Rarity of the central nervous system leptomeningeal hemangioblastomas

If you have the most unusual diseases known to humankind it becomes a fateful condition where you can't afford to be ignorant if you desire quality and extension of your life.

Few diseases of the present have little in common with the diseases of the past because of their rarity but like an owl, you have to pore over abstruse medical documents and make it your pastime.

When you are bombarded with heavy-duty medical words of a mysterious sickness as your diagnosis by medical men don't become trifle too dreamy and treat their words as gospels. I faced a peculiar outbreak of blind rage and reprisal in the unfunny days of my first brain tumour.

I spoke with authority because it was my body he would work upon and if he doesn't do a very careful job with his scalpel with full knowledge of what he was about to do then my fragile life bird would have flown away. 

So better not stare at them with stupefaction, even the most brilliant medical mind can make mistakes and it happened with me twice… when unwary surgeons worked for hours to save a patient's life, noted a minute detail but failed to test it for any further implications... next time it was when their negligence led to the other doctor saying "Everything is in God's hands" and I ended up showing an upturned thumb because God showed them the right path. They are not omnipotent, they use their acquired knowledge and skills to save a life.

I have a very serious condition known as "Abibliophobia" but I am not here to explain that. I am not going to reveal how I deal with it. It has no cure, if you really have it, you will slowly learn how to deal with it but I must warn you there's no recovery.

Strange but true we are afloat in a broad sea anchor-less,

Fear sets in when we shed a tear in aloneness,

Ah! What a mess!

" Have no fear!" said Hope,

"When the day gets sunny,

We will have a lot of things that are very funny."

So I say never stop believing in hope because miracles can happen any moment! You never know being optimistic can make the wave of "Hope's"  magic wand turn your life! 

A lot should be shared with others from what I have learned in a simplified way, so here it goes…

Brain tumours grow within a rigid, firm bony skull. Benign, slowly growing or malignant brain tumours may produce serious neurological symptoms and signs prior to treatment or cure but rarely metastasize outside the central nervous system (CNS), disability and death occur when the intracranial contents exceed the intracranial space, causing herniation and compression of respiratory centres.

Fewer than 5% of patients with brain tumours have a predisposing genetic syndrome. The most common of these are von Recklinghausen's types I and II neurofibromatosis, tuberous sclerosis, von Hippel-Lindau disease, and the epidermal nevus syndrome. These dominantly inherited neurocutaneous syndromes are associated with an increased incidence of specific tumours.

von Hippel-Lindau or VHL which is a genetic defect that causes capillary growth to go out of control. While the tiniest blood vessels or capillaries usually branch out gracefully like trees, in VHL patients a little knot of extra capillaries forms a growth or tumour and in certain cases, it turns cancerous. It is a genetic form of cancer VHL patients battle a series of tumours throughout their life. 

VHL may occur in up to 10 organs of the body like liver, kidney, brain, spinal cord or retina, inner ear, pancreas. There is also a possibility of neuroendocrine tumours.

To know about leptomeningeal hemangioblastomas we need to know about meninges or the coverings of the brain.

Meninges are the three membranous envelopes—pia mater, arachnoid, and dura mater, that surround the brain and spinal cord. Cerebrospinal fluid fills the ventricles of the brain and the space between the pia mater and the arachnoid. The primary function of the meninges and of the cerebrospinal fluid is to protect the central nervous system.

The two innermost layers of tissue, arachnoid mater and pia mater that cover the brain and spinal cord are together called the leptomeninges.

Now we come to Leptomeningeal dissemination of Hemangioblastomas

Hemangioblastomas of the CNS are solid or cystic vascular-rich tumours, most common in the cerebellum, less frequent in the brainstem or spinal cord and rare in supratentorial locations with meningeal involvement. 

Hemangioblastomas of the central nervous system are the most common tumours seen in patients with von Hippel-Lindau (VHL) disease.

Leptomeningeal dissemination of hemangioblastomas (HB) of the central nervous system (CNS) is extremely rare. Between 1902 and 2013, approximately 132 cases were reported. Few studies have reported leptomeningeal involvement in sporadic HB or in HB associated with von Hippel­Lindau syndrome.

Diffuse infiltration of the leptomeninges is known as hemangioblastomatosis and has been observed both in VHL disease and in patients with spontaneous mutations. 

No effective therapy has been established.

Detecting and treating the condition of leptomeningeal hemangioblastoma without delay seems to help survival, though the number of patients analysed is small. 

Because no case of de novo development of disseminated HB without previous surgery has been reported, it is strongly suggested that the spillage and spread of tumour cells through the CSF space may be an origin of hemangioblastomatosis in patients with a genetic predisposition to the condition, Care should be taken to avoid tumour cell spillage during surgery.

Prior to surgery of the initial tumour, planned embolization should be undertaken if possible to reduce blood loss. However, depending on the actual tumour structure embolization may be found not to be possible. Reducing blood loss may also help in reducing tumour cell spillage and spread.

 Looking at tumour cells in the spinal fluid under high-resolution MRI scans are all that is necessary for an accurate diagnosis. A biopsy isn't required for diagnosis as it may cause meningitis and blood loss thereby cell spillage. 

I was diagnosed with supranational leptomeningeal hemangioblastomas in 2013. I have been seeking anyone experiencing the same condition but didn't find anyone till now. So I consider myself a myth, a unicorn more so because a fellow remarked after he saw the picture of the scan of numerous lesions scattered throughout my brain,

" You have more tumours in the brain than people have lice in hair.''

There is no data on the competence of the surgeons and equipment used in the initial CNS surgery so trying to determine if cell spread was caused by any incompetence during my brain surgery (craniotomy) in 2006 would be extremely difficult if not impossible to prove beyond a reasonable doubt. The fact that the physiology of each tumour is different and the number of cases is so small means that an accurate comparison of surgeons is impossible. 

I get stereotactic radio-surgery before the growing tumours start putting pressure on the brain. I have lost vision of my right eye for not being able to avail radiation therapy at the right time because of financial reasons and also because  I was diagnosed with kidney cancer at the same time. 

Advanced radiation techniques, such as radiosurgery, are more effective than conventionally fractionated radiotherapy. 

Radiosurgery appears to be safe and has prevented local recurrences in my case, than conventional radiation which caused white matter changes representing chronic ischemic changes. I couldn't afford a cyberknife and underwent conventional radiation therapy in 2017 after which this happened. 

Sometimes tumours treated with radiation, on follow-up MRI imaging scans, appear stable without evidence of growth even mildly shrinking every time. 

I would like to add a little bit about an unexplored safe technology

It is a new exciting technology which may help people trying to minimise collateral damage which with radiation treatments has always been the challenge. 

The precision of proton therapy can be critical for protecting the brain’s delicate tissues. 

To treat more people with proton therapy is by making the technology even more accessible. Currently, this technology is available only in Apollo Chennai and expensive enough to cost an arm and leg. But in my case, they are totally confused, "It is not a straight-forward case" they remarked hence they need a fresh MRI to decide and talk to my previous doctors.

I keep myself well-informed so that I don't fall into the wrong hands. I love learning and gaining knowledge which brought in understanding, comprehension, a better grasp of my bizarre diseases, not to be afraid of death or lead an unlived life like a zombie.  Because in the end we only regret the chances we didn't take. Live life to the fullest and try bringing colour to my life. I feel alive, not just breathing. 

My only wish is that next World Brain Day will be dedicated to Leptomeningeal hemangioblastomas.

Sketch by Rishabh Khushwaha and Picture by Akash Sharma  Amish Masarani

From: https://timesofindia.indiatimes.com/blogs/warrior-princess/the-rarity-of-the-central-nervous-system-leptomeningeal-hemangioblastomas/

Imagine

Once upon a time, there was a Queen with the power of love and determination bestowed upon her. She had a daughter and when the daughter asked her 

 "What will I be?" She replied,

 "The future's not ours to see, but whatever comes your way face it, never be a dreamer, be a doer."

She belonged to a large royal family of proud descent but nobody thought her the joy of the family and had any compassion for her. Mother was the supreme nurturer and protector but the others ruled over her.

She was a nice, bright, lonely, unhappy girl who sat alone and silent without any playfellow thinking,

 

" If only I had someone who would kiss me and  understand my pain."

But her heart was like a sponge, sucking up feelings and emotions, even pain. She was born with the soul of a mermaid who could only suffer pain. She couldn't even confide in her mother.

Nobody was concerned or cared about the trifling little spirit being engrossed in the glory of their own story. She found herself sorrowful and alone but she couldn't mourn or weep or express her suffering although her heart shrieked and howled, she never uttered a word.

She was never very sociable and children used to make fun of her and refused to play. She had nobody to talk to. Oh! how she desired to be sitting with other children prattling away merrily, joking and talking nonsense. She had to turn to her mother who was her source of all love, nourishment, comfort.

This made the little girl terribly lonely as she needed some solicitude against the deluge of solitude rising from below as she was condemned to live in loneliness, never known before. Black heavy clouds covered her life, thunder rolled and amidst the bustle and noise of existence, she found herself lonesome, by herself. 

In her loneliness riding the wings of time thingummy, dryads and vivid colorful fairies appeared and whispered in her ears

“Don't feel sad, we are all princesses in God's kingdom”.

 

They played and danced with her and made her happy and laugh and told,

 

“Someday you will come out of your loneliness and meet the greater world, wage wars and win them! You'll be the warrior princess!”

The time came when she was rejected at the highest level and brought anxiety with it. Hah! Pain? Nobody cared if she lived or died because it will bring them to gain. King of Darkness tried his utmost that she dies.

Her father, the White King perished suddenly and left his family in difficult pecuniary circumstances which was a devastating blow to mother and daughter but all-powerful mother guarded her daughter with patience and fortitude.

In the dismal netherworld The Restrainer, Yama sat on his throne with his noose turning his moustache proudly and asking his accountant Chitragupta who is to be judged next. Somnolent Chitragupta came yawning ahead with his massive register and announced the girl's name. 

Yama was standing beside the procedure bed ready to toss his noose to get the soul of the girl. He is famous due to his responsibility for good decision-making based on records of a person’s deeds. But looking at the bold and daring guiltless face whistling a tune while the stretcher was pushed to the operation theatre he got flabbergasted and called his scribe Chitragupta, who fetched his logbook to check if the name was really there or not. Yama is also known as Dharmaraja, King of Justice, he is the punisher of the wicked but couldn't find any wickedness, vice, immorality in the girl's deeds or her parents. Scratching his chin he returned to his palace in the netherworld.

Help preserve my daughter! Mother begged the apothecary. While facing a horribly wicked malicious fate she never screamed with terror or annoyance.

In the midst of hunger, worry, for medicine and struggle, staying in a strange house, the girl was ambushed by a pathogen, a bug who came blowing in the wind and made the host suffer from every breath.

Wheezing like an accordion, panting for breath, coughing up blood because the sinister pathogen had not only invaded her lungs but travelled to the lower limbs through the lymph nodes making them throb like the sound of a drumbeat, she answered walked through the dark path every day, walking with faith that she was headed for sunshine.

As she made it through one ailment, another became ready to charge ahead. Once again in an extremely confusing situation, Chitragupta, the bookkeeper of the God of death, Yama made her sign the logbook when she was hooked onto machines, punctured with needles and tubes were going through them inside the operation theatre and Yama was standing behind nodding his head. She sat up, mustered up all her strength, saw her mother's face in front of her eyes and signed. Then when she laid down she showed an upturned thumb to them for luck. Yama covered his face, the Oh, no! It was a sure catch but he missed this time too! The way she was sneaking out he wouldn't ever capture her it seemed. This time too Yama could hear she was whistling inside her mind

Then again a fierce situation came and her heart stopped jumping with joy, enjoying the elixir of life and she learnt to shed tears of wicked pain hugging her mother at night when she felt her soul screaming out with the agony and howling in pain. She hugged her mother and muttered and cried as electricity went through her brain. She had a lancinating pain as if a live electric cable was held against her eyes, cheeks, jaw and teeth.

 Battling the darkness of pain and intolerance through the thorns of adversity, with her creativity she triumphed over the deepest fears of the subconscious. 

The creation of Man is supposed to be God's best job, greater than the animals with morals and principals but they have turned out to be leaders in their dominions and its authority which is supreme and impregnable. They practice killing weaker animals and are selfish by nature. They are the most miserable creation who only care about themselves. While travelling to road from childhood to adulthood she has witnessed that.  The widespread disease has brought out the worst aspect of human character!

She turned on the radio and found a station and enchanting music floated in John Lennon's voice.

Picture credits : Amish Masarani

From : https://timesofindia.indiatimes.com/blogs/warrior-princess/imagine-2/

A strong, fearless, badass unicorn

In my childhood when I read the story of Prometheus creating men, I never knew it would change my life. 

Prometheus was entrusted with the task of sculpting Mankind from clay to populate the Earth.  He was filled with grief as he found them living in caves in miserable conditions because there was no fire.

He went into direct conflict with Zeus and when Zeus withheld fire he disobeyed him and stole fire from heaven as a gift to Man. Zeus, the ruler of Mount Olympus had no compassion for Man and he meted out punishment for this daring crime to Prometheus.

Prometheus was chained to the Great Caucasus Mountains where an eagle was set to feed upon his ever-regenerating liver.  It made me realise the regenerative capacity of the liver later in life.  

My story is from riches to rags. Those heartless relatives...when I needed them most…the foxy ones conspired and deprived me and the rabbits turned tail and fled, fearing I might ask them to help me or stand by me. Family is not about blood bond, it's about willing to hold your hands when you need them most. 

We are all familiar with the phrase “Pandora’s box”. Out of his fury, Zeus ordered the creation of “Pandora” who opened a coffer bringing into the world pain, diseases, misfortune and all hurtful things and closed it leaving hope inside.

Within four months of a brain surgery for which my father ran across India in search of a suitable hospital, I had strange symptoms and vascular tumours were detected in my liver but due to lack of money, they were left untreated. The tumours grew and studded the liver in a way that transplant was the only way out. 

Devi Parvati sculpted a son to guard the door of her palace. When Lord Shiva tried to enter he drove him back and all the Gods. While Ganesha was involved in a duel with Lord Vishnu, Lord Shiva moved slowly from behind and cut Ganesha's head with his trident. Lord Shiva agreed to bring back Ganesha to life and grant him divinity. Lord Shiva did the first mytho-historic transplant surgery and Ganesha was brought back to life.

After the transplant surgery, Lord Shiva is believed to have given Ganesha an elixir to drink. One cannot help speculating if this was some potion containing an anti-rejection medication.

But I didn’t despair and kept looking for hope and I found hope amongst mankind not tied to me by any blood bond. I survived a landmark liver transplant with the funds acquired by donations. 

I was diagnosed with a rare disease von Hippel-Lindau or VHL. It is a genetic form of cancer. VHL patients battle a series of tumours throughout their life. VHL may occur in up to 10 organs of the body also there is a possibility of neuroendocrine tumours.

The transplanted liver needs the immune system to be suppressed so that it isn’t rejected like any pathogen. Immunosuppressants are expensive life-saving medicines. I am on immunosuppressive medicines for life.

Today we are aware, the liver is the most active organ in the body with the power to regenerate itself after large portions of it are removed. Liver functions normally even after seventy per cent of it is removed and can grow back to normal size within a few weeks provided the remaining thirty per cent is healthy. Thus, a living person can donate a liver out of affection and go back to normal life in a matter of days. This saves the lives of patients with chronic liver disease. Liver transplant is safe and possible due to this uniqueness

My father perished soon after the transplant and my foxy uncle took our house from us and we were left penniless and homeless. It was then that my real tough times began and we had two choices ...death or preservation of life.

Not only we faced shocking poverty where we didn’t have money for food the next day, but I acquired MDR- TB living in shabby houses and changed houses seven times hounded by landlords. 

My brain literally changed in chemical composition when I understood the frightfulness and the oddity of my nasty lingering illness and its larger economic implications.

 When in poverty, you face medical embarrassments, the humiliation of asking for financial help, physical suffering which is always there money concerns for food, medicines and rent.

Living in a lousy cramped house I faced many acts of kindness,  many acts of madness but didn't flop down to the bottom. Itching or scratching diseases have solid attention from the government and the public but in my case, many vociferous suggestions, whispering advice came to me disapproving my smiling visage.

 My brain tumours are the rarest ones from 1902-2013 only 132 cases have been reported globally. A fellow remarked after he saw the picture of the scan of my brain tumours

" you have more tumours in the brain than people have lice in hair.''

I was told I can't live beyond a few months. Soon as the countless tumours would continue to spread would put pressure on the brain and spinal cord and cause herniation and compression of respiratory centres. For the past seven years, I have tried to search for anyone with my kind of brain tumours but till now I have been unsuccessful. 

One of those tumours sitting atop my optic nerve in the brain makes me partially blind.  

It was a warm October morning when in a merry mood I sat down with a book when out of the blue something zapped across my right eye. There was a lancinating pain as if a live electric cable was held against my eyes, cheeks, jaw and teeth. It lasted for a few seconds to a few minutes but it was difficult to keep my right eye open. I underwent an MRI scan and was diagnosed with bilateral trigeminal neuralgia also known as " suicide disease" because it is the most excruciating pain known to humankind.

I was lucky enough to get a cyberknife with the help of crowdfunding just before the lockdown. It reduced the pain but I have it on the left side too which is pending. 

In the absence of government policy, the court has stepped in to develop a law and provide treatment for a rare disease, only lysosomal storage disorder patients get support from the government.

Somewhere in the Constitution, I have been given the right to live but I am being denied that.

I live with my sixty-seven-year-old mother and she is my caregiver. Our only income is her seven thousand rupees pension and in this crisis of the pandemic we are facing a lot of hurdles: not getting my treatment in proper time, proper food and also with rent, electricity and water bills but I believe God has made me with some good end in mind and is watching over me and the wreckage of my life will be sorted out by him. 

 I want my tangible trace existing after I am gone.

There's really a good chance of getting old with silver hairs if my venerable disease gets an opportunity for good treatment, my potentials are realized and my battle with the selfish people ends.

 I got a new lease of life after my liver transplant and every year I celebrate the day as my survival day. After fifteen surgeries including two cyberknife, and two radiation therapy I feel life is delightful. I was given a one-way ticket to this world but I could have got the life of a vermin- a mere bug being crushed under the feet or not having enough intellect to enjoy the sun poking its adorable head from behind a cloud…the star-studded clear blue night sky… or the grand sound of the thunder and with it the soul waking up or watch the iridescent play of colours of the rainbow.

I might add a finishing touch,

" When you hear hoofbeats think of horses, not zebras" … 

In medicine, the term "zebra" is used in reference to a rare disease or condition. Physicians are taught to assume that the simplest explanation is usually the best so as not to go around diagnosing patients with all sorts of unfamiliar illnesses that are highly unlikely. Common diseases are what doctors should expect to encounter.

Many medics seem to forget" zebras" exist and so getting diagnosis and treatment is difficult for those who have a rare disease.

While spending hours in front of the silvered mirror admiring the scars of a liver transplant, kidney cancer, incisional hernia repair which led to the unfortunate debridement, all I see while looking at myself in the mirror is a strong, fearless, badass Unicorn.

 When life was sliding out of me 

Hope roused the warrior inside me

 And I started my journey

From https://timesofindia.indiatimes.com/blogs/warrior-princess/a-strong-fearless-badass-unicorn/

Vasudev kutumbakam

Thingamajig dryad did gaze the distant moon

puzzling society madeth h'r swoon

oh! well, palmy community

with spunk did face fak'ry

dry-ey'd unruffl'd with a tra-la-la tune!

" Thou ragamuffin! Thou miserable creature!”shriek'd Mr Blessing quite out of breath t'rribly ov'r the phone.

"Vasudev kutumbakam" wast a bawbling group of cater-cousins who  hath believed " the w'rld is one family" and as those gents wend through the w'rld togeth'r, those gents'll standeth by each oth'r and ev'ryone those gents encount'r.

Th're wast a giant involv'd in the writing of an absurd comedy to exciteth the creative side of a man’s nature.  That gent wast a valorous sir who is't but did wish to holp people out of ado and 't wast his proposal to f'rm a group 'long with Madam Cloud.

The oth'rs w're pompous in their vanity icily did scream at the valiant soldi'r like a toad, ugly and venemous w'rds, m'rciless w'rds of disdain.

“Oh, indeed?” was her response. "Thou mayst not knoweth what kind of a mistress i am, i wast b'rn a princess, i am a warri'r princess".

"If thou hast strength, showeth us.  Thou art a spook, a phantom yond's wherefore fate hast hath left thee in darkness"

She  hath trusteth in the blasé lackadaisical fellow whose jointress the lady hadst holp with the doct'r f'r h'r min'r ailment

“Now, dram mite of a mistress, who is't doth thee bethink thou art? a princess?"

"I wast b'rn a princess, a warri'r princess and nobody speaks to me liketh yond, alas thee!"the lady hath said with valour.

Wheezing liketh an acc'rdion, panting f'r breath, coughing up blood because the sinist'r pathogen hadst not only invad'd h'r lungs but did travel to the base'r limbs through the lymph nodes making those folk throb liketh the soundeth of a drumbeat, the lady answ'red: "you bird brain, i am a divinity presiding ov'r f'rests and trees through which i walketh ev'ry day, walking with faith yond i am head'd f'r sunshine. "

But 't wast liketh living with bombs in h'r lungs.  The lady kneweth h'r self-w'rth, the lady hadst no conc'rn f'r mat'rial things but most wondrous inn'r pow'r and strength, the lady wand'r'd high-lone did inspire by mum's mettle without regard f'r circumstances. 

 

the lady wroteth a poem to expresseth h'r battleth,

A warri'r princess i am, 

i wage wars with headeth did hold high, 

a warri'r, nev'r afraid of wounds, 

a warri'r dies dancing that’s who is't i am. 

  

trudging hills nev'r trodden by, 

propell'd into unc'rtain t'rrit'ry, 

soul deeply wound'd by black melancholy, 

nev'r stooping to feareth 'r sentimentality, 

chasing desires, not waiting f'r fate to showeth m'rcy;

flowing f'rth with by fate delighteth in stark reality

Gloom of doom cometh what may;

did banish all w'rries, doubts, 

i hath moved onward in the track valiantly, 

imploding yet ebullient in a spree, 

compound'd difficulties, bitter cold mann'r can’t faze me,

benign friends expresseth f'rvency. 

 content with myst'rious, meaningless, contradict'ry, hostile, 

unexplainably warmeth and giving,

fearfully enclos'd minds,

i hurtl'd the absolute randomness, 

on the v'rge of unc'rtainty.  

 

 proff'r'd relations, friends, unfailing supp'rt,

 bravado, m'rcy, pity, arrogance,

a lon'r did rush f'rth in the path of life. 

 “pretty-nigh impossible!” wast toldeth ad infinitum,

equivalence did seek,

yet situations, reasons, causes remaineth distant,

the exactitude of suff'ring hast nev'r been met'd out to none 

Halt! patience!

i heareth people screameth,

but i'm at a pointeth of nay returneth.  

  

i’m brave, i rave,

grave only at which hour repressed,

cramm'd with mem'ry, hoarding much,

did endure much, weary of wounds,

feelings which hath built up in the war,

harden'd and did die inside,

soul searcheth'r i am,

reality seemeth absurdity,

kind, affectionate friends,

elevate me, eke out positivity

I still dareth to changeth the things i can,

i resuscitate ceaselessly,

i wage wars with v'rve

in a pointeth of nay returneth

aye, a warri'r princess i am. 

 

wild bouts upend'd direction, 

infallible friends f'rm'd mine own legion, 

did march with me without regression, 

did fly fearless without reasoneth, 

melancholy did replace by undying optimism,

did turn to mem'ry,

w'rries did banish, nev'r did look backeth in hist'ry.  

  

prettify, n'r falsify nay one,

those gents art but f'r a season,

gath'r'd to esc'rt the lost one,

by way of cosmic expression,

collective counsel mitigates privation

H're cometh the season

of faces blurring and fading hence

liketh a dreameth, in illusion. 

 

 life: - annus mirabilis!!

 chain'd me in an endless cycleth,

 not unfolding its myst'ry af're. 

 

life is a game of chance;

did grant once;

temp'rary stayeth wag'r'd

to expire, i thus learneth;

ent'ring the reality maketh thee standeth

in a tricky, dang'rous position,

whence, thou art in a pointeth of nay returneth. 

  

thus i welcometh changeth with open arms,

groweth and liveth vibrantly not in a trance,

soul dance​,

immense shall billow liketh a toweth'ring tsunami;

summon up the courage to liveth life once,

regression dishonour eff'rts and maketh those eff'arts undone,

thus i moveth on with fluency

friends not did attack by dubiousness;

tryeth utmost to f'rm a supp'rtive system;

don’t believeth living in ‘jocund company’

dying high-lone in ign'rance;

those gents wanteth to evolve from darkness;

tries revamping mine own life in earnestness;

those gents art not friends f'r a season, but a lifetime,

i hurtle the chaotic reality in their gl'rious presence,

i resuscitate ceaselessly,

wage wars from a pointeth of nay returneth. 

 a warri'r princess, i am

“I am not well: mine own headeth acheth badly.  at which hour the lady did seek supp'rt from the tend'rest one, madam cloud. 

 " O' God, wherefore dost thou, God giveth disease and mis'ry to thy children?" spake madam cloud.

At which hour h'r landl'rd threaten'd to turneth h'r out at which hour the greatest troubleth did creep up and did pause at h'r exit dragging h'r to death the lady did seek the holp of the giant and that gent f'rgot about his big speak of standing by oth'rs, helping those folk through rainy days.

The lady wonneth h'r battleth with canc'r of h'r kidney and brain tumour and hath left in the stipulat'd timeth given by the court but unf'rtunately, the lady's blindeth with the same eye.

The lady hadst the strength to mast'r h'r emotions and f'rge ahead.  The lady wast brave enow to believeth in h'rself and hadst nay feareth to holdeth h'r backeth.  The lady hath found positivity, excit'ment, warmth, vitality out of life while writing this st'ry.