O2B1F1E. STROKE 2023-04-26

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MOMENTS IN OUR LIFE-2         2026-06-25

O2B1F1E. STROKE 2023-04-26

(Gemini) Hennie, this is an incredibly powerful, thorough and deeply moving chapter for your book, Moments in Our Life. You write with such compassion, clarity and honesty about a very rough and emotional period in your lives. The transition from the sudden stroke and the anxiety in the hospital, to the big move out of Wellington, to the new beginning and the beautiful moments of pampering at Longridge and the Strand, is poignantly captured.

I have looked through your text carefully. The chronology is very clear, and the way you weave the medical details with your personal emotions and the fine details of your daily life is excellent.

Here are some fine editorial adjustments to improve the flow here and there, merge repetitions, and correct minor spelling errors, without losing any of your own voice, facts, or the rich detail.

RINIE'S HEART ATTACK AND FIRST HEART PROCEDURE 2023-01-14

(Hennie) Rinie became nauseous on the night of January 10, 2023, but I was fast asleep and knew nothing about it. Later, Dr. Johan Augustyn, her cardiothoracic heart surgeon, said that there were fresh signs that she had had a mild heart attack. She said she wanted to go to the doctor the next day, which was strange to me, because she doesn't like doctors at all.

Dr. Hennie Conradie examined her and said that her heart enzymes were very high. He took an electrocardiogram (ECG) and explained that some of the points that should have pointed up were pointing down, and that this was not right. He arranged for her to go to the Paarl Mediclinic for an ultrasound screening (sonar), and the doctor there immediately referred her to a cardiologist. Back at Dr. Conradie's, he promptly booked Rinie a bed at the Kuilsriver Netcare Heart Unit the same day. We quickly went home to collect a few personal belongings and headed into the city in the late afternoon. Because there was no room in the general ward, she was admitted to the intensive care unit (ICU) where a bed was available - this was a divine act, as we would later see.

Dr. Augustyn had apparently examined her that Tuesday night because he was not satisfied with her heart. He pushed a microcamera up her left arm to her upper right heart chamber where he performed an ablation. Her arteries were perfectly open, so there was no problem there. The ablation was done to form scar tissue on the inside of the heart chamber to counteract the irregular heart rhythm she had. We could see on her ICU monitor how her heart rate kept jumping wildly between 90 and 150.

Because the ablation was not completely successful, he implanted a pacemaker on the top of her left shoulder, closest to her heart, and connected the wires to her cardiac nerves. The battery apparently lasts more than 10 years. When the pacemaker was turned on to take control, her heart rate stabilized beautifully at 79/80. Then he went again through the veins to the upper right ventricle, this time to cut off the nerves that were causing the irregular heart rate.

For the next few days she was kept under observation to sort out her medication. I drove to visit her every day, and Marinus also came from Somerset West a few times. By Thursday or Friday, Dr. Augustyn said she could go home on Monday; everything seemed fine. On Friday they took an MRI scan and everything was normal.

THE SATURDAY AFTERNOON IN THE ICU

Saturday afternoon (January 14, 2023) I was on my way to Rinie when Marinus called me. He was talking to her as she sat in a chair next to her bed in the ICU. Suddenly he heard her speech becoming slurred and realized that she herself was not aware of it. He kept talking to keep her busy and asked Frieda-Marié to call the ICU nurse because there was something seriously wrong. Dr. Augustyn was called immediately and was at her side within 7 minutes.

Rinie had a stroke at about 14:00, caused by clots in the brain. Dr. Augustyn immediately injected a strong, concentrated blood thinner to try to dissolve the clots. By that time Marinus and I were both with her. Dr. Augustyn explained that if the blood thinner dissolves the clots quickly, the patient recovers fully almost immediately.

However, this was not the case with Rinie. The brain is extremely dependent on oxygen-rich blood, and if a clot cuts it off, that part of the brain dies very quickly. Then the patient has a stroke. This is what happened to Rinie. Because of that she was paralyzed on her left side - both her arm and leg.

When Marinus and I stood by her after 14:00, her eyes were closed, her face looked old and her head was turned only to the right. I tickled her left foot, but there was no reaction. While we were talking to her, she only looked to the right. After we left, Dr. Augustyn again pushed a camera up to the large arteries in her brain to try and dissolve the clots directly at the source. He had to be careful with the concentration to avoid the risk of fatal internal bleeding. He was able to dissolve the clots in the large arteries, but the camera could not reach into the smaller branches where clots were also blocking blood flow.

On Sunday, fortunately, she looked much better and less pale. Marinus and I stood on either side of the bed and she turned her head and eyes to both of us. With such a stroke, a patient apparently only looks at the "live" side, because the brain does not notice the "dead" side at all. I tickled her left foot again, and this time she immediately pulled up her leg - a huge improvement that must have been due to Dr. Augustyn's quick action with the blood thinner.

Rinie was in the ICU for several more days, during which Dr. Augustyn worked with her - we were there regularly during visiting hours. The ICU cardiac unit at Kuilsriver Netcare was very accommodating with visiting hours, which made it much easier for us as a family to visit her.

THE MEDICAL CAUSE OF THE CLOTS:

At the top of the upper right heart chamber, she has an "auricle", which is a space in which the blood does not flow properly, aggravated by the atrial fibrillation of the upper right heart chamber. Fibrillation is a rapid, irregular and uncoordinated contraction of individual muscle fibers. Instead of contracting in a smooth, unified movement, the muscle quivers. Although it can happen in any muscle, the term is most often used to describe a serious type of heart rhythm disorder (arrhythmia). Because the blood is not flowing properly, clots form that can end up in the bloodstream and then lead to blockages in the brain, causing a stroke, so that that part of the brain dies.

The auricle in the upper right heart chamber causes a lot of clots, and it is desirable that it be closed, to prevent further strokes. Dr. Augustyn says this reduces the possibility of further strokes by up to 90%.

Several people advised us that Rinie undergo this 2nd heart procedure. Dr. Augustyn said this procedure is done a lot, with great success. It involves pushing a camera up from her groin and then placing a "plug" over the opening of the auricle. The procedure is performed under anesthesia and Rinie can go home within 2 days.

After her stroke, I was always worried that it could happen again. She takes a very strong blood thinner daily, but after the 2nd procedure (in about a month) this blood thinner is apparently no longer needed.

THE ROAD TO RECOVERY: SPESCARE PAARL AND GOODWILL

When Dr. Augustyn finished with the acute treatment, Rinie was transferred by ambulance to Spescare in Paarl for intensive physio and occupational therapy. For me it was a great relief: a drive of only 20 minutes instead of 50 minutes to Kuilsriver, and the parking was conveniently close to the front door.

I visited her faithfully every day. She lay in a two-bed ward and had many visitors, especially from her bowling friends. She received physio twice a day - morning and afternoon. I regularly took videos and photos of her sessions with my phone and shared them on the FRIENDSofRINIE WhatsApp group (78 members) to keep everyone updated.

On February 15, she celebrated her 75th birthday in Spescare. Louise and Frieda-Marié organized a special party for her. Louise baked and decorated a beautiful cake, and Frieda-Marié brought a large bouquet of flowers and snacks. Marinus was there, of course. The staff sang "Happy Birthday" and "May God bless you and keep you" to her. When everyone clapped, Rinie folded her hands over her heart. She was visibly deeply moved, and there was tears in all of our eyes.

In total, Rinie was in the hospital between Kuilsriver and Paarl for about two months. As she last saw the house on January 11, she began to miss it a lot.

BACK TO THE HOUSE AND THE BIG DECISION

On March 13, 2023, Rinie finally went home. It was wonderful for her to be back in her own environment. At first, we borrowed an old type of wheelchair from the Helderberg church, but because the arms and footrests could not be removed, it was extremely difficult to get her out of our low queensize bed. We then borrowed a better one from the Wellington Service Center. Because our medical aid (LA Health) was so slow to provide a modern wheelchair, I bought one myself for R5,000 from Op Active. It made things much easier to transfer her between the bed, the wheelchair and our Honda Civic. At first, I enlisted the help of our neighbor, Eric, to get her into the Civic, but as we practiced it more, it became easier and I was later able to handle her by myself.

On March 17, we found a wonderful caregiver, Tash-lynn Gous. She helped us 5 hours a day, 5 days a week. She was excellently trained to wash frail people, change diapers and sheets, and do the transfers. She also cleaned the house, did the laundry and cooked food. Without her I would not have been able to cope at all, because a stroke throws a person's entire orderly life upside down.

Marinus summed up the situation perfectly. He himself was about to emigrate to Australia and realized that we would not be able to cope alone in the big house with the huge garden. He started looking around for a place with 24-hour medical assistance and found an open one-bedroom apartment No. 122 at the Ametis retirement home in Strand, which had just been renovated. We were able to move in there the last week of May.

The biggest, most beautiful surprise was when our son Christiaan (who lives in New Zealand) walked in here with Marinus out of the blue about two weeks before the move! He used his school holidays to fly over for two weeks to help us pack up. What a huge job he and Marinus did! They emptied the garage and attic and drove away three 3-ton loads of excess stuff. Christiaan advertised and sold many things on Facebook, took bags full of clothes and materials to the Hospice, and gave other excess stuff to needy families in the Perdeskoen neighbourhood. The children there even came running several times in the rain to help empty the car.

Rinie is doing well. Her head is clear and she speaks fluently. With the help of Jason, her physiotherapist, she has already progressed to the point where she can walk down the hall and back with his support. There is still little movement in her left arm, but its recovery takes much longer because an arm and hand have much more complex muscles to reactivate.

Christiaan made three lists for me: what to sell, what to store, and what to take with us to Ametis. In the end, on the advice of Chris Erasmus, we decided not to store anything. Lettie Lourens of Toeka Furniture sold everything at an electronic auction - admittedly for a fraction of the value, but that's the way it goes when you have to downsize from a big house to a small apartment. She cleaned out the entire house.

We are eternally grateful to our friends in Wellington for bringing food, visiting and moral support. It meant a lot to Rinie in particular, who left with a heavy heart. She always says she misses her lapa very much. But we had no other choice.

THE NEW LIFE IN AMETIS (BEACH)

We moved into Ametis (4 Gordons Bay Road, Apartment 122) at the end of May. The apartment is rented and is about 500 meters from Beach Road. From the 5th floor you can see the sea clearly; if the wind blows from the sea, we can hear the waves breaking at night when everything is quiet.

The staff at Ametis are all very friendly and helpful. We get lunch and dinner in our apartment if we want, but sometimes we eat in the dining room. The residents are also very friendly, so we think we will enjoy staying here. It will take some time to get everything in place, but we have time and are taking it easy for now.

I must also make special mention of Rev. Johannes Nortier from the NG Moederkerk Wellington. He turned up at our house one day on his own, had a nice chat and suggested that I drive with him to visit Rinie in Kuilsiver Netcare. At first I did not want to take advantage of his kindness, but he insisted. He is a wonderful, interesting person who does not speak like a pastor at all - he had a great visit and did not even say a formal prayer as one would expect. He picked me up again two days later. His chats cheered Rinie up immensely. He previously served in Heidelberg, Cradock (where we lived from 1955 to 1962), and Slot-van-die-Paarl. He is a true mensch who lives for his fellow man.

THE SECOND HEART PROCEDURE (JULY 2023)

On 23 July 2023, Sister Corrie Swart announced that Rinie had to check in at Kuilsriver Netcare at 06:00 on Monday morning. Reneé from the night staff helped pack Rinie's blue bag. To be on time, we had to get up at 04:00 so that Reneé could shower Rinie and wash her hair. It takes a long time to get her ready, and we only left at 05:15 in the early morning traffic.

At the hospital, she was taken to Room 2 on the second floor. I had to say goodbye to her with our usual four kisses. To pass the time while she waited, I had the car washed, visited Exclusive Books in Tygervallei, had a rump steak at Alamo Spur and went to see Tom Cruise's new Mission Impossible. When I got back to her after 15:00, she hadn't yet gone to theatre due to x-rays and blood tests, and Dr. Augustyn decided to operate on her on Tuesday morning at 08:00, when he was fresh.

Monday night was lonely in the big bed. Marinus called regularly for news. He loves his "Moeks" so much and knows exactly when she's not feeling well. He even contributes R250 a month so that she can regularly have her hair done at Ametis' salon (Rinie first thought it was her daughter Tania who arranged this, but Tania passed away five years ago). Marinus knows how a woman's heart works and that she always wants to look her best.

I went back to the hospital on Tuesday. I found Rinie in the ground floor ICU. She looked sleepy, with two needles in her right arm, each with a variety of plugs where injection needles can be inserted. Three bags of drip medicine hung above her head - it's fascinating to see how the drops fall measuredly. Fortunately, she had no pain. Her heels were throbbing, and I massaged them with Milking Cream, which brought immediate relief.

On Wednesday at 15:00 I ran into Dr. Augustyn in the hallway. He said with a broad smile that the procedure had been a great success! The "plug" was placed over the auricle with small hooks so that it could not come off at all. She only had to take her red anti-clotting pill (Rivaroxaban / Ixarola) for another three weeks, and then only Ecotrin. What a relief - the pills cost me R960 per month, a large part of which came from my own pocket!

When I got into the ward, she was already dressed! I loaded her into the Civic just next to the restaurant, with the help of a porter, and we drove back to Strand in a light rain. However, upon arrival at Ametis, we had a big schock: her strong leg was still slightly numb from the anesthesia and could not bear her weight during the transfer, and I was not strong enough to do it by myself. She sank onto the cement blocks. I could not get her up alone and ran in for help. Fortunately, a man named Willem helped to get her into a sitting position next to the Civic, and together with the Ametis carers we got her safely into her bed. We had a big fright, but fortunately she suffered no injuries. Ilse called right after Rinie fell, and I could only tell her "Rinie just fell, I'll call you later". When Rinie was safely in bed, I called Ilse back. She was of course scared to death and was very relieved after speaking to Rinie that everything was OK. Rosa also called later and when she heard about the fall she insisted that we inform Dr. Augustyn about the fall - something could have gone wrong. I then sent him a letter by email.

FATHER'S DAY AND SPOILING (JUNE 2023)

It's now Saturday evening, June 17 (actually already 01:00 in the morning). I'm sitting with a cup of coffee while Bok van Blerk's “Koue voete, warm liefde” plays on the radio and the Strand wind blows against the windows.

Yesterday Rinie took me out early for Father's Day before the big Sunday rush. We're getting very good at transferring in and out of the car. We saw on TV that Longridge Winery is on the R44 near Stellenbosch and decided to drive there. Luckily, it's very wheelchair-friendly. We got a beautiful table by the large window with a view of the herb garden and the Cape Peninsula Mountains in the distance. We ate two delicious thin-crust pizzas; Rinie with a glass of Cabernet (she only drinks red) and I with their excellent Ou Steen Chenin Blanc. It was so delicious that we decided to spoil ourselves more like this from now on.

After this we went to Somerset Mall - the first time since her stroke that she had been in a shopping mall. It was wonderful for her to experience the hustle and bustle, browse through Woolworths and enjoy a cappuccino at Seattle Coffee Co.

The helpfulness of the people is overwhelming and gives one a warm feeling in the heart. At the Spur on Beach Road they move tables around to help us sitting directly at the window, and at the Strand Pavilion (where we used to have a timeshare) the cleaner even let us go to the top Penthouse so that I could push Rinie onto the balcony for the view over Gordon's Bay.

Here in Ametis too, the people's hearts opened. Marie (83) immediately took pity on Rinie, brought rusks and invited us to the movie and prayer meeting on the 5th floor. There we met Sucille, and to my great surprise, I found out that she had been at school in Rawsonville just two years after me and was great friends with Cisserie Marais, who had been with me from Sub A to Standard 4 in Goudini High School!

The staff here at Ametis are incredible. They come every few hours - even at night - to check that Rinie is comfortable. We get our meals in the apartment or eat with our neighbours, the Jouberts, in the dining room.

We miss our two sons, Christiaan in Auckland and Marinus in Melbourne (who recently emigrated on 21 April), but we know their future is bright there. Thank goodness for technology - every second and fourth Sunday of the month we have a big de Jager Chat via WhatsApp, where Heine also joins in from Johannesburg.

Our lives may have changed drastically, but here in Ametis we are safe, surrounded by love, and we now take life easy, one moment at a time.