These are her carotid arteries, the specialist explains, and they're in fine shape! Really good, excellent, he enthuses, like a horse dealer appraising a polo pony's fetlocks. Look at those tubes, smooth as you like, nice clean divide - these are good carotids!
Glowing with pride they leave the scan room and follow the neurologist to his office, where he conjures up on his computer screen the magnetic resonance brain scans from the giant doughnut in Tenerife. He hasn't seen these before. He stares at one of them for some time, enlarging it for a better view. He's gone quiet. Finally he looks up from the screen. 'How long have you had high blood pressure?'
They don't really know, they admit. She became aware of it not much more than a year ago, when a routine check with their home blood pressure thingy gave some alarmingly high readings.
'Muchos años!' many years, declares the neurologist. 'Muchos años,' he emphasises, shaking his head. He points to the screen where a slice of her head looks like something from a delicatessen counter. Those little white areas, he indicates. Damage to the small blood vessels. They peer at the screen but can't quite make out what he's spotted among all the grey and white blobs. Brains are complicated things.
However, despite her superb carotids, it seems that all is not perfect in there and something must be done. It's possible, the neurologist muses, that although her blood pressure seems within reasonable bounds during the day it rises treacherously when she's asleep. Her stroke happened, he points out, during the early hours of the morning. He prescribes a 24-hour monitoring of her blood pressure, which these days can be achieved automatically.
A medical technician called Jonathan fits the monitoring device a couple of days later. It comprises the usual inflatable sleeve around the upper arm and a plastic tube snaking to the device itself. This is a metal box about the size of a pocket camera but surprisingly heavy. Jonathan plugs it into his computer to set it up. 'What time do you go to bed? And you get up at...?' The box will measure her blood pressure three times an hour during the day, once an hour while she's in bed.
He clicks a software start button on his computer screen then unplugs the device and clips it to a belt around her waist. A moment later it takes its first reading. 'Let your arm dangle while it's inflating,' Jonathan advises. This will later lead to strange behaviour while pottering about the house, where suddenly she will pause with one arm flopping uselessly like a puppet with a broken string.
At night, the technician has also advised, it's best to unclip it from the belt and place it in the middle of the bed, but perhaps he sleeps in a bigger bed than they do. It's like sleeping with a house brick. They wake occasionally to soft whirring noises and hisses of air. There is concern that she might turn over and compress the plastic tubing, raising her apparent blood pressure to the realms of a high-performance car tyre.
Jonathan removes the monitor the next morning, downloads the readings to his computer and prints an automatically-generated report. Clever software. The graph it provides is unequivocal: her blood pressure goes down during the night, not up.
'So that's good, then?' they venture hopefully. Jonathan nods. It's normal, what you'd expect from a healthy system, lower blood pressure when you're asleep. More good news to report to their family doctor, along with the healthy carotids.
The doctor is as pleased as they are, one potential problem less to worry about. However, he's also got the results of her latest blood test, which is also looking good except that she could do with eating a little more salt.
What? More salt? But doesn't salt raise your blood pressure? Indeed it does, he agrees, too much of it, but too little is bad as well. Ironic, really - they've been working for years to reduce their salt intake. They specify 'no salt' when ordering garlic prawns in a restaurant. They don't even sprinkle salt on the Sunday breakfast boiled egg, a habit previously ingrained from thumb-sucking childhood. But the very next day he reads about some goats in Italy who habitually climb the near-vertical wall of a dam to lick the concrete for its salt efflorescence. A clear message from Nature.
Boiling the spaghetti that evening, he sprinkles a little salt into the water. If it helps to keep her carotids in good shape, let's do it.
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