Subconjunctival hemorrhage: Nasty looking but harmless

My eye was well on its way to be healed when I took this picture.

My granddaughter noticed it first. The white of my right eye appeared to be filling with blood. It looked nasty.

As I take the anticoagulant Pradaxa, bleeding in my eye was concerning. I headed off to the the ER at University Hospital in London, ON.

Moments after entering the ER I was interviewed, my OHIP information was taken and I was asked to sit down and await triage. A few short minutes later I was being interviewed by the triage nurse. She seemed remarkably calm about my bleeding eye. A good sign. She asked me to take a seat in the waiting room.

A notice in the waiting room warned the wait for a doctor was running anywhere from four to six hours. I took a seat, picked up a magazine and scanned it for something to read. Interesting, I thought, my right eye is filling with blood and yet my vision seems unaffected. Another good sign.

I hadn't waited even two hours when I my name was called and I was taken from the waiting room to a small examining room where I noted there was what appeared to be a slit lamp instrument. These have a support for the chin and a brace for the forehead. With the patient's head held steady, an optometrist or doctor can shine a bright light into the eye to conduct a careful examination.

Soon a nurse arrived and had me read an eye chart. This tests visual acuity. I did fairly well. There was certainly no big difference between my two eyes. Whatever was occurring in my right eye was not affecting the vision.

The nurse left and an ER doctor entered. He carefully noted the meds I take and seemed especially interested in the Pradaxa, the anticoagulant I take to lessen my risk of suffering a stroke. He looked at the results of my visual acuity test and then examined my eye using the slit lamp unit. He put drops in my eye and left to help someone else while the freezing took effect.

When he returned, he used a computerized pen-type instrument to gently touch the surface of my eye to get an accurate eye pressure reading. All was normal.

He had a diagnosis: Subconjunctival hemorrhage. According to the Mayo Clinic this is caused by a tiny blood vessel breaking just underneath the clear surface, the conjunctiva, of the eye. There is usually no pain and no visual problems associated with this despite the frightening appearance. The blood trapped below the transparent layer will usually disappear in a week or two. There is no specific treatment.

The ER doctor made it quite clear that if pain should develop or my vision become blurry, I should return to the emerg. I believe the Pradaxa was a bit of question mark hanging over this whole incident. When one is on a powerful anticoagulant, any bleeding is cause for immediate concern. That said, it did not appear my eye was bleeding all that profusely and the Pradaxa did not appear to be the cause of my problem nor did it appear to be making the event worse.

The doctor sent me home. I had been in the ER a total of four hours.

In the last few months, the ER department at our local hospital has come in for criticism in the local paper. With my own personal defibrillator in my chest, an ICD, with a pacemaker in charge of my heart rate about 93 percent of the time, with a rather rare genetic-based heart condition, I have made more than my share of visits to the ER in recent years. I have no complaints.

The medical staff in the ER have tough jobs. In my experience, they are an amazing group doing damn fine work. Part of the reason I am alive today is because of the fine work done by the doctors and nurses in hospital emergency departments.

Sun Media: nattering nabobs of negativism

Jonathan Sher, of The London Free Press, reported on the treatment received by patients suspected of suffering a certain type of heart attack in Ontario. The news report was well written, was medically accurate and I believe, was overly negative in tone.

I believe it was this negative tone that resulted in a great many oh-so-critical online comments attacking the health care system in Ontario. "For 1 in 5, fast care isn't there," read the headline. According to the article, nearly one in five Ontarians with a specific type of heart attack, known as a STEMI,  are not getting the fast access to treatment required. All true. The reader is also told Canadian experts look to American counterparts for benchmarks against which to judge treatment times. In Ontario 18 percent fall short of the American/Canadian benchmark.

An online comment warned, "Be afraid. Be very afraid. Do not get sick or old in Ontario." This comment attracted the most support from the paper's Web-based readers with the warning sitting at the top of the comment heap. Another reader laid the blame on Deb Matthews, a London MPP and former Minister of Health.

Let's take another look at the situation in the States. We find articles where the Yanks are downright proud of the their health care system and the rapid advances being made in this area. A recent American study looked at 96,738 patients in the heart attack group under discussion and found only 17 percent had treatment times that fell short of the benchmark.

In Canada, Sun Media bemoans the fact that our health care system fails 1 out of 5 patients suffering this type of heart attack. In the States, the Yanks are proud to report that 4 out of 5 patient suffering these attacks are treated within the benchmark time. The numbers from the two counties are separated by about one percent.

Two of my uncles died from heart problems. My father died from a heart attack. I take powerful meds while watching my diet to keep atherosclerosis (hardening of the arteries) at bay. For these reasons, I carefully follow the ever improving treatment for heart attack patients. 

I see the Canadian health care glass as half full and continuing to fill as medical breakthroughs are made around the world. A lot of medical research is done in Canada and our medical community is aware of not only what is being done in the States but around the globe. 

Recently, when I had an ablation procedure to cure my heart rhythm problems, one of my heart surgeons was a doctor from the south of France. When I was wheeled into recovery after the procedure was done, I felt very lucky to be living in Canada and especially lucky to be living in London, Ontario. 

My health care has been world class.

Weight Watchers for those seeking heart healthy diet

With a failing heart and arteries showing signs of plugging up, I've been put on a Mediterranean diet. The hope is that a low cholesterol diet will help keep my blood cholesterol in check. But my doctors are not taking any chances; I'm also taking 10 mg of Ezetrol, a cholesterol absorption inhibitor.

I take Ezetrol in addition to 40 mg of Lipitor daily as the Ezetrol takes a different approach to cholesterol lowering than statins, which lower cholesterol by cutting cholesterol production in the liver.

By happy happenstance, my wife decided to start attending Weight Watchers at the very same time I was being placed on a low fat, low meat, diet. My diet and my wife's diet fit together like two pieces of good-health-diet puzzle. My wife has lost more than forty pounds and I have dropped about twenty-five pounds in the last few months. My doctors will be pleased when I next see them for a consultation.

Tonight we had spanakopita for dinner with a cucumber and tomato salad topped with slices of bocconcini cheese. On the side we had some broccoli florets lightly "buttered" with Becal margarine. My wife made a Weight Watchers' version of spanakopita -- a savoury mix of spinach and feta and low-fat ricotta cheeses wrapped with layers of flaky phyllo pastry. Each serving of the spanakopita was just four points. I enjoyed two pieces as I have a daily goal of 37 points.

I'd post the recipe but my wife adhered fairly closely to the Weight Watchers recipe. If you want the recipe, you'll have to join Weight Watchers. She did stray a little, she added a few roasted pine nuts to the spanakopita and a few slices of bocconcini cheese to the salad. I should note that this recipe did not call for eggs, not even yolkless egg substitutes, and parmesan cheese was also missing.

I admit, cheese is a bit of a no-no to those of us on low cholesterol diets. That said, I figure my daily intake of cholesterol today was well under 100 mg -- my personal cholesterol ceiling. My intake of saturated fat and total fat was also held in check. At the same time, I had lots of fibre while keeping my salt intake low.

Now to head out for a gentle walk about the neighbourhood. Light exercise is the final important ingredient in my heart healthy regimen.

ReThinking Heritage Districts

The City Hotel as it appeared in about 1895.

Considering how much of  historic London, Ontario, has been torn down and relegated to the history books, The London Plan devotes a lot of space to historic London

I've only lived here since the mid 1970s and yet I've watched a lot of historic London disappear. And I've been amazed at what passes for saving our architectural heritage. Think of the City Hotel, the Capitol Theatre and the Bowles Lunch building.

Today the City Hotel, later the Talbot Inn, is a facade with opaqued windows.

The City Hotel goes back to 1865. In 1886 it was extensively remodeled and enlarged. When I moved to London the name had been changed to the Talbot Inn. If memory serves me right, one could get a good Mexican dinner there along with a cold draft. At night one could catch some of the best blues musicians on the bar circuit playing next door. The inn barely escaped demolition when the other buildings making up the Talbot Block fell to the wrecker's ball. The streetscape disappeared to make way for a new downtown mall and hotel complex. (In the end, the mall/hotel complex failed to materialize despite the hasty demolition.)

The Talbot Block was a wonderfully intact row of historic buildings. It was possibly the most historically important block in the city. At one point, more than a thousand Londoners held hands to circle the block and loudly protest the proposed destruction. It was all to no avail. Everything was taken down. Only a poor imitation of the old hotel's facade remains as the exterior wall of the north-east corner of Budweiser Gardens, a sports and entertainment centre.

The London Plan proposes to protect our built heritage and revitalize London's downtown. The distinctive historical elements on our oldest buildings will be conserved according to The Plan. I say it is a little late to take the save-our-built-history approach. If there was ever a topic in need of rethinking, it's what to do with London's core and the remaining historic buildings.

Large chunks of the downtown have been demolished and rebuilt.

I propose a three pronged approach to creating an historic looking downtown core.

1. Restore remaining historic buildings.
2. Rebuild some of the easily duplicated missing historic brick structures.
3. ReThink the core by finding historic buildings facing demolition in other communities, buying the facades, or at least the most important and difficult to duplicate elements, and bringing them to London for reuse.

I know the last two suggestions sound absurd but they really aren't. In fact, both have being done successfully in many places around the world. Think Williamsburg in the States or Old Quebec in Canada.

 Ada Louise Huxtable points out in her book The Unreal America: Architecture and Illusion that "approximately 730 buildings were removed at Williamsburg; 81 were renovated and 413 were rebuilt . . . The next step replaces the "wrong" buildings with the "right" buildings, moved, in turn, from somewhere else." Huxtable calls the result a stage set.

Old Quebec City, despite its fame, has a lot of faux heritage buildings. According to the Encyclopedia of French Cultural Heritage in North America, Gérard Morisset, the art historian behind the reclaiming of the old city's past, believed "restoring a building does not mean maintaining it, repairing it, or rebuilding it; it means restoring it to a state of completeness that may never have existed." I personally saw some of the last Old Quebec heritage buildings under construction in the mid 1970s. The reclamation had been going on for about twenty years at that point.

The Capitol Theatre facade above left. The faux Bowles Building on its right.

London already has one handsome, faux heritage building: The Bowles Building. Originally one of the Bowles Lunch chain of diners, the building had a rich architectural heritage. It's clean, white terra cotta facade sported two large, ornate capital Bs on both sides of the second floor window. The terra cotta is gone, replaced by stone. The fancy Bs, difficult to replicate in stone, are also missing.

Deconstruction and skimming could repair London's core.

Detroit has a lot of once fine structures that are suitable for architectural salvage, both deconstruction and skimming. Deconstruction is the disassembly of buildings to their foundation to preserve up to 85% of the materials. Skimming, a less intensive method, salvages the easy-to-remove materials. The Architectural Salvage Warehouse in Detroit specializes in both deconstruction and skimming.

Cities are for people. At one time London's core was for people. The sidewalks were crowded day and night. If our city planners want to create a downtown heritage district, they are going to have to get busy creating. Otherwise, many of the remaining heritage buildings will disappear and the feeling The London Plan envisions will never materialize.

Heritage streetscapes are popular around the world.

Since writing this, the downtown core has lost another bit of heritage. Kingsmill's department store is closing and being bought and converted to use by Fanshawe College. One more reason to visit the downtown will have vanished. (My wife and I bought a lot at Kingsmill's.)

Many artists love the suburbs

Recently I read a tweet pushing the notion that artists gravitate to city cores. A linked article stated, "Artists are unlikely to move their garrets to subdivisions – their districts need to be close to the high-density commercial core to function properly." I shook my head. I haven't done a scientific survey but in my experience many fine artists make their home in a suburb of a nearby large city.

In the '60s I went to what is now called the College for Creative Studies in Detroit, Michigan. I loved that school and I admired my teachers – all successful artists in their own right.

Jay Holland lived in this neighbourhood.

I studied sculpture under the instruction of Jay Holland. Holland has been called the father of Detroit sculpture. With his powerful personality, he dominated the classroom and he did his best to mold students as he molded clay. His passion inspired students for 34 years. Holland lived in Oak Park. A suburb of Detroit.

Bruce Blyth lived in this suburban area.

Another instructor, Bruce Blyth, taught jewellery design. When my wife and I visited Bruce a few years ago, we found him living in a rather funky little bungalow in a neighbourhood I would guess was completely devoid of garrets. He lived in Livonia. A suburb of Detroit.

I could go on an on, listing artist after artist, all living in suburban communities, but I will stop with just one more example: Marshall Fredericks, best known to the average Detroiter as the man responsible for the Spirit of Detroit sculpture sitting at the foot of Woodward Ave in front of the Coleman A. Young Municipal Center. Fredericks lived for many years in Birmingham, Michigan, with his wife Rosalind until his death in 1998.

Fredericks was a very successful artist. I believe he owned the former Kresge Estate located in the area. If he didn't own it, he certainly controlled it – at least according to one of his sons. I went to a party there, thrown by the son, where I discovered a scale model study of the Spirit of Detroit tucked away in the old coach house and stable. 

I asked the son if he was worried about getting noise complaints from the neighbours. He laughed and said no. The neighbours leased their property from his father Marshall Fredericks. There would be no complaints, I was assured. The great artist had woven himself deep into the suburban fabric.

In my experience, many artists enjoy the suburbs. In writing this piece I learned that when Bill Girard, Jay Holland, Chesley Odom, Gordon Orear, Bill Rauhauser, Robert Vigiletti and Tony Williams gathered to chat, the seven artists met at Borders in Birmingham – a suburb of Detroit.

Masked hunter has nasty bite

The resolution isn't great but this image gives you an idea of what to look for.

Spotted by my wife at the bottom of bag just brought into our home, my wife called me to the kitchen. "What is it?"

It was big, almost an inch long. It had a sandy textured back and legs, a brown colour and looked strong with big, thick legs. My first guess was a stink bug but it didn't seem to have the shield shape I usually associate with the smelly critters.

I killed it with a tissue and then logged onto the Internet to discover what had hitched a ride into our home. I learned I had squashed a reduvius personatus or masked hunter. It was a good bug to kill as it can bite and the pain has been compared to that of a snake bite with the swelling and irritation lasting up to a week.

The name masked hunter comes from its habit while in the nymph stage of "masking" itself with bits of dust, lint and sand for camouflage. This proved the undoing of our masked hunter, also called an assassin bug, as it was easily noticed sitting quietly in a white-bottomed bag.

As adults, these European bug invaders fly and are attracted by outdoor lights glowing in the night. The adults have a sleeker look, no longer sporting the dusty, dirty appearance favoured as nymphs.

Small Yellow Lady's Slipper found in Ontario

The Small Yellow Lady's Slipper shown above was photographed growing wild at Inverhuron Provincial Park located a short distance south of the Bruce Power nuclear generating station.

This beautiful orchid was spotted growing at the edge of a small wetland beside a footpath leading to the dunes and the sandy beach bordering Lake Huron. Although we spent an afternoon exploring the park and found lots of interest, we took only photographs and left only footprints.