Happy Anniversary

Upgraded to KLM business class

For our 40th wedding anniversary in May 2012, we wanted to celebrate in a little more elaborate fashion than just a nice dinner out. We decided in the winter that we'd make Italy our destination and plan to be in Venice on our anniversary.

The Roman Colosseum

Colleen, as always, spent countless hours researching on the internet and made arrangements for accommodation and transportation between cities. We flew into Rome - a good start: KLM upgraded us to business class - and spent 4 nights in an apartment just up an alley from the Piazza Navona. The apartment was spacious and complete in every way. We were picked up at the airport and delivered to the fringe of the pedestrian-only piazza. From here we were able to walk to the Pantheon and Trevi Fountain. Our Rome pass got us public transportation and admission to the Colosseum and the Forum. We spent a day at the Vatican and visited the Vatican Museum, Sistine Chapel, St. Peter's Basilica and Square. On our last day, we visited the Spanish steps and some of the churches in 'Angels and Demons'.

St. Peter's Square

Pompei Scavi

Then it was off by train to Naples, where we picked up the Circumvesuviana train to Pompei Scavi. A fascinating day was spent in the ruins and the hot sun finished off the burn begun at the Colosseum and Forum.

Amalfi Coast at Positano

Colleen on Capri

Then on to Sorrento, where we were booked into the City Hotel for three nights. Our plans included a half-day trip with a driver down the Amalfi Coast - we had a delightful young man who actually spent over 6 hours with us.He was very personable, knowledgeable and accommodating. We had booked a small craft tour around the Isle of Capri, but they were not running because of high seas. Instead we took the ferry to Capri and boarded a larger tour boat to circumnavigate the island. We were very glad by the time we were done that we were not aboard the originally planned small craft. Capri was interesting and pretty, but didn't really have much to offer but high prices. One night in Sorrento we had a wonderful sea-side meal, with perhaps the best mussels we ever ate.

Florence apartment

Michelangelo's 'David'

Bartolomeo Christophori's first piano

The leaning tower of Pisa

Then it was off to Florence, where we had a wonderful apartment booked for three nights. We did the obligatory Florence list - Michelangelo's 'David', the Uffizi Gallery, the Ponte Vecchio, the market and the Duomo. One highlight we almost missed was the musical instrument museum in the Academia, where they have Christophori's very first piano, invented by him in 1711. We spent one day while in Florence on a day trip to Pisa - you've got to see the leaning tower of Pisa when you're that close; the next day we went to Arezzo, where we viewed the statue honouring Guido Monaco, who invented our modern system of lines and spaces and notes for writing music. We walked pretty much the entire length of the city, looking for the tourist information bureau, so we saw much more than we had planned, including the Duomo and the Piazza Grande as well as Guido's house, adorned with a plaque recognizing his invention of 'do re mi'.

Statue of Guido Monaco

A refreshing view of the tower of Pisa

We had decided that visiting the Cinque Terre by staying in one of the towns would be too difficult from a mobility standpoint, so we stayed in La Spezia and visited the Cinque Terre by train. When we bought our ticket, they warned us to be back in La Spezia by 9 pm of the second day because there was a planned 24-hour rail strike. This got us thinking about how it might affect our travel to Venice, but Trenitalia was able to change our tickets to avoid the areas being struck. So, with a little backtracking to Florence and a few more station changes than planned, we made our way to Venice.

Colourful houses in Burano

Christian, our gondolier

Our hotel, Casa Rezzonico, was very near a vaporetto stop, so it was very convenient. We travelled the whole length of the Grand Canal in both directions, with front seats on each vaporetto. We toured the Doges Palace and St. Mark's Basilica. One day we took the vaporetto to Murano and Burano and viewed the artisans and the most interesting house colours and canals.

Our flight home was from Marco Polo airport in Venice, so we caught the airport vaporetto and made our way to the terminal. Upon changing planes in Amsterdam, we discovered a beautiful Kawai grand piano with a note inviting travellers to try it out. Well ... what else could I do? Then we boarded our flight home to Toronto.

Piano at Schipol Airport

A wonderful trip, masterfully planned and successfully executed. Wonderful sights, food, wine and memories. The bucket list is done - next time we'll check out some of the B-list.

For more pictures, click on the link to the right.

Next stop - Amsterdam - Rhine - Zurich

Itinerary - two days in Amsterdam, Rhine cruise with AMA Waterways on Amacello to Basel, train to Zurich where we spend two nights and then fly home. More details at http://amawaterways.com/itinerary.asp?iticode=AI11

AMACELLO

We're only participating in the cruise portion of this itinerary and 'doing our own thing' in Amsterdam beforehand and from Basel to Zurich.

NYC, Florida and Bahamas Here We Come!

We're off tomorrow bright and early for Syracuse, where we catch the train to New York City. Although the purpose of the trip is not really to visit NYC, it seemed a shame to be there and not get at least a small taste of the Big Apple. We're staying at the Westin New York at Times Square Friday and Saturday nights. On Saturday we're taking a bus tour of the city and then in the evening we're going to see "Mary Poppins" at the New Amsterdam Theatre.

Sunday is pretty leisurely and we're off to the Port of New York to board the Norwegian Jewel. We chose this cruise particularly because a) it departs from NYC which is easy and cheap for us to get to and b) there are not shore excursions which are very demanding in the walking department. We stop at Port Canaveral and could take a tour of the space centre, but it's expensive and long and we may just investigate the port or stay on the ship and enjoy the empty pool and hot tub.

Next stop is Great Stirrup Cay, an island that Norwegian Cruise lines owns. They have apparently done quite a lot of development, particularly of the area where the tenders dock and food facilities, so that would be interesting to see (having been there on our last cruise).

Then we're off to Nassau, and it is apparently easy to get a real taste of the city without walking too far from the ship.

Then a couple of days at sea while we return to New York. We dock at 8 am on Sunday (April 3) and plan to get a 1:15 train back to Syracuse. Then we'll motor home to Gananoque.

Not a patient patient

I have to admit, all in all, that there is improvement in my mobility since my AVM surgery. I'm still recovering from the surgery - I had a misguided mind set that once the incision was healed I could get on with the rest of my recovery. Unfortunately, back surgery is a slow, painful process and it's going to take longer than I thought.


The day I had my stitches out I made an appointment to start physiotherapy. I want some guided exercises to help recover muscle strength in my hips, legs and feet and to learn to compensate for those deficits which are long-term (I can't bring myself to say 'permanent' yet). Unfortunately, the first two sessions have been spent concentrating on ifc (interferential current) treatment of my back. I'm quite prepared to have the physiotherapist heal my back, but I'm afraid I'll be out of insurance long before she gets to exercises for my muscles. We'll see how it goes for a few sessions. It's quite enlightening to be faced with health insurance limits that Americans must face for even their basic health care let alone surgery or hospitalization.

Dateline - surgery plus one week

An email update to my friends following my AVM surgery:


It's now been exactly a week since they rolled me into the OR at Toronto Western.

Here's how things stand. The surgery went well, as far as I can determine. I heard precious little from the surgeon - no details whatsoever afterward about the surgery (McP: this is where I could have used you) - and a very small amount second-hand through PetDoc and Colleen from a chance meeting they had with him in the hall while waiting to hear about me. They really had to get quite aggressive in order to get more than a dismissive "We know what we're doing." He did tell me I no longer have a spinal dural arteriovenous fistula and, after all, that is what it's all about. The goal of the surgery, his assistant reminded me repeatedly, is to stop things from getting worse; any lost function which returns is bonus.

I was supposed to return to PetDoc's apartment later the day of surgery - wasn't gonna happen! I had excruciating pain moving and was admitted to get that under control (ya gotta love the morphine pump - wouldn't let me take it home, though). Thursday I would have gone home in the evening but we discovered a pretty significant rash which the doctor couldn't explain. I was given Benedryl and moved to a semi-private for the night. The next morning Colleen and I got a cab to PetDoc's (she was working Friday). I was still, at this point, experiencing the excruciating pain but pain is not a hospitalizable offence. The pain was never from the incision but more generalized and quite intense when I would move - I mean scratch-my-nose move. Just as I was beginning to fret about how I would arrange for more pain medication (the hospital's pain-doctor-expert-lady had prescribed what appeared to be a very short course of medication) PetDoc (nice having a real doctor in the house) diagnosed some of my pain as muscle pain and we found that an extra-strength Ibuprofen in addition to what I was taking did the job!

Yesterday we returned to Gananoque - Toronto to Colborne with PetDoc and Colborne to Gananoque with Dadamom. It is nice to be home and as I become more mobile I'm looking forward to getting back to familar activities. I'm pretty much over the trauma of the surgery and weakness, etc. of lying around for 2-3 weeks and it's time to get on with it.

The major deficit is muscle stiffness and weakness in my legs and feet. I have the strength to stand and could kick a soccer ball - it would just feel very different from this time last year: more like I was swinging a log attached to my hip that was jointed at the knee. I can feel my legs and feet just fine and bend my knees, ankles, toes; it just feels very stiff with a sensation of numbness. I still become numb through the whole pelvic region if I sit without my 'special' cushion.

We were told that the compression of my spinal cord would be relieved over a period of weeks and what is going to happen quickly should happen within a couple of weeks. Any further recovery will takes months and even years. I'm going to start some exercises and return as soon as I can to regular activities. One of the most significant obstacles is still my feet - when I remove my sandals my feet and ankles become almost immediately very numb. No other footware prevents this from happening. Therefore, navigating in snow is awkward; I would grab a shovel and piddle around in the driveway or on the back porch if I had a way of making it less unpleasant; I may just have to learn to tolerate the unpleasantness. Or this may be one of the changes that will take place over time; Colleen, fortunately, understands completely about the feet (one has to be very understanding to tolerate sandals 24/7). After her stroke, she had a similar feeling and she encourages me by telling me that it was a year or more before that sensation changed.

If you have reached it to this point in my email you must be a real die-hard or a masochist. I thank you all for your help, concern, prayers. I apologize for the length of this missive, but I'm trying to make sure I have passed on an adequate amount of information to everyone who might care.

Will keep you posted (albeit more briefly) as things progress.

A Rare Condition - SDAVF

If you have numb legs and/or feet and your doctor can't figure out why, consider an arteriovenous malformation (AVM). An MRI with contrast die is the diagnostic tool for this.

It's been a loooooooooooooooong six months. In the spring I was diagnosed with benign prostatic hydoplasia as a result of an ultra-sound and lower spine x-rays. In May I had a pretty significant fall on my dock which bruised and numbed my right leg and foot. The numbness continued and was also noticeable in my left foot. In June I first noticedwhat I would call 'wobbly legs - very occasional unpredicatable muscle behaviour which would affect my walking. I also found kneeling awkward. By the end of June my legs and feet were numb but super-sensitive to touch and temperature. A wet dog rubbing across my legs felt like hot oil being splashed. The numbness and weakness continued to increase and by July 1st I was using a cane to walk.

Another visit to my family doctor resulted in a consultation with a neurologist, a urologist, and an MRI of the lower spine. These consultations took their course and eventually I went to St. Mary's of the Lake hospital for conduction tests - the tests ruled out peripheral neuropathy and pointed higher in the spine. Meanwhile the urologist was checking out the bladder and prostate and could find no problems other than a lack of 'sensation of fullness'. I could have told him I was numb without him putting two litres of fluid in my bladder.

Several appointments with the family doctor and another consultation with the neurologist resulted in a die-enhanced MRI of the entire spine and brain. Within hours the problem was found. A spinal dural arteriovenous fistula is causing congestion of blood around my spinal cord. The list of symptoms describes me exactly and the MRI clearly shows the congestion of the cord. Everyone was ecstatic because this condition takes, on average, two years to successfully diagnose. Prompt diagnosis and treatment can mean full recovery.

I got an appointment within three weeks at Toronto Western Hospital for a catheter angiogram and, if possible, embolization of the artery by 'The Glue Man' Dr. Karel terBrugge. Unfortunately, the fistula is in the artery connected to the main artery serving the spinal cord and embolization is not safe because of the high risk of paralysis. Under most circumstances, a surgeon would then , within a few days, tie off the offending vessel with the same result. Unfortunately, in my case, both surgeons who could perform this surgery were out of the country so home I went.

Two weeks later the surgeon's office called with an appointment for a consultation two weeks later and then surgery sometime in the future. This is frustrating because the fistula was found much earlier than usual and my condition continues to deteriorate as I wait for treatment. In early November everybody was high-fiving about diagnosing the problem and it now looks like treatment may be delayed for three months.

The main purpose of this post is not so much to inform family and friends of progress but to create an internet presence of my experience for the benefit of others. When I was googling numb legs and other symptoms, I never once came across a mention of SDAVF or spinal dural ateriovenous fistula - if I had, I would have gone running to my doctor insisting on a full MRI. Promptness of diagnosis and treatment is crucial to complete recovery. This condition is very rare and not likely on your doctor's list of things to consider.

If you are suffering numb feet, numb legs, arms, hands, hypersensitive skin, numbness to the midsection (especially when sitting), lower back pain, aching hips, difficulty walking, difficulty lifting your feet - ask you doctor to consider an arteriovenous fistula. Although these symptoms may not appear all at once, they will get progressively worse and only treatment will put an end to it.

I would be happy to answer questions and hear your comments.

Bell Mobility Update

Call me crazy, but I LOVE MY HTC TOUCH. It has all the features I want and need in a smart phone, and allows me unlimited email and internet for a very small monthly fee. When mine broke (on/off switch) I purchased a used one on eBay and swapped it in for the Samsung flip-phone PetMom was using. A quick call to Bell Mobility and wham-bam-thank-you-Bell-Mobility. So I bought another one (again on eBay) for myself. Another quick call to Bell Mobility and now we both have HTC Touch phones, sharing a plan and lovin' it. No new contract, no activation fee - just two phones that work beautifully. Bottom line - stay out of the Bell Mobility store. Just call 888-4-MOBILE and friendly, knowledgeable people will do exactly what you want. That's the way it's supposed to be.