Kate McAlister is an early childhood educator from California. After she finished her Masters, she decided that it was time to go on an adventure, so she did a backpacking trip through Europe. She caught the travel bug and when she returned to California, she started looking for jobs abroad. As she had never been to Asia, she found a job in Hong Kong and has been teaching here for seven and a half years. Kate loves the outdoors in Hong Kong and enjoys hiking, dragon boating and trail running, as she is an adventurous woman who loves to push herself to the limits.

Kate had a slight tension in her neck, but it was nothing that she was overly concerned about. Then suddenly, one Sunday two years ago, things went awry.

‘It sort of came out of nowhere. I did notice a couple days earlier there were some pains in my neck but it just felt like a little bit of a strain, it was nothing really. I didn’t give it much thought’

Kate had been dragon boating racing all day, and was feeling healthy and strong. However, when headed home, she had a strange tingling sensation that ran through the right side of her face. She started to feel nauseous immediately.

‘I wouldn’t call it painful, it just was a really weird feeling that went through my right side of my face and then a couple minutes later, I just started to vomit, and I really couldn’t stop’

Kate wasn’t sure what was going on as she was so focused on the immediate pain of vomiting that she was not really analysing her illness and she continued to vomit for about three hours.

Kate and her friend Tim decided that she needed to go to a local private hospital, which was not something that she would typically consider when just vomiting, but deep-down Kate believes that she knew that there was something else terribly wrong.

‘Tim helped me into the wheelchair and rolled me into the hospital. I remember the light been really overwhelming. I remember keeping my head down and just letting Tim have the conversations for me. I ended up seeing a doctor and they said that I had a migraine, so they gave me an injection for feeling dizzy and also one to stop the nausea. Then they put me back in a wheelchair and said that I could go home.’

The injections helped Kate for a little while but then she spent the rest of the night vomiting and was really unaware of how much of her physical body she was losing control of.

‘When I look back I remember crawling into the bathroom and trying to vomit into the toilet, but I couldn’t stay facing it. I kept on falling to the right

Kate recalls at one point, when Tim was helping her move back to the bathroom, she looked down at her foot dragging behind her and realised that things were not good. Prior to that, she believed the diagnosis, and was convincing herself that migraines must be this intense.

After about ten hours of vomiting, Kate called her boss to tell her how ill she was and that something wasn’t right. Her boss pushed her to go back to the hospital again. This time Kate went to the Queen Mary public hospital rather than a private hospital. Patients can often find there can be a long waiting time, but they do prioritise patients and Kate was seen by a doctor fairly quickly. Kate noticed once again that she was even more sensitive to the light and noise.

‘I remember having my head down and just having Tim talk for me again. The doctors did an initial run through to see if everything was okay. I remember them looking with a flashlight into my eyes. Very quickly after I had arrived, I heard the word ‘stroke’ and then I was immediately rushed up. I actually felt incredibly relieved because it was like someone’s taking me seriously, despite knowing something terrible was happening.’

Kate didn’t have the typical signs of a stroke. She didn’t have the droopy face or loss of speech, so it had not even crossed her mind that at 31 years old, she would be having a stroke. The staff were amazing at the Queen Mary Hospital. Kate was taking care of quickly, they did a CT scan and they found a tear in one of the vessels in the right side of her neck. The doctors explained that it was a tear that may have happened possibly a week prior and it had split, creating space for a blood clot to build. The stroke hit because the blood colt broke free from the location of the tear, moving up towards the brain until it got lodged in the narrowing of vessels, cutting off blood flow.

‘I was lucky! It sounds weird that I was lucky but the fact that the clot got so big that it didn’t go to the parts of the brain that could affect my memory and my speech was a blessing.

Kate’s friends all rallied to be by her side in the hospital very quickly. They offered to call Kate’s parents but she wanted to call them herself. She was afraid that they would be even more worried to hear the news from someone else.

‘I remember it would have been late night for them and I called and just said ‘hi,’ and their response was, ‘hi what’s wrong?’ They could tell already in my voice that something was wrong.’

Kate told her parents that she had just had a stroke and that she was alright. As you can you imagine, Kate’s parents were immediately incredibly concerned, yet they tried to stay calm to understand what had happened. Kate doesn’t remember much of what was said, but her parents arrived in Hong Kong within a couple of days after the phone call.

Kate was affected physically, mentally and emotionally by the stroke. She could not move the whole right side of her body. It was very traumatising for someone so young and vibrant to go through this kind of experience. One of the other common symptoms of having a stroke is fatigue and Kate felt absolutely exhausted. This is something she is still battling with in her recovery over two years later.

‘I remember thinking ‘Am I going to be like this forever?’ I was reflecting on that a while ago. I don’t think I really ever thought that I was never going to walk again. I think in my head I was just feeling that I was going to recover and I don’t know if that was just out of ignorance or wishful thinking.’

Kate returned to work quite quickly after the stroke and felt that she should push through and do her job as she was starting a new role as Principal in her school. After a few months of intense struggle, Kate, with the help of a neuro psychologist, realised that she needed to stop work and return home to recuperate in California for a while. When she was home in California she saw a number of doctors and they connected the stroke to something that happened to her Aunt. Thus, they were concerned that her stroke was maybe caused by something genetic. Kate’s Aunt passed away in her mid 30s from Spontaneous Coronary Artery Dissection (SCAD), a dissection that occurred in her vessels connected to her heart. Kate also had a dissection in a vessel, however, hers was in her neck. There is a lack of research around SCAD, so it is still uncertain whether there could be a genetic link. There is also medical research around strokes and SCAD being more common in women.

After the stroke hit, Kate struggled with finding her identity again. Her lifestyle changed dramatically after the stroke and it took her time to be able to be active and adventurous again. Still there are limitations.

Subsequently, the recovery process has been long and intense from both a physical and mental perspective.

‘You get to a point to where you don’t know what’s fatigue, and what’s depression. To be honest, I really felt like my identity had been taken away from me.’

Thankfully, many of Kate’s friends and family were there for her during this difficult time, holding space for her to go through her emotions. She has identified that she was grieving for the life, the energy and the body that she has lost. Sometimes the grieving felt like a heavy depression.

‘Once when my dad knew that I was having a really hard time, he could tell that I was off one morning and he just sat next to me on the bed and said, ‘You know I love you so much’. I know that sounds silly, but those things mean so much.’

Kate suggests that a powerful statement others can use to support someone in her situation is to say ’I know that you don’t know what’s going to happen. I also don’t know what’s going to happen, but I want to you to know that you’re not going to go it alone.’ Kate believes that it’s important that people acknowledge their emotions and the emotions of others.

‘You sort of feel like it’s going to be a permanent thing and I think you have to believe that when you are in grief, that things are always shifting and moving and nothing is consistent.’

Today, Kate has returned to her sport, and is running, hiking and dragon boating again. Not on a scale that she was before, but she is feeling really strong and believes that her energy has shifted. Kate is comfortable sharing her own story and this is a new aspect of her identify that she embraces. She can often connect on such a deeper level with people because of this experience.

To hear more of Kate’s inspirational journey of resilience and recovery, download her podcast episode on Hong Kong Confidential: Episode 50: Stroke. Available on Apple Podcasts, Spotify and anywhere you listen to your podcasts.