Amanda spent an hour looking through her many recipe books. This is the first time she has shown any interest in these for 6 months. Her anomic aphasia (we are narrowing it down to a very specific type now), means she can read in her head, but not aloud, or paraphrase what she has just read. But the books held her concentration for an hour.
Amanda had her third MRI scan. The first was on the night of her stroke and the second three months later. At that stage her brain was still too traumatised for any cause to show up. This one, six months on, would hopefully show something significant.
Because an MRI is magnetic, not radiation -based, the technician allowed me to sit in the room. As Amanda slid into the large drum, her faced encased in a Star Wars – like mask and her head held firmly in a skull – shaped mould I watched as the lights on the front panel began to count down and scan her brain millimetre by millimetre. Despite ear plugs, I could clearly hear the multi million dollar machine as it whirred, whined and clicked loudly and rythmically.
She had no idea I was sitting there for 30 minutes, in a sealed room, filled with high tech medical equipment, on a cheap old wooden chair. I also resisted the temptation, as she was pulled out from inside the scanner to say;
“Congratulations. The experiment was successful. Welcome to 1975.”
Today was the 6-month check with the neurosurgeon in Wellington, so a lunchtime flight on a stunning early Spring day had us at the hospital in good time. The surgeon had barely had time to study the scan taken the previous day in any detail. But immediately he was almost certain he could finally see an arteriovenous malformation – a tiny bundle of veins connected to an artery which should not be there. He quickly checked with a colleague who was also 99% certain.
Finally, after more than 6 months the mystery was almost certainly solved! This diagnosis also meant Amanda’s brain was now healed sufficiently for the AVM to be clearly visible.
Our son Joel, who also came to the appointment, decribed an AVM as like a small pool of slack water which sits on the side of a flowing river. The water in it eddys around and around and sometimes the rivebank breaks under the pressure.
The next steps, over the next few months are likely to be an angiogram to get better x ray images , and then a trip south, to Dunedin where they have the only Gamma Knife (sounds very ‘Marvel’) in New Zealand, to blast the AVM with a large pinpoint radiation dose to shrivel it away.
Amanda had used the hydrotherapy pool at Nelson Hospital. With only having a shower every day at home she hasn’t felt the benefit of being fully immersed in water for over 3 months. Luckily the local public pool also has a hydrotherapy pool.
We spent 45 minutes as she gradually regained her confidence and realised she could comfortably jog on the spot, and raise her affected arm a full 90° to her body, thanks to the bouyancy of the water. By the end of the session she was confident enough to hold on to the bar with both hands and let her legs float out behind her.
Speech therapy continues in a sometimes Groundhog Day fashion as Amanda carefully remembers the letters S, N, R L & T and then looks at them blankly 10 seconds later. But the Tactus Therapy app on her Ipad seems to be working better as she is able to rearrange 7 or 8 letters into a word which matches a picture 100% of the time.
This morning the occupational therapist spent time noting Amanda’s daily routine and how she has progressed since being discharged 3 months ago. She offered Amanda a neuropsychological assessment so any gaps in her rehab can be identified and added.
In the afternoon, Amanda’s physiotherapist was pleased to note the improvement in the use of her right hand and the progress she has made in the past few weeks. Even he is getting into recording her progress for posterity and used her ipad to take the following video, so her carer can see how to help Amanda when she visits each day. Luckily I was able to easily find the Duplo bricks after hunting in the garage for Scrabble a few weeks ago.
Amanda’s quote of the week:
Me:- “What would you like on your crumpets – Marmite, peanut butter, jam or lemon curd?”
Amanda:- “lemon curd please.”
Me:- “You know too much sweet stuff is bad for you?”
Amanda:- “Don’t buy it then.”