C1: COOKING AND TALKING ARE BAD FOR YOU

 

First published: 29 Dec 2016

There you have it: confirmation that cooking and talking at the same time are bad for you.

That’s what I was doing in my mother’s kitchen when I heard a loud, sharp, high-pitched sound, somewhat like a gunshot. The sensation told me my neck had cracked but there was no pain, simply a sensation of spinal re-alignment. Little did I know at that point that the crack was, in fact, not a chiropractic-induced ‘crack’, but a double structural break; fractures; a broken neck. And I was literally standing and talking. Not jumping around or demonstrating Regan’s Exorcistic head-spinning, but simply standing watching a pan of mince hot-pot, merrily bubble it’s way to goodness and gently commenting on the state of the world and it’s wife.

It took me three days to have the diagnosis, so let’s backtrack a bit and explain some perspective.

I know I’ve been a pain in the neck for many, many years but I’ve actually had a pain in the neck for seven months.

I’ve had multitudes of physio treatments both in Bali and in India but nothing solved the problem. I put it down to my chronic troubles which traditionally have been temporarily solved by the witchcraft of chiropractic but I haven’t been able to find one in India and they are now illegal in Bali because some charlatan Australians (no surprise there, then) misused their manipulative powers and imposed catastrophic damage.

In mid-to-late November I succumbed to an MRI scan (Magnetic Resonance Imaging) which found “a homogenous mildly expansile osteolytic lesion”. I was pretty sure this could be described as “a lump”. It was 1.3 x 3.2 x 2.2 cm up, down and across and there was a “mild associated soft tissue which bulges into the spinal canal without causing significant stenosis of cord compression.” I guessed that that confirmed my perception that it was not pressing on my spinal cord. No tingling, no numbness; air-piano still exceptional and wiggly-toe dancing no problem at all.

Also, “a small posterior protrusion” was seen in C2-C3 disc “without causing canal or foraminal stenosis.” That explained the chronic cervical problems over many years, none of which appeared to be more than an irritating discomfort.

So, the next obvious thing was a biopsy to check whether the lump was naughty or nice. I was traveling job-wise till 1 December then went to Bali where my doctor opined that it may not be straightforward because it was close to the spinal column so I then saw a neurosurgeon guy on the 14th December after my return to Mumbai. He advised a whole body PET scan (Positron Emission Tomography) to see if there was any other hidden treasure anywhere which could be biopsied much easier. That happened on the 15th. I was injected with radioactive isotopes so I probably glow in the dark and have acquired super-powers but, unfortunately, they don’t seem to include forecasting the winning 6/49 Lotto numbers or toughening up of bones. The results came through on Friday 16th and included a change from “.. mildly expansile” to “metabolically active” and the measurements were given as 3.6(AP) x 2.2(W) x 2.1(H) so it’s either growing or PETs are more accurate than MRIs or the other way around.

The same week ago I also started with a sore throat which made it very, very painful to swallow. No idea if the esophagitis and the C2 lesion were connected but they are at the same height, aren’t they? The PET scan said it was “likely due to an inflammatory process, such as (?) esophagitis.” Not eating or drinking much at all resulted in a loss of around 1kg per day because I was existing on nothing enhanced with nothing. A quarter cup of soup laced with soggy bread was my slow-sip limit. One can of beer on the plane took me three hours to finish. And, anyway, I definitely needed to lose weight. Once in Bali, it improved a lot; I could drink pretty well (not quite normally) and eat stuff like scrambled eggs and such – pretty normal food. At that stage, I hadn’t tried meaty lumps but there is no doubt in my mind that getting away from the ubiquitous spices of India helped immensely.

The good news: the PET scan found nothing else anywhere. “A CT guided biopsy may be performed to obtain tissue for histopathological confirmation …” So, that pointed to the next big thing – a biopsy. First Christmas festivities and then ‘events’ interposed themselves.

I was at a conference in Canada between 1 and 6 December where I fell badly, smashed my nose and injured both hands and added a serious wound to my lower right leg to join the serious one, still healing, from seven weeks previously. By serious, I mean 12 stitches. I put the falling down down to bilateral cataracts which are due for surgery in the New Year. Guinness could also have been a contributing factor but I tripped again three days later, stone-cold sober, when someone caught me before I could further practice the face-plant. Cataracts win the day. I think I’m falling apart.

I was back in Bali again so my local doctor was supposed to remove my 12 stitches on the 18th but the middle of the wound had pulled apart and she left them in. The plan was to get them removed in Canada after arriving back there on the 21st. India-Indonesia-India-Canada-India-Indonesia-Canada-India.

My glasses, only 8 months old – $1,000 down the drain – were destroyed/lost in my Canadian face-plant and, with traveling, I haven’t had time to seek out new ones. I tried in Mumbai but, because of the varifocal and photosensitive lenses, they couldn’t be made before I left. I tried again in Bali, same story and I guessed it would be the same in Vancouver so I am stuck with my falling-apart 9-year old ones for the time being.

Which brings me to my mother’s kitchen on the 22nd.

After the crack, my neck was sore and stiff but I guessed it would loosen up and sort itself. Cracks usually do that. The following day (23rd) most of the family – Tom and Christen, Hannah and Trevor – were gathered at Elliot and Jillian’s house for our Christmas dinner. It was undoubtedly a sprout that did the evil deed, but it was a well-cooked sprout, roasted and coated in crushed almonds and part of an all-round delicious offering. My neck muscles suddenly went into extreme spasm. No doubt I revealed my shock and pain because everyone became rather concerned. Scale of one to ten it was a 9 or a 9.5. Not a 10 – that’s when I scream and I was at that stage back in February/March when my lower back ‘went out’. Paramedics, incredible drugs and two, three-day of hospital stays sorted that, but 9.5 is not a good place to be. No screaming, though.

I sat stock still for two hours, no eating, and gently sipping heavily watered-down malt whisky; another first – the heavily watered, not the malt. Then I ventured standing and slowly moving around. Gentle walking helped but it was still pretty extreme.

Driving home took a strategically placed scarf as a neck brace to alleviate the ups and downs of Vancouver winter roads. Relatively smooth journey. I dosed myself with borrowed Tylenol 3 and lots of other goodies plus copious amounts of vodka and tried to sleep. No such luck.

The following day (Christmas Eve) there seemed to be a slight improvement if I was really careful, but as the day progressed it didn’t continue. I decided to give it another night.

Christmas morning I gave in and off we went to Emergency. Sat around for ages, then got the initial examination when the guy read all my previous scan reports and, in his best bedside manner, pronounced, “Well, that’s not good is it? I’ll copy these and send them to our radiologist at home.”

Which he did. The radiologist recommended a CT scan (computerized tomography) so I was parceled up and delivered to another department. The guy obviously wasn’t impressed by having to come out on Christmas Day because he was short-tempered and rather unhelpful, especially after the scan when I was trying to sit up. Have you ever tried to sit up from a prone position without tensing your neck muscles? No, thought not. Eventually, I did the scarf round the back of the neck thing and pulled myself up by my ears!!!

Then he examined the scans and, Whoah! What a change. Mister Bedside Manner charged into the room and, in front of all the other waiting patients told me I had a double fracture of the C1 vertebrae and, that if I moved wrongly I would be lying on the floor with my breathing paralyzed. I was strapped to a body board, with difficulty, and readied for transport to another hospital because the brace they needed to fit could only be done by physicians specifically trained in that item. So, a Mee-Maw, badly sprung ambulance ride (as in the siren sound: mee-maw, mee-maw, mee-maw) through rocky Vancouver. Mee-maw ambulance rides are rather fun but a pinned-down ambulance ride isn’t the same.

The specialist trained Neurosurgeon guy was straight from Central Casting. Remember the mad scientist in Independence Day? The one who looked after the Alien in the underground vault? “They don’t let us out much.” This was the guy’s identical twin, separated at birth. Very efficient, though. Brace fitted and off we go. No problem standing or walking around. My head is fixed. Really fixed. Fixed in position. No sideways, no up or down, no round and round and no backy-fronty movement. I’m a zombie.

Sleep that night was without copious drugs and I was up and at it the following morning like a fresh thing: clean sheets, freshly baked bread, favorite song on the radio, popping bubble wrap, dancing like no-one is watching, freshly brewed coffee, cleaning your ears … all that sort of thing. Christen, however, did point out that I’d had Tylenol 3, Morphine and vodka before hitting the sack but I think she was just trying to make me feel guilty.

My return flight to India was brought forward by 24 hours so Elliot and I went to a Thrift Shop to buy shirts – imposing neck braces don’t sit well with t-shirts or golf shirts, then for lunch, which for me consisted of a partial attempt at a pint of beer and half of a cup of soup. Then to the airport to meet Tom, Christen, Hannah and Trevor who were already there. Another attempt at a pint. Still unsuccessful. A worrying trend was emerging.

The flight from Vancouver to London was delayed so my connection was potentially compromised. Hope for a following wind.

264 films later London appears. The approach path took us directly over the Gurkin, the Shard, Buck House, Parliament etc. I’ve done that before at low altitude and it’s pretty awesome. Fairly gentle landing so all is good. Now to change terminals and hope the connection is OK. Can’t run. Only walk, gently and smoothly. The inter-terminal bus driver uses kangaroo petrol; not good, and the woman sitting next to me as I stand ignores the notice which says This Seat Reserved for Passengers With Difficulties.

I arrive at the gate just as the flight is closing but the pilot is a parent of one of the Mumbai swimmers and has arranged an upgrade to seat 1H. My debit and credit cards don’t work! The transaction is done from India and onboard I glide. Another 264 films and another acceptable landing. Thank you Air Canada and thank you Air India. My driver awaits.

We get to my apartment at 5 am so I try to sleep. Totally unsuccessful. Neck too tired and painful after being awake for two days and nights. I phone the hospital and make an appointment for late morning. They admit me immediately and explain the planned procedures:

  1. They will cut my neck and screw together the top vertebrae and my skull. Literally, screw together with small titanium screws. That will stabilize the vertebrae and I won’t need the brace. That bit is fairly straightforward assuming the fractures are separated from the spinal cord so I should be able to get out of bed in a couple of days. Maybe go home and come back when the stitches need removing.

However, and this is the difficult bit, when they’ve done the screwing they will cut out as much of the tumor as possible and send it away for testing – is it going to be naughty or nice? Until the go in and look they won’t know how much they can safely cut out without risking damage to my spinal cord – it may be a lot or it may be a little. If they get that bit wrong I am a mess. Sorry to put it that way but it’s the fact.

When they test the tumor they will likely get one of three answers: 1) benign – meaning it’s just a lump of stupid tissue which has been pressing on my bones – remove it and no problem; 2) A localized tumor which has been attacking the adjacent bone (that’s my guess because there’s nothing else showing up anywhere). That is relatively easy to treat with radiation therapy; 3) A full-blown invasive cancer which will spread through bones or other tissues unless it is treated aggressively. That means chemotherapy, radiation treatment and a host of other nasty shit.

The two dangerous bits are now, before the surgery, where a wrong movement could send a bone splinter into my spinal cord and paralyze me if I’m lucky! If I’m not lucky it paralyzes my breathing because it’s the top vertebrae we are talking about (C1). The brace is magic so providing I behave myself and don’t trip, it should be ok.

All my neural responses are great at the moment so there’s no additional damage apart from the fractures. I can walk on my toes and on my heels, my eyes accurately follow a light, my tongue sticks out in a straight line, no tingling or numbness anywhere – everything is good.

The other danger bit is when they cut out the tumor. If they touch the spinal cord they may produce damage. It all depends on exactly where the lump is and they can’t tell that until they go in with a knife.

The grisly details upset some people but there they are. They are what they are. Everything will be OK in the end: if it’s not OK, it’s not the end.

Martini is currently trying to get the Indonesian Consulate in Bali to issue an emergency visa but, if my previous experiences with them are anything to go by, that may be problematical.

The title, C1 refers both to the vertebrae and to the first of the Cancer blogs. Updates later. Motto of the story: try not to walk around for three days with a fractured neck!

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