Shredding

A beautiful sunny spring day, with a milder breeze today. I had my usual broken night, losing three hours sleep out of ten in bed. I was clear headed when I got up. I blew my nose and a large blood clot came out in the mucus. Later in the morning I had a further brief nose bleed. It's rather upsetting, but inevitable with my blood pressure volatile influenced by stress, still high, clot thinning meds and wounds in my nostrils and nasal cavity which are not well healed. I spent a few hours recovering from the shock. 

Then I tackled a particular chore I've been avoiding for months. I have a thick pile of A4 paper documents containing information about the 289 funerals I've taken since we returned to Wales. Many are annotated with handwritten pastoral details. I retained them in my file cabinet in case I was asked to minister again following another death in the family. I needed to shred them into anonymity, as they're sensitive confidential documents. It took me an hour, and yielded a large green recycling bag. Yesterday's rubbish collection emptied wheelie bins, but fortunately the content of sorted recycling bags is yet to be collected.

Clare went shopping and I cooked veg, rice and fish for lunch. Then, I had a half hour phone conversation from a member of the NHS stroke team, following up on the survey I responded to last week, asking how I was getting on with medication issues and managing everyday tasks in the light of visual impairment and memory coherence. I spoke about losing confidence in dealing with digital details. Cognitive behavioural therapy was suggested. I spoke about my feeling of losing control, echoes of anxiety and panic that are a legacy of the botched attempt to deal with the first catastrophic nose bleed after the stroke. From my experience, I don't think this can be addressed by reason and will power alone. A minor nose bleed can reawaken the same emotions. It left me wondering if I might benefit from hypnotherapy. Then after a short siesta, I walked in Llandaff Fields. All the chestnut trees are magnificent now, in full leaf with their characteristic 'candle' blossoms, lit up by afternoon sunshine. I went out again after supper to enjoy the sky as the evening light changes the colour of small clouds, and completed my daily step quota. I'm tired this evening, so earlier to be for me.

Appointment annoyance

I woke up from a good night's sleep to a clear blue sky, sunshine and strong gusts of wind making trees in leaf move energetically. Thick light blue and purple lilac blossom appeared from a distance like a banner being waved. A delightful sight. I posted today's Morning Prayer YouTube link to WhatsApp after Thought for the Day, then got up for breakfast feeling rather light headed and slow thinking, even before I took my daily doses of medication. It seems so random.

There were nine of us at the St Catherine's Eucharist in honour of St Catherine of Sienna. Unusually, the high altar reredos hosts figures of Catherine of Alexandria Martyr and Catherine of Sienna Doctor of the Church. It paid homage at the time to Catherine Vaughan, wife of the Dean of Llandaff, a benefactor of the church who laid the foundation stone. After coffee and a chat I returned home. Clare had started cooking lunch already and laid the table in the garden. Fortunately the garden is sheltered enough to allow us to watch the trees dance in the breeze.

A letter arrived from the UHW Cardiology department to arrange wearing an ambulatory blood pressure monitor for twenty four hours. The date given is when we're in Tenby on holiday. I called the appointment booking number to re-arrange it six times, The number rang, but  no reply. I was cut off twice, and got an out-of-office automatic response twice again. I returned a copy of the appointment letter with one of my own reporting this, stating when I am not available and asking for an acknowledgment by email or SMS. I don't look forward to wearing one of those devices as they are so disruptive, day and night and stressful to have to wear. It's hard to see how accurate they can be. There are smart watches that can monitor blood pressure. They may not be as accurate, but either way, what are they going to produce except a lot of high readings which will prompt another medic to recommend a pharmaceutical solution which is reduces my quality of life even further.

Most of today my head felt as if I'd been aroused from deep sleep and not yet woken up, my brain slow and dull. Writing the letter and printing it was an effort in being patient with myself. The task was eased by using my Linux workstation, which is very responsive - no latency. Having to wait for the phone or a Windows device to respond can produce lapses in concentration and transient memory, requiring a repeat of the procedure and train of thought in order to make progress. It's so frustrating and tiring.

Enough for today. Straight to bed now.

I went out and posted the letter I'd written after supper and enjoyed a beautiful pleasant sunset walk under a clear sky streaked with clouds shaped by high pressure air producing random gusts of wind at ground level. It was cold, so I stayed out long enough to complete my step quota on arriving home. 

Health check

Overcast this morning, but the sky cleared later in the day. I was grateful for a good night's sleep for a change. Clare's study group arrived at ten. I sat in the lounge, preparing the text  to record for another Morning Prayer, with the sound of lively conversation from the dining room in the background. While I was writing, Clare cooked prawns with rice for lunch. I set out by bus in good time, or so I thought, for my three fifteen hospital appointment at UHW. I didn't get the timing right, however, as the bus from the city centre takes fifty five minutes. 

Rather than being late I took a taxi from Central station. The driver was Iraqi. His accent was familiar. He reminded me of Basma speaking English. We had an enjoyable chat during the journey. Although I arrived in good time at the concourse I made a mistake about my destination clinic, and reached Cardiology Outpatients at the right time, confusing it with General Medicine Outpatients. I ended up ten minutes late as a result, with my blood pressure sky high. I had to wait a while to be seen, allow me to calm down. I'm not good under stress. Navigating my way around the maze of anonymous UHW corridors is something I have difficulty with every time. There are maps of the layout displayed prominently on each floor, but none of them actually tell you unambiguously where you are in the hospital.

I was seen by Consultant Dr Tom Hughes, who had received the report I emailed him, I had to consult the one on my phone to start the report, as he'd not yet found the one printed out for him in my case folder. He was please that the medication review had improved the situation. His colleague did psychometric and simple 'field of vision' tests. Having drawn attention to last Friday's chest muscle spasm and my concern  about a diaphragm hernia, he gave me a physical examination, which gave him no concern. The chest and diaphragm muscles are less painful today, thankfully. He said I'd made an excellent recovery and was in good health, but reiterated Dr O'Neill's opinion that I'd need to have a pacemaker fitted sooner or later. 

As it's based not on physical symptoms but on a electro-cardiogram readings. Are those taken periodically in the past few years consistent with the same anomaly?  I wanted to ask this, but wasn't quick thinking enough. I remember a friend telling me of an ECG reading taken on admission to hospital triggering a crisis alarm, when it turned out that the electrodes weren't positioned correctly. I have another meeting with cardiologist  Dr O'Neill soon. I must remind myself to ask this question about evidence consistency.

If only the way I feel truly reflected my state of health I'd feel reassured by Dr Hughes' opinion. Having said that, I remember Rufus telling me that after his TIA it took nine months for him to feel right in the head again. I suppose the same may also be true for severe concussion sufferers.

I walked towards the bus stop to start the return journey, but as the sun was shining, although I was a bit tired I thought a walk would be more beneficial than rattling around for nearly an house on a bus. I walked to the Gabalfa roundabout and caught a number two bus which dropped me off by Cardiff Met at the top of Llandaff Fields. That way I got some fresh air and didn't overtire myself physically. 

I went out to stretch my legs and walked for twenty minutes under a waxing half moon in a clear sky with Venus also bright and visible. It's cold tonight without clouds, a real breath of fresh air before bed.

Still recovering

Another miserable night's sleep in my new bed. To avoid stress getting out of bed on my still painful right side, Clare  pulled out the bed from the wall, so I could get out on my left side. As the bed was now free standing, the duvet wouldn't stay covering me for long. I've felt unwell for much of the day after so much disturbance. I have an appointment for a review with stroke consultant Dr Tom Davies at UHW tomorrow, and spent much of the morning writing a report to prepare for the meeting and send in advance, to make sure I mention all that's necessary rather than have to talk too much and risk missing out key issues. 

Clare went out shopping and I prepared veg for cooking, but was unsure what Clare planned to have for protein. I phoned her, but she didn't answer. I was distracted by my preoccupation with writing the report, so nothing was cooked by the time she returned, but she improvised a savoury quorn dish for protein and cooked the veg I prepared. After we'd eaten I went back to bed and slept for an hour, Then went out and walked slowly in the park with little energy until it was time for tea and the evening news. Clare went to choir practice. I went out as the sun was setting, walked down to Tesco's and withdrew some cash to pay for a taxi tomorrow, hoping that a bit more low key exercise would clear my sleepy head. 

Recovery from the rib cage muscle spasm is taking its time.  It's been an unwelcome set back. The pain has almost gone, but perhaps because of the shock, I'm reminded of how I felt when first admitted to A&E with the stroke. Thankfully, my heart beat is steady. It's not playing up despite these stressful days and nights.

The military stalemate over control of the Straights of Hormuz has resulted in the extension of the cease-fire, and American peace talks with Iran have produced an offer from Iran to open the Straights and end the war. America's insistence on radical reduction of Iran's enriched uranium stocks, has been deferred until a future date. Russia has supported Iran in the background all along, but now emerges opently in the as a power broker it seems, with a well published meeting between Putin and Iran's Foreign Minister. Trump's choice of negotiators who are not professional diplomats but cronies, whom Trump trusts, has come under criticism. They lack expertise in addressing a range of issues relating to nuclear deals. Heaven help King Charles and Queen Camilla on their American visit this week, given the disrespect Trump has shown for Britain's stance on the war he started, and for the British military. As Colonel in Chief of all our armed forces, this is a difficult and demanding visit for our Sovereign. The media world wide is waiting to see how he handles this awkward encounter on the 250 anniversary of the American declaration of independence. 'O Lord save the King: and mercifully hear us when we call upon thee'

Earlier than May

Cloudy today with occasional sunshine. Overnight news of a failed assassination attempt on Trump at a Press Association banquet in Washington. He tried to shoot his way into the lobby of the banqueting hall where security credentials were to be inspected. It happened in the same Hilton hotel where an attempt was made on the life of Ronald Reagan in 1981. The perpetrator had actually stayed overnight in the hotel beforehand, having travelled by train to Washington from California heavily armed. The story is so crazy it sounds as if it could have been written for a comic book. Trump thinks (or maybe hopes) it is, as he declares a crazy lone actor stopped by brave Secret Service agents putting their lives on the line. With so many reputable journalists witnessing the scene, this cannot be dismissed as fake news, but it's the second time in Trump's regime than an assassination attempt has been made against him. So much of his rhetoric is violent in character, is he becoming a magnet for political violence himself?

I slept fairly well and woke up slowly. I was quite clear headed when I eventually got up for breakfast just before nine. I went on my own to the St Catherine's Eucharist, as Clare decided to attend the afternoon Welsh Eucharist instead. Jeremy our ordinand on placement in the Parish is coming to the end of his stay with us. He worked with the half dozen children of Sunday Club and with them gave a cute presentation on Jesus the Good Shepherd to the forty strong congregation after Communion. One of the congregation's teenage Girl Scouts spoke to the congregation about being chosen to attend the 26th World Jamboree next year in Gdansk. She's raising her own funds to cover the cost and held a little sale during the coffee and chat session that followed. 

The sun was out for long enough for us to have lunch in the garden. Then the sky clouded over, so we did the washing up and siesta'd in our arm chairs until it was time for Clare to leave for church. Then, I walked and Llandaff and Pontcanna Fields, down to the Taff and back. In places where tents and walkways were installed for last week's Urdd rugby tournament, oblong patches of bleached grass  stood out against their rich green grass surroundings. Crows and gulls seemed particularly drawn to these patches, perhaps because of a potential feast of worms or insects surfacing in the absence of sunlight. A curious sight.

Despite my legs taking their time warming up slowly to the task of keeping me on my feet, I walked for an hour and a half and completed my daily step quota which I wasn't able to, the last couple of days when gut spasms laid me low and I needed to do less and recover. There's more early cherry blossom decorating the fringes of footpaths than there is on trees which have burst into the leaf quickly this week. May-trees and starting to blossom and there are other white flowers coming out on the river bank I can't identify. All are early, due to climate change, but lovely to look at and photograph.

In today's London Marathon a couple of runners achieved for the first time the extraordinary feat of completing the course in two hours. It's as significant as the day I remember well when I was a nine year old boy, when Roger Bannister ran the world's first four minute mile.

I spent the evening writing a review of my first six months since the stroke, to send to Consultant Tom Hughes before I see him in the coming week. Rachel called and we had a brief catch-up chat before I had to admit to her that I needed to get to bed.

Recovering

That must have been the worst night's sleep I've had in years, with muscle spasms causing sharp pain in my stomach every time I moved.  It was exhausting. I slept in the double bed so I could get out of bed on my left side when I needed to pee. It was a nightmare, but I was able to cope without having an accident. by first light pain from the spasm subsided enough to allow me to relax and slip into unconsciousness. I won't be able to do much apart from recovering. Thankfully the rib cage and shoulder spasms eased by the time I got up slowly at eight. it took me the best part of an hour to dress, working around residual stomach muscle pain. Clare cooked our usual Saturday pancake breakfast and the morning sunshine and clear sky lifted my spirits.

I lay low for the rest of the morning, avoiding putting stress on my painfully sore stomach muscles, too tired to think or do much. After lunch I went back to bed for a couple of hours, then went out and walked slowly for over an hour. I fell far short of my daily step quota today. A Red Admiral butterfly rested in a patch of sun on road by the stable and I took a photo of it which was adequate but not very sharp at full lens extension on my Panasonic TZ90. 

I took a slow release dose of ibuprofen at tea time, and this took away most of the discomfort. After supper, I spent time transcribing more of the notes from my Jamaica travel diary. I'm not sure how accurate the timeline is for some entries. I may well have mistaken the dates, unless a few pages are missing. I can only do a few pages at a time on any day. Transcribing I find mentally tiring. Reviewing what I've done so far reveals so many typos and maybe a few missing passages that need relocating in the correct place.

Trump has set out on a course to 'punish' Britain  and Spain for resisting his illegal declaration of war again Iran. His inflated ego is turning him into a dictator, wedded to the idea that might is right, and  'My will be done'. His attention is focused on 'reviewing' the status of the Falkland Islands as a British Dependency, making trouble between the UK and Argentina which continues to claim sovereignty despite defeat in Britain's Falklands invasion in 1982. He also advocates the expulsion of Spain from NATO, with no legal basis for breaking a treaty in force since 1949. "The defence alliance is based on consensus, not run by the United States"  said one senior NATO official yesterday. Undermining NATO unity when he doesn't get his own way makes me wonder if Trump is secretly working for the Russians. 

Ceasefire negotiations between the US and Iran have been extended. American envoys were about to be sent to talks in Islamabad, Pakistan, and then Trump cancelled their visit. Although America has blockaded Iranian ports, select shipping is being let through the Straight of Hormuz by Iran, while others are being attacked. Iran still has control of the Straight, despite being deprived of oil revenue to fund the war. 

It's hard to imagine how sufficient trust can be established between negotiating parties while Trump engages in capricious gestures towards allies and adversaries alike. The hard-line Iranian Revolutionary Guard Corps seems intent on imposing its will by repressing its critics, overruling those advocating negotiation and diplomacy. Mixed messages are coming from the government about peace talks. Trump can't resist deriding Iranian 'infighting' and shifting his own bargaining position, sabotaging possible diplomatic initiatives. This is likely to lead to the resumption of hostilities. Neither Iran nor America can afford economic damage. Iran will tough it out, knowing this will add to Trump's deepening unpopularity.

Meanwhile in Lebanon the ceasefire has been extended which means that negotiations between Israel and the Lebanese government continue, while Israel continues to wage war against Hezbollah and the civilian death toll continues to mount. 

Muscle misbehaviour

A woke up at eight to another bright sunny day with a cloudless sky. I slept awkwardly on my right side straining a ligament in my shoulder. In addition, my rib cage muscles and diaphragm hurt as if I'd been crushed by a wrestler. I had fair night's sleep, but it was unfair in terms of the outcome. I transcribed a few more pages of my Jamaica travel diary, promising Clare I'd cook lunch, but was so absorbed in making sense of my own hand writing that she'd returned from shopping before I realised it was nearly one. 

Nevertheless, I got to work on cooking a  savoury dish from scratch with frozen chick peas, while Clare prepared the veggies. We sat down to eat by twenty past. Although my head was clear enough during the morning, I felt tired and sleepy after we'd eaten and dozed uncomfortably in my armchair for half an hour before going out for a walk. I felt stiff and needed to walk slowly stopping at benches around Llandaff Fields to sit for a few minutes to let my limbs recover. I wasn't out of breath thankfully, but feeling light headed and sleepy due to the medication.

The muscular pain in my right shoulder, rib cage and diaphragm worsened. I think I may have had wind trapped in my intestines as well as muscle spasms that made me yelp with pain when moving about. After Clare and Ruth left for an Anthroposophical talk in Bristol at five, I went out for a walk to see if this would relieve the pain, but it didn't. I returned home, rubbed arnica oil into my rib cage, drank chamomile tea and ate oats with kefir for supper, so I wasn't taking my evening capsule on an empty stomach. Drained of energy, I tried to relax and contain the pain until I'd recovered enough to get myself up to bed.