that of urban cowboy than city
gent, this wardrobe malfunction
intrigues him more than inconveniences
him.
Terry says: "I lost the automatic
mechanism that allowed me to
do up a tie.
"I stood in front of
the mirror with my PA and tried
to copy what he was doing with
his necktie, but it wasn't altogether
successful. But it doesn't
matter — I rarely wear them."
Although his health history
might have been a red flag that
Terry was at risk of a stroke,
he remains philosophical that
nothing could have been done.
And he continues to observe,
with interest but rarely alarm,
the symptoms of his cardiovascular
problems.
"Since my stroke I have
noticed I have full recall of the
lyrics of advertising jingles from
40 years ago. Is a stroke a gateway
to a world of ancient ads?
"In other respects, I don't
suffer from memory loss as
much as slowness of retrieval.
"I say: 'What's the name of the
actress that appeared in that
programme, you know the
one.' And later on, I shout
out the name.
"I'm a fanatical worrier
only over things I have
some control over."
His one concession
to his health might
be to cut down on
gruelling long-haul
travel to promote his
work.
"Book tours," he
says gravely, "kill
you faster than
drink and drugs."
• Making Money by
Terry Pratchett is
published by
Doubleday at £18.99.
www.dailymail.co.uk
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