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Brain Surgery – Part One

While immersed in a fog of anesthesia, I was concerned I might awake from my brain surgery looking a little like Frankenstein; perhaps scaring small children and whole villages. After all, they had drilled two holes into my skull to insert wires that could resemble horns. Instead, I was greeted by smiling family and friends who calmed my fears, and I began the recovery process fairly perky. I knew in advance that I would have two electrodes inserted in my brain with some sort of device holding each one in place. Fortunately they are fairly flat as opposed to the horns that were used some years back, so I avoided the old fashioned protruding plugs that looked as though they could be attached to jumper cables. If you look at the stitches on my bald head, some old guy could take it that I was a diehard fan of the Baltimore Colts (not Indianapolis) or I was kicked in the head by a small donkey.

I was also pleased they didn’t completely shave my head. They kindly left a mullet in the back. My first request after waking up was for a Dr. Pepper and grits.

I wondered what I would say in this blog after the surgery. It turns out this experience was extremely personal and emotional.

The first surgery seemed to be a success in the eyes of my family. My wife, my daughter and her husband, as well as the four grandchildren came to Portland to support me. My wife was extraordinarily calm while keeping fear and happiness in balance. During her career she was a professional actress and an extraordinary Professor of Marketing, and she balanced the “show must go on” attitude with realistic expectations. She knew the surgery was technically successful , and that a positive attitude is crucial in these situations. You could see her resolve.

My daughter had put together a blog called “Den’s brain blog” to keep all our friends updated on my status. The thousand plus hits it received where wonderfully supportive, and I recommend this kind of communication to anyone in my situation.

My son-in-law had brought the grandchildren along because he had an instinct that family learning came from actual life experience. He has a “I’ve got your back, no problem” attitude built firmly on his Swiss and Italian origins.

The grandchildren were amazing. Perfect for their ages ranging from 4 to 12. The four-year-old girl had worked on a whole routine of cute that would make Shirley Temple update her script. She charmed me.

The seven-year-old boy described in detail his version of the surgery, and how I came to look “wacky”.

The 10-year-old girl gave me tender hugs and the sense that the kind of confidence that she brought to her gymnastics was the therapy I needed.. I was ready to team up, but no balance beam. I immediately felt stronger.

The eldest, a 12-year-old girl, an artist at heart, stood slightly apart.  I could see her quiver under her perfect straw hat with a blue bow and simple beautiful summer dress, nearly tearing, but smiling so broadly that she glowed. She came over and gave me a tender kiss as I said “I’ll be okay”.

“I know, but it’s still scary”.  She knew enough to see danger but flew on the wings of the miracle. Like daughter and mother before her she was developing the capacity to take reality and find the part that carries inspiration, and not just the challenge of the day. I was inspired.

Inspired, strengthened, charmed, protected, not overwhelmed and with the love and strength of my life partner I emerged from the fog ready for the next phase; recovery.

I also thought carefully about what was coming next. The miracle begins with the people who created the technology and imagined a better way to do this procedure. They imagined doing the procedure while the patient was asleep, an amazing progression in the process. Secondly, they created a mechanism where the precision of placement of the electronic probes could be virtually exact. Finally, they lowered the probabilities of infection and bleeding as well as stroke. These are not discrete or mutually exclusive goals. Pursuing them all at once improves each. The technology developed is extraordinarily refined. I don’t presume to know how it all works but as I rolled into the operating room I was overwhelmed by the number of people there for this event and the interactive complexity of the systems. Crucial to this process is something called CERETOM, a device that allows real-time CAT scan imagery to be integrated with an MRI creating a three-dimensional virtual GPS location target while facilitating insertion of the electronic device in one attempt. This allows the patient to be asleep instead of awake trying to evaluate effects from various placements. To be able to sleep through this was a blessing and I raise a toast of good Irish whiskey to all those who preceded me in this procedure who were awake. I pay homage to your courage and fortitude.

My friends supported me in many ways by supporting my wife and family by simply “being there virtually” on the day of the surgery. I remember vividly a stalwart friend visiting me in the fog of recovery looking about in amazement at the technological apparatus monitoring my existence. He was there through the fog, and that counts. I believe, for example, if you speak someone’s name who you care for they reappear for a moment. I believe that positive thoughts are cumulative and their force can challenge negative outcomes for dominance. No guarantees, but possibilities can be imagined that outnumber a limited range of outcomes. Enough on the supernatural.

The real challenge arises when you have to deal with the unintended consequences of all this technology. When you are so closely monitored chaos can erupt. There should be a way to notify the attending nurse and/or a backup when your blood pressure rises, heart rate falls, IV comes out, or you shift in bed without alarming the entire ICU. The problem, of course, is lost sleep. Sleep is very likely a major component of the healing process. This is a problem that appears to be universal in ICUs around the country. Here a little patient centered focus would be appropriate.

If you think immigration is a bad idea please don’t get sick. Nursing care is an international phenomenon and the quality is outstanding. If you think that there is a way to find the perfect economy by relying solely on the private sector or the public sector I also suggest that you do not get sick. It is obvious when you are in the bowels of the hospital that the public and private sector work together to provide the research and resources to make DBS “brain surgery” possible. My friend was observing the remarkable technology resulting from the partnership. This technology is specific enough to keep me alive, and general enough to save lives in dire emergencies. Sometimes clarity comes not from imaginary experience but from the real thing.

The learning curve is high and steep in hospitals. It is overcome by the merging of data in modern hospitals. I wound up in the hospital an additional day because of negative response to anesthesia. By the second surgery the staff had worked through the problem and found a solution. I certainly never felt like a number but a living breathing patient. The second surgery is where they attach the electronic probes to wires and the control mechanism. The wires are inserted and “snaked” under your skin down to the shoulder blade and the control device is placed under the skin just below the shoulder blade. It is a bit lumpy when completed but who has no lumps at 67. Today this is completed so efficiently that it is an outpatient procedure. There are no unexplained lumps so the surgeons must have packed out what they packed in leaving only what they intended.

My nephew came from Texas to help me and his aunt deal with the second surgery and the trip home. He never commented on “the mullet” hairdo despite being from Texas, and began working on my golf grip as he wheeled me around town. Just what I needed; someone who was looking past the present that could be altered by my loyal barber in seconds while pointing toward the future dealing with the fact that I had nearly lost my grip.

As we lifted off and went back to Montana I was able to note how many people whom I had never met took time out from their BIZZY LIFE to wish me well. Every good thought counts.

In my next entry I will report on is the activation of the system. The neurologists wait roughly a month after the surgery to make sure there’s no rejection of the devices or infections before they actually turn it on. I’m not sure that at point whether I become a cyborg or just bionic but at least I’m not Frankenstein the economist. More than children and villages that would seem at least to scare small countries.

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One Response to Brain Surgery – Part One

  1. Tom Anderson says:

    Thank you, Dennis! I did not know about this blog until your recent email. It ‘s hopeful and inspiring. I wish you all the best.

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