Chapter 25 : Quinces and shopping trolleys

The Derwent laps up the hills of Hobart. Effortlessly turning every piece of lowland into a flooded river bed. The Derwent doesn’t run swiftly. It flows downwards and seawards. It is useless. Nobody drinks it. Nobody washes in it. Nobody goes to work on it. It isn’t beautiful. People sail on it. A few people row on it. It could be said to aid recreation. Occasionally. And Regatta Day attempts to make this river the heart and soul of this city. The River Derwent is the thing that defines our city. It is Hobart.

I’ve been told many things about various things. What about the last post? What has been said to me?

Well I’ve been told, “It’s a good look inside your head. Can see what you’re been thinking.”

Is this the only way I can communicate with people. By writing down my thoughts. Can’t I just speak to them? Go to a pub, have a beer and talk to them.  Or is writing down your thoughts a better less confusing way of communicating.

I’ve also been told, “Best post yet. If you go back to some of your original posts then there is a level of insightfulness.”

This comment is a compliment of one post by comparing it to other posts which were not good. Or another way of saying it is, “the other ones were bad and this one is not as bad.”

I suppose it is normal to compare posts by the same person. To rate them.  All sounds perfectly normal. Best to accept it

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In my back garden the quinces are ripe. They have softly gone from a green to yellow. They are all lumpy, unevenly shaped and contain coddling moths. And people want them. You can give them away. I know how difficult it is too chop them up. They are hard. They are one fruit that must be cooked. Before they can be cooked they must be prepared. This means cutting them up, removing the pips, removing the coddling moth and any remnants of it.  You could say that this is hard work. You could say that quince jelly is tasty. You could say quince jelly is something you can show of with pride. A local aficionado will know how much effort or love you have put into each jar. If somebody is uninterested or blasé about your scones with quince jelly you will know that they have never prepared and cooked quinces. Their dispassionate lack of interest in your jelly will tell everybody that they have never cooked with quinces.

One of my daughters says about my latest post, “It’s not offensive, I found it interesting.”

These comments leave me unsatisfied so I ask her more questions. She backs away and says,” Why are you so interested in what I think?”

I continue my questioning and she retreats signifying that I am taking it too seriously. I want to grab her and shake her until she realizes that I am taking it seriously because I have faced my own mortality. I’ve been to God’s waiting room and was told, “Come back later. We don’t have anybody booked by your name.  We are expecting a guy called ....”

When we arrived in Hobart we thought we were escaping the travails of a big city. The traffic jams, the parking centers, the traffic lights. Not now.  The traffic has followed us here.  The car parks have infiltrated the city. They are breeding and threaten to take over the city. Nowadays the car parks always seem to be full of people and cars behaving badly. For some reason a person in a car seems to think they can behave any way they like. They can’t be seen. In their car they are invisible. They remind me of supermarkets and shopping trolleys. Give some-one a shopping trolley and their behavior will change. Why is that? Who knows?  Perhaps the driver of the trolley thinks other people will look at the trolley not the person steering it.

Chapter 24 : How are you?

"You look better than when I saw you last time. Last time I saw you, you had just got out of hospital."

I immediately think, “Don’t say such things. Don’t remind me of hospital. Why do you do it? Why do you see me and immediately remember certain moments. Bad moments.”

Next person I see says, “Hello, are you getting better?”

Once again what can I say? I could ask them something. Change the subject.

Next acquaintance approaches me and says, “You look alright.”

What can I say? I could say, “I’d rather talk about something else. I don't want to talk about how I am."

As usual Jack gets it right. I visit him and Christine.  We talk normally about the things around us.  The sheep, the climate, the weather and his property. After about an hour he says, “You are physically looking just as good as normal. How do you feel?”

That’s a good question. He hasn’t been overwhelmed by my illness. He has treated me the way he would have normally. And he hasn’t ignored my illness because he can’t handle it. He has faced up to it honesty, openly and logically.

I answer him openly by saying, “A lot depends on my test results. I am having a couple of tests.  The results should tell me if I am getting better. They should tell me what caused my illness. They will open my world.”

I then add the postscript, “I feel really good.”

This is basically true except I am sick of the numbness. I wish it would go away. My teeth and lips feel numb. Not a problem unless you eat.  Then it can become a big problem, especially if the food is hot. People don’t want to hear about that. You can’t complain about your teeth everytime you eat.

How am I going in general? I am reminded about the comments of one doctor who spoke to my daughter and described me as the miracle man. Apparently my recovery was miraculous. I was the man who came back from the dead. The ambulance man has also described me in similar ways. He didn’t expect me to survive. Of course, he didn’t tell me. I heard it about third hand. It actually makes me feel good to hear that people didn’t expect me to survive. Except they won’t go and tell me what they were thinking.

I enter the front room when my wife is talking on skype. I immediately hear, “You are getting better.”

Somebody is watching me from the UK. Once again I don’t know what to say. I don’t want to talk about my health. I am very happy to talk. Honesty and openly. I could tell her all the good things arising subsequent to my illness.

The first would be all the things I have got out of doing. Numerous times I have said I am not doing that because it puts my health at risk. This may or may not be true but it is something that people cannot argue with. I always win.

The other would be the way it has changed my view on life.  Depends on who you speak to. But some people have said that I am more tolerant, more relaxed and happier. I definitely feel very un-inclined to complain about the standard of service. I prefer to accept it and thank them for doing their best. For trying. Most of the time I don’t feel like it is my responsibility to get everything working properly. I just feel grateful. That’s all.

The other thing that I am grateful for is my knowledge of preventive medicine. My knowledge of nutrition, physical exercise and how to live has improved. Hopefully in very small ways interacting with the people around me I can impart some of this knowledge. Hopefully some of my improved knowledge of nutrition will osmotically seep into some of the people I meet. And then maybe they will benefit.

What else can I say? I don’t know. Hopefully someone will comment and trigger a response from me or a comment from someone else.

Chapter 23 : Results of MRI tests

           Need to look at my results from my MRI tests.

MRI Results says possibly cavernomas or amyloid angiopathy.  This suggests both are equally likely. That there is a 50/50 chance of either occurring. This is a big mistake. It is much more likely that if you have two possibilities one is more likely than the other. What I need to know is the possibility I have CAA.

Being an uninformed and uneducated lay person I have gone to my friend Dr Google to try and help me. I have found the following. These are some possible guidelines for diagnosis of CAA associated with intracranial haemorrhage.

If the patient is older than 60 years and clinical and MRI data reveal a single lobar, cortical, or corticosubcortical hemorrhage without another cause; multiple hemorrhages with a possible, but not definite, cause; or some hemorrhage in an atypical location.

MRI may show evidence of multiple large and small, petechial cortical and subcortical hemorrhages, even in patients without a history of previous hemorrhage.

Punctate (usually < 5mm), round hypointensities, termed microbleeds, are frequently identified in white matter. Although these cerebral microhemorrhages are often present in amyloid angiopathy, they are not diagnostic of amyloid pathologically. Any conclusions regarding the significance of cerebral microbleeds must be interpreted given the individual patient or population being evaluated.

Microbleeds may be associated with hemorrhagic transformation of ischemic stroke. Microbleeds may be more common in patients with hypertension, but no characteristic pattern occurs in the distribution of microbleeds. Microbleeds may suggest a hemorrhage-prone angiopathy involving brain parenchyma distant from identified microbleeds.

MRI sequences show evidence of hemosiderin deposition that corresponds to old hemorrhages. In patients who present with lobar hemorrhages, evidence of old petechial bleeds can help in the diagnosis of cerebral amyloid angiopathy (CAA). Not an issue in my case. No old hemorrhages with hemosiderin formation.

How do these guidelines compare with my MRI results which are as follows?

Hyperdensity within right and left frontotemporal lobe.

Haemorrhage within right frontotemporal lobe.

Haemorrhage in left temporal lobe. May be subarachnoid or parenchymal.  Could be left superior frontal lobe as site of haemorrhage.

Multiple intracranial hemorrhages.

Looking at my results all the evidence suggests multiple intracranial hemorrhages of unknown aetioliolgy. All the evidence (including Dr Google) suggest that the best way to aid diagnosis is to have another MRI when better. I am now free of symptoms and booked for a new MRI in a few weeks. Can’t wait.