Bats in thd Belfry

 Did I forget to mention here the bat that flew into my house the other night? It's the second time this has happened during my residence in Bali. Different house, and different bat, I assume. Have I mentioned that I hate bats, along with rats, and cockroaches, and spiders. And what could be worse, after all, that a flying rat?

So this bat flew in and then of course started flying in circles kind of around the light fixture, like he's some kind of huge moth or something. Once they get in, they don't know how to get back out. I gathered my courage and showed him the way out with a broom. Eventually, he got the message.

Existing

 I'm still here, if anyone is wondering, spending my days in a sometimes painful, sometimes aching, sometimes nauseating fog. And mostly inside the house with the air conditioning on, because after one day of welcome clouds and wind and rain, we have returned again to the hellish heat wave.

I do seem to be adapting to the blood thinner, clopidogrel, but I'm still having plenty of trouble with the cholesterol lowering agent, which has now been switched to rosuvastatin. Even so, I can only bear this if I take Xanax at the same time and put myself to sleep. 

I watch a lot of TV at home, but I often find that I have missed half of whatever show I'm watching, as my brain has decided to go somewhere else. Where it goes nobody knows.

I sleep a lot.

The other day, I dreamed of my old dog Smokey. My goodness, how I loved that dog, and he loved me too. But in the dream he was back again and all was well and we were so filled with joy to be with each other again. Other people were there too. People I miss. People I love. It is indeed heaven, my friends. I have seen it.

Impractical Paradise

 After talking things over, my doctor and I decided on a change in my cholesterol reducing agent from atorvastatin to something called rosuvastatin, along with a decrease in the dosage. I'm hoping that this will be at least somewhat more tolerable. More tolerable then the nightly near death experience of atorvastatin, I mean.

In the meantime, I have discovered that I have become super sensitive to tropical heat. This of course is unfortunate, given that I live in the tropics. So if anyone out there has a little place in Alaska for instance, or maybe North Dakota, that they can rent me for about $300 a month, I'm willing. A little snow just now sounds like heaven.

It's such a strange thing to have happened. Among the many strange things that appear to come along with stroke. I remember a time when I used to go to the beach here everyday, no matter the temperature, and swim in the ocean, and lie on the beach, and think nothing of it at all. 

Ah, the good old days.

As it is, paradise has become pretty damn impractical. Guess I'd better change the blog name.

The Smoker's Paradox

 Smoking induces cytochrome P450 1A2 (CYP1A2), a hepatic enzyme involved in the metabolism of clopidogrel. Clopidogrel shows better inhibition of platelet aggregation in smokers than nonsmokers,⁸⁾ and smokers are less likely to be hyporesponders than nonsmokers.

In plain language, this means that clopidogrel, the blood thinning drug typically used after a stroke, works more effectively in smokers than in non-smokers. Thus we call this the smoker's paradox, in that we all know that something that is bad for you cannot be good for you and yet in this case the thing that is bad for you is good for you, while still being bad for you. Got it?

Well I'm learning all sorts of fun facts as I study up on medicine, having become aware that the doctors here certainly aren't going to do it for me. Good thing we have the internet these days.

Another thing I have discovered is that the main odious symptoms I am suffering come not after all from the effects of medication but from the effects of the stroke itself. Severe headache, dizziness, vertigo, mild nausea. This is due to damage in the cerebellum, the area of the brain responsible for regulating senses such as sight and hearing, along with balance and so on. Even though I am using voice typing on my phone, it is still necessary to look at the screen and read the text and this has instantly given me a bloody bad headache. So I'm going to call it a night, and give it another shot tomorrow.

Facing It

 Having a stroke is a real drag. I do not recommend it. It's one of those things that shows you, much to your surprise, that ultimately you are not in control of your own body, you are not in control of your own life. Suddenly your body decides to do its own thing. One eye stops seeing, for example. Both eyes go blurry. One leg becomes paralyzed. Suddenly your neck freezes and you feel as if you're going to pass out and you experience a temporary incontinence of bladder. You did not plan this and there's nothing you can do about this. You are at the mercy of your own body. When I lie down at night, or indeed increasingly in the middle of the day, I can feel my own brain trying and failing to think. I can feel my brain being stuck in place, not being able to move forward with whatever thought I might have intended. It's very hard to describe, and it is very unpleasant. It seems that the longer I take this medicine the doctors have put me on--the high cholesterol agent and the blood thinner--the worse I feel, and the farther away I am from being well. It's depressing. And so one begins to face some things. Such as the fact that one is no longer young. In 2 months I will be 70. What time, after all, have I in which to recover? And what would recovery even look like at this age? Yes, one begins to face some things. Like it or not. There is no choice.

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.