Saturday, 25 August 2012

Firing thru the lesions

It would be almost a week to the year in coma. It is hard to classify what stage of unconsciousness Miranda is now. For the past year she had to excruciatingly and painstakingly pull herself out of it. All hope of seeing her normal again was hanging on a thread. It still is - and daily is a battle of sorts. After the seizure suffered last month her eyes seem to be more focused when she is fully awake, a condition more appropriately termed "minimally conscious state" (MCS). The jarring truth about the brain trying to "wake up" is that the left brain is left scarred by the stroke. Dead tissues revealed by contrast CT-scan somehow will hamper the normal thought processes we all take for granted. Seizures are traumatic - even to watch. The synaptic firing in a thought process is still not entirely understood in terms of normal bodily behavior, but a guess is that the firing sequence cannot complete as it hits a damaged axon, destabilizing the other neuron processes of the entire brain. The neuron network collapse is grossly term a seizure or convulsion suffered by many stroke victims. But the recovery process must continue despite the trauma. Somehow the brain must find a way to heal...the trauma of seizures is like her rite of passage.

10am: Not since her 64 years to this day is Miranda helpless as a newborn babe. She made her best achievements in perfect health and that include bending backwards for friends she liked. It just takes a leaky brain vessel to take all that vitality away. Like a debt waiting to be paid. The brain controls most of the body - maybe now is a good time to revisit learning to talk and motor control. Her dear Japanese friends would say to her - Miranda, Ganbatte!


When I get older, losing my hair, many years from now
Will you still be sending me a valentine, birthday greetings, bottle of wine?
If I'd been out 'til quarter to three, would you lock the door?
Will you still need me, will you still feed me when I'm sixty-four?

You'll be older too
Ah, and if you say the word, I could stay with you

I could be handy, mending a fuse when your lights have gone
You can knit a sweater by the fireside, Sunday mornings, go for a ride
Doing the garden, digging the weeds, who could ask for more?
Will you still need me, will you still feed me when I'm sixty-four?

Send me a postcard, drop me a line stating point of view
Indicate precisely what you mean to say, yours sincerely wasting away
Give me your answer, fill in a form, mine forever more
Will you still need me, will you still feed me when I'm sixty-four?


Sunday 26 Aug 11am: She looked pleased at her party last night surrounded by friends day and night. Some even think they saw a hint of a smile. Her boggy temple continues to mystify. And I must keep my cough away from her.

Monday 27 Aug 10am: The boggy bubble burst. Neurosurgeon (NS) saw her and readmitted to the hospital for fear of infection. But there was shortage of beds so now sharing with 4 other sick people coughing and wheezing away. Fear of infection? Oh Lord!

Tuesday 28 Aug 7.30am: The decision was made by the NS last night after observing skin breakdown on her forehead. As this is written the operation to remove her implant is ongoing. Low grade infection discharge to be cleaned thoroughly. Miranda may have to live the rest of her life with a sunken skull. Pray God protect her even now. And the strength to face this setback.
4pm: Came out of surgery breathing heavily, eyes opened, trying to look at me. I saw thru them, with the puffed-up face a brave girl. A pretty brave girl.

Birthday: The first photo since her stroke (sorry, from a cellphone). Her face is now different again, since her implant has been removed.

Thursday 30 Aug 8am: Doctors have identified the bug as the SA type and now testing whether it is MRSA or MSSA. Pray that it is not the resistant MRSA. They planned to keep her on intravenous antibiotics for 2 weeks in the hospital. Hate to think of those inserts in her wrists. But yesterday and today her eyes were opened large, and can focus although her left eye remains swollen.

Saturday 1 Sep 8am: One year has passed. She's still not ambulatory nor communicative. But her swollen eye has subsided and focus on her left. The good news, thank God, is the bug is identified as MSSA, more sensitive to antibiotics. If her scar heals well the doctors plan to release her home in 2 weeks. Can hardly wait.

Sunday 2 Sep 10am: She's awake like most of yesterday but interrupted rest last night. Me too, but I'm getting better, having to unwind the tensed week. Today is a time for talking & reading to her. Pray that she coughs and clears her throat better without anguish. It seems to grieve her all the time.

Monday 3 Sep 9am: When she greeted me thru large open eyes I had a rush of tears as I beheld her dented skull. The NSurgeon did mentioned that the atrophied brain does recover a little. Pray that it will recover, like the last time, or even more. Have to also ensure no chest congestion causing those grievous gagging. Now she's cleared of phlegm with throat medication, thank God. Will quarantine myself for next days - don't want to pass her another flu bug.

Wednesday 5 Sep 8am: Resting (for me). Now almost restored from a silent mental break-down last week. Have to stay strong for her, knowing that if she has her senses back she will want me to do the same.

Thursday 6 Sept 8am: Lord, have mercy on us as we seek to strengthen each other, everyday ministering in mental and physical restoration, as a couple or as a family of friends.

Saturday 8 Sep 8am: As I bade goodbye last night her eyes followed me from the bed. She's lacking the usual physiotherapy that we gave at home because her BP tends to drop due to surgery. And I was also indisposed. I'm fighting a mental and physical gloom to get back to cheering her.

Sunday 9 Sep 7am: So the intravenous run of  cephazolin and vancomycin will end Tuesday. She gets occasional spasms of wakefulness, eyes staring wide. But her head is no more locked to her left, although I wish that the left skull is fuller. 6pm: God is kind to me today. From the changing room attendant, golf caddy to the salesperson at the club, everyone has a kind word of encouragement for Miranda. Helps me think out of the gloom of losing such a vibrant, high-energy person in one single stroke.

Tuesday 11 Sep 8am: Going home at noon. Not one more minute in an infection-prone hospital. She's got a urinary tract infection (UTI) and a concern now is that she might have difficulty emptying her bladder. So I brought home a catheter set so her doctor friends could help out in that eventuality. At 3pm the urine came - thank God another problem overcame.

Thursday 13 Sep 10am: I can see she still enjoys a shower at her own home. Still praying her left skull dent recovers and her memory better. I'm getting help from all her friends for the little things to be done. Thanks also for bringing the Comforter to my side thru your prayers, the lonely hours aren't so gloomy.

Friday 14 Sep 10am: Everything seems so difficult - the physio, shower, bed management without the safety of a skull cover. Have to move carefully to avoid abrasion or it may cause further infection. The stitches are healing but what an extensive cut. The NS have reduced shunt flow in order to reduce the dent in the skull. UTI seems to be over but excising of her phlegm still a problem. Pray that it will improve with the brain's recovery. Last night a visiting friend has given me tremendous help mentally and spiritually. It looks like I might survive this, for now.

Sunday 16 Sep 1pm: She enjoys having a face massage, especially around her dented skull. But she still has problems coughing out her phlegm (while I have problems digesting). I'm making it a habit to talk to her slowly about everyday matters. But it gets tiresome after only 15 minutes of one-way conversation. But it is the privilege of having her hear me out and enjoying her presence. Brain hemorrhages are known to have taken people away suddenly. I'm thankful for still having whatever I have of her.
 Always helping out, I've seen her in the kitchen even during student days.

Tuesday Sep 18 11am: I feel rested today because last night I trusted that God will heal her somehow. The joy of greeting her returned. Every time I looked at her face, the left side occluded by the sunken skull I twinge. Then I realized that for 8 months the cranioplasty had camouflaged it - since the day of her stroke it has always been like it after the major surgery to save her. The infection above the dura never worsen her brain, thank God.

Thursday Sep 20 2pm: More vocal yesterday and today, but nothing intelligible. Her stitches are healing nicely and hair starting to grow again. But the prayer is to please restore her left brain!

Lift up, O lift up your face and countenance
For only God can order life, death, sickness or health
Nothing I do can turn back the clock, or wish them away
And there is only that much I can do

So turn your heavy eyes upwards
Looking down only drags me lower
Look up and above to sky and sunshine
Lifting out of my gloom and weariness

Saturday Sep 22 noon: Eat, sleep and walk - the ingredients of mental health. She slept most of Friday and nothing much last night. Need to catch up myself. But her physio is sustained to clear the chest congestion and muscle tone. How precious are friends! Their visits take the sheer tedium of one-way conversations out of my confinement.

Monday Sep 24 noon: Nothing to report - the nadir of our lives makes us hold even tighter onto the sleeves of God. Pray that her utterances can become more meaningful rather than one of despair. It will be when she comes out of coma.

Wednesday Sep 26 1pm: Queer that she's not needing as much sleep as before. Had expected her to restore her sleep cycle after a night of wakefulness. But these days she'll open her eyes to visitors at a mere touch.Which means that there are many opportunities for cognitive interaction - needed badly.

Friday Sep 28 11am: Last night I was so convinced that God will move on Miranda. She has recovered her sleep and took her PT well this morning. Still waiting for her to show awareness of the environment. Maybe later today.

Sunday Sep 30 10am: A troubling find - a mosquito bite to her forehead has caused redness over the scalp. May have to see the neurosurgeon again about possible re-infection. God I can't take it anymore!

Tuesday Oct 2 3pm: So after my protestation the neurosurgeon allowed me to take Miranda home for oral antibiotics, rather than intravenously in the hospital ward for the skull cellulitis. Been praying that the redness reduce. If it enlarge we might have to admit her again. Hoping for the best.

Thursday Oct 4 10am: Although some redness have also appeared above her right eyebrow they are beginning to reduce.  Hoping and praying.

Saturday Oct 6 10am: Redness have shrunk - a battle won. But the war is still raging. Her head is still locked to her left and still show no recognition of friends. Maybe soon.

Monday Oct 8 11am: Still praying her mid-brain will recover to regain consciousness. Today I extended her exercise standing on locked knees. They have to get used to taking her body weight.

Thursday Oct 11 8am: Waited 2 days for better news. It came yesterday when 5 colleagues came to cheer her. She seemed to be aware of their presence.

Saturday Oct 13 9am: More colleagues came yesterday but she lacks sleep. Her coma seems to deepen every time sleep escapes her. When she closes her eyes then she could begin to turn right from her locked position. Still waiting and hoping it will improve.

<End of post>  Next - "Shell"


  1. Hi Kian,

    It's Teck here. I know it's her birthday and have been thinking of her. I wish I can say Happy Birthday to her as I have done for so many years. Will you give her a special hug from me?

    Wilson & I also wish you well. We have followed your blog all the time and we admire your tenacity and your love for her. Surely the Lord knows that too.

    Keep well.

  2. Hi Kian, She is always close to my heart. Happy birthday, Miranda. I pray that you will continue to improve - slowly but surely towards cognitive recovery. CC

  3. Thank you Teck and CC. Provided me a picker-upper.

  4. Hi Kian,

    So sorry to know that Miranda has to be re-admitted. She looked so much better and alert last Sat evening during the BD party. Hope she'll go through this procedure and show more progress in her path of recovery soon.

    All the best for both of you,

  5. Hi KT,
    Remembering M & you this day.I will never forget that 1am decision moment to do the second surgery.Psalm 23.PKian

  6. Hi Florence and PKian. Yes I do feel bad also when a decision such as cranioplasty to restore her skull & face turned out infectious, even if it sounded right at that time. That 1 am decision saved her, but she also endured much in the last 3 major operations. I feel for her.

  7. Hi Kian,

    Glad that Miranda is back home safely. Be strong and resilient. Miranda needs you now more than ever.

    Kong Peng & Winnie

  8. Hi Kian,
    I was in the Engineering foyer today and Miranda's face was on a screen! The screen looped the profile of a number of NUS engineers who have contributed much to the nation and science. Her contributions will never be forgotten. She is never far away from our hearts and prayers. As you know, she is fighter and and I am looking forward to her recovery. .

  9. Thank you KP, Winnie and Christina for your encouragement. Each day I recalled what she did and was to others and me. So I'm still learning to live the way she did. These memories are salutary to our lives.

  10. Hang in there, Kian. You are doing great - you can despair but don't give up.

  11. Life is difficult.Life is complicated. : M Scott Peck.
    Be strong and courageous.PKian