Hello Friends and Family and Interested Persons (and those who are all three!)

Hello Friends and Family and Interested Persons (and those who are all three!)

Today, I am full of thanks.

First, "thanks you" does not come close to the gratitude I have for Jeri in my life. Still, even thought something is obvious, this does not mean it should be unsaid. Jeri has been willing to put her own life on hold, at a particularly precious time for her, in order to devote herself to caring for me. Words fail and I can only hope that the intent is felt.

Next, a big "thank you" to Melissa who has done such a great job with this blog. Melissa is the hereto-unsung hero of my recovery.

Third, another "thank you" to all who have wished me well, made me laugh, included me in your prayers, baked me cookies, cooked us dinner, or simply sent warm healing thoughts my way. All of these have helped me heal and made me feel humble and grateful.

Fourth, a big thanks to the team back at work who have kept me free from "work stress" and especially to Joe who has attended some "fun" meetings on my behalf. A big thanks to my boss, Carol Griffin, who has been an unfailing support throughout this "process." Finally, a big thanks to the entire University of Alaska community who have extended their patience and good-will to me.

All-in-all, I remain thankful that my problems are so minor. This has been one of the most disruptive events of my life. However, I have not lost sight of the fact that it is only pain, and my prognosis for recovery has always been excellent. Not everyone is so fortunate right now.

The road to recovery is two-fold. I need to heal from the surgery and I also need to heal the nerve damage that I've sustained. Neither should be horrid... The surgical healing should be pretty-much complete in a few weeks (just no heavy-anything so I don't re-injure). The nerve healing will be several months (nerves are finicky).

Cheers and best wishes to all,

- Michael

Update from Juneau!!!

There's a scene in the movie State & Main where Alec Baldwin's character, befuddled with drugs and alcohol, crashes his car. Stumbling from the wreckage, he says, "...and that happened."

That's about how it feels to be back home in Juneau right now. We're a little dazed, kind of confused, and not really sure how it's all going to feel tomorrow. We're looking at a fair amount of wreckage: our work lives are in disarray, our various plans and projects and hobbies have been all but forgotten, and our normal routines no longer fit the circumstances. We're trying to figure out what Michael can and cannot do in the ordinary course of events. Prep a salad? Yep. Lift a carton of juice off the top shelf of the fridge? Nope.

For Michael, who was in such extreme pain for so long before the surgery, it's a challenge just to remember that he is post-operative. He tires quickly and tends to overextend himself. Above all, he has to avoid creating strain in his neck that could re-herniate the disk. This means not lifting anything more than 5-10 pounds for the next month or two. Michael is determined to ramp back to normal activity levels while learning to truly listen to what his body is telling him about what he's doing, how he's doing it, and how long he's sustaining the activity. There's a lot of self-awareness and self-discipline to be gained on the road to healing. This process will be gradual, beginning with 10-minute walks two or three times a day. For someone who was planning to run a leg of the Klondike Road Relay in September, this is going to require tremendous patience and dedication.

We are grateful for the support and kindness of our friends & family, for wonderful health care, and for flexible and supportive work environments. We're looking forward to discovering the "new normal" of daily life as quickly as possible.

On the up side, our cat, Chrissy, thinks that all this down time is most excellent. The photo is of Michael kicking back with the kitty in his new "injured Papa" chair.

Recovery Period

Michael spent Wednesday night in the hospital. Once he was in his room at about 8:30 p.m. I was allowed to come see him. His post-surgical pain was under control through medications. More importantly, he was already noticing that the nerve pain in his arm had greatly diminished. To our surprise, Dr. Farrokhi came in to check on him around 9:30 after completing another surgery. We weren't the only ones having a long day! After that, Michael swiftly progressed from juice and water to hot cereal, and was ready to sleep a little. I took a break at our hotel for an hour or so. When I returned to the hospital, the nursing staff brought me bedding and pillows and showed me how to open out the nifty visitor's chair into a cot.

By about 4 a.m. we were touring the ward in between naps. Doing laps in the hallway helped Michael shake the anesthesia and start getting his body functions back in order. In the morning he was assessed by another doctor doing rounds and more or less cleared to leave. What with one thing and another, he didn't actually check out until 4 p.m. Having a full day of post-operative medications, meals, and vital-sign monitoring in the hospital did not seem excessive to me. Considering that his post-operative plan calls for no more than 10 minute walks for a few days, I also appreciated having the hospital staff wheel him out of the hospital, across the street, and to the door of our room at the Baroness.

With Michael settled into our room, my friend Stephanie scooped me up for a brief outing: REI and World Wraps, which we brought back to the hotel for dinner. Michael spent the evening catching up on the Daily Show online.

Our current routine is very familiar: medications to track, broken sleep, periods of time in which things seem nearly normal (in an extremely sedentary way), and setbacks (usually at night) when pain and exhaustion dominate. We are acutely aware that Michael's spine is compromised and will require ongoing mindfulness and care, not just during the 6-month recovery period, but always. The big difference is that there is a very good chance (80-90%) that the impingement on the nerve has been relieved sufficiently that Michael will not be in chronic pain for the long term. If the situation is not resolved to a comfortable level by the 6-month mark, spinal fusion is still an option.

After a follow-up appointment with Dr. Farrokhi on Friday morning, Michael would like to return home. I have not yet made reservations because change fees apply each time we alter our plans. This is both a practical fact and a metaphor. If I've learned nothing else from this experience, I am beginning to limit my investment in a specific course of action. Things change when they change, and life is a lot easier when I don’t have to shed so many expectations before I can adapt.

The morning after...

Jeri called this morning here is the update. They are so very thrilled with the outcome of the surgery. Michael has the feeling in his fingers back and is healing well. The current plan is to get sprung from the hospital this afternoon and then meander back to the Baroness for a few days. Michael has a follow up appointment with Dr. Farrokhi on Friday, any plans to head home will be made then.

Post Surgery Mini-Update (by Mel)

Jeri just called, Michael is out of surgery and doing fine. 90% chance that this surgery will be all he needs to get better. He is going to spend the night at the Hospital since they started so late.

There will be a longer update on status soon.

Update Pre-Surgery (from Jeri)

We're hanging out in our room at the Baroness, waiting for the pager to go off and summon us across the street to Virginia Mason. They're obviously running late because Michael's surgery was scheduled for 3:15 Seattle time and they haven't called us yet. Not a problem... we'll wait! I just hope it really happens today. All bets are off after yesterday's chaos. Assuming the surgery takes place today, the earliest we should plan to fly home is Friday. Also, while this is an outpatient surgery, I won't be surprised if they keep him overnight after starting so late in the day.

That's about it for now. I'll send an update tonight if I can.

Everything changes for the better! (From Jeri)

Hi all,

This has been a tumultuous day! We started out confident that Michael was getting surgery in Kirkland on Wednesday. This morning we were told that Dr. Cunningham's office had been unable to book the OR at Evergreen for that date, so we were looking at Wednesday the 24th instead. We did some fast thinking and decided to fly home this evening on our original tickets to await the surgery, barring unforeseen developments. Unforeseen developments arrived promptly at 4:30 p.m. when Dr. Farrokhi said he could get Michael on his schedule for the minimally invasive foramenotomy tomorrow.

So... 3:15 p.m. tomorrow, same procedure, but now with Dr. Farrokhi at Virginia Mason. It's all good! We scrambled to deal with hotels, plane reservations, etc. and now everything is peaceful again. More decisions coming up any time now, of course. In theory we could fly home in a couple of days, assuming no complications. I'm leaving things open-ended until we're through the surgery and immediate post-op period. Meanwhile I am just trying not to get psychic whiplash from all these mid-process reversals.

Thanks, everybody, for your understanding & assistance as we navigate the rapids!

Current Word

Looks like we're flying home tonight after all, UNLESS we come up with a different plan between about 3:00 and 5:00 when we meet with Dr. Farrokhi. Michael can't get into an OR for his surgery until the 24th and there's not much point staying here racking up expenses when we can wait at home. I did tell him that if there's any sign of him deteriorating I am hauling his butt back to Seattle on the first available flight. But anyway... that's the current word.

Sunday in Seattle (From Jeri):

We're glad we decided to hang out quietly at the hotel this weekend. It's been relatively peaceful and restorative. As Michael continues to improve, he is aggressively ramping back on his oral medications. On "Hell Day" (Friday) he consumed an all-time high of 85 mgs of Oxycodone. His total for yesterday was 25 mgs. The addition of Valium to the regimen is creating a little mental confusion, especially in the middle of the night, but has helped ease the intense muscle spasms he's been experiencing.

As mentioned on the Saturday update, there are many unknowns which will not be resolved before tomorrow. Meanwhile we're comfortable and have access to everything we need. We discovered yesterday that our hotel has a quiet little rooftop garden, and we spent the afternoon basking like lizards in the sun. Some people get pasty white when they're injured; Michael is getting a nice George Hamilton tan.

.

What's the What as of Saturday, June 13, 2009

Perspective check: We're so glad it's only a herniated disk and predicted outcomes are good to terrific. I can't imagine how we'd cope with a graver condition. We have had so much help and support in the past two weeks, and are grateful for meals cooked, errands run, rants listened to, messages delivered, work tasks offloaded, prayers offered, doors and hearts opened. In a society that values self-sufficiency above all, we've pretty much decided it's crap: it takes a community to sustain an individual, in good times as well as bad. Thank you so much for being part of our community.

The Lowdown: Yesterday's travel and medical marathon took a lot out of both of us. It was a very hard day for reasons of pain and exhaustion, but we're already seeing the payoff!

• The good news is that Michael slept more last night than he has all week, after getting the steroid injection from Dr. Wen, taking some Valium, and reducing his dosage (amount & frequency) of the nefarious Oxycodone. In fact he is sleeping soundly as I write.

• The better news is that we met Dr. Cunningham, and discussed the pros and cons of the surgical treatment options at length. Dr. Cunningham proposed a minimally invasive foramenectomy and discectomy to decompress the herniated disk. This procedure involves a cervical laminotomy to provide access to the herniation. This access "window" is essentially a foramenectomy.
  

• Spinal fusion remains an option to pursue at a later time if necessary.

• The great news is that Michael is on Dr. Cunningham's schedule to have the discectomy performed next Wednesday at Evergreen Surgery & Physicians Center in Kirkland.

With Dr. Cunningham's enthusiastic support, we will follow through with our plan to meet with Dr. Farrokhi at Virginia Mason on Monday afternoon. We want to approach surgery with a balanced perspective, and were impressed with Dr. Farrokhi's objectivity when we consulted him in February. However, Michael is feeling very good about the surgical option currently on the table, we are already much happier with the short-term pain management that's been prescribed, and unless we encounter serious doubts in our research and consultations, the decision's made.

Update from Michael (FB post):

(answering a question on if there was any good news)

... I suppose the answer would be "yes and no".

The "No" part is that there seems to be a consensus that my condition is now dire enough to require surgery -- no more "alternative therapies" for me!

The good news is that we have found a doctor who works in the same clinic where I received my steroid injection. She specializes in less-invasive methods and I have a surgical alternative to "fusion" scheduled for next week.

Soo.... re-reading my last post, I guess I'm *not* through with alternative therapies. :-)

Status Update - from Jeri (via FB)

4 a.m. wake up after 1:30 bedtime... plane delayed in Juneau due to
server failure... surprisingly comfortable & relaxing flight... Seattle high overcast... checked in at the Inn... watched Michael get a big needle stuck between his vertebrae... talked to a surgeon... did pre-surgery bloodwork... Valium... room service... first square meal of the day at 4 p.m. Now need nap and/or more of Seattle's Best.

Thursday's Update from Jeri:

Today's major stressor was: Hey, you might not be able to get that steroid injection cuz you've been on drugs!

It's my own fault, really. I called Dr. Wen's office to ascertain what Michael could or could not take prior to the procedure. The person I spoke with didn't know whether Dr. Wen even knew Michael was on his schedule, and pointed out that they usually have people off all medications for 4 days prior to the procedure. In my right mind, I might have remembered that Dr. Wen just did a procedure on Michael last week when he'd been taking everything the ER threw at us the previous weekend. I'm not so much in my right mind, at the moment. I also found out that the MRI report had not yet been sent to Dr. Wen's office. They'll need that, most likely. We had a harrowing wait through the morning and into the afternoon before getting the call back: "You're good to go, kiddo!"

I think the hardest thing Michael had to deal with today was me. And the hardest thing I had to deal with today, was me.

Otherwise we just had another:

• gorgeous Juneau day
• outpouring of friendship, support, & caring from our friends, family & coworkers
• round of phone calls & errands
• series of pills, ointments & ice packs

Ellie & Bob set out for Seattle today and called this evening to report sunshine and blue skies. While Michael and I lie low and hope for healing, the two of them will represent the Alaskan branch of the family at my sister's graduation on Sunday... the event we planned our trip around, a month or so back, just before everything went bad in Michael's neck. An interesting coincidence, isn't it?

Daily Report (from Jeri):

Apparently the gods have decided not to test us with two bad days in a row. Wednesday has been gentle enough that both of us were able to prep our UAS budget worksheets for FY2010 and turn them in on time (no guarantees as to accuracy) via email. We somehow rolled another gorgeous Juneau day and Michael spent part of it outside on the massage table. While Ellie made lunch for Michael, I went to Fireweed to receive a much-needed, much-appreciated massage, followed by a yummy chicken satay roll-up from the Thai place downstairs from the clinic. Our house sitter came by this evening to pick up a key. She also introduced us to Ember, her chug (chihuahua-pug mix) puppy. Ember is high on entertainment value! We've just had dinner (Lawrence Lee Oldaker brought us shrimp/crab risotto) and watched an episode of Bones. We're winding down for an early night, other than those pesky intermittent doses of medication and a few million things on my to-do list.

Michael decided last night to stop battling with the idea of trying to get a full night's sleep and surrender to the reality that he's subsisting on catnaps. He set a timer to wake him up at regular intervals so he could move and stretch and try to keep his muscles from locking up. This strategy may have contributed to an easier day. Our other big discovery was ice massage: when his fingers go numb, an ice massage of his neck (where the inflammation originates) quickly restores feeling. He is liking this a lot. http://www.my-physical-therapy-coach.com/ice-massage.html

Tonight, tomorrow, and tomorrow night: then Seattle, and (eventually) resolution.

How is Michael surviving?

Step one: Have a in-house Certified Massage Practitioner.
Step two: Have a prescription for some really strong pain meds
(that barely touch the pain).
Step three: Have ridiculously gorgeous weather to lay in the sun.
and finally,
Step four: Have patience... it can only get better right?

Update from Jeri:

Tuesday was a tough day. We attribute this partly to the after-effects of lying on the MRI table for 1/2 hour on Monday afternoon, and partly on a bad reaction to a sleeping aid. The medicine helped him sleep, but did not help him to loosen up and unclench during the night. It also seems to have caused extreme nausea, a headache, and chills. It was about 2 p.m. before Michael was back to "normal." At that point, it was business as usual: pain, drugs, and conversation (most of it quite lucid). The positive side of all this was that the apparent gravity of the situation promoted a burst of necessary activity and many of the things on Jeri's to-do list have been accomplished. This evening we explored the efficacy of ice massage to reduce inflammation and pain in muscle tissue. Michael approves and Jeri has a new technique to add to her repertoire.

The plan for the near future is:

• fly to Seattle early Friday a.m.
• receive a steroid injection, posterior presentation (the same procedure that was used successfully in February)
• consult with a spinal surgeon specializing in minimally invasive procedures
• spend the weekend in Seattle, lying low and hoping for dramatic improvement
• consult with a neurologist at Virginia Mason on Monday afternoon
• fly home Monday night

However, we are giving serious consideration to staying in Seattle for the duration of this adventure. If surgery is needed, it makes sense to us to undertake it at a major medical center, after taking the opportunity to benefit from several professional perspectives on the current situation. Fortunate souls that we are, we have been offered a place to stay while we are in Seattle. As a way of reducing expense and stress associated with our plan, nothing could do more to help.

Thank you, friends & family, for checking in on us virtually, and for everything you are doing for us "IRL" as they say in the gaming world--In Real Life.

Who needs these kind of options?

With the trip to Seattle only days away, the research goes into the surgery options. I have included descriptions of the two most likely options.

The first option is Anterior cervical discectomy - According to the all knowing internet, this is the most common surgical procedure to treat damaged cervical discs. Here is a link with a cool 3D animated video (Click Here). It does a good job showing what the injury looks like. It is called anterior because the cervical spine is reached through a small cut (incision in medical talk) in the front of the neck (anterior means front).

The second option is Minimally Invasive Surgery - This in done through small incisions (hmmm a bit invasive) and utilizes cameras and high power microscopes. Here is a line to a FAQ on this one. (Click Here).

What is Wrong with Michael???

This blog is to keep the friends and family of Michael informed on his status.

I have been asked to continue posting updates, when I receive them, as a venue to keep everyone informed AND to allow Michael and Jeri to get the word out without having to retell his tale many times each day.

Michael had another MRI today and it was not great. Mike and Jeri are currently scheduled to fly to Seattle on Friday.

The following was written by Michael, on June 4, 2009, explaining what the heck is wrong.

val⋅e⋅tu⋅di⋅nar⋅i⋅an
–noun
1. an invalid.
2. a person who is excessively concerned about his or her poor health or ailments.

Well, a couple folks have asked “what’s up” so I figure I better provide a little more information. If you are not really interested in my weird and wonderful physical ailments, just stop reading now.

As some of you know, I suffered from a herniated disk in my neck earlier this spring. Fortunately, I responded well to a steroid injection in my neck. Since then, I have worked very hard at improving my posture through physical therapy and yoga in order to address the underlying problem.

Unfortunately, I got a kink in my neck about three weeks ago and this has snowballed into a serious problem. I was able to get a spinal steroid injection on Monday, but this did not seem to help much. At present, I am taking very strong pain killers just to “take the edge off” and am finding very little relief. I can’t work and am having a tough time just keeping two coherent thoughts in my head. Fortunately, my boss (the Vice Chancellor) has been very, very understanding and flexible.

Where do things go from here? I have another MRI scheduled on Monday to see how much has changed since January. On Friday, I will be in Seattle for a last-ditch steroid injection attempt. While I am there, I will be investigating if I can be a candidate for less invasive surgical options.

However, I don’t have a lot of time. I am steadily losing muscle function due to the impinged nerve (and the pain is a whole mess o’ fun too!). Consequently, I have scheduled spinal fusion surgery for the 23rd of this month. If any of the other treatments work, I can cancel the surgery; however, unless I get lucky, they will have to fuse several of my vertebrae together to resolve the problem. While I don’t want this, the prognosis is extremely good and I should be pain free (after about two months of recovery).