It Sucks and So Do I

For a while now, I've been using voice type instead of typing with my fingers in the normal manner, which is because my fingers don't really work properly anymore, especially those on the right hand. Hard to imagine now that I used to play Mozart and Debussey and Chopin with these fingers of mine. Oh well, Time Marches On.

For the first time in some 20 years I smoked less than 20 cigarettes in a day. In fact I smoked less than one. Yes, today I smoked not a single cigarette. Although I missed it like hell, I also sure as hell don't want to have another stroke, and if that means, in part, stopping smoking, I intend to do so. I had not been aware in the past (for who looks into the various causes of stroke except for people studying to be doctors) that smoking causes cholesterol to be especially sticky, making it even more problematic as a clogger of arteries and thus a causation of stroke. As a replacement, I have been sucking air through a straw cut down to be the size of a cigarette. Lol. Not quite the same thing. I thought of purchasing some nicotine gum online, but the fact is I have done that in the past and I know that one tends to end up both chewing the gum and smoking cigarettes anyway.

I started smoking when I was 18 years old, just after entering college. For a period of time during the 1990s, I stopped smoking. And then after the divorce from my second wife, I began again. I had stopped for perhaps 9 years, although I do remember sneaking a cigarette here and there. The thing is, aside from the addiction to the nicotine, smoking becomes wrapped up in so many activities that one does. It becomes, for instance, a part of reading a book. It becomes a part of writing. It becomes a part of thinking or working. It becomes what one does on a break from work. It becomes a part of one's life.

In short, it is very difficult indeed to stop. But at the same time, it is very unpleasant indeed to suffer from a stroke.

I have felt today, for the first time since the stroke event, almost human again, and as if I might actually recover. I managed to go most of the day without a severe headache, and for part of the day without any headache at all, which has certainly been a relief. So I am hoping that things will march on in a positive direction for the next month until I see the doctor again and we can take a look at my blood check and cholesterol levels and whatever else doctors look at. In any case, I will keep my fingers crossed, and keep sucking on my straw.

MRI Part II

 The story of My Life, or rather of my general ill health, is moving faster these days then I can keep up with on this blog.

Let's see now, where were we ...

Ah yes, the MRI ordered by Dr Yoanes at Kasih Ibu Hospital. Predictably enough, this showed multiple small lacunar strokes over a period of time. With great brevity, the doctor pointed out these highlights on the MRI picture, wrote a prescription for three medications, and said goodbye. His next patient was waiting.

These meds were 1) atorvastatin, to lower my cholesterol, 2) clopidogrel, to thin my blood and 3) Xanax, for fun, I guess. Well that's not true. The Xanax is to interrupt the severe headaches I am having and allow me to sleep.

So in brief, I was feeling like shit when I went to the doctor and after I left him I felt even more like shit.

I spent the next day wondering about all of the things that the doctor did not have time to speak with me about. Such as how long will I feel like shit? How long is the recovery period from these strokes? To what extent will I recover?

As I have said all along, Dr Yoanes is competent in his field, as far as knowledge goes, but I'll be damned if he ain't the worst I've ever seen at doctor/patient communication. And remember, I worked for 25 years in an American Hospital.

So after stewing about this for some time and scanning around on the internet trying to get my own information, I talked to my girlfriend and she insisted that I try a different doctor at a different hospital. Smart girl. She looked up some numbers for me and put me in touch with a number for the international wing at Sanglah Hospital. And boy am I glad she did.

Dr. Angga, a young Indian fellow, could not be more different from Dr. Yoanes. He led me patiently through a thorough explanation of the MRI, exactly what it showed, where the problems were located. He proceeded to answer each and every question of mine, again with patience and thoroughness, and even good humor. He told me that he knows Dr. Yoanes and that he considers him quite able and intelligent. But when I mentioned the doctor's lack of communication skills, Dr. Angga just smiled and kept politely quiet. 

So anyway I came away with the same medications that Yoanes had prescribed plus two additional medications, both intended to address the headaches, which may, according to the good doctor, be caused by the atorvastatin. I will see him again in about a month after getting another blood panel. To be certain, I still feel like shit, but a little better sort of shit now.

MRI

 So yesterday I finally got around to going to see the doctor. I made an appointment with my usual neurologist at the hospital and showed up early in the morning with only one patient in line before me. That patient, happily for me, did not appear for his or her appointment and so I went in first.

The doctor seemed more communicative this time around. Maybe he found my complaints, of which there were three, more interesting than usual.

The first, as I have earlier mentioned, was losing the sight in my right eye temporarily on two occasions. The second was the near fainting incident and the painful stiff leg that went along with it while I was having a coffee sometime last week.

A third, which I don't think I've mentioned here, has been a 3 week long headache, sometimes quite severe, along with a tense feeling of pressure in my forehead and behind my eyes and nose.

In any case, the doctor seemed to take these complaints seriously and felt that an MRI would be necessary and perhaps and echocardiogram as well. Not good news for me, because of course these things cost money. Nonetheless, these recent troubles had kind of spooked me so I thought I'd better agree to the tests and see if anything serious is going on, other than old age I mean.

Therefore, I returned to the hospital the next morning to have my MRI. As far as I can recollect, it has been perhaps 10 years since I last had an MRI. It turns out that they are just as annoying and uncomfortable as ever they were. So now this MRI must be sent to the doctor and then I will see the doctor once again. Apparently the MRI scans are sent to an outside facility and so I have to wait for 2 days.

In the meantime, my headache went away for about 3 hours today, which was purely wonderful! It's back now, but it was nice to briefly feel human again.

This Last Week's 'Entertainments'

Another delightful week with Evelyn has come to an end here in Bali, but the heat wave has not, nor have my weird health problems.

In the latest incident, just yesterday, I was sitting at The Daily Baguette cafe, enjoying my usual cappuccino and slice of banana bread while reading a book, when suddenly I felt very light-headed, lost visual focus, and experienced a painful paralysis of my left leg, especially the thigh. I felt myself involuntarily leaning to the left while reaching to the left with a hand that did not seem to be functioning normally. My great fear at that moment was that I was having some kind of seizure and would soon pass out and tumble from my chair onto the ground. This would have been greatly embarrassing, so I struggled to stay conscious and began to massage my upper thigh. My vision cleared within 30 seconds or so, I would estimate, but the muscular pain continued for some time longer.

After this, I was unable to return to reading for fear that the symptoms would recur.

So what the hell was that all about? A small stroke? A small seizure? Who knows? I thought about rushing out to the hospital, but then I remembered how fruitless my last visit there had been just a week before. So I just gave up on the banana bread and the coffee and drove myself back home, or rather to Louis' Villa where I have been staying again while she is on vacation.

Although I have not had any further notable disturbances since that time, which was only yesterday, I have continued to feel very tired and vaguely unwell since. If nothing else, I have learned that it is unwise to venture out as long as this heat wave persists. So, I'm spending a rather boring time here, with Etta the dog, until the 12th, when I will return home to my own little house in Sanur. If I live that long.

In fact, the extreme heat kept me and Evelyn in the house most of the time she was here (unlike me, she is smart enough to know better than to go outside in this sort of heat and humidity). During the day, we watched movies and cooked meals, and then sometimes ventured out in the evening when the temperatures had cooled somewhat.

I suppose that eventually I will go back to the hospital and report these occurrences (and who knows, maybe new ones by the time I act). Or in any case, I suppose that I should.

Don't Panic!

This last week in south Bali has been so hellishly hot and so fiendishly humid that I suddenly found myself short of breath a few days ago. I mean gasping for breath whenever I was outside. Of course, I was not sure that this was the actual problem (given the widening array of actual problems that I have), but it was becoming clear that something seemed way wrong and that I should probably address it. Therefore, I did one of my most personally hated things and headed for the hospital. I was thinking that perhaps they would give me an inhaler or something like that. I chose Sanglah Hospital as an alternative to the usually highly annoying and incompetent Kasih Ibu, where I had once been diagnosed with an infection that I did not have and on another occasion erroneously told that part of my right ear would have to be removed because of skin cancer (and I got that close to actually doing it!).

So anyway, I headed for Sanglah, only to find that the parking lot was full. More than full. Full two times over. As I drove around in circles, baked to a blistering crisp, and gasping for breath, I finally gave up, said F-it, and wedged my bike eventually back out of the superfluous parking area.

What now?

Well, I decided to go to the Prodia blood lab instead. Maybe my borderline diabetes had finally crossed the border. Air hunger, after all, is one symptom of high blood sugar. Or maybe my blood pressure was high. It had been so one time in the past. In any case, I figured I could get a few basic lab tests and present these later to some doctor somewhere who worked in a facility that had a parking lot with at least one open space in it.

Using the trusty navigator app on my hand phone, along with earphones, I was straightaway led into a maze of backstreets and alleys that did not in fact end up at the Prodia lab. It turned out that one had to do this by turning off ones navigator and finding the place for oneself.

Having gotten the blood draw, I gasped my way home to wait for the results.

The results showed, as has been the case for the last 3 years, borderline high blood glucose and high cholesterol. I had succeeded so far in spending 650.000 rupiah to find what I already knew. Knowing this result, did not decrease my shortness of breath. It had gotten worse.

Okay then, Kasih Ibu. It is fate. It is a curse. 

Off I go.

At Kasih Ibu they tell me that no doctors are available and send me to the emergency department, which constitutes an insult to language, actually. It is one small room with two beds and one curtain. The emergency department. The department itself is clearly in need of emergent care.

A resident comes in, I tell her my story, and she decides I need an EKG and a chest x-ray.

Oh my God! See, I knew I was dying!

And so we wait. Tick, tick, tick.

And then a lot more ticks.

At last, the tests are done. And they reveal the worst. They are normal.

Could it be, I suggest, as I suggested in the first place, that my problem with breathing has something to do with the unusually extreme heat and humidity?

Hmmm.

They place an oxygen tube in my nostrils and go away. About an hour later, an Indian doctor shows up. She wants to talk about blood sugar and cholesterol. In general. I steer her back to heat and humidity.

In this kind of heat, people need to be less active, I think, she tells me. What are your daily activities?

Activities?

Yes, what kind of physical activities do you do in a typical day.

Umm ... Drink coffee and watch TV.

Thr end result of this emergent visit is that they do not prescribe any medication and they do not cure me of my shortness of breath. They suggest that I see a doctor at some future time. If I'm still breathing.

Dejected, I return to my house. I have not been there 5 minutes when I realize that I have left all of my documentation on a table at the hospital. My ekg, my x-ray, my patient billing information, and so on.

Shit!

My breathing grows worse yet.

Back to Kasih Ibu.

Not absolutely necessary. But they had told me in the emergency department that my usual doctor, the astoundingly incommunicative Dr. Yoanes, would be working this evening from 6:00 until 9:00. Heck why not pop in and see him after picking up my paperwork? Not that I miss him, but damn, if I'm going back anyway, why not?

It is my good fortune to find that apparently no one else cares to see Dr. Yoanes. At 6 o'clock, I am the lone patient outside his door, something unheard of in Indonesia, where the hallway outside a doctor's door looks something like the parking lots. 

I tell the doctor about my shortness of breath. But he wants to talk about blood sugar and cholesterol. He is irritated that I did not get a full laboratory panel. If you do not get a fasting blood sugar and the complete cholesterol panel, we cannot see where your levels have been.

Okay, sure. Now how about this shortness of breath?

He motions for me to get onto the examination table. As a rule, Dr. Yoanes does not speak. He motions with one hand. He proceeds to perform a cursory neurologic exam.

I pass with flying colors, I think, at least for a neurologically compromised person. Yay.

I begin again to describe my earlier experience in the ER and what brought me there.

What is your typical activity level, he asks?

Oh God. 

This started like 3 days ago, I tell him. I started to feel like I couldn't get enough air. Each day it got worse. As soon as I go outdoors, I can't breathe. I struggle to get a breath. I start to feel panicked.

Ah, the doctor says. 

That could be it!

Mm, he says. 

He gives me two prescriptions. One for atorvastatin, a cholesterol lowering agent. A second for something called clobazam. And says goodbye.

On arriving home, I look up the med.

Clobazam: A benzodiazepine, typically given for panic disorder. 

Patient, heal thyself.

The Bostonian

 I happened to meet a Bostonian the other day, which is something I understood with the first words he spoke. How pleasant to meet a Bostonian, I thought. I have never met one before. I have never been to Boston. Funny how one would need to come to the other side of the world to meet a Bostonian.

The first thing this man said to me was "Are you a truck driver?"

Interesting. Not a common opening to conversation.

"No," I answered. "Why?"

"You walk like a truck driver."

Interesting as well. How does a truck driver walk? I have no idea. I'm thinking maybe slow and kind of bent over. Or maybe kind of like a sailor who is used to the rolling of a ship over waves. 

The next thing I noticed about the Bostonian is that his eyes were reddened, as if he had been smoking some weed. That would be a dangerous thing to do here in Indonesia, an inadvisable thing to do given the strict laws against drug use and the harsh punishment if caught. Still, he did for all the world appear to be stoned, and the more I talked to him, the more stoned he seemed.

Having exchanged these few simple words and observations, we sat quietly for a time. My coffee arrived at the table and I took out my novel.

"What are you reading?" he asked.

I showed him the book cover. The Poppy War, book one of a trilogy by R.F. Kuang.

"Oh, I don't read that kind of shit," he said.

"Yeah, I don't generally read this kind of shit either," I agreed. "But I've read and admired this author's other work and so I wanted to try this one as well. But to be honest, I don't like fantasy sort of stuff, you know swords and arrows and magic powers and all that."

"Don't blame you," said the Bostonian. "I don't read that shit."

With this understood, we proceeded to talk about various other things, such as the city of Boston and what he is doing here in Indonesia and what I am doing here in Indonesia, and about Oregon and the beautiful Pacific Northwest.

"I love Portland," he said. "I have friends there. They grow the best pot in Oregon. It's not like in Boston. The pot in Oregon is fresh. The pot in Boston grows out of sewers."

Good to know, I guess. Not that I'll be sampling any Boston pot. Nor Portland pot either for that matter. Personally, I never did like pot, although of course I have tried it long ago, like everyone else in my generation.

He began to tell me then about a book he would like to show me, but someone stole the book, so he can't. The book had something to do with how nobody gives a fuck. In fact. That seems to be more or less the title of the book, from what I could understand. It was not clear whether this was a book someone stole from him in an airport or a cafe or wherever, or whether he himself had written such a book and then somebody either stole his book or stole his idea for this book.

"What are you eating? he asked.

"Lemon cake."

The Bostonian went inside the cafe for a moment, and then returned with a slice of lemon cake. We ate in silence.

"I've got to go soon," he said.

"Ah. Well, pleasure to meet you."

 Do you know what time it is?"

"Just about 11:30."

"Is it really?"

"Yes."

The Bostonian nods, looking both at me and past me.

"One more thing, bud. Is this Sunday?"

BABEL, An Arcane History

 'Betrayal. Translation means doing violence upon the original, means warping and distorting it for foreign, unintended eyes. So then where does that leave us? How can we conclude, except by acknowledging that an act of translation is then necessarily always an act of betrayal?'

'But that's the great contradiction of colonialism. ... It's built to destroy that which it prizes most.'

BABEL, An Arcane History, R.F. Kuang

It has long been a habit of mine, when stumbling upon writing that stands out from the dross of literature, to proceed through everything that writer has written. So it has been for me with R.F. Kuang, whose novel Yellowface I reviewed here at an earlier date.

I've just finished reading her long novel BABEL, An Arcane History. Babel, which of course refers back to the biblical Tower of Babel, becomes as well, in Kuang's hand, the all powerful, though fictional, school of translation at Oxford college in the 1830s. Students at Babel are tasked with wielding the power of words, and that power is employed in the transfer to silver, which, here, is not only the the coin of the realm but an element possessing magical potentialities brought out by the power of words etched into silver bars. Endowed with such power, the silver becomes the engine of the industrial revolution, putting England far in advance of any other country. It's all about money, or rather silver, and silver is all about power, over individuals and over countries of individuals.

It is also all about betrayal, all kinds of betrayal, betrayal of ideals, betrayal of the nation, the nation's betrayal of its populace, the betrayal embodied in colonialism, the betrayal of beloved friends. Translation itself, as the quote it tells us, is a betrayal of language.

And I guess what I've said so far is a betrayal of the cogency one would expect in a book review. Lol. 

BABEL will be particularly fascinating to nerds such as myself who are especially interested in linguistics and etymology. Lovers of words. At the same time, it may be tedious for those not interested in such things (especially at 500 pages of small print). Nonetheless, the novel establishes a good pace and keeps it up for the most part throughout. It has the flavor of Dickens, not only for the early 19th century setting, but for the style of the writing and the drawing of the characters. Oliver Twist goes to college and ultimately finds himself in A Tale of Two Cities.