There was no sign that Leo Marcus Remedios Jr was at risk of stroke. He led a fruitful, active life cooking, gardening, brisk walking, and doing social work with his church. He worked as an accountant, based in his company?s Batam office.

But on May 5 2004, he collapsed from a chair in his Singapore office onto the floor.

The 50-year-old bachelor recalls: ?I was taken to the Singapore General Hospital by ambulance. When I awoke I could still move but my speech was slurred.?

Mr Remedios had suffered a stroke of the brainstem, the part of the brain located at its base, above the spinal cord.

?I was lucky not to have travelled that morning to Batam where I usually work,? He said.

According to Mr Remedios? physiotherapist Ramaswamy Suresh from the rehabilitation centre at the Society for the Physically Disabled (SPD), brainstem stroke is one of the most severe forms of stroke and is often fatal.

?The brainstem is responsible for the vital functions of human life such as breathing, heartbeat and blood pressure control,? explained Mr Suresh.

According to the American Stroke Association, 65 per cent of all brainstem strokes are fatal.

The stroke did not take his life nor affect his ability to use his mind, but it left Mr Remedios unable to walk, or even speak intelligibly.

To date, there has been no conclusive explanation for the occurrence of his stroke.

?I did not have the classic medical conditions of stroke victims like high blood pressure, high cholesterol or diabetes,? he said.

?At best I can speculate that it could be due to ageing or a family predisposition.?

Having his life altered so suddenly affected Mr Remedios emotionally at first.

?I was depressed and asked, ?Why me?? Then I quickly came to terms with my condition because of my religious convictions,? says the Roman Catholic.

?I felt that my condition was part of God?s plan for me to actually improve and change my life and I should do my best since I had a special chance given to me. Hence I had a strong will to rehabilitate myself and considered my condition as temporary.?

Start of recovery

Determined not to let the condition beat him, Mr Remedios began rehabilitation therapy two months after his stroke at SPD, undergoing physiotherapy and occupational therapy twice a week.

A highly motivated individual, he has progressed so much, today he attends physiotherapy only once a week.

The rest of the time, he exercises at home.

?The initial therapy was painful because it was meant to loosen the limbs and arm muscles especially by stretching the muscles,? he said.

?This led to walking, standing and free movement of one?s hands. This is a necessary stage for stroke victims to go through to get back to normal.? <

Being unable to talk or write was the most frustrating disability for Mr Remedios.

?My stroke is also called ?locked-in syndrome? because I could not communicate my ideas to others, locking all thoughts in my brain. I could only make unintelligible noises in the earlier months of recovery,? he recalled.

As the months went by, things improved slowly but he still finds it a problem talking over the phone. Even now he is sometimes misunderstood by others, and finds it an effort to speak properly.

He now gets about in a manual wheelchair. Initially, he was unable to walk or stand up. With therapy, he began to walk again with a walking aid, ?but I found I was not steady even then. It will be some time before I can walk independently?.

He also found that he could not reach his back with his arms, so someone has to help him to bathe and change his clothes.

After the stroke he had to be tube-fed with liquid foods for a year. By now he has resumed a normal diet. The one thing he cannot do is drink fluids through the mouth. His reflexes have been compromised so fluid tends to enter the lungs and this might cause pneumonia.

?I take water by tube through an opening in my stomach,? he said.

The most marked improvement is in his ability to use his hands.

?At first I could not write my name or use the computer to send out e-mail ? in fact, the first six months I could not even move my fingers and toes.

?But slowly, over the months my hands are gradually regaining steadiness,? said the man who conducted this interview by e-mail.

?I consider myself very successful in this regard!?

Some effects were more unusual: Mr Remedios still suffers from constipation (which he takes medication for) and pseudobulbar palsy, a tendency for inappropriate emotional outbursts.

?I tend to laugh for no apparent reason, or cry when I read a sad story or watch a sad movie,? he explains.

?I tend to be short-tempered and less tolerant of others. This medical problem is due to the brain not being able to control emotions properly. This behaviour gets worse when I am tired, excited or stressed. But over time the control has partially returned.?

One thing he misses, given that his reflexes are ?like an old man?s?, is driving.

?My doctor can't recommend that I renew my driver?s licence,? was his wistful comment.

Still keeping busy every day

After Mr Remedios' stroke, his company had hopes that he would return to work and even made provision by outsourcing some of his duties.

But it soon became apparent that his working life was over.

"Personally this is just early retirement. After being in the workforce for more than 30 years, I think I am entitled to sit back and relax!? He said. Mr Remedios credits his supportive family for his good cheer.

?My relatives fussed over me like a newborn or bride on her wedding day when I came home from hospital. It was the most attention I had had since I was born!? he jokes.

?My two sisters took turns to stay with me in the first nine months after my return from hospital. They also helped me financially and gave me emotional support.?

He also had help from his brother-in-law, other relatives and church friends.

Not all was rosy. ?Most of my girlfriends ran away because I now have less money to splash on them,? he quips.

?I even heard from my friends in SPD with the same condition as me that their wives became unfaithful and their children ignored them. It may sound like a joke but it is true!?

These days Mr Remedios has a routine: he does his exercises every day, answers e-mail and surfs the Internet.

On Thursdays, he takes a taxi with his maid to the wet market. On Sundays, he goes to church. Occasionally he goes window- shopping with his maid, and visits his uncle.

At home, ?I supervise my maid in cooking and cake-making to make sure she does it my way. If I was well, I would do it myself.?

?My life is quite busy with my matters, instead of my company?s,? he says.

?As they say, when it rains it pours ? life can be quite hectic even after a stroke!?

Theresa Tan is a freelance writer.Related article: Surviving stroke