Notes on a Haemorrhage, a Stroke and More

'Where the fuck is my left internal carotid artery? The right-hand side is there, illuminated like a big, fat, white worm.'

Before

It’s early January 2025 and I’m feeling good. No, make that smug. I’m feeling pretty chuffed with myself. I’ve lived with vasculitis - a rare autoimmune disease - and its assaults on my body, joints and kidneys for over a decade now and have endured hospital admissions for sepsis, acute kidney injury and immunosuppressant induced infection. I’ve toughed it out through months of taking high dose steroids and other drugs that, whilst saving my life, have made me feel like the walking dead. And each time I’ve bounced back.

No more spectacularly than having a relapse in 2021 - caused by having covid and flu jabs together - lesson learned there - I have worked to get fit and strong. I ran the 10 mile Great South Road race in October 2024 and here I was training for a half marathon in February. I weight train, cold water swim in the sea (all year round), ski, hike and generally spend almost all of my time outdoors. I am feeling more than good.

At the beginning of February I was three km into what was meant to be a 12-15km training run and I was suddenly hit by a wave of fatigue. I wasn’t running fast - I’m no sprinter - so I slowed to a fast walk. The fatigue envelopped me like a thick fog and my legs turned to lead weights. I also felt the dread rising - I knew this feeling. I recognized it from previous relapses. I sat down on the ground and leant on the sea wall, it was all I could do not to curl up and go to sleep right there but I hauled myself back to my feet, turned around and slowly walked back home.

The next morning, I took myself off for a blood test - I always have a supply of blood test request forms issued by the consultant who looks after me. It’s an early warning system. If I feel ‘rough’ I get a blood test done and we look at the numbers the next day. The numbers on this occasion confirmed what I had been dreading: the vasculitis has become active again, slipping out of remission and a full relapse was imminent. As I spoke with my consultant on the phone I reached for my diary because I knew he was going to suggest coming into the renal unit for a dose of the intravenous immunosuppressant, Rituximab, that has worked so well since 2021 when I first had it.

We agreed a date, said goodbye and I emailed the half marathon organisers to request that my place be referred to 2026. I also emailed my coach and let him know I’d be taking some down time for the next few weeks until I was feeling better.

Apart from binning my training schedule and regular swims - I can’t even bear thinking about getting into cold water when I’m in a relapse and funnily enough at any other time I love it - life carried on. Dog walking, snoozing, visiting my elderly mum in the nursing home where she was being cared for due to advanced Alzheimer’s, doing a bit of housework, watching TV and going to bed early. Repeat daily. My husband and I talked about going to our place in France in March as I was not up to skiing and mountain fun just yet. My dear mum’s health had nose dived last year and she was now unable to get out of bed. She had entered the end-stage of dementia; losing her swallow reflex, sleeping most of the time, being very distressed when she was awake. She forgot who we were (me, my sister, my husband, her grandchildren) well over a year ago and when I saw her most days, she thought I was one of the carers.

A few weeks passed and Imbolc heralded the stirring of the land. Although we were in March it still felt wintery to me and the sea looked perishingly cold. A lengthy discussion was had with the nursing home staff and the community medical team who suggested that now might be a good time to take that break to France because who knows how mum would be in a couple of weeks.

We organised boarding for the dog, book the car ferry to Caen then drove to the Alps. We had just over 24 hours of breathtakingly beautiful views before the phone rang and a very concerned nurse at the nursing home suggested that we might want to come back as mum wasn’t expected to last the week. So, we packed up, got in the car and came home.

Thunderclaps

It was the evening of March 18th, and here I was, sitting at mum’s bedside with my sister and her partner. It was clear that mum was fading. She was like a tiny bird in amongst the bedclothes. Mercifully, she was sleeping most of the time although when she did surface it was in deep distress. She had been prescribed a suite of end-of-life medications to ease her transition, but the nursing staff hadn’t yet established a frequency which held her pain and anguish at bay. When the night nurse came in I asked her about setting up a syringe driver to ensure a steady delivery of morphine. She wanted to wait until morning. I didn’t want mum to suffer overnight. We agreed that she would contact the on-call GP to get another opinion.

As the nurse left the room I stood up, readying myself to go home for a shower and some food before we all returned for the night. Out of nowhere my head felt as if it was in a vice. I could literally hear my blood pressure spiralling and I felt nauseated. I clutched at my head; I had an overwhelming urge to lay down and as I passed my hand in front of my eyes, I was aware of bright flashing lights and a loss of central vision. I could not see my hand in front of my face. I heard myself saying this aloud and I heard my sister saying she was calling an ambulance, and I thought ‘so this is why these headaches are called thunderclaps’. And then it was lights out. Nothing.

Do you know where you are?

Nothing. No sound. No light. No sensations. From nine in the evening until five thirty the following morning when my eyes opened as I focused on a nurse standing at the end of the bed I was in and heard her asking me ‘do you know where you are?’ I looked around, my vision was blurry and occasionally double, but I knew that I was in a hospital bed and therefore I must be in hospital. I answered the nurse’s question with a yes. Then she asked me if I remembered anything. I told her that I recalled lying my head on the chair in my mum’s room and then everything went black. The nurse came round beside me and took my hand. ‘Oh-oh’, I thought, ‘bad news coming’.

She explained, in gentle tones, that I’ve had a subarachnoid haemorrhage - a bleed on the brain - and also a stroke - a bleed inside the brain - and also two major seizures -an electrical disruption of the brain - and I’ve just come around from resuscitation and peri arrest - game over scenario. It took a few seconds for that information to percolate, but my brain was racing and thinking coherent thoughts (I think!).

I did a body scan, feeling my feet, wiggling my toes, clenching muscles, moving my tongue around, sensing that I had a urinary catheter in situ, feeling the oxygen flowing up the nasal cannulae, looking at the multiple drips going into my arms and eyeing up the vital signs monitor that I was attached to. Alive and functioning as far as I can tell. I heard myself asking the nurse how long I’d been unconscious and where my husband was. At that moment my husband appeared at my side. He was white as a sheet and looked like he’d been to hell and back. He was asked to step outside during the resus procedure and had only just been called back in. We both cried.

I’m only 64.

The rest of the morning involved being moved to the acute stroke unit, trying to persuade the nursing staff to remove the catheter and to let me try and stand - I was desperate to know that I could stand up. I slept. A lot. Unaware of what was going on around me my body entered the healing mode of slumber. When I woke up it was the evening and my daughter and one of my sons were sat beside the bed. My husband had gone home to shower and refuel, and my eldest son was en route from his home in Melbourne. I was still obsessed with getting my bladder back and getting upright so the nurse said we could try.

The catheter came out easily, I flooded the bed amidst much apologising. Another nurse joined us to get me cleaned up, put me in clean night clothes and help me get out of bed, stand and transfer onto a chair while they renewed my bed linen. Then I was helped back into bed with strict instructions to use the call bell if I needed the loo. I promised that I would. I know the drill. My son and daughter looked shocked but were doing their best to be chatty. I just wanted to hug them so that is what we did. And I slept some more, oblivious to the shouting from the woman with dementia opposite me, the constant noise of call bells and the busyness of the ward staff. The other patients looked so old. ‘How can I be here?’ I thought to myself, ‘I’m only sixty four.’

The next morning the stroke consultant came around and told me the same story that I had heard from the nurse in ED. He was very pleased that I didn’t appear to have any paralysis or weakness, that my vision was returning to normal and that my speech, although slurred, was intelligible and made sense. I’d also remained continent and been able to use the toilet unaided - this was a source of big satisfaction to all, including me! The consultant explained that the various brain scans that were taken in the ED had been viewed by the neurologists at the regional neuro centre - 30 miles away - and I’d been started on anticonvulsant therapy under their supervision. I was told that I’d be managed by the stroke team for the next six weeks and then my ongoing care will be coordinated by my vasculitis consultant. I was told to expect to remain in hospital for about a week and that I’d have to have another head and neck MRI scan as an outpatient.

I nodded away, not thinking about the future, just grateful to have seemingly dodged this particular bullet. My eldest son arrived, straight from the airport, my other children, husband, sister and sister-in-law all came to surround me with love. I knew I would be okay.

And then it was the next day and my sister was holding my hand while she told me, through her tears, that my mum had died peacefully that morning.

Facebook: a conduit to the outside world

I was home from hospital and ensconced in our lovely loft bedroom where it is light and airy and everything around me was familiar and very dear. All I seemed to do was sleep. For hours at a time. When I was awake the world seemed to be too much for me: too noisy, too bright, too fast. The sensory overload was overwhelming, and I could only cope with very limited encounters with everyday life. The TV hurt my eyes so much I could not watch it. The kettle boiling sounded like a train rushing through a tunnel. People moving around the house seemed to spin me like a top. I’m told that this was all very normal following a brain haemorrhage and that it would gradually improve. I hoped that would be the case. Meanwhile I retreated. To my bed. To wearing dark glasses. To communicating with the outside world via Facebook. I needed people to know that I was still here and what I was experiencing.

These are notes about the next weeks and months where I try to capture my ongoing evolution as the new normal emerges and reshapes on an almost daily basis.

Notes from the Explorer

31/3/25

Please don’t use the language of war as we traverse this path.

Instead let’s talk about easing and adapting, taking as long as it takes to do whatever it is that we can.

Yes, there will be work but there won’t be any fighting, no monumental battles only the breath, the pause, the feeling into the body and soul to ask ‘what do you need? How can I help you?’

I’ll be a pilgrim, not a warrior, an explorer, not a conqueror, someone who wants to live in harmony and not adversity.

There will be joy in the simplest of things and sadness will be allowed at the table too.

There will be wonder at the vastness of it all and a gentle arm will be placed around fear.

There will be everyday humanness while God or Spirit or The Universe takes care of the big stuff.

There is love and that is more than enough.

This will be a lesson in patience and fortitude and humour and frustration and gratitude and swearing. But it won’t be about blame.

Some things are down to choice, like the way we choose to treat each other and the values we live by.

Other things really are bad luck, wrong place, wrong time, a quirk of genetics, a glitch of fate quietly percolating away unseen, until the moment it becomes apparent.

There won’t be a bounce back because you never go back. Only forward. Always forward. Helping each other as we go.

7/4/24/ Small win, the big scary

Waking up in the night, still alive then, and I can get myself to the loo.

Standing up when each movement feels as if I’m on the deck of Pete’s dive boat ( if you know, you know) and tottering around anyway.

Being able to coordinate eyes, arms, legs and hands and sensing the cotton wool numbed sensation that makes me sound drunk when I’m tired as one side of my face takes itself to bed.

Glad that I could eat and drink unassisted whilst monitoring my swallow and swearing at the irony of a lack of appetite and my deep fried brain’s need for glucose as it works so hard to make new - I hope improved - connections.

Overwhelmed by the brilliance of my senses to the point that, without the filtering system I’d taken for granted all my life, they actually hurt, demonstrating exactly what raw nerves felt like.

Being able to do something every day, getting dressed, some household chore that is now like rocket science, a walk around the block - when did that turn into fifty miles - and then sleeping solidly for several hours afterwards.

So grateful that I can read, write and understand, that language hadn’t deserted me and hearing my speech go mushy as the day went on.

Feeling feisty, feeling frustrated, feeling WTAF? Feeling confused, feeling angry, feeling loved and willing all those blood vessels inside my skull to please not explode again.

Taking each day as it comes, the small win and the big scary and loving everything about sleep.

Not sure if I should be posting anything, not sure if it’s a good use of my energy but feeling compelled to do it anyway. I’m doing online shopping so, what the hell?!

8/4/25 Magnetic north

The anxiety grabs you early in the morning, before daylight has infused colour into the world and while your vision matches your thoughts all fuzzy and grey.

You and your beloved work your way through your ‘plan’ for the morning - because we both love a plan and, fuck knows, we’re clinging to anything that looks like an anchor just now.

You get to the hospital in good time: time to park, time to wobble your way from the carpark into Costa (so noisy) for a cup of decaf milky warmth, time to have a bit of a weep, time to practice that tapping thing that is meant to help keep panic in its box.

I am so grateful for my beloved - here as ever, rock solid. What is this doing to you my darling? How does anyone do this alone? Can I recruit a thousand volunteers so that no one has to?

You must have a venflon and some contrast dye injected. My kidneys are already knackered and they genuinely don’t enjoy having to process this extra chemical, but the MRI people have spoken to the renal and vasculitis people and they agree: brain trumps kidneys so JFDI and you will your kidneys to expand beyond imagination and get filtering. Note to self - start drinking as much water as is humanly possible for the next week.

Dear God - the scanner is sooooo noisy. Ouch. You stuff the earplugs in and pull on the noise cancelling headphones, mumbling thank yous as you go. You lay down and try to lip read what the MRI people are telling you. Blurrbbleee brubblll lie still, blmmnns srrrgubbs, squeeze this…. You nod, shut your eyes, trust the process - it’s not as if you haven’t read up on it, all those shifting and jangling magnetic fields. Physics. Magnificent.

And then you slide into the world that is now just you and the scanner. And you head north. Your favourite point of the compass where it is raw rock and snow and elemental beauty beyond words. Where the sea eagle soars and the elk makes his lazy way up the riverbank to saunter past your open-mouthed wonder. North where those magnets mingle with solar flares and concoct a heavenly spectacular that cannot be anything other than divine in origin. And your breathing calms as you inhale the cold air and run your hand through the darkly iced waters.

And you know, one way or another, you’ll go there again.

10/4/25 Sea legs

A sparkling morning after a night tossed in and out of wild dreams sees my husband and I heading for the sea front and a wobble around the rock gardens and along the newly completed sea defences.

My woolly head which is currently on a permanent gimbal is transmitting instructions to my spongy legs and, with a bracing arm to steady me, we saunter. I am no longer a runner (been there, done that, got the T-shirt). No. I am now a flâneuse, a stroller, taking the air and admiring the view and not thinking about my core. But I am concentrating.

Focusing on the sun on my face, each step I take, not moving my head around too much, smiling and saying hello to strangers, glad that I put on some lippy today, savouring my decaf coffee, feeling lightheaded.

Hooray, up she rises!

19/4/25 Inner ear

We walked along the low tide beach this morning.

Post-rain on an Easter Saturday with the sun just starting to break through.

And the east wind blowing hard.

I pulled up the collar of my down jacket and concentrate on keeping my balance, shoulders braced forward into the bluster as the air became substance and buffeted my head.

My first thought was to get back in the car. My second was to pull up my hood to defend my ears. I did neither. Only held onto Mark’s hand for stability as he wrangled the dog and her ball at the same time.

I decided to surrender to my surroundings, to let the air move and swirl around me, over me, through me. Pushing and pummelling, working its way into the labyrinth of my ears and from there inside of my head where it blew out some debris from these past weeks.

Shingle crunched and slipped underfoot, and I remembered all the steep downhills I’ve ever walked where small steps are the ones that get you to where you’re going.

And now it’s early evening. I’ve spent the afternoon asleep in bed, spent from my efforts, the window open and the breeze playing across my face and arms.

Adjusting my sails and hoping that this earache will subside before bedtime - but then that’s what paracetamol is for.

25/4/25 Inside Outside Upside down

So it’s follow up clinic in outpatients and you’re trying to make eye contact with the receptionist who looks as if she’d rather be anywhere but here. You put your biggest smile on and chirp a cheery ‘hello’, giving your name, who you’re here to see and the time of your appointment. You are rewarded with a grunt, some papers shuffling and a ‘sit down, we know you’re here’ all delivered without looking up at you once. Ah well, you think, maybe she’s having a rough day. And at least they know I’m here.

You’ve waited just over an hour now, quietly observing the comings and goings, having the occasional whispered chuckle with Mark - who has the look of a man forced to watch paint dry - and mentally redesigning the entire clinic layout and flow in a way that I feel would significantly improve the patient experience - old habits die hard, I am a former nurse and manager.

Then your name is called and you get up and shake the hand of a consultant with a kind face, introducing yourself and thanking him for seeing you - as your consultant is off sick and earlier that morning you had pushed back on the telephone call that suggested your appointment be cancelled ‘No. That’s not going to work for me. I need to have some information supplied today to take forward to another follow up clinic tomorrow. How can we make that happen please?’ Hmmmm. Pause. Muffled side discussion. ‘

‘I can get you in to see another consultant, same time.’

‘Will he have had sight of my notes, my discharge summary and, most importantly, my recent MRA neck and head scan?’

‘Oh yes. That’s all here.’

Bingo. Book it Danno.

The kind faced stand-in introduces himself as Timothy. You all file into the clinic office. Timothy sits at the desk; you sit to his side. Mark has the supporting actor’s seat, set slightly off at a distance so it looks as if he could catch you if you should fall off your seat.

We begin. Potted medical history. Summary of recent admission. Acknowledgement of complexity - thanks again, vasculitis - the gift that keeps on giving. And then it’s dim the lights, curtains up and scan images on screen. You take a keen interest - after all it is the map of the blood vessels that supply your brain. And you do love a map. Timothy is talking you through the scan, gently explaining the anatomy but his voice is a bit distant because you’ve seen it. Or rather, spotted its absence. Where the fuck is my left internal carotid artery? The right-hand side is there, illuminated like a big, fat, white worm. The left-hand side fizzles out just above the base of my neck and then - is gone.

I force my attention back into the room and onto Timothy’s voice, he’s doing the basic explainer version so you let him know that you’re a retired nurse and it looks as if one of your major blood vessels is completely occluded. Is that right? You notice that mark has turned a whiter shade of pale. The conversation jumps up a notch as you and Timothy are now clinicians discussing ‘asymptomatic ICA occlusion, right side compensatory flow and how vasculitis may or may not be implicated but that this - surprise - finding is coincidental and not what caused the sub arachnoid haemorrhage and resultant ICB (stroke) into your caudate nucleus five weeks ago.

Interesting in a Chinese curse kind of way.

You discuss implications for future management, the need to get further imaging and input from the neuro people at Southampton and how best to expedite that. Timothy is on the case, you’ve been able to ask all the questions you needed to ask and feel equipped to take this new info to your next follow up which is with your coordinating vasculitis team tomorrow. Mark is looking shellshocked.

As you leave you thank Timothy for his time, you thank the nurse who is showing you out and she says that she’s the person you spoke with on the phone earlier that day, the one who got you in to see Timothy. You thank her again. And go home. And start processing.

Your sister and her other half call round and, over a cuppa followed by an epic beef pie - Mark has been doing his chef therapy in the kitchen - you explain what happened at today’s clinic, that ye s- it’s alarming to discover that a major artery to your brain is totally blocked but luckily blood is being supplied from the other side so well done Mother Nature in designing it to do that, you discuss what you want to get out of tomorrow’s clinic meeting - getting seen by those neuro people pdq! and getting a plan in place for monitoring and managemen - and you all feel ok and that things are in hand.

You don’t sleep much that night. You cry a bit but mostly you can’t stop shaking.

And now tomorrow has become today and you’re off to a wobbly, tearful start as you sit down with Mark and you support each other, sharing your fears and your hopes and your desire to get life back on an even keel and just get on with the business of living.

Your clinic appointment goes well. Your vasculitis consultant knows you and is all over the complex management which has now blossomed into a multi system bouquet with a few atypical conundrums thrown in for some clinical spiciness. You both joke about ‘good case studies’ Ho Ho.

You come away feeling mightily reassured and able to exhale. Mark feels the same. Nothing has changed but someone is taking the lead and, at least for now, you can breathe and let them hold you.

You both head outside into the garden where the spring sun is shining and everything is green and full of life. And you get your hands into the soil, and you sow seeds and dig weeds and apply mulch and fill a watering can and yes, your head is a bit spinny and your hands shaky but who cares. Mark is washing down the greenhouse, getting it ready for your seedlings that are covering the dining room table. You sit on a garden chair and watch the many bees on the rosemary.

It’s late afternoon. You’ve slept for three hours. You see a WhatsApp from a dear friend who has taken a nasty fall whilst out shopping and has face planted the pavement. You message her and arrange to drop round tomorrow morning with a couple of cinnamon buns - more of Mark’s cheffing - and maybe to have a cuppa with her while Mark walks the dog.

Life? Bloody crazy, isn’t it?

30/4/25 Frequency

The low yet multi-tonal hum of bees has been my aural companion these past weeks.
Starting early in the morning when all the bees congregate on the rosemary flowers.
The honey bees, the carder bees, the miner bees, the bumble bees.
Humming at a frequency that soothes my nervous system like nothing else.
It calms frayed neurons, bridges shattered synapses and stays unwanted thoughts.
The humming drone is a balm, an auditory ointment, a vibratory emollient that wraps me up and holds me steady.
Throughout the day as the spring sun intensifies the bees continue their foraging, pollinating as they go
Wandering through the floral offerings of our small, urban green space.
Enjoying nectar from blossoms and dandelions, from dead nettle and meadowsweet.
And as I potter around, moving beneath the pink and white canopy my head is bathed in the sound and sensation of healing and gratitude.

3/5/25 Moment
Yesterday was a gloriously ordinary day. We walked the dog. We stopped off for brunch. I did the hoovering while Mark washed the car. I planted out some veggies. The gasman came to service the boiler. I washed up and looked out of the kitchen window. And there it was. A moment of wonder. A pair of sparrows had flown into the garden with a fledgling and parked the baby bird in the rosemary bush where it hunkered down amongst the dense green, fragrantly thin yet robust leaves. Then the adult birds set about going from plant to plant to bush to tree, gathering up bugs to bring back to the now open-mouthed baby, its yellow beak stretched wide and greedy. As fast as they ferried the bounty back the baby bird gobbled it down. I stood, mesmerised by my own back yard nature-watch. Loving the harmony of it all. Everything in balance.

13/5/25 Telling it how it is

I’m just about to send my driving licence back to DVLA - it has been revoked because I’m no longer medically fit to drive. It’s as if all of the loss and grief of these past weeks is coalescing around this one act and I’m shedding many tears.

Yes, I know about the bus and the train and my reduced carbon footprint but right now I don’t care about that. My reality in this moment is deep sadness, loss of my sense of self and certain things I’ve loved doing and I’m just not ready for it and whatever the new normal turns out to be. I’m not writing this to invite comments about strength, resilience, inspiration or any other positive thinking epithets. Simply to acknowledge, to witness and sit with my feelings and to honour them. Sometimes shit happens and it truly sucks.

16/5/25 Evolution not revolution

Walking Madge every day.
Gardening.
Ironing a delicate dress.
Cooking a meal that isn’t a one pot, chop em up and chuck it in number.
Having a conversation and not having a headache afterwards.
Standing on one leg (ifkyk).
Planning a solo bus journey.
Staying awake late enough to see the solar lamps come on and the bats flit out.

10/6/25. Better out than in.

Oh the feelings spewing out of me these past weeks.
The anger.
The rage.
The frustration.
The disappointment.
The abandonment.
The betrayal.
The loneliness.
The despair.
The sadness.
The longing.
The grief.
The impatience.
The irritability.
This really is the shadow stuff. Stalking and looking for a place upon which to project.
Meanwhile I do battle with it every day.
I am bruised and battered as I do my best to stay steady and ride this storm.
Trust this process.
Integrate.
Transform.
And keep those I love and care for away from the thorniest parts of me.
I lay low, choosing carefully when and where I engage.
Why?
Because I don’t want you to be caught in the crossfire.
One swipe of this super sharp tongue could take your head off.
And I really wouldn’t want that.

Losing mum and recovery

Mum’s funeral was held on Wednesday April 16^th 2025. I was able to attend but I was still pretty traumatised from the events of the past few weeks, and I have little recollection of the day other than there was such a loving coming together of family and friends. It’s only now that I’m really starting to feel the grief and loss. My relationship with my mum is a whole other article - a book perhaps - but the memories spark word creations and, as my recovery progresses, I feel that the emotions engendered by loss will integrate with those that spring from love.

3/8/25 A memory

I watched the hawk hovering above the trees.

Mellow early evening sun framing its body against the clear, blue sky.

We had just been picking blackberries, shiny and lush in their thorny hedges.

Slipping our hands between the sharpness to gently grasp the yielding, juicy fruits.

And I suddenly thought of her. Sitting at her table, looking through her window at her favourite tree with the dancing leaves.

Watching the birds making their way home for the night.

And I thought of all the blackberries we had picked together when I was a child.

And all the sweet, sticky jam she made to bring late summer sun to a winter breakfast table.

I’m glad that she is no longer suffering.

I’ve missed her for a long time, so each memory is a precious one.

And for those, and many other things, I am very grateful.

Now.

Almost eight months to the day have passed and I’m sitting here at my laptop, having relearned basic word processing skills (a big step up from just making a cup of tea!). The autumn garden outside is dying down into the period of rest and renewal that marks this part of the year. I always think of this as a kind of dying to live. I feel that is what has happened to me. I’m changed, a bit of me has withered but new shoots emerge each day. I am now able to go to the gym and, under close supervision, I train with weights to help me reclaim my balance, strength, coordination and tone. I do pilates on the reformer (think medieval torture table!) once a week which is also helping a great deal. And, most importantly for me – I am back in the sea, swimming. Running is currently off the agenda as the high impact gives me a headache; my brain is still healing. I have started exploring the world again: journeys by train to big cities, going to the theatre and immersing myself in light and sound, concentrating on reading a book, tackling more complex tasks. Each day brings a new challenge and, often, a new cause for celebration. But I don’t compete, with myself or anyone else. This is a big change for me. I’ve come to realise that being competitive isn’t necessary for me to thrive. I can simply be. Now, every morning as I walk the dog my mantra is ‘It is today. I am here.’