When Stroke Strikes

There's a patient in the Neurosurgery ward who died last Friday. From stroke. The only problem is that she didn't die fully. I saw her today. She smiled at me. I asked her how old she was. She smiled at me. I asked her when she was brought into hospital. She smiled at me. I realize she couldn't talk. "Ok, each of my fingers stands for 1 day, nod when i have the correct number of fingers held up." I stuck out 1 finger. She nodded vigorously, still smiling. 2 fingers. She nodded. 3 fingers, she nodded. I realized that she was there, but she was gone.

How does one not die fully? Well, the smart alec answer would be: the same way in which one can have type one-point-five Diabetes Mellitus - they both boil down to a matter of classification. Type 1.5 Diabetes, otherwise known as LADA (Late autoimmune diabetes in adults) is a Type 1 diabetes which presents in adults instead of children. The 0.5 stands for the fact that it is neither a true type I or II diabetes, but somewhere inbetween; in limbo. Just like my patient.

She was alive well one morning but by afternoon collapsed with a massive stroke involving both the anterior and middle cerebral arteries of the left brain, causing her speech centres as well as her motor and sensory centres for the right side of her body to shut down. Her right arm and leg were completely paralyzed, so was her right face, turning her smile into somewhat of a grimace. Like the look you give when someone has played a bad joke on you. Only that you aren't really you anymore. Whatever other people say about that, its pretty much as good as being dead really.

She appeared happy though. Eerily happy. Oblivious to her newly acquired disability. My clinical skills tutor says its because her comprehension centre in the brain had been knock off. So ignorance is indeed bliss.

The tutor then embarked on a tirade against the British and Australian governments for their abysmal efforts in public stroke prevention by endorsing health campaigns and screening tests for the number one risk factor for stroke: Hypertension. Stroke is the 2nd most common cause of death and disability in Australia. Wouldn't it make perfect sense (if not cents) to increase public awareness of the lifestyle changes needed to circumvent this tragedy?

I've glad that I've managed to cook without buying any salt this year and I've since sworn not to buy any more light sauce (liquid salt) for the rest of the year. I'm not sure how, but the 2.5 bottles in my cabinet is gonna have to last me that long =)

Gourmando Review: The Point @ Albert Park Lane

Ok, I tried finding a pretty picture of the place in daytime but it didn't work out. The boyfriend and I had a 3 course lunch there last Saturday =)

Skate (fish that has been cooked such that the meat is loosened from the bone)

Kerf's initial order: Gentle on the taste buds (perhaps too gentle) with a hint of sourness. Meat was a tad overcooked. Knife was way too blunt to allow elegant eating without having sauce flying.
Overall score: 6/10

Porterhouse Steak


My intial order: Supposed to be medium rare but was more medium than rare - tough on the outside and slightly raw inside, albeit without blood. Challenging on the masseter and temporalis muscles. The sauce was slightly below expectations (although being stronger, it was more agreeable to my tastebuds than the fish's sauce); I thought I detected a hint of bitterness too. Overall score: 6/10 (Black Angus in Singapore has better steak)

Kerf and I ended up swapping our mains 3 minutes into the meal =)

The desserts saved the day:

Hazelnut Parfait

Beautifully done! 10/10. Best hazelnut dessert I've tasted.

Chocolate tart

This one's a bit hard to rate because hey, its chocolate. Its good by default. 8/10 because although its good, its not any better than chocolate desserts I've tasted elsewhere.

Conclusion: The ambiance and service were faultless (it overlooked a lake!), but I don't think I'll ever be coming back for the mains. Desserts maybe. Then again, considering this meal was $40/person, I might need to think twice. I mean I could have an equally good meal at Giorgios and have spare case to go shopping with right?

Where your kidney has gone

July 2006

"Shhh. Don't make too much noise when we get in there alright, Faith? Your mommy's tired and needs some peace."

"But...but...Mommy has been sleeping for so long! She didn't even wake up for my birthday party last week."

Jansen lowered himself to his daughter's level. "Baby, I hope you won't blame your mommy for that," he began. "Remember how mommy used to have to clean her blood using that machine we have at home every day? Well, its not working anymore. Mommy needs a new kidney.

"Where do new kidney's come from?" Faith inquired. "Darling, I'll tell you when we get home ok? Let's go in and tell mommy how much we love her first."

They entered the ward where Lindsay had lain for the past 4 weeks. It was a reasonable-sized room with a single bed and an attached toilet. A large window let the afternoon sun in, perhaps serving as a reminder that the beautiful world beyond the beige-coloured walls of the hospital still existed; that the world hadn't stopped.

It pained Jansen to see his wife in this state. What had happened to the beautiful cheerful girl he married? There she is a voice inside his head whispered. Her kidneys were already failing when you met her. Nothing has changed.Except that everything had changed.

Shortly after they married 6 years ago, Lindsay's kidney function deteriorated to the point where she needed dialysis. She had been diagnosed with Type I diabetes at 5 and kidney damage was almost unavoidable. But apart from the need to be hooked up to the a machine by bubble-tea-straw-sized needles for 4 hrs 3 times a week, she lived a regular life.

And he loved her. They planned to have children together and went to their specialist to discuss a management plan for Lindsay's pregnancy.

"There is no way I'm going to let you carry a child in your current condition!" they were told. It was too late. Lindsay discovered a month later that she was 6 weeks pregnant. 8 months later, Faith was born. Faith, a reminder of what they needed most.

Now Faith was 5. She was a big girl. Everyone told her so. But no one told her what to expect when she entered the room. It had been 2 weeks since she last saw her mother. Her dad had a full time job so she had been sent to live with her grandparents in the country.

The last time she saw her mother, she looked normal, even though the doctors had said her kidneys were not working. Now, her skin looked yellowish and her legs appeared twice their normal size. Did kidney failure make one fat?

"Mom?"

"Mom, can you hear me?"

Lindsay struggled to open her eyes. "Y..Yes baby...How was your birthday party yesterday?

August 2006

A kidney became available and the transplant took place within 24 hrs.

December 2006

Lindsay woke with a start, only to find Faith's large hazelnut eyes pouring into hers. A cheeky grin lit up her face - she had rolled up a piece of tissue and tickled her mom's nose with it as she slept on the verdant grass under a tree. Summer had just arrived and the young girl had been pestering her mom to take her out for a picnic with gran and gramps.

Lindsay wiped the sweat from her brow and sat up. Faith jumped back in alarm, missing Lindsay's grip by inches.

"You can't catch me!" she teased, laughing and running toward the lake on the other side.

"Oh yea? We'll see about that!"

"Can you see that?" Jenny turned to her husband Phillip, poking a long thin finger in his side excitedly. "Wha?" he grunted, casting his eyes in the direction of her other finger.

The old couple sat in silence, watching their daughter and granddaughter race across the slopes.

That evening, after dinner, Phillip retired to his study to take a call from David, Lindsay's brother who lived in the States. His voice was quiet and strained, "...son, I wish you were here today...Lindsay...she..she ran. Its been over 20 years...I...I didn't think I'd see that again in this lifetime." Beads of tears rolled down his cheeks, staining the handwritten thank-you letter for the donors' family.

That's where your kidney has gone.

Disclaimer: Names have been changed for confidentiality reasons.