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The stroke survivor turned rehab provider

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When Mark Fricker suffered a stroke aged just 32, the lack of access to dedicated rehabilitation inspired him to retrain as a stroke rehab specialist. Here, he shares his inspirational story

Mark Fricker is very matter-of-fact about the impact of his stroke.

I view it as a positive moment in my life,” he says.

“I now help people walk again, which is very rewarding, and I feel I have been given this chance in life to help others.”

Back in 2002, when Mark suffered a devastating stroke while on holiday, the outlook seemed bleak. With nowhere near the access to specialist rehab Mark knew he needed, he resolved to do it himself.

Eighteen years later, Mark is now helping others who are in his very position back in 2002, showing them how possible it is to rebuild your life and achieve your aspirations.

Having gone back to university to retrain, he has become an ARNI stroke rehabilitation specialist, supporting scores of people each year to rediscover new possibilities in their recoveries. 

As the founder of Destination Fit, a studio in Weybridge, Surrey, Mark supports stroke survivors, alongside people with neurological conditions including Parkinson’s and Multiple Sclerosis, on their journey to recovery. He has also established Mark Fricker Neuro Rehab, which extends that specialist support into at-home rehabilitation.

With limited NHS aftercare or resources once a stroke survivor has left hospital, I wanted to offer help to people who were in the same position that I was and to show them with hard work, determination and a commitment to succeed they can progress towards regaining some or all of their lives back,” says Mark.

Mark’s dedication to supporting stroke survivors came from his own experience of recovery, which saw him suffer a major stroke while on a motorbike holiday on July 1, 2002. He was only 32 with an eight-year-old son.

I was with a group of friends on holiday riding our motorcycles back from Germany when I collapsed and passed out,” he recalls.

“I crashed into a friend in front of me and we both fell off at high speed. I dont remember this, in fact, I dont have any memory for around six months prior to the stroke.

I remember waking in a small Belgium hospital with a broken right arm and dislocated shoulder and not being able to move my entire left side of my body, I had blurred vision and could hardly talk.

I was then flown back to the UK and it was only then that we discovered I had had a haemorrhage on the brain.

I spent six weeks in a stroke unit in London before being discharged, still paralysed and unable to walk or use my hands and arms.”

Mark’s realisation that access to specialist rehab was not readily available was devastating, but also inspiring.

The aftercare for stroke survivors then, as it still is now, was a 30-minute physio session once a week for six weeks,” he says.

I attended one of these sessions for the first week, realised that it would be nowhere near enough rehabilitation to get me walking again, and decided I would research stroke rehab and do it myself.

I set myself a long term goal of completing an ironman triathlon within five years. I knew I had a long road ahead of me as I couldnt even stand unaided but was determined I wouldnt stay in a wheelchair at the age of 32.”

Mark set aside six hours each day for his rehabilitation exercises, and refused to be deterred by the fact he could not move his left side.

The first time I was able to pick up a marble was when I knew I would overcome my disability,” remembers Mark.

“I cried with joy and that one action motivated me more than anything else.

I spent the next two years working on my rehabilitation. I could eventually walk with a stick, hold a knife and fork and drink from a cup.”

Mark’s hard-earned recovery then made him realise the desire to help others who faced a similar long and difficult journey ahead.

I decided to retrain and went back to university to study sports science and in 2007, five years after my stroke, I completed an ironman triathlon,” he says.

I also passed the level three personal training qualifications and set up Destination Fit in 2011 to help others become active and healthy. I became an ARNI stroke rehabilitation specialist and am trained in Parkinsons and MS conditions.

“I wanted to give people hope and to prove to them that with determination and support they can achieve their own personal goals”.

In the nine years since Destination Fit has been operating, Mark and his team have helped people of all ages and with a variety of conditions, improving their lives and, importantly, vastly increasing their belief in their own ability.

One client, Issy, suffered a stroke aged only nine and whilst at school. She was left completely paralysed on her right side and with some cognitive issues. Her parents were told she would never walk again, or have the use of her right arm.

She has attended Destination Fit twice a week for 18 months, and her sessions have enabled her to dance, run and rediscover many activities which previously seemed impossible.

Another client, Doug, is 71 years old, and suffered a stroke 15 years ago. He has been working with Mark for two years now, initially to improve his walking. As a result, he was able to walk around his local garden centre – an unthinkable accomplishment prior to his rehabilitation work.

“Having been through this gruelling experience of recovery myself, I am committed to giving people hope and belief they will get through it and can achieve their goals. That is what we are doing with so many clients, who are achieving fantastic results, and what we will continue to support people to do,” adds Mark.

Interviews

Video: Watch the latest edition of the Curious Case Manager

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Episode six of the Curious Case Manager features Fifth Sense, a charity for people affected by smell and taste disorders.

In this episode Vicki Gilman talks to Duncan Boak, founder of Fifth Sense and Nina Hill, director of development and operations.

They discuss Duncan’s own experience of loss of smell after he suffered from a traumatic brain injury, and how this led him to establish the charity.

Duncan and Nina explain the history and development of the charity and explain how they support individuals with smell and taste disorders through providing information, advice and access to a network of specialist clinicians.

Other topics include the causes of smell and taste disorders, smell training, smell memory and practical strategies to improve the quality of life of sufferers.

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‘Lockdown inspired me to run a marathon’

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Having suffered a brain injury which left her struggling to rebuild her life, Helen Whiteley found salvation in running. Here, she tells how she went from running for the first time to completing the Virtual London Marathon in only eight months.

“On November 24, it will be eight years since I suffered a traumatic brain injury (TBI) from a fall at home. I was found unresponsive at the bottom of my staircase at home by my husband Simon; I have no recollection of how I got there.

“I was initially taken to Huddersfield Hospital but once I was stabilised I was transferred to the Leeds General Infirmary neurosurgery department. It was here I was diagnosed with an acute subdural hematoma and fractured skull and was taken immediately into surgery for an emergency craniotomy to evacuate the hematoma. I was then placed in an induced coma on the neurosurgery ICU ward, where I stayed for a number of weeks.

This period was extremely traumatic for my family, especially my daughter Isobelle and son Isaac, who were only 13 and 9 at the time. My family were told that is was unclear as to whether I would regain consciousness once the drugs were withdrawn, and if I did, what permanent physical and mental disabilities I could be faced with for the rest of my life.

Fortunately, I did recover, albeit very slowly, although the brain injury has changed my life and who I am.

Following my accident, I suffered acute anxiety and was unable to leave the house and struggled with my balance needing a stick to help me walk. When I eventually was able to go out, I needed to be accompanied at all times. The simplest things were a struggle due to my lack of self-confidence and awareness of situations; I was taken out regularly by my physio to ensure I was able to cross a road safely.

I found it difficult to interact and communicate with people and was unable to cope in busy or new surroundings. I had, and still have, a very poor memory, struggle with cognitive functions and have lost my sense of smell and have a reduced taste.

I needed coping strategies like lists to ensure simple daily tasks like cleaning my teeth were completed. In February 2014, I suffered a seizure and have been diagnosed with epilepsy which is now controlled by medication.

I know I am not the same person I was before. I have no filter, speak my mind and can be immature, much to the horror of my children. These are all consequences from my brain injury.

Furthermore, I no longer work full time as an accountant for the NHS, as I had to retire due to ill heath, but I now work part time in a library which I do really enjoy.

I have been on a long challenging journey to get to where I am today but I have had the support of my family, my parents, occupational therapy, physiotherapy and the independent living teams.

Running came into the equation in January 2020, when my friend Gill signed me up for the Couch to 5K beginners running program with my local Northowram Pumas Running Club. I found the prospect of taking part in this extremely scary, very challenging and somewhat out of my comfort zone, having never run before.

At the first session I nearly went straight home but the support from the club run leaders was amazing. I progressed slowly on the programme, first running one minute then walking one minute, and slowly increasing this. On March 7, I did my first 5K park run with the Pumas. I was overjoyed that I had achieved this but then lockdown happened and everything changed.

During lockdown, I continued with my running. Through challenges set by our C25K run leader I felt confident to go out and run on my own and eventually I tried running off-road. The running club have been fantastic during lockdown, setting challenges for us to do and I set myself mini challenges, slowly progressing to run 5 miles, 10K, 10 miles, and 2 half marathons.

I had never taken a selfie before I started running, but as I made progress the pictures began to get posted on the running clubs social media. I have totally embraced the running bug and I am amazed by how far I have come in such a short period of time.

Prior to January of this year, I had never run or even thought I could after walking with a stick for the majority of my recovery to help with my balance issues. Running has helped in my recovery by increasing the confidence I have in myself and making me more independent, as well as introducing me to a new social group.

In hindsight, if it hadnt been for lockdown, I wouldnt have continued to run as I have. I would have been unsure of running with groups of different people and would have felt pressured. Lockdown enabled me to build up my running at my own pace with virtual support from the Pumas.

I decided to take on a new challenge and registered to take part in the Virtual London Marathon on October 4, running alongside Gill and Nic from the Pumas and following a route mapped by the running club, finishing in my hometown of Halifax at the historic Piece Hall.

This would be just a month before my 50th birthday, and nearly eight years since my life changing accident – as well as being only 8 months since I put on my first pair of trainers!

I only had one month of proper training prior to the marathon and the furthest I had run to that point was 18 miles, but I was determined to complete it. I committed to raising funds for Headway, as well as for the neurosurgery department at Leeds General Infirmary who cared for me after my accident.

I wanted to give something back, which hopefully in a small way will help support patients and their families at this critical time and to say thank you to the brilliant consultants and nurses who saved my life.

On race day, we set off from the Wraggles in Queensbury at about 8.40am. We had so much support during the run. Cars beeped and total strangers clapped and cheered us on. I was so emotional and absolutely amazed that Id done it and finished it in 05:37:45.

I know how very lucky I have been to recover from my injuries with only minor disabilities, but there are many people who are not as fortunate as I have been in my recovery. What I am doing is for them.”

To support Helen in her fundraising for Headway and the Leeds General Infirmary neurosurgery department, visit https://www.justgiving.com/crowdfunding/helenwhiteley

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The psychiatrist fighting for domestic violence victims

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Australia’s New South Wales government has promised to improve brain injury testing for domestic abuse victims after a psychiatrist drew attention to inconsistent care for vulnerable women. Psychiatrist Karen Williams urged the government to adopt a concussion protocol for family and domestic violence victims after doing her own research and being shocked at what she found.

It started when Williams noticed the disparity in how her patients were diagnosed and treated.Williams specialises in the treatment of post-traumatic stress disorders (PTSD), often with military, police, emergency personnel and other first responders.

But she also treats the general population, the vast majority of whom are women with histories of child and domestic abuse.

“I was getting two populations,” she tells NR Times. “The military patients, who are clearly identified as having PTSD, and the female population, who are mostly identified as having depression, anxiety and personality disorders, but had incredibly high rates of abuse in their histories.But Williams saw that whilst both groups had similar symptoms, and similar levels of trauma, they had very different treatment options.

“There’s a lot more funding put into supporting traumatised soldiers and first responders than there is for women who have experienced trauma within their home.

“In Australia, we don’t have much at all for women and children victims of abuse.”

This was a particular concern because of the amount of times Williams had heard about multiple head injuries and concussion among women who were victims of domestic abuse, which is similar to boxers and those player high contact sports.

“Women who’ve been unconscious several times or strangled have symptoms such as memory deficits, insomnia, migraine and mood swings, which all could be put down to PTSD and depression, but also brain injuries.”

But if Williams wanted to find out if a patient had a history of brain injuries, she would have to refer them for neuropsychiatric testing, which costs up to AUS$1000.

“This is completely unaffordable for many abuse victims so it just doesn’t happen, so we don’t investigate women who’ve had brain injuries.

“One brain injury unit told me they would consider taking on a patient if they could provide evidence that an assault happened – such as hospital records.

“This completely fails to take into account that the vast majority of domestic violence survivors will not report any assault to anyone and will not have so-called evidence.”

Then, Williams was speaking to a colleague whose son had had a head injury in a sporting field.

While they were together, a nurse rang to follow up the treatment he’d received in the emergency department.

“The nurse asked how her son’s personality and memory was, and gave a fantastic run-down of the symptoms that can happen after a concussion,” Williams says.

Williams was shocked – she’d never heard of someone ringing up women after a head injury in a domestic violence case.

She rang the local emergency department and asked about their protocol following a head injury obtained during sport.

She was given a detailed outline of the observations they take, their plan over the weeks following the patient’s injury and the advice they give the patient.

Williams called several emergency departments in other Australian states, and whilst all had a protocol for sports players following a concussion, none said they had a protocol for women who had been the victim of domestic abuse.

“There wasn’t one place that said they had a particular protocol.

“If they knew the woman had had a head injury they’d give them the basic head injury protocol, but nothing specific that took into account the very individual needs that a woman with a head injury in a domestic situation might have,” she says.

Williams says research indicates health care professionals correctly identify family violence victims about one per cent of the time.

“In sporting players’ protocol, there’s a recognition that says that your patient may not know what they’ve experienced in the past was a head injury, so the advice is to be really explicit. They’re given a list of questions to break it down with that player to make sure they understand what could be a head injury.

“There is opportunity for scanning, and neuropsychological testing if there is evidence of persistent symptoms.”

Williams says doctors should be going through the history of women, too, to see if they’ve lost consciousness in the past.

“There are a variety of mechanisms in which a woman experiences brain injuries in a domestic situation, many more than sporting probably, and the more head injuries a woman has, the greater her chance of long-term problems,” Williams says.

This includes a higher risk dementia, PTSD, migraines, learning problems and memory problems.

“But women aren’t told this, so many don’t know that they’re at risk of these things.”

Williams says there is a ’hidden epidemic’ of women in the community with brain injuries no one knows about, who could have been diagnosed with mental health issues instead.

In 2018, Brain Injury Australia released its findings after looking at the prevalence of brain injury in victims of domestic violence.

It found that 40 per cent of victims who attended hospitals in Victoria, Australia, for domestic violence had a brain injury and the majority were women.

But there’s no specific treatment for these women, Williams says, and many won’t even know they have a brain injury.

“Abused women are a very neglected population, and when you think about the money being spent on sports, and sports players, there’s no reason we can’t look after woman as well,” Williams says.

But despite these findings, Williams says it didn’t lead to any change.

“When I found all this out, I was angry and upset,” Williams says.

She arranged to meet New South Wales’s Labour MP Anna Watson in August, and when Williams told her what she’d found, she says Watson was ‘mortified’.

“She immediately got on the phone with the office of the minister for the prevention of domestic violence, and requested a meeting as soon as possible.

In the Zoom meeting a month later, Williams went over what she had found with Mark Speakman, Attorney General and Minister for the Prevention of Domestic Violence, and outlined the obstacles facing women.

But he made no promises, and Williams said she felt he didn’t understand the urgency or gravity of the situation.

Watson then went to the media, and the story was reported on. Within a week, the government produced a statement promising to investigate the issue.

“We’ll all be watching and holding them accountable,” Williams says.

“I will be trying to follow up, I won’t let it go.”

Williams is disheartened that it took media coverage to get the government to respond, but says she’s learnt a valuable lesson.

“Part of the reason I’ve spoken to the media and been vocal about it, is my experience is that when we do things quietly and ask for things politely, the government says there’s no money, despite being one of the wealthiest countries in the world. But when the voting population starts getting angry and asking what’s going on, that’s when we see an answer.

“It’s been a sad realisation for me to recognise that people don’t respond to do the right thing, they respond to winning the vote, so I will keep being as loud as possible in the media.”

Leaving brain injuries undiagnosed has significant consequences, Williams says.

“You’ve got women feeling like they’re a bit crazy, women wondering, ‘Why don’t I remember things, why have I got headaches all the time, why can’t I sleep?’

“It makes women feel worse, like something is wrong with them rather than identifying the underlying cause that we’re completely missing.

“If women are unable to work due to the physical and psychological side effects of a recurrent head injury, they need to be able to apply for NDIS funding (National Disability Insurance Agency). f they don’t know they have a brain injury they will be left to flounder – which is what is happening now.

“The vast majority of doctors don’t know about this. The medical system failing these women.”

There will be a lot to work out as support becomes available, Williams says, as some women could fear that having brain injury diagnosis could interfere with them getting custody of their children.

But, ultimately, change will benefit these women.

“All women deserve to know the truth about what’s happening to them,” she says.

“In some cases, their brain injury will be the final straw. They might think an act of violence isn’t a big deal, but if a doctor says, ‘Look how many times this has happened to you, you could end up long term brain damage’, that might be the final push that makes her take steps to leave. There’s no excuses to justify why these conversations aren’t had.”

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