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Left Foot Dragging

also Two Week Checkup and One Month Checkup

Ed had complained Monday to his doctor about his left foot dragging - his left leg was *really weak* - and his left hand couldn't find the keys on the keyboard. A series of tests were scheduled - "Blood work" Tuesday, Doppler Ultrasound Wednesday, CT Scan Thursday, neurologist Friday, ...
Dr. Lym at work ;-))

Thursday, May 22, 2009, Ed went to Kaiser for the scheduled CT Scan, and at the conclusion was escorted to the Emergency Room, where the radiologist showed images representing a pancake volume of blood in the right hand section of Ed's thick skull pressing his brain into the other section.

Something about Subdural hematoma. I couldn't remember any blows to my head, usually considered a cause. They also asked if I was in an abusive situation at home. I did mention I was married, and everyone nodded knowingly ;-))

A room was sought in Kaiser Redwood City which has a neurological surgical section. After a room was secured, he was transported - no sirens :-(( - to that facility to await surgery.

There was a complication - Ed had been taking baby quantities of aspirin "for his heart" at his doctor's suggestion.
Surgeons hate aspirin as the blood coagulating platelets are largely disabled with aspirin on their surfaces, and surgical patients tend to bleed a lot more. Ed was given a bag of donated platelets (which looked like a bag of honey. The surgeons were still not happy (it takes about 5 days for aspirin levels in a body to decrease to a level more pleasing to surgeons :-))

After a day of pondering, the pros and cons of further delay were weighed, and impetuous Ed voted to get operated on "right now". ( Friday night. ) Unfortunately I do not remember any sawing or drilling noises - I don't even know the size of hole that was presumably made :-((
     (When questioned later, Dr. Caroline von Koch said that the hole is was either 7 or 9 mm, and there is a titanium patch or plug to keep my skin from sagging in.)

Saturday, various family members arrived to "visit" :-)) i.e. make rude remarks :-(( They remembered that one of my favorite expressions was "I need that like a hole in the head". Owing to various political differences - they had long suspected I was trying to conceal an extra hole -
These photos have been placed in the "Public Domain" by one of my sons, Randy Thelen, stating "If you can make a buck on 'em, be my guest!!"
Note red droplets in drain tube

Metal Staples???
Gina Thelen, a daughter-in-law, found a Phrenological Chart, and had visitors comment. Someone noted the hole was over "agreeableness".
I wonder what was meant?

My tormentor
During all of the above, I was tethered to an I-V bag and a "Baxter Colleague Single Channel" I-V pump. - The I-V pump was a cantankerous tan box with a slot for the I-V tube. It likely had some roller that would move the fluid along, it did have a little tube pincher thing that pinched the tube during part of the cycle. It was very sensitive to blockages of the tube (by say bending it sharply) and to air bubbles in the tube. It had a red light that flashed and a little horn that would wake a nurse in the hallway (and me) if the slightest problem, like me bending the arm that had the I-V inserted. Getting a good night's sleep with that contraption was impossible -

It also complains loudly if it has been unplugged for a while (low battery), say after un-plugging it to go for a walkaround - like going to the potty.

All of a sudden I (and wife Betty who was staying in the room) would be blasted out of sleep by that blasted machine complaining - usually of me bending my arm during sleep.
     And every two hours, day and night, somebody woke me up to check my "vital signs" :-((
By the time I was leaving the hospital I was a sleep deprived old grouch !! Betty and I were "stir crazy".

Good News -
     Ed can now walk relatively normally again :-))
     - I continue to like Kaiser care :-))

Bad News -
     - Ed's left hand can now touch type again ;-))

Conclusion -
     Ed has developed a hatred of standard hospital practice of restraining their patients by use of the ever present, ever connected I-V bag. He now considers it a not so veiled method of restraining unruly patients. Say that "George" wants to corner some cute nurse - that is very difficult to do while dragging the I-V stand, pump box, and connecting tubes. (Ed had previously thought I-V bags were a profit center, as his local tax supported Washington Hospital charges 75-1 mark-up per bag, not including the installation charges.) A Tale of a Hospital "Visit"

Epilog - day 13 after Subdural Hematoma drain

The stitch and staples were to be removed at Fremont Surgical Center Friday morning June 5, 2009. Mr. Sean Kennedy, PA-C, Physician Assistant, greeted me.

13 days after the "procedure". Uneventful. I have worn a shower cap to prevent soaking. The 1401 gang (and I) have been more than curious how to get those steel staples out of my scalp. - Here is the tool and a close up view of the jaws. The middle jaw goes between the two outer jaws.
The game is to bend the visible part of the staple back, backing the prongs of the staple right out of ( my ) scalp. I have been assured by the 1401 gang that this is no problem - painless. :-| So the Physician's Assistant "Prepared the Surface" (patted on some fluid)- and goes to work. Oddly I feel almost nothing - there must have been a topical anesthetic in the "surface preparation".
After an amazingly short time, (? three minutes? ) the staples were out and the stitch sniped and pulled He dabbed my scalp with hydrogen peroxide (no feeling) and said he was done. I asked if I could have the "Extractor", "Sure, we just throw it away anyway Really?? Don't you sterilize and re-use it?? No - less expensive to use a new one next time.
He also gave me the used "Suture Removal Set", none of which is re-used. The little plastic sleeves protect the soft world from the sharp points. He did not use these particular items in the removal.

One Month Check-up

Life has been pretty normal (for me) since the staples have been removed. Slight itching of the "wound", and chunks of red scab (resembling short red worms) have been very loose and I pulled 'em off.

So - on June 25, 2009, I went to the One Month Check-up with utter confidence in a receiving good report. The surgeon, Dr. Caroline von Koch, viewed the CT scan taken a few minutes before,

extra hole?


Sorry, I forgot which was which. She said the fluid got lighter? darker? with time.
and said the result was normal. She asked detailed questions about headaches, weakness, nausea, blackouts, ... , and I reported negative on all above. :-))

She showed me that there was still "fluid" pressing on one hemisphere of my brain, but the it appeared to be less - and she hoped it would be naturally absorbed by my body. She said that there was no evidence of recent leakage.

She scheduled another CT Scan and appointment in a month to track the situation.

She somewhat apologized that there was still "fluid" pressing on my brain. She said that a more complete flushing and drainage could be accomplished by using two or more hole in the skull, but usually that is not necessary. Also sometimes people need two or more operations to get rid of neurological symptoms.

Two Month Check-up

A little new leakage noted in the CT scan -
     Scheduled another scan in two weeks

Two Month + Two Week Check-up

No new leakage, size of old blood decreasing :-))

Various "friends" have sent references to other trepanation operations - including

I wonder what if anything was used as an antiseptic and an anesthetic

Maybe they want to keep me humble ??

trepanation in ancient Peru

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