Hubbard going on the IL

[RunOverByHubbard]

To my fellow Raiders fans:

As you know, I have been a Raiders fan for a long, long time (since the 1969 season) and been through all the crap the last decades. I have been on a Forum since, I think, the late 1990's. Been here for a while now. And, I see how we all drop the differences when we need to as we have this one thing in common -- the Raiders. But, I know we have more in common than just a football team we like, love, and get frustrated about. We rally around each other no matter our politics, backgrounds, religions, or anything else. I come to you knowing how much you all can give. I need a bit now.

I got the double whammy going. On Feb 7th, I tore my Achilles tendon skiing at Mammoth Mountain with my daughter. I am an advance/expert skier and rarely fall. But, I did fall that day and did a somersault when I hit a big 'ol mogul straight on without my binding releasing. I felt my left heel tear. I had surgery on Feb 17th and it went well. The first surgeon advised against surgery "due to my age" -- I am 74. But, I got a second opinion (push your medical providers you all) and she was great and said "we will get you back on skis if that is what you want to do." I am on the 9-12 month path of rehabbing it but in the early stages. It is slow work (as I listened to Kevin Durant and Jason Tatum describe online). My goal is: Walk the dogs (two big retrievers) by July; hike by August; golf by October; and ski by January.

Meanwhile, tomorrow, Thursday March 26th, I go in for brain surgery. Long story short, I have a connection between arteries and veins on the side of my brain that should not be there. If you want to look it up, the shorthand is called AVF. I won't describe the surgery but it is delicate and takes 2-3 hours. It is a rare condition -- one in one million people get this -- WTF is up with that?!?. I am very lucky in that my Kaiser neurosurgeon is very talented and experienced at this kind of surgery, even though she does not do it frequently. Kaiser send patients to her from around the northern California. It probably has been there for years and finally manifested itself the last few months. I get out of surgery tomorrow afternoon sometime and stay in the ICU overnight. If things go well, I get home Friday afternoon. I won't be posting for a few days as even I have the ability to restrain myself if need be. So, silence from me for a few days after the surgery is to be expected.

I have been incredibly lucky health-wise for a long, long time so 2026 is the time when I suddenly get to feel my age and then some. I know I can count on you to send me vibes, prayers, thoughts, well wishes, and the like. Thanks in advance for that and I'll let you know how it went when I can.

RunOverByHubbard
(Bill in Sacramento CA)

[Attyla]

Did they ever tell you the location of the AVM? Was it in the brainstem? It would make sense if that was the location because thats where the cranial nerves that govern hearing and balance originate. Incidentally, the doctor who did your procedure is an interventional radiologist. Thats not the same thing as a neurosurgeon. Thankfully, it doesnt sound like you will be needing a neurosurgeon!!!!

Have been wondering if the issue might be the Basal Ganglia which could account for the balance issues. Again, just guessing, balance issues can originate from a variety of things but given the surgery was in the brain, I would think that could be a brain issue and not an inner ear issue.

[RunOverByHubbard]

Updating. I was in ER for 24 hours and if you know that wing of the hospital, not a fun place to be for a long time. I got a CAT scan that saw no visible brain bleed. Got a three part MRI late at night (the radiologist asked for a second look, then a third look using contrast dye) and I knew by midnight that there was no brain swelling and no blood loss. I started Prednisone when I got home -- a steroid that will work on inflammation. Hey RabidRaider -- big thanks to you as I read what you wrote when I got to ER:

"I suspect it's inflammation post procedure that's close to the auditory area of the brain. When the inflammation clears things will get back to normal. Some anti inflammatory meds like Prednisone should help."

I asked the ER doctor to ask my surgeon if I could or should go on a low dose of Prednisone and she said yes, it won't hurt. So 30 hours later, I can report that the bad head ringing is diminished, not by half, but it is just the first day. I posted to the Forum about this situation with the knowledge that you all are great and I got that excellent idea from one of you. I met with my surgeon this morning in a video chat and yes, Cruisin' w/Tooz -- she is an interventional radiologist, and a damn good one. Now that I am coherent, she pulled out the pic's of my past and new MRI and is pleased that blood flow is being rerouted and not spilling out that she can see. She showed me how she placed the platinum coils, one by one and jeez -- this was a long, delicate, complicated surgery. Placing a couple of coils is invasive and delicate -- putting 15 coils in there is epic. It was on the right side of my head and involved quite a big area, but not the brain stem. It is the blood that feeds the brain and the eyes that is at stake here. I won't go into the long term outlook but needless to say, I will be very aware of issues if they arise. There is also some random post-surgical fluid (lymph?) in my mastoid bone that was not there before and she says that will cause hearing problems. She says recovery to no headaches can take a month as the brain finds its new equilibrium.

This year has not been a great 2nd year of retirement. I have been living indoors for almost two months -- no golf, no skiing, limited going anywhere, two surgeries, three times in the hospital. After 40 years of great health, as I said in the first post -- I got the Double Whammy. I am now trying to get back to normal and the rehabbing my Achilles. The 2026 season is not that far away and I need to get off the DL.

[Rabidraider]

Hey Bill, so glad things are working out. Outcomes from these procedures are remarkable good. Just take it easy and be careful in situations were balance could cause an injury like stairs etc.

Go Yankees!

[raiderboyron]

Hey ROBH! DON'T rush it. At our age (range) things can go away rather quickly when it comes to our body strength. It does come back but remember: Follow instructions. Feeling like you can do something and doing it are not the same. Limit yourself to the lighter side. I didn't follow protocol and paid the price with 4 extra weeks of healing. That was 4 extra weeks of an unnecessary situation. Of course we're men. We know whats best right?

[Xramfan]

Good news sir!

Welcome home

Go Dodgers!!!!

[raidersince63]

Bill, we're all glad things are looking much better for you and hope you'll be posting regularly again very soon.

Like I said before, listen to your doctors, stay the course, and stay positive.

[raider_kin]

Great news sir. Take you rehab slow but steady.
Golfing misery will still be there in a few months

[Raider_Len]

Glad to hear you’re on the mend! Sending healing thoughts and wishes your way.

[Cruisin with Tooz]

Updating.

If you had to be readmitted, at least it was a good weekend for it. You didnt miss much Giants offense.

videoframe_47229.png

This is a layout of the 16- bed hospital ward that Hubbard was admitted to. You can see Hubbard there in Room1 and the ward exit from Room 16. After he was discharged Hubbard wanted to say goodbye to the other 15 wusses who couldnt tough it out at home. There's one catch. As a noted efficiency expert, Hubbard didnt want to see any patient more than once on his way out. What path did Hubbard take to leave the ward and see the other 15 patients, without seeing any patient more than once?

[RunOverByHubbard]

I think will be my final post in this thread and if all goes well, the last for a long time about health. If you want to skip the medical stuff (and i know there are some out there like me that like science/medical stuff), go to the last paragraph starting with "To be sure, if this was ..".

I got out of Emergeny ward after 26 hours. Had three MRI's in a row Sunday night after a clean CAT scan (radiologist wanted a different pic, then one with contrast dye injected into arm). They were looking for brain bleeds due to symptoms I got overnight on Sat/Sunday. Got antibiotics for a UTI (bladder infection due to catheter for over 24 hours). Sent home. The antibiotics did not work and sure enough, two days later, I got a message that the culture was back on my piss and the bug was resistant to Batrim. So I got a new drug which is working. Meanwhile, I met with my wonderful surgeon on Tuesday and we went over my situation in detail with many looks at the cross sections of the MRIs. When she showed me a few days before what she was dealing with up there (right side of my brain), I was out of it and it did not stick. Here is what she is pleased about: three days post surgery, way less blood in the right side as the connections between the arteries and veins as flow was shutting down nicely (due to metal coils damming the place up). Arteries feeding the right side were shrinking -- not trying to pump blood through congested circulation system. Again, this is called an arterial-venous fistula (AFV), but I had multiple ones. The pulse I could feel in my right ear was GONE after three months. I was left with headaches and reverberations in my head from sounds and even my own voice. The Prednisone is apparently working on that (and thanks again to RabidRaider for suggesting that mode). The bad news is that she says for unknown reasons, my brain wants to try to hook up arteries to veins that should not exist. She said everything should quiet down in one to two months as my circulation reaches a new equilibrium.

To be sure, if this was not found and corrected, it would have eventually (a month? 6 months?) burst under pressure and I would have died. So my push on the original doctors that led to the discovery which led to the diagnosis and fix was very likely essential. Big lesson for us all in your interactions with doctors. My primary care physician was narrow-minded and stubborn. Someone asked how I first knew I had a problem. Since I am literally about a one in a million person with an AVF like this, you don't have to worry much, but I think if you had a embolism growing upstairs that could turn into an aneurysm, some of the symptoms might be relatable. But, we do hear of people dropping dead of such things precisely because there are no symptoms. I did have symptoms which were: slight, migrating headaches; a feeling of fluid under my skull when I tapped it (behind and just above my ear); feeling of pressure in my head (especially when I was coming on to an edible cannabis thing -- something I did about once every two months); feeling like my ears were full; and finally at the end, feeling my pulse in my ear that was an unmistakable.

I was daydreaming about this: what if we all got biannual MRIs of our brains to look for AVFs, tumors (benign or worse), etc? What if every hospital/medical center had 8 MRI machines, instead of the overbooked one or two? I would not mind this country spending money on that to prevent bad outcomes that cost a lot more than the cost of an MRI machine annualized.

Thanks agains for your support. Life is getting back to normal bit by bit and I am turning attention to my Achilles so I can get back on the golf course by Fall and the slopes by January

RunOverByHubbard

[Attyla]

The devils advocate in me wants to respond, but first let me say that I am glad to hear you are improving. Now the advocate. On average, large medical centers in the US have 4 MRI machines. Smaller community based hospitals have around 2. Now here is where the numbers come in. A MRI machine can perform between 10-25 scans per day. That load per hospital they can handle based on available data and it tends to meet the need pending ER usage. The average cost of a unit is about 1M per. Every moment a unit is not being used costs money. And more importantly, every moment they are being used costs money. Who covers that expense? That would be the insurance companies. And who pays the insurance companies? That would be you and I in premiums. And if we double the number of units in larger hospital units, and even more in regional hospitals, that cost is pushed to the general population. And, here is the tricky part. Each unit requires additional techs to man each unit and it would not be one person. On average it would be four. And each tech makes around 100K per year. And that does not include the techs who maintain the units, which are not the MRI techs. And when, again, the units are not in use they cost money because each unit take up space in a hospital. Space that is either added on at great expense, or takes up existing space that could be used for other life saving technologies. And who foots the bill? That is us. Because our insurance system is broken we get the bill eventually. Medicare and Medicaid aside, private insurance is going to have to adjust their rates to address the additional expense. And Medicare and Medicaid would quickly be funded out with the additional coverage.

There are no easy answers when it comes to modern medicine. It is why we use the term "medically necessary" when it comes to scans and procedures. If modern medicine just removes that caveat from medicine, the costs spiral out of control and the entire system collapses under its own weight. And frankly, I am way oversimplifying the situation. We have a vast shortage of doctors in this country, a huge shortage of nurses and on down the line. Medical staff are already working dizzying numbers of hours and every hour they work in overtime, the higher the risk for errors. And the number of MRI techs is also thin. Schooling is also not cheap. My own hospital company has a program where we entirely fund training for nurses and techs with the agreement that they work for us, at full pay, for a number of years after graduation and we still have shortages.

All that to say, while the sentiment is noble and admirable, the implementation of such a scope of treatment and the additional cost would quickly make healthcare unmanageable in this country. And in other countries that have universal, care would suffer backlogs that would quickly push those who need such care back potentially months.

Bottom line, doing biannual scans of every person would cost fortunes, require far more units than 8 per hospital or medical center and push costs to the average person beyond affordability, and the poorest among us would be hit the hardest.

But I am happy to see you getting better. Those scans you did get are well worth the cost.

[BoJacksonRules]

Glad you’re still with us to witness our turnaround

[RunOverByHubbard]

Glad you’re still with us to witness our turnaround

Indeed, indeed - appreciate it. I love the draft so much that I will be active the next month.

[Oaktown Superman]

The devils advocate in me wants to respond, but first let me say that I am glad to hear you are improving. Now the advocate. On average, large medical centers in the US have 4 MRI machines. Smaller community based hospitals have around 2. Now here is where the numbers come in. A MRI machine can perform between 10-25 scans per day. That load per hospital they can handle based on available data and it tends to meet the need pending ER usage. The average cost of a unit is about 1M per. Every moment a unit is not being used costs money. And more importantly, every moment they are being used costs money. Who covers that expense? That would be the insurance companies. And who pays the insurance companies? That would be you and I in premiums. And if we double the number of units in larger hospital units, and even more in regional hospitals, that cost is pushed to the general population. And, here is the tricky part. Each unit requires additional techs to man each unit and it would not be one person. On average it would be four. And each tech makes around 100K per year. And that does not include the techs who maintain the units, which are not the MRI techs. And when, again, the units are not in use they cost money because each unit take up space in a hospital. Space that is either added on at great expense, or takes up existing space that could be used for other life saving technologies. And who foots the bill? That is us. Because our insurance system is broken we get the bill eventually. Medicare and Medicaid aside, private insurance is going to have to adjust their rates to address the additional expense. And Medicare and Medicaid would quickly be funded out with the additional coverage.

There are no easy answers when it comes to modern medicine. It is why we use the term "medically necessary" when it comes to scans and procedures. If modern medicine just removes that caveat from medicine, the costs spiral out of control and the entire system collapses under its own weight. And frankly, I am way oversimplifying the situation. We have a vast shortage of doctors in this country, a huge shortage of nurses and on down the line. Medical staff are already working dizzying numbers of hours and every hour they work in overtime, the higher the risk for errors. And the number of MRI techs is also thin. Schooling is also not cheap. My own hospital company has a program where we entirely fund training for nurses and techs with the agreement that they work for us, at full pay, for a number of years after graduation and we still have shortages.

All that to say, while the sentiment is noble and admirable, the implementation of such a scope of treatment and the additional cost would quickly make healthcare unmanageable in this country. And in other countries that have universal, care would suffer backlogs that would quickly push those who need such care back potentially months.

Bottom line, doing biannual scans of every person would cost fortunes, require far more units than 8 per hospital or medical center and push costs to the average person beyond affordability, and the poorest among us would be hit the hardest.

But I am happy to see you getting better. Those scans you did get are well worth the cost.

I’ve worked as a lab tech since 2000, and trust me, if they pushed what ROBH suggested, there’s so many around here where I live, who would demand an MRI, even if they didn’t need it. They’d want one done just because. It’s been a while back, 12-18 months ago, a guy came to the ER of the hospital I work at because he had heartburn. He’d seen his doctor the day before who told him to double his dose but still came by ambulance.

[RunOverByHubbard]

I hear you both and get it. I just hear a lot of stories these days of people waiting weeks to get onto an overbooked MRI machine. Getting an MRI likely helped save my life the way things were building up in my brain circulation. Although, in my case it was narrow minded MDs who hung me up for a few months. I have had a number of good conversations about the state of our medical system of late especially in light of the fact that I had to actively self advocate for both surgeries and how apparently overworked the primary care physicians are.