This is Lumbar Puncture!

If you didn’t notice, and judging by the lack of messages on my answering machine when I got home yesterday, you didn’t, I’ve been lying low at U of M hospital since midday Tuesday. I went to the ER with a massive headache that started early Monday afternoon and hadn’t dissipated at all through the rest of that day and was still prevalent Tuesday morning. I was thinking that is was dealing with a condition that people with SCI get called autonomic dysreflexia, which is a way the body reacts when there is a problem going on below the site of a person’s injury that the person can’t detect because of the injury. Usually, things like sores or ingrown toenails or even something as simple as needing to go to the bathroom will trigger autonomic dysreflexia; and how a person knows they are experiencing it will be headache or elevated blood pressure or even just feeling very flushed.

So, I went into the ER explaining that I had this headache and when I told the doctors that I had just recently returned from Portugal after having my surgery, that’s when things got a little more complicated. I was subjected to the usual testing: vital signs, blood draws, urine samples. The doctors were concerned about a possible infection relating to the surgery, so they wanted to get a lumbar puncture, a procedure I wasn’t thrilled about undergoing. One of the diamond-in-the-rough benefits of a SCI, though, is the overall lack of sensation when experiencing certain medical treatments. Because the spinal tap is performed so low on the back I really couldn’t feel a thing, which I’m assuming is a real plus with that procedure. The results of the spinal tap did show a high white blood cell count in my spinal fluid, so I was admitted overnight to get an MRI and I ended up staying through until Thursday afternoon. I’m being treated for bacterial meningitis, even though none of the cultures came back positive. I guess I have several of the symptoms, but no real evidence of having meningitis.

I’m home now, needing to be hooked up to two different IV antibiotics every twelve hours, which is always a blast. Since I started on the IVs, my headache has gone away and I do feel better, so hopefully this doesn’t set me back any farther.

News Of the Day

It's probably kind of ridiculous that I, of all people, don't have a primary care physician, but I don't. I mean, who goes to the doctor? I never really needed one before my accident, so when it comes to things like getting surgical staples removed those of us without primary care physicians need to go to the urgent care clinic. That means I get to answer questions from befuddled nurses like, “who put the staples in for you?” and “why didn't your doctor take these out?” After establishing the fact that I brought them back as a souvenir from Portugal, where I underwent an experimental surgery, I had the staples removed. Not a very difficult procedure, but just painful enough to make you wince and distract you as you try to keep a count. I think the total was somewhere in the 12 to 15 range. The doctor asked if I wanted to keep them, but I declined.

I've posted pictures in the photo gallery from Portugal, and I added captions to the old ones, but I think the old ones are pretty self-explanatory by now. Most of the pictures are from after my surgery, so you see me in yet another neck brace. I've decided that neck braces are a good way to eliminate a person's photogenic qualities. Hopefully, I'm done having the back of my neck laid open, and having doctors play around with my spinal cord. I think twice is twice is more than enough, so I'm guessing I've used up my quota. Dr. Lima did however save some of my extra olfactory cells, just in case down the line I need some sort of recharge.

By my calculations, I saw about 1.5 km of Lisbon, and that would not have been possible without my parents helping me up and over the uncut curbs and pushing me down the cobblestone sidewalks of the area around hospital. Lisbon was not wheelchair friendly, but I didn't really expect it to be. I'm sure there will be future American patients that go there and come away amazed by how inaccessible Lisbon is, but I think it's important to keep in mind that (a) it's Europe and (b) the city is also hundreds of years old. Those aspects of Lisbon that make it difficult for me to get around—the hills, cobblestone sidewalks, narrow streets, etc.—are also the same things that give the place character and that attract tourists to Lisbon in the first place. People don't travel to New York City to marvel at the wide sidewalks and curb cut outs. It isn't those types of things that attract people to visit place. That's not to say it wouldn't take too much to make it more wheelchair accessible, and maybe as more and more people go there to work with Dr. Lima, improvements will be made. I would definitely go back. It's a pretty place, and the weather this time of year was great compared to how slowly spring comes around in this part of the world. But, if there is ever reason for me to go back to Lisbon, hopefully the improved wheelchair accessibility, or lack thereof, will be a moot point.

For now, I have about a week to rest up until I go down to Rehab Institute of Michigan to meet with Dr. Hinderer about starting their physical therapy program. So until then, I should be around my apartment most of the time if you want to drop me a line.

Coming Home

We’re back, and I’ve regained the reigns on the keyboard. There’s plenty to talk about in terms international experiences, possible recovery outcomes, etc, but for the sake of Carepage posting limitations, I’ll keep it down to today’s travel. We got up in Lisbon at 2:30am local (9:30pm eastern Saturday night), which got us to the airport by 4am. This will be more than a 24-hour day, but my plan is to press on until a typical bedtime here to expedite readjusting the body clock back to where it’s used to be. We made it home Sunday afternoon at about 3:30pm. The travel was relatively easy, just long, as expected. The transfers on and off the planes were fine, and any worries we had about negotiating a cross-airport gate change during a one-hour time window in Amsterdam were put aside with the help we received from the airport staff.

On the way over to Portugal, the woman who sat next to me was very much interested in my surgery and so we talked at length about it and she was very helpful in getting me situated. When I boarded today the man in the window seat next to me was already seated and listening to his iPod. So I figured this would be a run-of-the-mill “you do your thing, I’ll do my thing over here” type flights; which is fine because I was gassed and was completely content on just watching the movies and going to sleep. But, up front before take-off, the flight attendants are constantly coming by and offering passengers stuff - drinks, magazines, snacks. I noticed that the flight attendants all knew this guy’s name. You must have to fly a lot to be recognized by the crew, ask you how you’ve been, etc. One of the crew asked him if he was still in Minneapolis, which kind of explained things as Minneapolis, Detroit, and Amsterdam are all NWA hubs. If this guy did a lot of business travel that could account for the name recognition, but he said that no, he was in LA now.

We started talking because I needed his help setting up the TV screen, so he asked about the movies I watched on the way over, which ones were good, and vice versa. The hilarious thing was that he had an LA celebrity encounter story for several of the stars of the films being shown. He explained how it was so strange that he runs into people like Annette Benning and Warren Beatty trick-or-treating with their kids, that Angelina Jolie lives in his neighborhood, and that he told his wife to keep an eye out for Brad Pitt.

I thought that he must be sort of movie producer or studio executive, but it turned out that he is a TV anchor name Paul Magers (pronounced “Majors”) from KCBS in LA and used to be an anchor in Minneapolis for 20 years. He was in Rome covering the death of the pope for the local LA news. We didn’t talk much about the pope, but I guess his crew spent the entire trip doing live feeds back to LA, so they were in the middle of the night for most of their time there. But here’s what I learned from Anchorman Paul Magers about the pope: (1) he’s not embalmed. Magers said, “He was looking pretty bad by the Friday, sunken cheeks, drooping nose and chin.” (2) the pope literally has no possessions. Magers said, “even his shoes are issued to him from the Vatican.” No word on if they took the shoes back. (3) their crew was setup on the roof of a monastery, and he said they felt bad because in the course of a live newscast, it’s inevitable there will be the occasional problems, and they kept swearing in front of the nuns.

He ended up being pretty cool and very knowledgeable about Michigan in general. He’s a big fan of the Boyne Mountain – Traverse City region. He said if people from northern Minnesota saw some of northern Michigan, they probably wouldn’t think so highly of themselves. I guess he has some golf buddies who went to Michigan State, and he commented on how they were always wearing their green MSU stuff. We talked Michigan football. He asked why Michigan doesn’t go undefeated every year, and I was like, “You’re preaching to the choir, man.” But I told him lately it was the inability to stop mobile quarterbacks. He got a kick out of the fact I told him OSU fans are notoriously hostile to Michigan fans in Columbus, and that they only graduate 40% of their student body (that might be a slight exaggeration).

After we landed in Detroit, as he packed up all his stuff, we're exchanging well wishes, etc., he asked me, “Dan, have you ever seen the group Train, perform?” To which my reply was, “No,” expecting him to suggest I see them in concert, like maybe that was what he was jamming to on his iPod earlier. He then said, “But you know who they are. Seen their videos?” “Yes.” “Well I’ve been trying to think of who you remind me of, and it just dawned on me that I think you look like the lead singer of Train.” I didn't have the heart to tell him I think Train sucks.

When I got home, I tracked him down online, and here’s a link to his video coverage of the pope. The thing is his TV voice is way deeper than his actual speaking voice.

Post-Op Day 7: Dianne writing on Dan's site

Yesterday afternoon, Dan definitely felt stronger. Dan, his mom and dad decided to enjoy the beautiful afternoon here and stroll on down to the Praça Imperial near Dad's hotel. His dad had scouted the area for the most wheelchair accessible sites, and still we found the journey challenging. There are almost no curb cutouts, so we had to lift the chair over curbs or dare the Lisboetas who drive the avenues like it's the Indy 500. Dan endured the bumpy cobblestone sidewalks without pain to his neck and enjoyed seeing some of the statues and buildings that he hadn't had a chance to see since we arrived.

Later, we sat in a café near the park and enjoyed a couple of glasses of cerveja, which is really quite good. As it became time for dinner (7:30 pm), we decided the restaurant there was as easy as any to get a wheelchair into. Dan enjoyed his costeletas de porc as a nice change from fish. By the time we had wheeled him back up the hill to the hospital, we had all had enough of an outing. Dan was doing fine, but his dad had definitely had a workout.
Today, Dan feels good, except for a little low blood pressure upon getting up. Dad says the backs of his legs ache from pushing the chair uphill. Dr. Lima stopped and checked Dan's sense of smell. Dan doesn't think he lost any smell or taste (as they only harvested material from one side of his nose), so one less side-effect to deal with. Dr. Lima also checked his legs, and thinks that the feeling is coming back slowly. We exchanged addresses, phone numbers and e-mail, and Dr. Lima said he will see Dan in Detroit when he comes to visit. He will continue to follow Dan's progress in a long-term study. He gave us the discharge papers for Saturday.
We will actually leave the hospital Sunday morning around 3:30am to be ready for our 6:00 a.m. flight back home. Matt and his family do not fly out until Thursday next week. They were not able to get an earlier flight reasonably, so have decided they will see as much of Lisbon as they can while they're here. We said our good-byes to Dr. Lima, as he hopes to have the day off Saturday and Sunday.
This afternoon, Dan and his dad are outside sitting in the sunshine. It is cool enough today for a light jacket, but we certainly cannot complain about the weather we have had so far. We look forward to seeing you when we get back to Michigan. The libraery is closed on the weekend, so this will be the last posting from Dianne until we return home.
Love to all Dan's family and friends.

Post-Op Day 6: Dianne writing on Dan’s site.

Dan had a couple of tests this morning, but we expect them to come back okay. He had no fever in the night, slept quite well, and is feeling stronger today.

Dan spent some time before we came down here talking with a 38-year-old man from Greece who had been examined by Dr. Lima for surgery later this summer. They had a nice discussion and exchanged e-mail, address and phone numbers. We have met some very nice people here. Everyone (except the banks) has been very helpful and friendly. If you even attempt to speak a little Portuguese, they go out of their way to be nice. Most people (especially under thirty) have very good language skills. We have learned that school children learn French (which is a linguistic cousin of Portuguese) as a second language in 3rd grade, and add English later. When you ask, "Do you speak English?" most people say, "A leetle bit." Then they proceed to astonish us with their language skills, even in fairly technical word areas. It's embarrassing not to be able to respond even a tenth as well in their language, but they seem to appreciate that we try. As long as we don't speak Spanish to them, they seem happy.
Weather here is beautiful. The weather forecast shows rain and snow in northern Europe, including Paris, as well as British Isles, but southern Spain and Portugal and supposed to be warm and dry throughout the rest of the week. We plan to take Dan out to the nearby neighborhood this afternoon, so the sunshine is appreciated, thank you very much.
Well, Dan's dad went up to the hospital room to get his camera. He wants to photograph Daniel doing his e-mail and show folks back home this hospital library. They do a lot with few Euros. It isn't University of Michigan, that's for sure.
Thanks to all of you for your messages. We get a kick out of hearing from you, because it's hard to get much American news at our hotels and on TV here at hospital. We have to go online to find out sports news, for example. Dan was pleased to know the Tigers won their first game.