Friday, November 06, 2009

The Year in Jim: Epilogue

"If I wasn't done before, I'm done now."

In the finals of the Grand Masters tournament in July, Alex caught a swing pass near the sideline. I was about 10 yards in front of him, being fronted, so I faked a step in and bolted long as he hucked the backhand. Because of the thin air or his poor touch, I had to keep chasing after it and laid out for it. I caught it a split-second after it hit the ground and put it down*. But as I got to my feet, I noticed that both of my arms were tingling.

* - I knew it was down and never considered calling it up, but I somehow had time to turn around and notice my defender pointing down before I did anything with the disc. Maybe I was paying attention to my hands. I later asked the observer whether he would have called it up, just to see what he said. He said it was down, but maybe he was just covering for himself.

At Regionals, down 6-4, we had turned it and I noticed DJ of GLUM was looking to throw it into the endzone, so I dropped off my guy. He threw it, and I had to take an awkward angle to the disc to try to block it. I missed and ended up hitting the ground. Once again, my arms were tingling, and I headed to the sideline for a break.

Around the same time, a similar feeling happened when I landed funny playing basketball. In all these cases, there was a sharp hit and an immediate sensation which began dissipating immediately and within about a minute I was back to normal.

Then at Nationals, it happened at least three times, but this time I didn't have the sharp hit. Once, I simply reached out suddenly to try to block a throw, and twice, I was simply running hard. The last time, my last point, I was sprinting to make a jumping bid at a block, but as I swing my arm down to jump up, my arm isn't responding right, and I am unable to jump. By this time even _I_ have become a little suspicious of what's going on (unless it's debilitating, I generally don't seek medical advice; even for nagging injuries, I don't do a whole lot except for occasional ice and ibuprofen and maybe rest; I considered it a major step this year when I bought several pairs of new shoes to combat nascent plantar fasciitis). I mention this to a few people over the next few hours, and tentatively make plans to see a doctor when I get back, when I get around to it.

That night, I end up at the beach after the bars close, and I'm standing next to Alex, no doubt spewing about something. Two of our friends see us and decide it'd be funny to tackle us (and I have to agree with that), so they rocham to see who gets whom and charge us. I see tje charge at the last second but can't prevent it and end up flat on my back. However, my legs immediately feel very heavy, and I realize that I can't get up. As soon as I am aware of it, I try to wiggle my toes and find that I can, and then I begin the struggle to get up. I can finally move my arms and legs after maybe a minute but it's like pins and needles, times 100. I can sit up a little bit, and can sorta flop my arm over. It takes me probably five minutes before I am able to stand under my own power. Never in this time range did I have any change in mental faculties, no shortness of breath or seeing stars (well, I guess I could see stars since we were outside and it was a clear night). Eventually I'm ok, and fortunately someone finds a doctor in the group and he interviews me and determines that I'm not in any imminent danger of paralysis or death, but that I really need to see someone as soon as I get back.

Over the next day and a half, I'm sore, though not appreciably sorer than I would be any other year, and my arms and legs feel a little weak. Additionally, my arms feel a little weird. I have a little trouble sleeping so take some ibuprofen.

I go to my PCP on Monday afternoon and describe my symptoms, she calls a specialist to discuss, and they set me up with X-Rays and an MRI. Within an hour of the MRI, I get a call at my house suggesting that I should probably go to the ER this evening instead of waiting until the morning, since the doctor would "hate to see a young guy like me paralyzed." (He quickly added that he'd hate to see any age person paralyzed.) We arrange for the boy to have a sleepover, and get to the ER at about 8. Now, I didn't really think there was any imminent danger, and they didn't whisk me to the front of the line, but they put me in an uncomfortable neck brace and make me lie down, where I stay for the next 8 hours or so. I tell them I had an MRI at another hospital, but when they finally see me four or five hours later, they ask me if I have the MRI. My wife has to then drive to the other hospital to get a CD of it (they don't share information electronically) so they can look at it. The resident on call is somewhat apologetic but otherwise the staff isn't all that attentive or sensitive to the fears of this patient. I eventually see a neurologist at about 2 or 3 in the morning (or was it 1?), and he's half-asleep. (The reason I was directed to this hospital was that the other one didn't have a neuro staff working.) After looking at the MRI, he tells me I can go home but they'll give me some steroids or other anti-inflammatory to reduce the swelling in my spinal cord. He goes off to ask his "spine guy", and comes back and says in a monotone, "Our spine guy got kinda excited when I said I was sending you home." "Is that excited happy or excited agitated?" I reply. "Yeah, he wants you to stay here tonight. How are you with that?" What do you think, bucko? Oh, after he leaves, the nurse comes back and says, "So, you'll be having surgery in a day or two, is that right?" Huh, how about that.

In another hour or two, I get some more X-rays and then get ushered upstairs to a room, where they finally remove that cursed neck brace and I can get to sleep for a bunch of hours. I get woken up at about 9:30 and am told that they are scheduling a CT scan as soon as they can. Around 2 they come in and tell me that it will be at 4. At 4 I am picked up and taken to the CT area, where I am propped up without a word for about 40 minutes. Finally I get taken in, the tech apologizes and says an emergency had to get screened, I jokingly say "but I was here first", and we get the CT scan done. Unfortunately, the "team" doesn't have time to look at it before their shift is over, and I have to hang out until "first thing in the morning" to get the results.

At about 10, I'm told by a nurse practitioner who is trying to make me think she's a doctor that they'll be letting me out that afternoon but that I'll need surgery and that the attending neuro will talk to me after he's out of surgery at 1 or so. At around 3, after hearing nothing, I'm a little upset at the lack of attention. In 36 hours of an expensive hospital stay, I've had 10 minutes of diagnostics, 5 minutes of an NP, a bunch of vital signs readings (I made a control chart of my pulse rate), and a whole lot of waiting. Luckily I have my laptop and there is wi-fi, so I am able to keep in touch with the team and let them know what is going on, and my wife has spent a lot of time at the hospital with me, though she was also trying to do work. It's just annoying that they tell me so little and leave me waiting for long periods of time past when they said they would do something. I called the patients advocate line to pre-complain about my bill and the lack of attention, and I almost never bring my complaints to the authorities, generally just keeping them to those within earshot.

Finally, sometime after 4, the team (attending, sleepy doc, and NP) comes in, and I learn that I have two of my neck vertebrae compressed against each other and there are spurs and there is some impingment on my narrow spinal column. The fluid that I thought I heard the MRI guy say was there is not there, but there is swelling, which will have to subside over the next few weeks prior to doing anything. I'm lucky that I'm not paralyzed, I'm told. I ask whether that's "lucky like there was a chance that I could have been paralyzed, or lucky like 'I'm surprised you're NOT paralyzed'", but the attending doesn't seem to understand my question, as he apparently has not been briefed on how to handle levity. (The nurses who frequently came in were personable.) There is no fracture, I'm stable, I'm in no immediate danger, but I'll need a laminectomy. I'm confused about a lot of it but he is staring so sullenly I don't know what to ask. They write nothing down and discharge me with instructions to wear a (more comfortable but still not fun) neck brace and take the OTC medicine of my choice for pain and schedule a surgery consult for the next week or two, which apparently gets scheduled for December 8 without telling us.

There is a wide enough range of outcomes per teh Interwebs that I can't tell what to expect from post-surgery without more detailed knowledge of my specifics. I have the MRI and CT Scan and have sent out copies to a neuroradiologist friend who will share it with his colleagues, and I'm going to get a second opinion. I think there's a good chance I've played my last competitive ultimate game, and I can live with that, but I'll be really disappointed if I can't golf or play softball (not to mention what would happen if I get another traumatic hit prior to surgery and end up paralyzed).

Ooh, I get shivers just typing that sentence.

27 comments:

Phil said...

You know you're old when you find yourself saying "I think there's a good chance I've played my last competitive ultimate game, and I can live with that, but I'll be really disappointed if I can't golf or play softball." Of course, by this standard I was old seven years ago.

I don't care what other people say, I, for one, am glad you aren't paralyzed.

As for the medical care stuff, according to the Republicans we have the best medical care in the world, and if you lived anywhere else the care would have been even worse and you would have had to wait even longer for it. So, count yourself lucky to live in the U.S. of A. Yessir.

Seriously, this is a really sobering story, must have been quite an ordeal for you and Jackie. I'm glad it looks like it will work out OK. FWIW, my dad had similar surgery a few years ago, and other than not being able to tilt his head back as far as he used to, he's generally fine; he plays volleyball and softball, and jogs and bikes. But of course, he does all of these at the intensity of a healthy 75-year-old, not a 45-year-old. Point is, though, you might not be as restricted as you fear. Good luck.

Aaron said...

If possible post how the next month goes.

Wish you the best.

-Aaron

Jim Biancolo said...

What a nightmare! I'm sorry you went through all that, and still have more to go. Best wishes for a successful surgery. I'm going to hope for more Ultimate out of you, but golf/softball will do at a minimum. Good luck!

Anonymous said...

Needless to say, I'm bummed to hear about this, we are glad everything will to hear everything will turn out alright. and yes, thank god you are in the U.S. of A. :)

$

dix said...

wow, I bet now the guy who won the rosham and got to tackle Alex is relieved.

That's pretty scary. Best wishes for a full recovery.

dix

Robin said...

Hi Jim, have been a long time fan and appreciate all that you have done for the sport of ultimate. Really sorry to hear about your situation. I wish you all the best and for the best possible recovery. Thanks for sharing all that you've shared over the years.

Vector said...

Jim,
The guy who shared a Surly with you and Alex after the semifinals is a trauma radiologist and your story scared the crap out of him! It's me. You will be in my thoughts and (for what it's worth) prayers until you report on your recovery from surgery. If you need a third opinion, I know where you can get it. Your neuroradiologist friend is definitely qualified though!

Tony
Surly #5

dp said...

JIm - Horrible news, thoughts and prayers from the Powers family. No wonder malpractice insurance is so high, sounds like you we're treated by a bunch of idiots. Hope the 2nd opinions go well, and I hope everything else that happens as a result of that go well too.

dp

Anonymous said...

Hi Jim,

Sorry to hear about your trouble. Who hasent felt a bit of tingling after a fall (lay out) or a blow? As I understand it is a standard operation and I am sure you will be fine. I wish you luck and speedy recovery.

Regards,

Carsten (also 45)

parinella said...

Phil,
Maybe I had some unrealistic expectations of the wait times. I didn't have a problem with the wait in the ER. I can understand the wait for the CT scan, but I didn't like the lack of information for the whole experience. Sure, if the doctors had to babysit every last whiner, costs would be even worse. But patients would be more satisfied and there'd be fewer malpractice cases.

There were a couple political comments on the DoG email list in response to my updates. Also got "Do they suspect your swollen head has finally put too much pressure on your spine?" Ah, love those guys.

Tony, thanks for the beer and the offer. I hope to be back out quaffing a few more.

Carsten, that's what I thought, too, which is why I never saw anyone after the first three. Episodes 4-6, however, and definitely Episode 7 were a little more cause for alarm.

I don't think I'll have much of an update for a few weeks. Thanks for your concern, folks.

luke said...

wow!
that is a clffhanger.
good luck with the surgery and here's to a speedy recovery.
best wishes jim.
luke.

parinella said...

Here's the summary report for the MRI:
Seven views demostrate normal bony mineralization and alignment. There is moderate narrowing of the C5-C6 intervertebral disc space and mild narrowing of the C4-C5 and C6-C7 intervertebral disc spaces with endplate sclerosis and osteophytes. There is probablymild narrowing of the C3-C4 intervertebral disc space, as well. No fracture or subluxation is seen. THe prevertebral soft tissues are within normal limits. There is mild to moderate narrowing of the C3-C7 neuroforamina secondary to uncovertebral and facet hypertrophy and apparent congenital narrowing of the neuroforamina.
Impression:
1. No acute abnormality of cervical spine.
2. Cervical spondylosis, facet osteoarthritis and neural foraminal narrowing, as described.

Martin said...

Jim, I'm sorry to hear about your predicament. Your last comment was totally lost on my non-medical brain (like most Mechanical Engineers I believe we all work on gears, springs and dampers). I'm going to assume that it was all good news and hope that your surgery goes well.

You've been a pleasure to watch play, and although I've never gotten to meet you personally I love everything you bring to our coaching blog and the ultimate community in general. Please keep us updated. Best wishes.

Martin
Rival #47

luke said...

jim, Cervical spondylosis sounds like the 'interesting' aspect... and i'm using what passes for doctor speech. are you saying that you do or do not need surgery? are they just telling you to stop laying out? or rest and rehab? and i'm sorry your medical experience was less than ideal: i don't think it's either a positive or a negative on the american health system. it sounds like you were given what passes for good care, albeit with a typical level of lack of bedside manner. my dad is a doc, and my 'educated' opinion is that the higher you climb on the tree of specialization, the worse bedside manner gets, without necessarily affecting care. I hope that you have gotten good care, and I'm sure that you will receive excellent care in what must be a rather trying time, regardless of your expected sardonic wit.
luke.

Adam said...

Jim - I'll be thinking of you and hope that all goes well. Let me know if you need anything, and I'll be happy to encourage Marshall to do it (or, alternately, I'd even do it myself)...

-a

Fryjol said...

You have been a great help for many of us, I respect your work both as a player and as a writer. Even more important than going back to the fields is getting well. I´m sure you will.

I´m sure that I can say in behalf of my "80 people/4 squads" team from Ibague, Colombia that we are whishing you the best

parinella said...

Update from NP (not really an update so much as getting info I should have had last week):
They still really suggest surgery, saying that without it I would be at constant risk.
Surgery would be a laminectomy without fusion. They make an incision in the back of the neck, cut the ligaments, then scrape away some of the wall or roof of the vertebrae to give more roof. While they're there, they free up any nerves that are being squished. 1-2 days in hospital, about 2 weeks off work, mostly for pain management, 6 weeks until strenuous activity (I suppose I could play and handle), eventually back to normal (though I suppose there is still some risk due to the narrow spinal column). No brace required post-surgery. Some of the generic descriptions of laminectomy had a worse recovery process.

Still need to schedule second opinion. One recommended surgeon is out-of-network so I'd need to see what coverage is provided.

Thanks again to everyone for your concern.

geofford said...

Wow, Jim.

Wishing you all the best for a full recovery. A pleasure to have shared the field with you, Doctor.

geofford.
GLUM #18

AMC said...

sounds like you'll be good to go for Kaimana & Paga! Sweet. Perfect timing. love the comment you got about the swelled head...hahaha.

Leonardo said...

Last game of ultimate, pshaw! You could even go Paga style again in '10. Sand is so much softer, isn't it? Just _be careful_ with that swollen head problem.

TL

Anonymous said...

Hey Jim,

just read your blog. Wow...now that is something unexpected. Good thing we didn't tabletop you this year at Paga;-)

Man, I wish you all the best and my thoughts are with you and your family.

Lots of good vibes from Munich
Jens

Andyg said...

Hey Jim, sounds like you've dodged the bullet. I guess listening to your body is a really good idea.

Pretty ironic looking back on our conversation in FL. Great to hear that now we are just talking about treatments, surgeries and second opinions. Amazing a prank was able to be an alarm that got you to the doctor and on your way to recovery. It's crazy how one moment can change so much.

Good luck with the process, you have our thoughts and prayers for a speedy and successful recovery.

Andy

parinella said...

I really don't know what might have happened had it not been for the prank. I could imagine a worst case of diving in the water and going numb and not being able to get myself up. We can't tell for sure, but it's probably likely that the next big trauma or the one after that might have caused something bad. I know that almost everyone would have gone after the succession of minor incidents, and some hypochondriacs would have gone after the first one, but I could also picture putting off the appointment until "later". In fact, when I called one of the spine surgeons for a second opinion, they pencilled me in for June 8, pending further results that would merit a sooner review.

If I'm healed enough to go scuba diving and snorkeling, I would consider Kaimana, even if I couldn't play (much?). There is that danger, though, of falling down while walking from the party back to the beach. Always that danger.

Justin said...

Hey Jim,

Man that sounds really scary. Paralysis is one of those recurring nightmares for me (I bet for lots of folks). Here's hoping the surgery exceeds expectations and we see you running around in Hawaii.

All the Best,

-safD

creative anomaly said...

good luck, jim! all the best, and a speedy recovery. i'd hate to stop getting schooled by you in the occasional tournament.

adam

Anonymous said...

I wish you a healthy, quick, and full recovery.

Sincerely,
Karen

Felix said...

All the best for a full recovery, Jim. Hope to see you at Paga again this year.

Felix