Carole, You can't. Its not published yet. haven't got a publisher yet. Bill -----Original Message----- From: Carole Hercun <[log in to unmask]> To: [log in to unmask] <[log in to unmask]> Date: Monday, September 06, 1999 8:07 AM Subject: Re: Surgery for rigidiity >Hi William: What a fascinating chapter, both of your >life and of your book. Where can I get a copy of "My >Second Life"? Carole H. > >--- William Harshaw <[log in to unmask]> wrote: >> Debbie, >> >> When I had my pallidotomy in Dec '93, as Dr. >> Ronald Tasker, my >> neurosurgeon, made the lesion in my right globus >> pallidus, I could feel the >> rigidity leave the left side of my body. It has not >> returned. >> >> I attach Chapter Eight of my book: My Second >> Life. >> >> copyright 1999 The Harfolk Press >> may not be reprodced without permission >> Monday, November 30, 1998 revise >> >> Chapter Eight >> >> NEUROSURGERY >> >> ... the brain is the most interesting, complex and >> wonderful thing in the >> universe ... and it's a wonderfully exciting thing >> to study and be in >> contact with. ... The brain is you, it's not just >> biologically or >> genetically, it has all your experience, it's you. >> -Oliver Sacks >> >> >> >> When I returned to the hospital on Tuesday, December >> 7, 1993, I was ready >> for surgery, eagerly looking forward to the >> operation even though I was >> apprehensive. Other than my overnight doing the >> pre-op testing I hadn't >> stayed in a hospital since I was twelve years old >> having my tonsils out, and >> I enjoyed the novelty. I brought a good supply of >> books and music tapes. >> Because the operation was unusual, everyone seemed >> to want to know about me >> and I was being paid a lot of attention. I felt >> quite important. >> I was sharing a room with a man from Huntsville who >> had an inoperable brain >> tumour. His wife was with him constantly, and I >> sensed, from overhearing the >> doctors and nurses, that he did not have long to >> live. Even so, there was a >> sense of calm surrounding the couple as they >> prepared for his inevitable >> death. >> For the first few hours after I was admitted, I was >> too busy having my >> medical history taken, for what seemed the nth time >> by a nurse and then >> again by a surgical resident, and then being visited >> by Jan Duff, Dr. Lang >> and Esther and Howard to take in the reality of what >> was going on beside me. >> I dimly recognized that this couple were preparing >> for the husband's death, >> but there was no weeping and gnashing of teeth; >> rather, there was hope. As >> the wife left that Tuesday evening, she turned to me >> and said, "You will be >> in my prayers tonight. God bless you." >> She had enough room in her heart for me, when I >> would have thought her >> whole being would be focused on her husband, on her >> family. I was touched >> and inspired by her generosity of spirit. >> Later in the evening, Dr. Lozano and Dr.Tasker, the >> neurosurgeons, came to >> see me and discuss the operation. Dr. Andres Lozano >> is tall, with >> close-cropped black hair and wears plain wire-rimmed >> glasses. If anything, >> they made him look younger than his thirty-six >> years. He had the aura of an >> ascetic about him. He was the expert in >> pallidotomys, having done thirteen >> previous ones at the hospital. Dr. Tasker, known >> behind his back as "The >> Lone Ranger", and with a reputation for iconoclastic >> brilliance, was >> Lozano's mentor, having pioneered the thalamotomy, >> where lesions are made in >> the thalamus, another procedure used to reliving >> Parkinson's tremors. In my >> operation Dr. Tasker, although the senior, would be >> the number two surgeon, >> learning the pallidotomy procedure from Dr. Lozano. >> With me they were a >> "good guy, bad guy" team as they discussed the risks >> and potential benefits >> of the operation. Tasker spelled out the negatives, >> while Lozano emphasised >> the potential benefits. >> The operation I would be having was a stereotaxic >> pallidotomy. Stereotaxic >> refers to the finely calibrated metal frame that >> would be fixed to my skull >> for the operation. It fulfils two functions: it >> provides precise three >> dimensional co-ordinates for the positioning of >> surgical instruments within >> the brain; and it is bolted to the operating table, >> immobilizing the frame, >> and, therefore the head. Pallidotomy refers to the >> globus pallidus, >> literally "pale globe", a part of the basal ganglia >> which is the deepest in >> the skull. The pallidus regulates the braking action >> of the brain; in >> Parkinson's patients the brakes are being applied >> too heavily, causing >> poverty of movement and clumsiness. (Parkinson >> himself had noted that >> sometimes, if patients of "his" disease had a >> stroke, the characteristic >> Parkinsonian tremor was less evident, although >> muscle weakness more than >> made up for the eased tremor.) In the pallidotomy, >> the neurosurgeons make >> some lesions on the pallidus which would result in >> scarring. When properly >> placed, the scars relieve the patient's symptoms. >> Stereotaxic surgery dates back to the nineteenth >> century when its use was >> pioneered by veterinary surgeons. It was not until >> the 1930s that the frame >> was used for surgery on Parkinson's patients. By >> today's standards, these >> early procedures were crude, even barbaric. The >> procedure was little more >> than trial and error and the results were often less >> than satisfactory. In >> one American case reported in 1951, first the motor >> cortex was disconnected, >> then other connecting fibres were cut and finally >> the head of the caudate >> was severed, which finally relieved the Parkinson's >> symptoms. It is hard to >> imagine that there was much brain function left. >> Meanwhile, in the 1960s, the potency of L-dopa >> medications became >> recognized as far superior to herbal extracts and >> their synthetic clones, >> and to some extent replaced surgery as a treatment >> for Parkinson's. But >> L-dopa has its limitations. In my case and many >> others, it produces >> dyskinesia as a side-effect. As these limitations >> became recognized, >> stereotaxic surgery was undergoing a revolution in >> technique resulting from >> the application of computer technology and >> miniaturization of surgical >> instrumentation. Technology assisted as well in >> understanding the geography >> of the brain and the specific function of many of >> the parts of the human >> brain. >> As the two neurosurgeons discussed the operation >> with me, I realized for >> the first time how much responsibility for its >> success would fall on my >> shoulders. I would have no aesthetic because there >> would be no pain. I >> needed to be alert and mentally clear so I could >> give timely and accurate >> responses to the surgeons' questions, particularly >> about the location of the >> optic tract, a scant one millimetre from the globus >> pallidus, and itself >> only one millimetre in diameter. Should the probe >> damage the optic tract, my >> vision could be impaired. If the procedure resulted >> in bleeding, a stroke >> could result, with all the complications that come >> with it, including the >> possibility of death. >> Somehow, all the cautions and potential problems >> that Dr. Tasker discussed >> were insignificant when Dr. Lozano described the >> potential benefits of the >> operation: moderation of dyskinesia, easing of >> muscular rigidity on my left >> side (the operation was going to be on the right >> side of my brain ) and a >> lessening of the reptilian appearance my >> Parkinsonian mask had given me. Dr. >> Lozano had estimated the risk of something going >> seriously wrong at between >> two and three per cent. The two surgeons were >> putting benefits and possible >> hazards of the operation clearly so that so that I >> would be able to sign a >> >=== message truncated === > >__________________________________________________ >Do You Yahoo!? >Bid and sell for free at http://auctions.yahoo.com >