S'pore man who had sudden stroke at 36 holds on to hope while walking his long path to recovery

Stories of Us: 3 years after he suffered a stroke, Ian Tang has learnt to be patient, and enjoy the small victories.

Nigel Chua | December 11, 2021, 11:10 AM

Follow us on Telegram for the latest updates: https://t.me/mothershipsg

When Ian Tang woke up in a hospital bed after a life-saving brain surgery, the first thing he did was to post a selfie on social media.

Tang suffered a sudden hemorrhagic stroke in November 2018, at the age of 36.

While unconscious, his wife made the decision to opt for surgery to remove the blood clot in his brain, the more proactive of two possible options (the other was to have doctors administer a "clot buster" drug that would dissolve the clot).

"I wanted to tell everyone that I was alive lah, [but] I don't know why I posted it on social!" chuckles Tang.

"I was celebrating being alive. It was a lot of relief. My first reaction was that I'm glad I'm still alive."

He offers a guess that it was partly because he was still "very drugged up" at the time.

"It was a very strange time," he muses.

Speaking to Mothership over Zoom one afternoon, Tang recalled the crests and troughs on his journey of recovery, from that initial euphoria and relief at surviving the surgery and the highs of reaching milestones in regaining his independence, down to the sobering moments that brought him to accept that his life would never be the same again.

The thing about recovering from stroke, Tang says, is that effort doesn't always translate into results.

But he's still had to channel a certain sense of optimism toward his recovery goals, even while accepting that he might never reach them.

In other words, sticking to the path of recovery, while not knowing what the eventual destination might be.

"You have to work with what you have," he says simply.

"Be patient, and take joy in the small victories."

"Oh no, something's really seriously wrong."

Tang, who'd been working in Taiwan at the time, still remembers much of what happened on the day of his stroke, recounting the story in arresting detail:

"It happened in the morning... I think just about 8 to 9am, usually the time when I would wake up to go to work. I was out on the balcony of my apartment texting my friends.

I was texting halfway, and then I realised that whatever I was typing with my hands was different from what I had in my head. So in my head I was typing a sentence. But when I looked at it with my eyes it looked like a string of random letters and numbers. So I thought, 'Eh, something's wrong here.'

And then after that, I started dropping my phone, like for no reason. It's like, very strange, you hold something in your hand then suddenly you just let go of it, without real volition, you know? You just drop it.

And then that's when I knew, 'Oh no, something's really seriously wrong.'"

He managed to take two steps back into the house before collapsing face down on the apartment floor.

"The worst part of it is that as I was going down, the only thought I had was that I don't want to break my phone screen, [it'd be] very expensive to replace. So I actually tossed my phone onto a table to make sure it doesn't land on the floor.

So I was down on the floor and I had no phone with me to call for any help. And I was alone at the time, my wife had already left for work."

Photo by Bruno Nascimento on Unsplash

As he lay face down on the ground, unable to move his left side, Tang recalled an old advertisement he'd seen about the warning signs of stroke, and realised that what he was experiencing matched up.

Even with this realisation, Tang remembers being "oddly very very calm", as a "cold, rational numbness" to his possible impending death set in.

"The only thing I was annoyed at was that the floor was really very, very cold, because it was all bathroom tiles. And then I just crawled myself to a floor where there was a floor rug.

I was much warmer, but face down on it, and then I just basically laid there, and waited to die."

Stroke getting more common among younger people

Tang remembers much of what happened after he collapsed — being woken up by the sound of the apartment's door chime, hearing his his wife scream, and that poignant phone call to his mother while in the ambulance to the hospital, unsure whether it'd be his last time speaking to her.

He also remembers getting diagnosed with a hemorrhagic stroke after doctors found a blood clot in his brain, and lost consciousness soon after.

The surgery was a success, and needless to say, Tang survived the experience, which had caught him by surprise. He says:

"There was no warning sign, there was nothing before the day [of the stroke], nothing the day before, or anything even in the weeks preceding, where there was any indication that I was going to have a stroke."

Strokes remain relatively rare for people at Tang's age, with 20 recorded instances of strokes among every 100,000 of those aged 30 to 39 in Singapore in 2018, according to data from Singapore’s National Registry of Diseases Office (NRDO).

NRDO data also shows an increasing incidence of strokes among those aged between 15 - 29 years old — a 32.3% increase over the decade from 2009 to 2018.

And while one of the most commonly known risk factors for stroke is age, there are other factors that determine one's likelihood of suffering from a stroke: Hypertension, high cholesterol, uncontrolled diabetes, smoking, and being physically inactive.

These factors are just as relevant for younger people and according to Tang, younger stroke survivors may have a different path to recovery.

A kind of invincibility

"When you're younger, there's a kind of invincibility you'd feel," says Tang.

"I was like, okay, stroke is not something that's permanent, it's gonna happen to you, then you just recover, and you will bounce back from it," he recalls.

This was Tang's initial mindset while going through rehab some two years ago, after he had the stroke.

Tang, a keen musician, recalls how this "super overly-optimistic" attitude led him to order a new guitar in anticipation of his recovery, even though he hadn't yet gotten back the ability to move his fingers independently.

"I think the best word to use is hubris, lah. You think that everything has been going so well up to that point that it would just continue to be okay."

At the time, Tang's recovery was going well. He was in what doctors call "the golden period": The first few months after a stroke, where the brain's ability to adapt (also known as neuroplasticity) is at its highest.

"The realisation of my disability did not hit me until much much later," says Tang.

As it turned out, he would soon be told by his physical therapist that he was not likely to ever play the guitar again.

While she "tried to soften the blow as much as possible", Tang was finally hit by the gravity of the situation as the therapist's words sunk in.

Yet, he recalls his first reaction was a stubborn, "No, I don't believe it."

Turning point

He then committed himself to physical therapy and rehabilitation with renewed motivation, confessing that he'd not taken it that seriously before.

He began to try to move around on his own, even during rest time in his hospital ward.

Photo by Frederic Köberl on Unsplash

"My motivation was like, 'Yeah, I'm gonna beat this, I'm gonna get better,'" says Tang.

A fist pump moment

Returning to Singapore in 2019, Tang continued his rehab in a community hospital here.

Tang realised the need to learn to depend less on those around him — in particular, his wife.

"I was very cognisant of the burden placed upon her... Actually to me, I told her, 'I wouldn't have blamed you if you wanted to break it off.'

Because, you know, this is not what people signed up for what. But she stuck by me all the way. So I'm absolutely grateful to her for that."

Tang is aware that some of their friends who knew about the couple's situation were inspired to comment that her decision to stick by him was "what true love is".

But he shares that between the two of them, true love is less of this "feely feely stuff" and more of thinking of how each of them, as members of a husband-and-wife team, could help each other.

For Tang, it was learning to be more independent, as this would help his wife be less worried when she left the house to go to work.

In line with that objective, one of Tang's goals in 2019 was to learn how to walk without a cane, and improve his balance and endurance.

He set himself the target of completing the 5km race at the Standard Chartered Marathon at the end of 2019, and together with some friends and family, reached the finish line on a sunny December morning, just over a year after his stroke.

Runners at the 2019 Standard Chartered Marathon. Photo via Standard Chartered Marathon on Facebook.

"I told everyone that I was going to do this, and they were like, 'Okay! Let's do it together.'"

So that was a very "fist pump" moment for all of us. You know, like the end of The Breakfast Club."

"And we all did it together. We crossed the finish line together," he says.

Emotional vs physical recovery

But while Tang was making literal strides toward recovery in a physical sense, another important aspect of his journey — that of his emotional recovery — was still in progress.

"The emotional recovery was actually much harder than the physical recovery. A lot more difficult," Tang says.

Buoyed by the progress he was making in 2019, Tang started to look into getting back to work, and started interviewing for jobs. 

But a strong sense of ennui began to set in, and he found himself wondering: "What am I doing here? It feels so meaningless, is this what I really want?"

He also found that he wasn't able to project his usual energy during interviews.

Another clue that things were not as they should be was his temper.

"I also started getting a bit more short tempered sometimes, especially with — I'm sad to say — with cab drivers, or Grab drivers," he says, explaining that the "chatty" drivers would "tend to state the obvious" and ask him point-blank if he'd had a stroke.

"And that would set me off. I would get very very angry about it."

Photo by Art Markiv on Unsplash

Feeling that there must be something within him that was "not fixed yet", Tang sought professional help from a counsellor, and was able to come to an important realisation:

"The counsellor said, 'You are probably in a process of grief.' And when he said that, then it all clicked into place for me. Like, oh yeah. That's probably what's happening to me, I'm going through the stages of grief, and I haven't really adjusted my mental state yet."

Coming to a place of acceptance

Tang remembers 2020 as the year where he worked through his grief, and to accept the reality of his new circumstances.

"I'm different now, and I'm probably never going to be going back to how I was before. [And in 2020 I was] accepting that reality and working through the grief, and taking a hard look at what I'm going to do next."

In the midst of all this, Tang even found a job, though he was soon retrenched when the economic impact of Covid-19 set in.

The setback came with an important silver lining though.

"Mental health was a thing that was easy to talk about, and [it was] easy to seek help if you needed to."

Learning to ask for help

Another important phase of Tang's journey was learning to ask for help with certain tasks that he currently can't do (such as opening a jar).

Photo by Darío Méndez on Unsplash

"If you need help, you need help, right?" he asks rhetorically.

"What I realised is also that Singaporeans are very kind, like they're kind in a very reserved manner. If you ask them for help, they will help! They're more than willing to help. But... not many people will offer to help."

Tang has learnt that people are generally willing to help him, they are "just paiseh (embarrassed or shameful) to show it."

Thus, he says, his part of the equation is "to not be paiseh to ask".

The journey continues

Tang explains that as a stroke survivor, a lot of "self-advocacy" is needed, to "educate people around you about your condition, and what you can do, rather than what you can't do."

In that vein, he's also started to volunteer with the Singapore National Stroke Association (SNSA) to start a support group for young stroke survivors.

The importance of this support group lies in the fact that many existing programmes are targeted at older survivors, leaving gaps yet to be addressed.

Younger survivors, Tang says, might be going through the same issues he'd faced before, and sees his role as a befriender, alongside his wife, who's volunteering in support of caregivers.

"The main thing that they need to know is that they're not alone. There's people around them to support them, and people who understand what they're going through and offer advice."

Looking for milestones on an unknowable path

Tang is still looking forward to more milestones in the future, among them, being able to ride a bicycle again, and to ride together with a few of his young nephews.

But, Tang stresses, it's important to remember that progress may not always be linear.

"Because it's not like exercising," he explains, where more repetitions generally translate to bigger and stronger muscles.

Instead, Tang says, "with stroke it's different... your effort doesn't always equate to results."

"While you still need to keep moving... You also need to understand that despite everything you do, all these things may not happen lah. The function might still not come back. So that's the reality of it.

"I think that's really the dichotomy that all stroke survivors have to face. We have to be practical about things, but optimistic at the same time. Very strange lah.

We have to manage our condition now, but we still have to stay hopeful and know that it might come back in the end."

Top image via JOHN TOWNER on Unsplash

Follow and listen to our podcast here