Monday 12 November, 2007 – 00:46 by Swannie in his MRSA coma.
I don’t have a lot of time. It takes effort and expense just to survive, and I don’t have a lot to spare writing this blog. But I really need to write down what has happened to me before the memories fade or become corrupted. And I do need to think about the past and how it affects how I think about the present. There is no doubt that while I am slowly improving in some respects, I am also slowly degrading in others. I know that the end resut will be death (an end we all face, so I’ve been told; but I seem to have faced and beaten it a few times already). Things I should have done have slipped in priorities, but I do hope to catch up soon. In the meantime, please bare with me as I try to achieve what has to be done right now, so I have the chance of a later in which to achive more.
About three days after being moved into the recovery ward, I had pretty well come to terms with what I thought had happened: something inexplicable had affected my motor control, and this something had mystified everyone, including me. But I was showing signs of a very slow improvement, and I wanted that improvement to hasten.
I woke that morning and reached for my hospital bottle, and knocked it over instead. When I reached for it, I pretty much fell out of bed as well. What little motor skill I had managed to learn to accomplish my minor waking tasks had disappeared while I slept. I decided to wait for breakfast, then do my toilet while my bed was being made. After some stumblings with cutlery, things progressed pretty normally, until I grabbed my walker and headed off to the shower. Things seemed harder, but I put that down to the novelty of not having to share my bathrooom with a nurse LOL.
Later that morning, I tried to walk around the bed using my stick, and discovered that I also had to slide along the wall in order to not fall down. When my now carer arrived around noon, I discovered that the few words I had practised over the past week were missing: basically, I was back at the same grunting level of speech I had been when I first came out of the coma.
This was actually good news. Such a change in my circumstances would most likely be caused by a small stroke, and a series of small strokes while I was in the coma would explain my apparent neural damage. While there was enough heparin in my system to allow me to dismiss the notion of any thrombosis, my blood pressure was still dangerously high, a precursor to strokes. More positively, there was physio available for strokes, and I had some chance of more than a slight improvement.
I argued as best I could for a scan to see if there had been any stroke damage, and after about a week, I got the scan. I was damn disappointed that nothing was revealed. Nothing at all. Now, that was a crushing blow, putting me back into the category of "…you are perfectly healthy, there is nothing wrong, so we must all be imagining you are crippled…", a result I definitely did not want.
After I forced my discharge, there was a slow improvement over about six weeks, as Margaret overfeed me and made me take long but sumbling walks (mainly in shopping centres). About seven hours, partly on a stick and partly pushing a Woollies trolley, was my maximum. Then I needed a second stick about the time the Prof gave me the diagnosis of being sentanced to 25 years as a cripple.
While at home I did manage some slow progress, mainly by practising workarounds for common problems, and practising thinking instead of reacting, two things did not improve with time. I still remained partly incontinent, and my epiglottis still refused to behave (leaving me with massive coughing fits as I tried to avoid choking on saliva and/or food and drink).
I thought I had discovered and rectified most of the holes in my memory. But over the past few weeks a few strange things have occurred. Periodically, I forget some of the talking habits I have relearned, forget completely where I put things when I should not have forgotten, forget some small movements I had reduced to habit, and more noticablly, forgotten some typing habits I had carefully practised. Overall, I can notice some slight improvement, mainly in my speech and typing, but most do not see it. And some of my movements are faster or more confident. At this rate I should approximate the abilities of a 90-year old by the time I am sixty LOL.
Critical Mass Decay
What most people do not understand is that the slow mental decay we attribute to age is related to the slow decay of functioning neural cells in non-functioning glial cells as we age, starting about the mid-twenties, and continuing steadily until death. Generally, this decay is counterbalanced by better use of what remains, especially in the use of experience to counteract the lessening of raw ability. An exception is senile dementia, which is caused in a small number of us (this number is increasing as the age of death is increased) by a rapid increase in the conversion rate to glial calls. This is officially termed "age atrophy". My NMRI scans show only minor age atrophy, but obvious other atrophy of the cerebal cortex and even larger atrophy of the hindbrain. This is still relatively minor, since it can’t be detected by a CAT scan, but is large enough to ruin my motor control and wipe out a lot of memories that contol habitual muscle movements.
My concerns about this are myriad. The sudden loss of new memories and habits, albeit a relatively small loss, indicates the loss of neural cells, probably due to age. Especially in the hindbrain, I don’t have a lot of cells to spare. Luckilly, by this age I have copied a lot of hindbrain functions to the cerebral cortext, and is probably the reason I can still function. But the choke point is the capacity of the hindbrain. If I lose enough cells in my autonomic nervous system, my body may cease to function properly (as is evidenced in many quadraplegics who seem to die because the body no longer receives corrections in operation from the hindbrain). Already. some autonomic nervous system functions have showed no signs of improvement, and indeed show periodic signs of worsening. On top of this I now have a restriction in movements due to osteoarthritis (and a 2-inch increase in the size of my waistline).
In summary, I am worried that I am in a race with older age, one I will eventually lose. To this I have to add the concern that I might lose just a few too many critical nerve cells if I can’t find some corrective therapy soon. Life would be made less hard if the medical profession would listen to me, since I am in a rather unique position of being able to describe knowledgably what is happening to me.