The dizziness set in as Paul Lambe was speeding through the Port Tunnel a year ago.
He slowed to a crawl but managed to get out of the tunnel. Stepping out of the car, he realised his right hand side was paralysed. “I rang my wife but can remember nothing after that.”
Lambe was suffering the classical symptoms of stroke. Half a generation ago, his fate might have been death or, at best, permanent incapacitation.
"When I was in training, someone like Paul would have been brought to A&E, started on aspirin and then moved to a nursing home, where he would have stayed for the rest of his days," says Prof Peter Kelly, consultant stroke neurologist at the Mater hospital.
Luckily for Lambe, though, the “gold standard” for effective stroke treatment has been established in a major clinical trial completed months earlier.
“When we saw the positive benefits in this trial, patients began to see the treatment as part of routine care practice,” says Prof Kelly.
‘Clotbusting’
Lambe was to be one of the first patients to benefit. The ambulance arrived within 10 minutes, the Mater having been alerted, so the stroke team were waiting for him.
Within minutes he was treated with a “clotbusting” drug and scanned twice so the location of the clot in his brain could be identified.
Then he was whisked off to Beaumont Hospital, where a team had been assembled to operate.
A tube was inserted in his groin and guided to the brain, where the clot was removed. Half an hour later, he was wide awake and being shown the offending clot in a beaker.
He went back to the Mater’s stroke unit for recovery. “That’s when I realised something special happened to me. There were 10 patients in the ward with different degrees of disability – and me. I was able to walk around and talk. I was fine. I actually felt a bit guilty about that.”
Lambe's case was one of a number highlighted on Monday by the Health Research Board, which says thousands of Irish patients have the opportunity to benefit from a range of clinical trials funded through its €100 million investment in clinical research infrastructure.
Prof Kelly says the reason his patient received “three strikes of the bat” in terms of treatment is down to the clinical trials that ensured the best possible care was available to Irish patients.
Given that each dependent stroke survivor costs the State €500,000 in nursing home costs in their lifetime, there are financial as well as clinical benefits, he points out.
Cork woman Grainne Foley was 28 weeks pregnant and had just learned her baby was experiencing growth restriction in the womb when she signed up for a clinical trial examining this issue. "For me, it meant more scans and closer monitoring," she explained.
Babies
Her son John was delivered and is “flying” now at the age of three, she says. The study involving 1,100 babies experiencing growth restriction led to new international guidelines and improved survival rates for small babies.
Other trials involving Irish patients are looking at ways of improving blood flow in the legs of diabetic patients, trying to reduce inappropriate use of antibiotics by GP patients for urinary tract infections, and assessing the use of aspirin in low-risk women to prevent pregnancy complications.
Minister for Health Leo Varadkar said huge improvements had been made in stroke treatment, cardiology and cancer due to investment in research and giving access to trials.
“Ultimately, we want any patient who is suitable to take part in a clinical trial to have access to the latest treatments available in a safe environment.”
