RSS Feed

Supersalt Me

There is a terribly trashy reality television show on cable TV called ‘Supersize vs Superskinny’. On this show, people who are unhealthily overweight swap eating habits with people who are dangerously skinny.

The underweight people cringe and look rather nauseated when suddenly faced with plates piled high with meat, cheesy pasta, creamy potato bakes, and huge slices of pizza dripping with oily cheese. Meanwhile, the overweight people stare in stupefied horror at the miniscule portions of tasteless boiled vegetables, lean meat, and salads without dressing.

It’s entertaining enough when it’s three a.m. in the morning and you can’t sleep, and haven’t been able to do so for the last two nights. For that matter, it’s also entertaining enough at three p.m. in the afternoon when you’ve been housebound for weeks and all you really want to do is sneak off to the nearest highway, hitch a ride, and make a new anonymous life in some overpopulated sprawling city (you know, open a second-hand book shop and fall in love with the flower seller around the corner; that sort of thing).

‘Supersize vs Superskinny’ varies in it’s usefulness to the contestants. Some of them make real changes while others slowly revert back to their former habits.

The way you eat is hard to change. I have always relied on food as an emotional safety net. If I felt stressed out, sad, or angry, I could go into the kitchen and whip up something comforting and delicious and feel like I could cope with the world again. It’s not just the factor of eating nice-tasting food, but the whole cooking process that does it. Chopping up ridiculously huge amounts of garlic and throwing it into a pan sizzling with good quality olive oil. Quickly running out to the garden, picking fresh herbs and chucking them straight in so that you can smell the delicious aromas wafting around your kitchen. Making soups, pasta sauces, fresh salads with feta cheese and olives and lovely salad dressing. It’s all pretty good. It gives you a sense of control, meaning, and fulfilment. And yes, it tastes pretty damn good too.

What I’m finding most difficult about my life right now, is that I’ve been placed on a fluid and salt restricted diet. This is because I have congestive heart failure, and too much fluid and salt would mean a further build up of fluid in my abdomen. Having a skinny frame and looking five months pregnant is bad enough already and, of-course, has dire consequences for my health, so the last thing I want to do is make it worse. I can only have 1.5 L of fluid per day, and no more than 93 mg of salt per 100 g of food.

Well. That’s how it would be if I followed Dr More Dreadful’s advice on this. Actually, he would probably tell me not to eat any salt what-so-ever. Even when it occurs naturally in some foods, like celery. However, there is also a diet sheet for heart failure patients from a nutritionist at the hospital, that says it is acceptable for patients to sometimes have up to 300 mg of sodium per 100 g of food. It also says that if you are out one day and have to buy food from a take-away shop, it is okay to have a sandwich on normally salted bread as long as you don’t have other salty things with it- ie, cheese, mustard, pickles, etc (all the nice things, basically).

Bread is pretty salty. It usually has over 600 mg of sodium per 100 g of bread. It seems strange to me that this is allowable, when so many other things aren’t.

Mostly, I try to find the middle path between Dr More Dreadful’s hardline approach and the part of the nutritionist’s diet sheet that says 300 mg of sodium is acceptable. This is difficult, however, and lately, I have been eating more and more of the 300 mg range, and even adding tiny pinches of salt to things like rice, pasta, and potatoes.

And yesterday I was very bad. We’re talking major deviancy here. I had to go to Manly Vale to have a blood test, and we went to a cafe for breakfast before-hand. I had ricotta cheese – not a salty cheese, but the amount of salt in ricotta varies considerably, so I really had no idea what was in it (not good!) on actual normal white bread with who knows how much sodium in it (dastardly!). And on this abominable salt-laden cheese-fest, I had grilled tomatoes. I asked if the chef could leave off the salt while cooking the tomatoes, but the waiter said that they were pre-made and they already had salt in them. And now dear Reader, prepare to be shocked. I shrugged and said I would have them anyway.

Truly, truly, evil. And today, when I weighed myself, I was 300 g heavier than yesterday. Was it really the bread and tomatoes? Or was it the extra pinch of salt I put on my popcorn the other night? Or is it actually related to some other factor that is beyond my control?

My friends and family have been wonderfully helpful in tracking down low-salt products in supermarkets and cooking elaborate low-salt dishes. The problem, however, is not that there are not enough low-salt foods that I can eat, it is simply that I like salt. I really just want to eat food with salt in it. There’s no getting around it.

So I sympathise with the contestants on ‘Supersize vs Superskinny’. Food is important. It’s hard to break habits. I’m going to have to learn to live with this diet until I start the Flolan, and probably for a few months afterwards before it starts working properly.

Months and months without brie, Camembert, fetta, haloumi, even good old tasty cheese. Without dolmades and olives. Without potato chips or nachos, without my delicious tomato and basil soup, or my hearty potato and leek soup. Without plain old lovely toast and butter. Without San Remo spinach fettuccine with butter and soy sauce (trust me, it’s damn good). Without roast vegetables, mashed potato, and mushroom gravy. Without (shock, horror) proper pasta sauce with actual parmesan cheese. 

Oh the hardship.

This morning after having a mini nervous breakdown over my 300g of weight gain (yes, I’m becoming incredibly neurotic) I made a fairly okayish crepes Suzette. It had no salt at all, which made me feel like I was making a good choice for once, and it was also pretty darn fantastic to actually cook something, as lately I’ve been too tired to do much cooking.

While I do seem to be getting better – no more temperatures and an iron infusion has lifted my energy a little – I’m really just waiting to start taking Flolan. When this happens my life will be a lot worse for a little while then maybe it will get better.

The Strange Case of Dr Less and Dr More

Things with me have been a little weird lately. I don’t seem to be getting better. Every night, my temperature suddenly spikes over 38C and I feel strange. Even my eyeballs feel hot. My mother brings me Panadol and an icy pole, and it goes away after a few hours. The next day I feel the same as I always do; which is tired.

Tired, tired, tired.

Yesterday we went back to the hospital to run tests to find out what the temperatures mean, and for a general check up. We waited for two hours to see one of the specialists who was looking after me in hospital; Dr Less-Dreadful.

Dr Less-Dreadful says things like, ‘You don’t seem to have quite so much fluid on your stomach so maybe your putting on a bit of weight.’ This makes me think I might be getting better, and feel happy; hence the ‘less dread’.

Unfortunately, another specialist, Dr More-Dreadful-Than-Anyone popped in a few times during the consult, shook his head sadly, and said things like, ‘You’re just not getting better. You might not even make it to transplant. We’re going to start you on Flolan as soon as we can.’

When I was in hospital Dr More-Dreadful-Than-Anyone always seemed to be the one who would give me the worst news. These doctors all seem to have differing opinions, and his were consistently the most depressing to hear.

And yesterday, Dr More-Dreadful followed up his usual statement of doom and gloom with, ‘You might do really well on Flolan and not need a transplant.’

Hang on – is this depressing news? The possibility of avoiding big scary monster under the bed transplant? Isn’t this what I wanted? Isn’t this what any normal person would want? You would think that this news would have made me declare my specialist ‘Dr More-Wonderful-Than-Any-Other-Doctor-Living’ and campaign for a national day in his honour.

But it didn’t.

You see, I have kind of been getting used to the idea of transplant. I’ve been thinking that although it’s scary as hell, and painful, and involves a mind-boggling amount of medication just to stay alive, and although there are all kinds of risks and different diseases to deal with afterwards that it might just be okay. I’ve been thinking of how many people recover very quickly, have few problems, and go on to lead almost normal lives, often for more than twenty years.

I’ve been thinking things such as, ‘After I have a transplant I’ll be (almost) like a normal proper person again. I’ll be able to work, travel, wear the clothes that I want to wear. I’ll even be able to fit into my lovely vintage woolen skirts that I miss wearing so much. I’ll actually be able to wear my favourite black knit stockings with little cats printed on them again (yes, I’m a crazy old cat lady; it happens). And if I wanted to, I could get up early every morning and go jogging. I could randomly break into a run and just keep running. I would be able to live in a house that has stairs. I wouldn’t even notice stairs any more. There will be many, many, things that are such huge obstacles now that I just won’t notice any more.

But the aspect of post-transplant life that I felt most strongly about is that I wouldn’t have pulmonary hypertension any more.

I am so phenomenally sick and tired of having pulmonary hypertension. It’s boring and depressing and exhausting and I would love to just not have it any more. I want it gone from my body. It is not welcome, and never was. After transplant, I may well have a host of other lovely diseases, who knows – but I won’t have pulmonary hypertension.

In any case, the entrance of Flolan into my life has snapped me out of all of these rather idealistic thoughts. Flolan is an intravenous drug that is fed directly into your heart via a central line. This means you have a thing sticking out of your neck all the time attached to a pump which you have to re-fill with medication once a day. You have to maintain the site and prevent infection, which could be life-threatening. You have to keep the medication below a certain temperature, so the pump is kept in a little bag surrounded by icy-cold gel packs. It’s a very strong drug, and side effects include bad headaches, jaw pain, and various other lovely symptoms.

It’s a scary, scary, drug.

On the up-side, people on Flolan do pretty well. If the drug agrees with me, I could even be doing many of the things I hoped to do post-transplant.

Dr Less-Dreadful still thinks transplant is the best option for me. He thinks it would give me a proper life, one where I wouldn’t be hooked up to a pump. This could be true, but then I also might have a longer, and nearly as fulfilling, life on Flolan than I would with a transplant.

Both doctors, however, agree that I have to go onto this drug very soon. Whether or not I have a transplant later down the track will depend on how well I do on it, and also on what I feel about my quality of life. So in a few weeks, I will go into hospital again (something I am not looking forward to), have the line placed, then the nurses will teach me how to use this drug without killing myself.

I’ve known about this drug as a possibility in my life for many years, so it’s not a total shock. I’m sick of being sick, and tired of being tired, and even if this drug is difficult to live with, it at least represents some kind of change. Hopefully a good one.

“The horror! The horror!”

I’m out of the hospital now. Life is much better.

When I first went home, I was still using oxygen 24/7, but the long tubing on my oxygen concentrator allowed me to actually walk around the house at will.

Amazing.

At St Vincent’s I’d been literally tethered to the bed by several meters of tubing on a canula coming out of the wall. I also had portable oxygen on a heavy, stiff-wheeled, trolley; but these seemed to run out very quickly, and busy nursing staff were not always available to scrounge up new ones for me. So being at home and suddenly being able to walk up and down the corridor, in and out of my bedroom, into the bathroom, kitchen, and even go sit on our sunny little front porch, seemed an awful lot like freedom.

Exhilarating stuff.

But then, of-course, I got used to it, and started to take it for granted. And then I began to perceive it the way I had before I went into hospital – that is,  as a very long, annoying piece of tubing that becomes tangled up all the time, is always in the way of other people, and always, always becomes stuck underneath a particular corner of the fridge whenever I go in and out of the kitchen.

Not freedom after all.

However, there is another, far more unpleasant aspect of being on oxygen all the time: coughing up blood.

When you have a high level of oxygen flowing into your nose all the time, the blood vessels can burst, and then blood either comes out your nose, or, as happens in my case, runs down the back of your throat and accumulates in a weird kind of rattly cough.

Picture this; it’s night-time and the hospital ward is dark and almost quiet. You’re lying in bed, trying to ignore the beeping of the alarm on your bed-neighbor’s IV pump, so that you can drift off to sleep. Suddenly, you feel this strange rattly sensation in your throat. You open your eyes. “Ahem. Ahem.” Clearing your throat doesn’t seem to help, because there’s immediately more of it. And then more. You sit up. If you don’t sit up, you feel like you might drown.

You fumble for the tissues, for a napkin left over from dinner, for anything. Cough, cough, cough, and you spit it out. It tastes weird. It’s hard to see in the dark, but there’s a dark, shadowy shape in the tissue, a weird blackness to whatever you coughed up. You switch on your mobile phone and use it as a light source (the hospital’s bedside light doesn’t work) and you see that it’s not black after all, but…

Blood! Auuugh! What the hell?

And then you feel the rattle in your throat again, and you have to quickly grab more tissues because there’s a heap more still to come up.

Ugh.

This is not like Nicole Kidman’s character in Baz Lhurman’s Moulin Rouge who tragically coughs up a tiny spot of blood and then dies of TB in the middle of a song about how wonderful love is. Or poor insipid Beth from Little Women, who in between lady-like and restrained coughing fits into a snow-white, beautifully embroidered, handkerchief, tells Marmee and the girls how glad she will be to get to heaven and be with the angels.

This is more like Stephen King’s Carrie. Or HBO’s True Blood. Unfortunately, telekenisis and vampire superpowers are not part of the deal.

One of the handy things about being in hospital, however, is that you can push a buzzer next to your bed and (eventually) a nurse will come, and then you can hysterically demand to see a doctor, NOW, even if it’s in the middle of the night.

So after a bit more waiting, a lot more coughing, and a lot more blood, and using up a whole box of tissues which probably constituted an entire old-growth rainforest, a doctor showed up and told me the thing about blood vessels in your nose and being on oxygen all the time. And the vasodilator drugs I’m taking don’t help. Nor does the fact that I have low platelets, which mean my blood is slow to clot.

Well goody for me.

Since I’ve been home, it’s happened a few more times, meaning that both my parents are now irrevocably traumatised. If it keeps happening, they’ll probably develop post-traumatic stress syndrome and start having gory flashbacks.

“The horror! The horror!”

That is a quote from Joseph Conrad’s Heart of Darkness, by the way, which is perhaps a rather hyperbolic point to make about this situation. Sorry about that.

In any case, since I’ve been out of hospital, I’ve been able to stop being on supplemental oxygen all the time and go back to only using it at night. I haven’t had any incidents for an entire four days, which is wonderful.

So I’m hopeful that I’m getting better; that things are improving. The doctors have given me three months to put on some weight and do some physiotherapy and then they will put me onto the transplant list. I’m still hoping that now that I’m back on the wonderdrug my condition will improve and I won’t need to go on the list.

The list is a scary place to be.

But I’ll write more about that another time.

 

Hospital Life Continues… and Continues…

I’ve been here for just over two weeks now. It’s getting old fast.

Whenever I have the energy, I take one of the portable oxygen cylinders and make my way down to the end of the corridor, where there is a foyer, a view, and a tropical fish tank. Walk, walk, walk, stop. Catch breath. Occasionally I lean against a wall to have a rest. Sometimes I see someone I know; a nurse, a social worker, a nutritionist, and then I have to talk to them, say things like, “Oh yes, feeling much better, thanks. Trying to get some exercise.” A big part of hospital life is constant social interaction.

The fish tank is lit up with ghostly lights and contains several species of fish. The largest ones have fan-like red tails and glide sedately in and out of thick pillars of seaweed , while others are tiny and dart quickly from one place to another. There are round shelled snails stuck to the glass walls, and tiny wizened creatures with six legs and large eyes and thin little feelers that crawl through stringy tangles of seaweed.

After gazing at this fascinating part of the expedition for some time, I go to a room off the foyer that has chairs, tables and huge windows looking out over the green circle of the park and the tall grey buildings all around.

I stand behind one of the chairs and do some exercises, lifting up and down on my heels. Five times, then rest, then another five times. Then I sit down and do breathing exercises. Breath in, breath in, breath in, hold, hold, hold hold, breath out. Cough. Five of those. Five of lifting my arms up and down, five of lifting my arms up and down in a slightly different way.

Mostly, when I’m not attempting what I suspect is woefully inadequate physiotherapy, I watch movies, or sleep. I’m tired pretty much all of the time. I’ve even had to ask friends and family, who have all been wonderfully and amazingly supportive and helpful, not to come in as much because I’ve been so tired.

The day before yesterday they told me I had pneumonia and I thought that explained the tiredness. Then yesterday they told me I didn’t have pneumonia, but another kind of chest infection. They are still trying to work out what it is. I thought I might go home tomorrow, but last night my temperature spiked again and my oxygen saturation was low so I’m doubtful of that now. But you never know with these doctors; they might decide I’ve been languishing on the state dollar long enough, and it’s time to kick me out and see how I go at home. One can only hope.

This week I met another post-transplant patient who happened to be in the bed next to mine for a few days. Out in the real world she works as a secondary-school Drama teacher. Her small and skinny frame is somewhat at odds with her face, which is large and rounded from Prednisone, one of the main anti-rejection drugs. She has what I could only call large suffering eyes and a rather wicked sense of humour. She was very talkative, and didn’t mind me asking questions about her life after transplant. She is going well, usually works almost full-time, enjoys life, and has had only a small amount of hospital visits over the three years since her lung transplant.

While she was here, however, she underwent a particularly horrible procedure called plasmapherisis during which her blood was cleansed of excess antibodies.  Having the line put in was the worst, she said. The doctor put it in the wrong place the first time and had to pull it out again and she could feel it ripping painfully through her heart. She said the actual plasma exchange part, a separate procedure to be done at intervals during the week, wouldn’t be so bad. However, when she came back from the first one she seemed pretty low. She said the procedure had made her feel so nauseous that she couldn’t even look at the walls. The doctors had to stop half way through.

Life after transplant, I suspect, is like this. In and out of hospital. Up and down emotionally. One procedure after another to grit ones’ teeth through. One health crisis follows the next – rejection, anaemia, various types of aggressive cancer. Your teeth can crumble and fall out. Your bones succumb to osteoporosis. Many patients get diabetes permantently.

And it’s not just about the patient. The patient’s family and friends have to go through this as well – endless hospital visits and driving to and from procedures. Endless medical check-ups for a variety of heightened risk factors. Constant emotional support that must be sustained for years and years.

I know there are good sides to transplant. I’m trying to focus on them as well. The other day when my dad was visiting he said, “After your transplant we’ll go mountain climbing,” which I have to admit sounds pretty awesome. Hiking, travelling, going back to uni and actually finishing a degree, getting a job like a proper normal person. These are all things that could happen.

However, hospital life is not exactly conducive of such thoughts. Currently, my world is sterile surfaces, flickering yellow lights, cannulas and needles, portable oxygen cylinders on heavy wobbly-wheeled trolleys and long stretches of linoleum with nothing more exciting at the end of them than eighties-patterned lounge chairs and a fish tank.

Perhaps hospital is the wrong place in which to be coming to terms with all of this. This is where all the bad parts of transplant life happen. This is the place you try to forget in between the other parts of your life. Your busy, proper, normal life – where perhaps, for a few moments every day, you are able to forget you are even sick at all.

Facing a Life in the Medical System

I’m lying in a bed in the Cardiac Care Unit of St Vincent’s Hospital, Sydney. Today is Wednesday, which means that I’ve been here for a week.

It’s 5:30 am and a light is on at the nurses’ station, but my room, which has six other beds, is dark and quiet. I can hear the low whooshing of the air-conditioner and the more urgent hissing of oxygen in the cannula that goes into my nose.

The sounds remind me somehow of the ocean; of being at the beach with the water rushing in and out around my ankles. There’s a dull, hot, itching sensation in the part of my arm where the IV catheter goes into my vein. Yesterday, during a CT scan, radioactive dye was injected there and burned the surrounding area of my skin. I don’t like thinking about these things, so I close my eyes again and see the sun rising pink and yellow over the glassy waves. I feel the cold wetness of sand under my feet and the shock of the freezing water on my skin. The smell of salt and seaweed.

I think about how only a few years ago I went away for a weekend to a friend’s shack on Bruny Island, Tasmania. One night we camped out on the tiny, deserted, beach in swags and woolen jumpers and woke in the blue early morning light. Even though I’d had to sleep propped up with all kind of pillows because I didn’t have supplemental oxygen, and even though it had been annoying and tedious getting back up the steep hill to the cabin afterwards, even though that day I sat by the campfire, watching with muted envy as everyone but me went for a long bush walk, and even though, driving home, I sat silent and afraid in the passenger seat of my friend’s car, noticing my breathing become mysteriously more and more difficult ( the after-effects of a weekend without supplemental oxygen), it had been worth it just to wake up outside, in the midst of that sunrise.

At least I think it was. That is a hell of a lot of ‘even thoughs’.

So now I’m here, in this hospital bed, weighing up many things. What makes something worthwhile? I came in here with an accumulation of fluid from heart failure, which is getting worse. Even with IV diuretics I can’t say with certainty that the fluid is staying off. Everyone here is pushing me to have a transplant, but I’m hesitating. The social worker thinks I’m delusional because I have this idea that if I go back on one of my drugs for a while, I will stabilise, my heart failure will improve at least slightly, and might not need a transplant for years, or even at all.

I probably am delusional. And I don’t know if I even want a life with Pulmonary Hypertension where I am ‘stable’ but can’t do the things I want to do. But transplant is no picnic either. There is a woman in the bed next to me who had a heart transplant seventeen years ago. She is currently sitting in her bed, concealed by curtains, making the most horrific retching and vomiting sounds. Her borrowed heart is failing, and she knows she is likely to die. Her eyes are like dark bruises but her voice is always pretend-cheerful; she likes to joke with the nurses, boss the other patients around, and complain about her slacker ex-husband. After having met her for only a few minutes yesterday, I could see she was somewhat unhinged from reality. Perhaps it’s the only way to cope with having a transplanted heart for that long.

Transplant could let me have a better life for a little while; perhaps a longer while. Once I get over the horrors of surgery and recovery, once I get used to the many drugs I’ll have to swallow, and the many unpleasant procedures I will have to regularly undertake, I probably would get some good years out of it. If things went well, I would be able to go camping all night and not worry about supplemental oxygen. A short hill from the beach back up to the camp-site would be nothing. I’d be able to go on that long bush-walk; I’d feel the fresh air in my lungs and the ground beneath my feet and feel healthy and confident. I could travel, I could have a career. I could go back to uni and study Journalism. I could do heaps of things that I’ve long since ruled out in my current state of health.

But will I get used to the drugs? And the medical procedures? Heart biopsies, every six months at least. You lie conscious, on a table, passive and inert, while a surgeon threads a needle down through a vein in your neck to pull some tissue from your heart so that they can analyse how healthy it is. You can actually feel the heart tissue being cut away. That is not something I want to experience. Then there are lung function tests, CT scans, echocardiograms, six-minute walk tests and bossy nurses who make you cough up sputum into little yellow-capped sample containers.

For the rest of my life I will be at the mercy of the medical profession. This is how it is for me, already, of-course, although this week things have been rather extreme.

All week I have been here, lying in bed, weak and tired. All kinds of people come into this room – I have no control and I can’t stop them. They might take eight vials of blood in one sitting, or give me an injection of icy cold IV diuretics that makes my heart beat erratically. Or they might change the dressing on the cannula in my arm, painfully ripping the strong adhesive away from my sensitive skin. It might be a dermatologist from the transplant work-up team who wants to check my whole body for potentially cancerous moles. Or I might be put in a wheelchair and wheeled by an anonymous and silent orderly down long corridors and into elevators full well-dressed professionals who avoid eye contact with me, to be left in a room to wait for some test or other. And then sometimes my troupe of specialists will come into my room and range themselves in a semi-circle around the end of my bed. Staring down with an uneasy mixture of professionalism and compassion, they will give me the latest bad news. Heart failure. Liver failure. Transplant the best option. Small chance of stabilising, but in the long-term, and most likely in the short-term; transplant of the heart and lungs.

Worst of all is the fact that all of this is my fault. I am guilty. I did it to myself. If I hadn’t stopped taking Sildenafil I never would have ended up here. I could have continued my disabled half-life: sick, but stable, pushing myself through exhaustion and fatigue while trying to appreciate the things I can still enjoy. But I stopped taking the drug. Too expensive. Couldn’t fit it into my welfare-scum budget. Stupid, I know. My family, who have always been extremely supportive, would have paid for it. We could have taken out a loan, if necessary. I know this. I deliberately didn’t tell them. I thought I would try going off the drug. I was still taking the other main PH drug, Traclear, and I thought maybe the Sildenafil wasn’t doing anything anyway.

Also, in the back of my mind, was a small voice of protest. It seemed wrong that I should have to live like this. ‘Stable’ but never, ever, healthy. Never able to do anything. Always tired, always trying so hard to focus on the positive, always telling myself about people whose lives were worse than mine, trying to be grateful for what I had. Always having to shut out how scared and sick I felt a lot of the time. It seemed wrong that anyone would have to pay that much money to sustain such a barely livable life.

In the face of what has happened this week, my protest seems rather trivial. However, I still haven’t made up my mind. How does anyone make a decision like this? Unless my doctors are right and it’s not really a decision at all.

Last night I found a pen, and on the back of a physiotherapy booklet, drew a very messy line graph illustrating my likely prospects with and without transplant.

The first line – the transplant line – goes upwards – heading towards, but not quite reaching ‘optimum health’. Then, after some years, it curves sharply downwards towards ‘serious complications’ and then ‘death’. The non-transplant line is different. It assumes that my health stabilises on Sildenafil, and goes up slightly. Then it continues along in a horizontal line, a fair distance from ‘optimum health’, but also far away from ‘serious complications’ and ‘death’. It continues well beyond the junction where the transplant line turns downwards. Then, at some point in the future, the line curves sharply upwards at a junction marked ‘new drugs and/or treatment’ and continues along for many years at almost optimum health.

I wonder what my specialists will say when I show them my graph. Will they think I am delusional, or will they think I have a fair point?

Going to Rehab with Alfred

Recently, I’ve been going to pulmonary rehabilitation.

I’m getting fit and taking charge. I’m becoming an active, engaged sick lady; doing my bit for our staggering health system by comandeering my own wellness program and revitalising my… Er, vitals, I suppose.

But pulmonary rehabilitation is not as thrilling as it sounds. It takes place in a huge echoey gymnasium in a building next to the Royal Prince Alfred Hospital. People, most of them in advanced years, shuffle around, coughing with the pathos of consumptives in 19th Century novels.

Some of them slump in chairs and tell me sad tales of How They Ended Up in This Place. Some of them are on walking frames hooked up to oxygen, and are urged on by sporty-looking physiotherapists with stopwatches. The physiotherapists call out encouraging phrases such as, “Looking super Meryl!” or, “Just one more lap, Bernie!”

Even worse, is the fact that when I’m similarly hooked up to an oxygen hose and walking frame, the oldies seem to overtake me at astonishing speeds. They can really rip around that gymnasium when they want to.

But it’s not all bad. For example, on my first visit I watched in awe as a tiny little old lady with huge owl-like plastic glasses (the envy, I’m sure, of many a Sydney hipster) sat down at a weights machine and proceeded to lift incredibly large and heavy looking weights many times.

Impressive.

And the physiotherapists are actually pretty nice. And I have to admit that when I’m walking in endless circles, being overtaken by numerous old folks, and a physiotherapist yells something encouraging, it actually helps.

The physiotherapy itself is relatively easy; they don’t work you too hard in-case you get too tired and end up worse-off than when you started. But progress is slow. And it’s difficult to get there.

Because there is an odd lack of disabled parking near the hospital, I drive my car to a nearby bus stop and catch a bus that wends its way through Lewisham, Petersham, and Newtown before letting me off at Camperdown. For the first few times, I assumed it would be incredibly boring and took a book to read. I had, however, forgotten the endlessly fascinating soap-opera of inner-city public transport.

Old ladies with brittle mauve-coloured perms who sit straight-backed and vigilant, handbags perched on their knees like well-behaved lap-dogs, murmuring to each other about poor Ethel who finally went into the home last week.

The large woman who, breathing heavily, staggers in on crutches then heaves herself down across two seats and proceeds to tell anyone listening graphic and rather gory details about her latest knee surgery.

The woman with brown-stained teeth and rather a lot of plastic bags who keeps a stash of pressies for a little girl who embarks two stops later. Every week the little girl lets out a shrill scream at the sight of Santa Clause Lady and imperiously demands that she hand over the goods. Last week’s present was a long rectangular box of smokey grey and blue eye-shadow.

I do have to be careful. I can’t get too distracted pondering the age-appropriateness of eye-shadow for five-year olds, because it is vital to keep an eye out for my bus stop. Missing my stop means walking up several long hills and alternating between cursing myself for my stupidity and wishing the disability pension could stretch to a Sherpa Guide and donkey.

Finally, the bus pulls up outside the Royal Prince Alfred Hospital. I then walk fifty meters or so downhill to the building containing the physiotherapy department, which happens to be right next to the Alfred Hotel.

This Prince Alfred must have been a top bloke. Imagine that; being commemorated by a hospital and a pub. Here is a picture of old Alfie. Didn’t he have splendid whiskers?

Sometimes, making my slow ‘walk, walk, stop, catch-breath’ way up the steep disabled ramp outside the building, I imagine his Highness cheering me on with impeccible British aplomb, “You can do it old gel, by Jove!”

After rehab, perhaps he would shout me a celebratory schooner of lemonade at his pub and apologise for the lack of a disabled lift. “So sorry old gel. We hadn’t invented elevators when we built that place. ‘Twas a positively brill effort on your part, however.”

The Second-hand Persian Cat Memorial Etsy Exhibition

A week and one day ago, it was a rainy and miserable Sunday. We ate butter cookies, lasagna, and crackers with cheese, grimly contemplating the heavy grey clouds, and the rain spattering the windows. The yellow snap-dragons I’d arranged in a vase on the table did nothing to cheer anyone up.

The day before, the Second-hand Persian cat had been put to sleep. Yes – in my previous post, I wrote that I hoped to avoid this. A couple more years, I said. Sitting in the sunshine, front porch, etc, etc. That’s what I wanted. I don’t know if that was what he wanted (if cats can even want things in that way) but it was what I wanted.

However, malfunctioning kidneys and consistent rapid weight loss kind of got in the way of all my grand plans for his future. Towards the end he was at the vet’s being fed mushy AD cat-food with a syringe, on a drip, dehydrated, and still losing weight.

Over the week, he went from 2.4 kilos to 2.1 kilos, to 2.0…. He got smaller, and smaller, and lighter, and lighter, and then he was gone.

His body lay wrapped in a blue silk shroud in his basket in the living room. Around him, I’d placed  photos taken when he was younger, fluffier, fatter, and a good deal healthier.

At a certain point I picked up his tiny, skinny, cat-body, went outside into the rain and tearfully put him into the hole a friend had dug in the ground. Then I covered him over, my friend and my sister put some rocks on top, replanted the plants we’d dug up, and put in a new one. Then we went back inside. Such is the death of a cat.

This week I’ve been looking in op-shops for a small cat statue to put on the Second-hand Persian Cat’s grave. These places are usually veritable gold-mines for the kind of Persian-cat themed kitschery I desire, but for some reason, recent searches have yielded not a whisker.

I can only speculate on why this is. For example, a bus from the local nursing home may have recently discharged a group of little old ladies who subsequently stormed Dulwich Hill and Marrickville op-shops for Persian Cat paraphenalia, carting their loot back onto the bus with chirrups of exultant, old-lady, glee.

Or perhaps the Worldwide Society for the Breeding and Husbandry of Persian Cats had their annual conference at the local RSL club, and in the thirty minute break between the award winning talk: ‘A Flat Face is A Well-Bred face’ and  the Cat Fancier Association’s groundbreaking powerpoint presentation ‘Vets Lie: Cats Don’t Really Need to Breathe’ went on a souvenir shopping spree.

In any case, I didn’t find anything. And Ebay yielded a similar lack of results.

Etsy, however, was a different story. Etsy.com: the wonderful online world of Craft meets Art meets small-scale Entrepreneurialism. A warning: It’s weird there.

Typing the search terms ‘Persian Cat’ into Etsy produces some kind of cataclysmic, sonic, hyper-tronic, telekinetic, boom in the cosmic kitch-palace interspaces of the universe. It’s like the Big Bang with cameo brooches, needlepoint, modelling clay and lots of ‘expressive’ acrylic brushstrokes.

Mind-blowing stuff, really. Crazy. And ultimately, gloriously twee.

So, dear readers, without further ado, I present the Second-hand Persian Cat Memorial Etsy Exhibition. Some works are chosen because they actually remind me of The Second-hand Persian Cat, some are chosen because they represent everything that is catastrophic (bad pun intended) about typing ‘Persian Cat’ into Etsy, and others are chosen for a little bit of both reasons.

Enjoy.

1. Cat Fairy

A work of startling emotional depth, embracing themes of hope, love, inspiration, and fairy princess crowns. Oh, and indecipherable brown-coloured script and some dots. Puzzling, but very, very, pretty.

'Cat Fairy White Persian' By pinkglitterfae, Ontario, Canada

2. Cannibalistic Butterfly Cat

This next work continues our theme of ‘cats with wings’. Alarmingly, this cat/butterfly/genetic mutant may be about to catch and eat a member of (one of) its own species! Cat Fairy Princess surely would not be amused.

"My Butterfly" by Seasonsway, Colarado, US

3. “Aaawwwwww…”

This one gets points for pure cuteness factor. And also, for resembling Sir Butterball in the days when he was a young, ferocious, hunter of caterpillars:

The Paw of Friendship II' by ZoeWithLove, New York.

4. The Perfect Painting for the Dining Room Wall

I’m a bit shocked at this one actually. Persian cats are supposed to be silken-haired, regal, dignified, souls who would never dream that anything so crass as a toilet even exists. A bit like the Queen of England, they simply don’t do that sort of thing. 

'Chinchilla Persian Cat in the Bathroom', by lulunjay, Guyton, USA

5. Stoned Kitty on a Playing Card

I’m actually thinking of purchasing this one. The fact that Mister Persian Cat looks a little, er, ‘under the influence’, merely confirms its vintage. It’s what everyone was doing in the Seventies, right?

'Hand Crafted Refrigerator Magnet Vintage Persian CAT Playing Card' by Dimedame, McMinnville US

6. Persian in Profile

So soulful… So enigmatic…

A post-card version of a painting by the wonderfully named Schmoomunitions, Portland, Oregan.

7. Persian Felted Sculpture

I actually think this one is kind of awesome. Its huge, ochre-coloured eyes are very arresting, and felt seems to be a perfect medium to depict Persian cat fur. It’s a large, oddly-shaped, ball of pure fluff, staring at you like you owe it something. Brilliantly accurate.

'Symon' by LaCharmour, Taunton, Massachusetts, US

8. The Babushka Persian

Is this sad, scary, or both? I can’t decide. It reminds me a bit of the Second-hand Persian Cat in his last week. So it makes me sad. But mostly, it’s kind of cute. It also slightly resembles E.T. dressed in drag.

'Penelope' also by Schmoomunitions. Made of paperclay and a lacy vintage slip.

9. Eeeek!

Is it the open gates of hell, perhaps? Or a portal to another universe? Actually, this is the scary alien-like interior of a typical Persian cat’s mouth – usually glimpsed only when yawning. Mr Second-Hand Cat used to frighten the bejesus out of me on a regular basis.

'Rawwr!' by ZoeWithLove.

Here is another work in this series which is reassuringly pretty and whimsical. It reminds me of how The Second-hand Persian Cat used to love sunning himself. Although, come to think of it, this cat looks a little freaked out. As if someone just put him in a strange noisy thing called a car and drove hundreds of kilometers to a weird drippy tree-filled forest thing, and then plonked him down in a sunny spot to get some quick shots in before he scarpered and became the Godfather of the Forest Feral Cat population.  But at least there’s not a multiverse portal in sight.

'Sunkissed' by ZoeWithLove

10. Cat Contemplates Universe

This one is just divine. Golly. That huge, wondrous, boundless, mysterious Universe. That cute fuzzy little fella looking up at it all. Makes me get all teary. Honest.

'Persian Cat' by Todd Young, Fort Wayne, Indianna, US

10. The Sailing Vessel You Can Eat

This one is unfortunately not Persian cat themed, but it’s okay, because it has DOLPHINS. Those deliriously happy, tuna-chasing, cancer-curing, new-age-movement-inspiring sea-mammals  just make everyone’s day. And best of all, after our kitties finish their sailing fun, they can have a nice chewy snack.

'Dolphin Ride' by Kitty Cassandra, Virginia, US

11. ‘Charming’ Fluffy White Cats and Butterfly.

Once again, a depiction of these sadistic killer cats in action – hunting that beautiful and fragile symbol of peace and love – the butterfly. ‘Charming’? These cats would rip the head off a white dove given half a chance.

A vintage print titled 'Charming Fluffy White Cats and Butterfly' by an artist called 'T.Richard'.

12. Another  “Aaawwwwww…” Moment

Cuteness times ten, expressive brushstrokes, and it’s on a mouse-pad. Hmmmm, yes it does seem to be depicted bobbing up and down in a sea of green and blue, and therefore possibly drowning – but you can’t have everything, can you? And it’s got cute widdle whiskers. Aaawwwwww…

'Persian Puffball Kitten' Mouse Pad, by Artbyljgrove, Portland, Oregon.

13. Persians with Power

This feisty lady-cat is hell-bent on vengeance. Unfortunately, whoever designed her dress, didn’t take into account the fact that she might want to walk through a door-way at some point, not to mention the fact that she really functions better when using four feet. Luckily, her portrait makes a stunning feature for this drawstring bag which according to the seller is perfect for tarot cards, oracle cards or even cosmetics. Lovely!

'The Persian Swordswoman', from Bohemiancats, Prague, Czech Republic

14. Pretty in Bubble-gum Pink

This little piece (sculpture? Ornament?  Trinket?) really does seem to express something quintessentially Persian-catish. It’s just so darn cutesy, pink, and plasticky, and the way its little head is tilted on a slight angle is exactly how Mr Cat used to look up at me from the kitchen floor when ‘politely’ (ahem) inquiring after his dining arrangements. Anyway, I quite like it. And there are lollipops in the background. Take me to Persian Cat-land, Mr Second-hand. We will  be dazzled by the many colours and eat sugar until our heads spin.

'Itty Bitty Pretty Kitty' by Snew, Minneapolis, US

15. Last Drinks.

This is the end of the list folks. I quite like the cats depicted in this set of note-cards, actually. They look a little bit like bulldogs, and possibly owls, but only if you think about it too much. The blue cat looks rather down-hearted. Has he just heard some bad news? Perhaps bars with stripey orange wallpaper spotted with green, and rad eighties-looking table-cloths aren’t very cool any more. The tabby cat seems a bit perkier; bearing up the inevitable trials of life by sharing a glass of red with an old chum.

'Persian Cats at the Wine Bar' a note card set, by Jay Schmetz.

So, in the spirit of friendship, and alcohol: this last one’s to my old chum, the Second-hand Persian Cat. To the cat who was, magnificently and consistently, the Bestest Darn Cattest in the whole Wide Worldest. *drinks wine*. Aaaaah.