Skip to main content

Advertisement

Advertisement

‘I’m now just half a man’: Singaporean in his 30s gets stroke during hotel staycation; more new cases seen among younger adults

SINGAPORE — As a working adult, Mr Johnny Woo Jia Ying was caught up with getting promoted on the job and accumulating wealth, but surviving a stroke three years ago changed all that.

Follow TODAY on WhatsApp

Dear readers, help us make your news reading experience better. We would appreciate it if you could take part in this quick survey. Thank you very much! 

  • Strokes are on the rise in younger and middle-aged adults here, latest data shows
  • The increase may be linked to risk factors such as stress, high blood pressure, diabetes and obesity, which affect more people at a younger age
  • Young survivors may have more potential for recovery, but they have more to cope with after a stroke 
  • They also have a higher risk of other stroke-related conditions, such as cognitive impairment and dementia
  • A Singaporean in his 30s told of how uncontrolled high blood pressure led to a stroke

SINGAPORE — As a working adult, Mr Johnny Woo Jia Ying was caught up with getting promoted on the job and accumulating wealth, but surviving a stroke three years ago changed all that.

Now, the 39-year-old Singaporean’s resolution for the new year is simply to “stay alive” and be in good health.

In March 2021, a blood vessel in his brain ruptured while he was having a staycation in a hotel here.

It was a haemorrhagic stroke and he was 36 at the time. 

Doctors told TODAY that the incidence of stroke in younger and middle-aged adults has gone up. 

Recounting how his life changed drastically after this health setback, Mr Woo now wants young people to know that strokes can happen at any age.  

“Please don’t think a stroke won’t happen to you just because you’re young. 

“That’s what I thought, too, that a stroke is something that happens only later down the road, but who knew that I would get it before 40?” he said, adding that the stroke was a big wakeup call for him to focus on his health.

Before the stroke, he was not paying attention to his health — he had high blood pressure, led a fast-paced lifestyle and loved to drink alcohol.

“Do I have regrets? Of course. But for now, I have to move on,” he said. 

Three years after the stroke, Mr Woo still has some weakness and numbness on the right side of the body and some trouble recalling certain things. He works as an executive at a statutory board.

Singing and running marathons — two activities that he used to love doing — are no longer possible. 

“I used to wish for promotions, to earn more money — those were all very standard and cliched (goals).

“But since having a stroke, I just want to stay alive and keep healthy, as well as for everyone around me to be healthy,” he said. 

MORE STROKE PATIENTS IN THEIR 20S TO 40S

There are two main types of strokes:

  • Haemorrhagic strokes account for around a fifth of all strokes
  • The rest are ischaemic strokes, which occur when there is not enough blood supply to the brain

Young and middle-aged adults may think that they are safe from strokes.

However, it can happen at any age and figures show that it is affecting more young people.

Referring to the latest data from the Singapore Stroke Registry Annual Report published in November 2023, Dr Alfred Seng said that although the number of young stroke patients are relatively small compared to those aged 60 and above, their rates have risen over the years.

For example, in the 40 to 49 age group, the incidence rate of stroke increased from 73.4 to 97.5 per 100,000 population — a 33 per cent rise — over 10 years (from 2011 to 2021).

For those in Mr Woo’s age group (30 to 39 years), the stroke incidence rate rose by almost 50 per cent, from 17.8 to 26.4 per 100,000 population over the same period. 

Dr Seng is a stroke rehabilitation consultant at Tan Tock Seng Hospital and is an executive committee member of the Singapore National Stroke Association.

The association is a support network for stroke survivors and caregivers. It supports more than 800 stroke survivors, of whom 28 are aged 40 and younger. 

The youngest member is 22 years old, Dr Seng said. 

WHY DO YOUNG PEOPLE GET STROKES?

Doctors said that the main reasons for the increase are linked to risk factors such as diabetes, hypertension (high blood pressure), hyperlipidaemia (high blood cholesterol) and obesity. Most of these, though, are modifiable with lifestyle changes or treatments that control the conditions. 

Dr Kaavya Narasimhalu, consultant with the National Neuroscience Institute, where Mr Woo was admitted to the intensive care unit, said that more people now have such risk factors at a younger age. 

In younger adults, the biggest risk factor for a stroke is hypertension, followed by smoking, she said. 

Research shows that uncontrolled high blood pressure increases the risk of stroke by four times. 

Those who smoke 20 cigarettes a day are also six times more likely to have a stroke compared to a non-smoker, the World Stroke Association states. 

Misguided fears about taking medication for chronic conditions may mean that some patients are not getting the treatment they need to control stroke risk factors.  

Dr Kaavya said: “I think many people here have this fear of taking medicine. 

“They may think ‘I have hypertension (but) it's not causing me any problems, so I'm not going to deal with it’. 

“They just don't want to know, and even if they know that they have a (medical condition), they don't want to treat it. That's a big problem.” 

She added: “It's a bit foolhardy to say, ‘I know my blood pressure is high but I'm not going to do anything about it’. 

“You always want to prevent (strokes) rather than treat them when they happen.”

Stress can also cause inflammation in the body, which can lead to a build-up of plaque in the arteries and increase the risk of a stroke.
Dr Zhao Yi Jing, a neurologist with Zhao Neurology and Headache Clinic 

A stressful lifestyle is also a possible stroke risk.

In a study published in the medical journal Jama Network Open in 2022, psycho-social stress reported by patients within the previous 12 months before a stroke happened were associated with an increased risk of haemorrhagic or ischaemic stroke.

Referring to the study, Dr Zhao Yi Jing, a neurologist with Zhao Neurology and Headache Clinic in Mount Elizabeth Hospital, said that stress can cause changes in the body and lead to the development of cardiovascular diseases such as an increase in blood pressure.

“Stress can also cause inflammation in the body, which can lead to a build-up of plaque in the arteries and increase the risk of a stroke,” she said. 

Dr Kaavya said that stress could also be an indirect risk factor for strokes. 

“When we're stressed, we may do things that are not great for us, like smoke, drink or eat fatty food,” she said. 

HOW THE STROKE HAPPENED

Mr Woo believes that he might have been a ticking timebomb since 2015. 

Back then, a health check for a separate medical condition revealed that he had high blood pressure, but he did not follow up on his abnormal blood pressure reading. 

“I didn’t like to go for medical check-ups,” he said. 

Besides his love for heavily salted foods such as sausages and pork knuckles, Mr Woo also loved drinking alcohol. 

He used to be easily anxious and stressed, which he believed contributed to the stroke. 

Several days before it struck, Mr Woo had headaches but he attributed the symptom to a tiring day at work. 

He was having a staycation with his wife when he started experiencing drowsiness, weakness in his limbs on the right side and difficulties typing. 

“Even then, I convinced myself that I was simply tired,” he recalled. 

“But when I tried to stand up, my right leg gave way and I collapsed. By then, I could not speak.” 

Mr Woo’s wife Koh Yu Fang, 34, who works in a treasury, said that she knew a stroke had occurred when she saw that his face drooping and she immediately called the ambulance. 

“I’m not working in the medical field but I’d have to thank the Health Promotion Board and the media for educating me on stroke signs.

“The medics and doctor said that luckily, I reacted fast (and called for an ambulance),” she added.

WHY PROMPT TREATMENT IS CRITICAL

When treating a stroke, time is of the essence. “Brain cells begin to die when they are deprived of oxygen,” Dr Zhao explained.

“If the person reaches the hospital’s emergency department within hours of the symptom onset, early treatment can be instituted, which may reduce the severity of the stroke,” Dr Seng said. 

Dr Kaavya said that in ischaemic stroke patients, there is a narrow window — about 4.5 hours — in which medication can be given to try to dissolve the clot that is blocking the blood vessel. 

For haemorrhagic strokes, the aim would be to bring down the blood pressure as fast as possible to lessen the bleeding in the brain.

“Most times with strokes, unless you’re within that window period, there’s not much to do to reverse it once it has happened. 

“So, the best way to do anything about (stroke) is to prevent it,” Dr Kaavya added. 

“A lot of the rehabilitation work in stroke is training other areas of the brain that are not affected to take over the work of what is already affected.” 

FAST: LOOK OUT FOR THE MOST COMMON WARNING SIGNS OF A STROKE

A stroke is an emergency because more than a million brain cells die every minute that it goes untreated.

Learn to spot the signs with the FAST method:

  • F – Facial drooping (often on one side of the face)
  • A – Arm weakness or numbness (typically on one side of the body)
  • S – Speech difficulties (for example, slurred speech, difficulty speaking or understanding speech)
  • T – Time to call 995 

Other symptoms of stroke include double vision or vision loss on one side, difficulty swallowing or imbalance when walking. 

Note that some people may suffer a “mini stroke”, or a transient ischaemic attack initially, where symptoms resolve within 24 hours.

Seek medical attention immediately and do not dismiss the symptoms even if they resolve because this attack is often a warning sign of an impending stroke. 

Sources:

  • Dr Alfred Seng, executive committee member of the Singapore National Stroke Association
  • Dr Zhao Yi Jing, neurologist with Zhao Neurology and Headache Clinic at Mount Elizabeth Hospital
Collapse to view
Young people generally do better than older people in terms of recovering from a stroke. But then, take into account that they would have their residual disability for many more decades compared to an older person.
Dr Kaavya Narasimhalu, consultant with the National Neuroscience Institute

WHAT YOUNGER STROKE SURVIVORS HAVE TO FACE

Although younger survivors show more potential for better recovery compared to older ones, they have a harder time getting used to a different way of life after a stroke. 

“Younger adults are in the productive stages of their lives — starting and building their families and careers, “ Dr Seng said.

“They also have important roles to play as spouses or parents and to support their dependents.”

Depression occurs in about a third of stroke survivors at any one time — and the mental health condition is associated with poorer function post-stroke and higher mortality, he added. 

Getting in touch with patient support groups such as the Singapore National Stroke Association can be helpful. 

Dr Kaavya said: “Young people generally do better than older people in terms of recovering from a stroke. But then, take into account that they would have their residual disability for many more decades compared to an older person.” 

Post-stroke, about 30 per cent of patients will have cognitive symptoms, she added. 

These can range from mild cognitive impairment to dementia, affecting many aspects of life such as memory, thinking, planning, language and attention span. 

Mr Woo underwent months of rehabilitation to re-learn how to speak, eat, walk and use the bathroom independently. 

He continues to experience side effects. For example, he now takes a longer time to memorise things and speaks more slowly. 

Due to numbness of his vocal cords, he can no longer belt out his favourite songs. He can no longer run. Heavy lifting is also out of the question.

Visibly emotional when he talked about the things he can no longer do, he said: “I tell my friends that I’m now half a man.

“As the man in the household, I’m supposed to lead, but because of (the side effects from stroke), I can’t do certain things. So it feels like I’m not a complete man.

“For example, I can’t lift heavy things. I feel bad that my wife has to take on that role. Sometimes, I will still help as much as I can with my left arm.” 

Mdm Koh does not feel the same way and always tells her husband not to think like that. On his recovery, she said: “With love and patience, nothing is impossible.”

Mr Johnny Woo and his wife Koh Yu Fang are planning to have a child.

Despite the setback, what has gone well was that Mr Woo turned his lifestyle and diet around. 

“When I woke up in intensive care, I told myself, ‘No more alcohol’,” he said.

He now has a healthy, balanced diet and tracks his blood pressure regularly. 

He has also learnt to better manage his emotions.

“When things were not in my way, I used to get easily frustrated and angsty. 

“Now I’m a lot calmer; I even feel it in my brain because... my head now feels a lot less ‘tight’.”

Besides having a caring spouse and family, he attributed his recovery to a supportive boss and early return to work. 

“Working required me to remember things, so that definitely kickstarted my brain and helped with my recovery.” 

Mr Woo also has another wish for the year: To start a family. 

“We had to postpone many things after the stroke episode. Now, my wife and I are trying for a baby. Hopeful for a (Year of the Dragon) baby,” he said, referring to the zodiac animal for Chinese New Year in 2024.

Related topics

Health stroke brain

Read more of the latest in

Advertisement

Advertisement

Stay in the know. Anytime. Anywhere.

Subscribe to our newsletter for the top features, insights and must reads delivered straight to your inbox.

By clicking subscribe, I agree for my personal data to be used to send me TODAY newsletters, promotional offers and for research and analysis.