Written June 1, 2023. At Kansas City, Missouri.

Yesterday a good friend reminded me that I had not written a final post from our seven weeks in England. As you will see, my mind has been on other things. Before I explain further here is a brief recap of our May 10^th return to the United States:

Our final night in Manchester was spent at the Radisson Blu Hotel located in Manchester’s International Airport. It was pleasant enough, but we were desperately eager to be on a plane heading west. We ditched tourism that night in favor of room service. When the time arrived to check-in for our flight we received notification that online check-in was not available to us. This created some anxiety.

It turned out that this was nothing more than a requirement that we present our international travel documents in person. However, not knowing this at the time, we arrived especially early the next morning at the Virgin Atlantic desk. To our relief check-in went smoothly, and then on impulse I asked if there was any possibility to secure an upgrade to first class seats. The answer was YES! “How much?” I asked. The sum was quite reasonable to these travel weary souls. I forked over my credit card. As first-class passengers we were entitled to relax in the Virgin Atlantic Airway lounge prior to takeoff, food and drinks included.

The only remaining stress was the timing between our arrival at JFK airport in New York and the departure flight for Kansas City. According to the flight itineraries we had less than an hour to make it through customs and board the final flight home. We were told it was a virtual impossibility and we were likely going to be spending the night in New York.

The flight across the Atlantic was elegant and we were pampered by the delightful attendants. Real food, real China, real cutlery, and best of all real booze. Could it get any better than that?

YES! Our flight landed an hour ahead of schedule! What was more, as holders of Global Entry passes, we were able to casually walk by the near endless serpentine line of humanity at passport control and thanks to facial recognition we virtually walked straight through to the terminal to pick up our bags and re-deposit them on the other side of Customs. We made it to our next flight with time to spare.

As we approached Kansas City black storm clouds loomed in the distance. There was the staccato strobe of lightning strikes that were cloud to cloud and cloud to ground. The pilot aborted his first approach to the runway and circled a few times before attempting a second landing. On his second approach he got closer to the ground, but a sudden gust caused the plane to bank sharply. The pilot hit the gas, put the plane’s nose skyward, and retracted the landing gear.

The third time was the charm… sort of. It was again a rough approach. As the plane touched down it was again struck by the gusting winds and bounced two or three times hard on the tarmac, skidding sideways before finally being secure on the ground. Among the passengers there was a communal “gasp” followed by the silence of relief and then applause. More good luck, we were almost home.

It was at least four days before my sleep cycle was restored, just in time for the crush of reality and the next “adventure” to begin.

Between May 16th and 30^th I had appointments with a dermatologist, an audiologist, an ophthalmologist, and my general practice physician. These were all routine checkups along with my annual physical. Each of these appointments went well, but it looks like hearing aids may be in my future. I now have proof that I do not intentionally and selectively ignore my wife.

At Christine’s insistence we made time for family pictures.

I have not yet mentioned the two most important medical appointments: On May 17th I spent the better part of two hours meeting with staff at the University of Kansas Medical Center for my final pre-surgery work-up. One after the other I met with personnel from anesthesiology, pharmacology, and surgery. The big event is tomorrow, (June 2^nd). I will report at 5:45 a.m. for Deep Brain Stimulation surgery (DBS). Neurosurgeon, Jennifer Chang, MD, will bore a small hole (about the size of coin) through the left upper area of my skull. My head will be immobilized while she inserts a tiny electrical implant into the thalamus of my brain.

She will then run wires under my skin and down to my chest where in two weeks she will surgically implant a controller (neurostimulator), attaching it to the wires.

Much of the first procedure, lasting between 4 and 6 hours, will be done while I am awake.

It is hoped that this procedure on the left hemisphere of my brain will reduce or eliminate the life-long tremors that I experience in my right hand and arm. These tremors have become progressively worse with age and are now significantly impacting my quality of life. Later in the year I will decide whether to undergo the procedure on the right side of my brain.

I did not come to the decision to undergo this procedure easily. I announced it to my wife in an open letter published as I was hiking in Spain last year. Here is a link to that letter:

“The Decision”

I previously wrote in greater detail the specifics about the DBS surgical procedure. Here is a link to that post:

“My DBS Surgery”

I greatly appreciate the kind words and the expressions of thoughts and prayers that I have received in anticipation of tomorrow. A candle has even been lit by a dear friend and her mother on my behalf in a small church in Germany.

The likelihood of the “unthinkable” occurring is less than 1%. However, this is major surgery and unlike my arm, which is an arm, or my leg, which is a leg, my brain is the essence of me. Christine and I have had “the talk”, and we will likely have it again tonight. My life of 71 years has been a blessing and borrowing from the lyrics of the song, “My Way”:

“My friends, I’ll say it clear. I’ll state my case, of which I’m certain. I’ve lived a life that’s full, I traveled each and every highway. And more, much more than this, I did it my way. Regrets, I’ve had a few, but then again, too few to mention. I did what I had to do and saw it through without exemption. I planned each charted course, each careful step along the byway. And more, much more than this… I did it my way.”

Peace Everyone. Pete

Written in Alma, Colorado, March 9, 2023.

During the summer of 2005 Christine and I embarked upon a one-month trip overseas. It was an extraordinary tour that included travel deep under the English Channel from London to Paris and return via the high-speed Eurostar “Chunnel” train.

This was Christine’s third and my fourth visit to Paris. Nevertheless, over the course of four days we again took in all of the city’s major tourist sites.

On this occasion we shared the experience with Philippe and Patricia Pluvinage and their two children, Camille and Thomas. Years earlier this wonderful French family from Bussy Albieux had hosted our daughter, Alexis, as a foreign exchange student.

Back in the United Kingdom we toured the length and breadth of the British Isle, from Edinburgh, Scotland, to Swansea in Wales. In between our journey included Cambridge, the City of Bath, Stonehenge, Durham, and London, among others.

At York we even encountered a canal boat, reigniting my 1974 dream of someday navigating the canals of England in just such a vessel.

Little did I know that 14 years later the dream would be realized, and again reprised in 2023. But that is the subject of Part 2 of Our Coming Journey.

Portions of that tour again included dear friends. This time it was Huw and Nina Thomas of Wales.

As we drove near Durham in England, we happened to see signs indicating the nearby path of Hadrian’s Wall. I have always been fascinated by ancient history, embracing those studies in high school and college. We detoured to find “The Wall”.

The Roman Emperor Hadrian (Reign: 117-138 CE) sought to consolidate the Empire’s hold on central and southern Britannia by erecting a massive defense line against the unconquered Scots to the north.

Construction was begun in 122 and largely completed by 128. The serpentine wall extended from the West Coast of England near Bowness-on-Solway to the East Coast of England at Wallsend on the River Tyne.

As originally constructed, the wall measured between 8 and 10 feet thick, 12 feet high, and was further reinforced by a parallel ditch excavated 20 feet wide and 10 feet deep. The builders also took advantage of natural land features such as valleys and cliffs to further enhance the barrier’s effectiveness.

The length of Hadrian’s Wall was garrisoned by soldiers billeted in stone forts, milecastles, and intervening turrets. It is estimated that 10,000 soldiers manned Hadrian’s Wall. Rome feared the Scots.

Today, much of the wall remains visible although significantly reduced in height as stones were “quarried” over the intervening centuries by locals for the construction of buildings and roads. Hadrian’s Wall was declared a UNESCO World Heritage site in 1987.

In 2003 a British National Trail footpath was officially opened to follow the length of The Wall, from coast to coast. From this coming March 28th until April 8th Christine and I will hike the entire length of Hadrian’s Wall, 12 days which will include a few extra night stays along the way. Our path will cover nearly 100 miles. A special treat will be two nights at 14th Century Langley Castle, where we will lodge in “royal chambers” for my birthday.

In addition to hiking Hadrian’s Wall, we will spend time in Manchester and Liverpool, thereafter, taking charge of a 62-foot canal “Narrowboat” which, along with Kansas City friends, we will pilot for three weeks. But that is again the subject of Part 2 of Our Coming Journey.

Peace Everyone. Pete

PS. During our July 2005 stay in London, we experienced the elation of London’s successful bid to host the 2012 Summer Olympic Games. We also came too near to losing our lives in the tragedy of the July 7^th terrorist bombings that rocked the city. That is the subject of my next post. This link will be active after March 14th:  The Terrorist Bombs of 7/7 and Our Very Close Call 

Written February 12, 2023. At Kansas City, Missouri.

I am 70 years old and I have been aware of my Essential Tremors (ET) since grade school. My mother had this condition and it is likely that it has been passed on through me to one or more of my children and grandchildren. I was fortunate to lead a productive life relatively unencumbered by my tremors. My tremors, however, put some limits upon my occupational aspirations. I became an attorney rather than pursue a profession in medicine or science.

My wife, Christine, and I retired in early 2015 giving ourselves over to the pursuit of travel, writing, and time with family.

Over the past eight years my tremors have worsened to the point that in February of 2022 I sought guidance from physicians at the Department of Neurology at the University of Kansas Medical Center. Given my family history and manifest physical symptoms, a confirming diagnosis was immediate. Two pharmaceutical treatment options were tried and ultimately deemed unsuitable; Propranolol because of my slow resting heart rate, and Primidone because of its impact on my sleep and emotions. I was deemed a candidate for a surgical option, either Focused Ultrasound (FU) or Deep Brain Stimulation (DBS). I put treatment decisions on hold taking an “I’ll think about it” attitude. The thought of brain surgery was daunting.

In September and October of 2022, while hiking solo across Portugal and Spain, I became acutely aware of the everyday assistance that my wife had increasingly rendered to me over the years. In an open letter to her on my travelblog I announced that I had come to the decision to undergo DBS surgery. Here is a link to that heartfelt letter:

October 28, 2022, The Decision

In December I returned to the University of Kansas Medical Center and in consultation with staff made a final election to undergo the DBS surgical procedure. I was presented with 3 options for the implanted neurostimulator, two by Medtronic and one by Boston Scientific. I selected the Boston Scientific unit because of its programming capabilities and that it is rechargeable.

The University of Kansas Medical Center has three neurosurgeons who perform FS and DBS surgeries. The surgeon with whom I consulted in January is young but very experienced. On average she performs two of these procedures each week. We spoke for nearly an hour, and I felt reassured in having selected her to perform the operation. The plan involves three separate operations. The first scheduled in June will implant an electrode deep into the thalamus of the left hemisphere of my brain which controls my dominant right hand. I will be awake for most of that procedure.

Two weeks later the neurostimulator will be surgically implanted into my chest and attached by wires running from the implanted electrode, under the scalp and skin, down my neck to the stimulator.

Approximately 2 weeks later neurology staff will fine tune the neurostimulator to my particular needs. Later in the year, but as yet unscheduled, a third surgery will implant an electrode in the thalamus of the right hemisphere of my brain thus extending the treatment to my left hand.

An MRI under full anesthesia was conducted in mid-January with and without contrast. The findings were normal and a possible hurdle to surgery was eliminated.

Last week I underwent a detailed neuropsychological examination, again through the University of Kansas Medical Center. Over the course of more than 3 hours I was extensively interviewed by a psychologist and completed a score of tests in areas that included Dementia Screening, Verbal Memory, Attention, Language, Executive Function, Perceptual Function, and Emotional Function. It was exhausting.

It is curious to me the amount of stress that I experienced in the days preceding the neuropsychological examination. What if I was not deemed an appropriate candidate for surgery? What if testing revealed cognitive issues or problems? It occurred to me that this anxiety was unique and never previously experienced by me in the course of any other medical test, examination, or procedure. Tests for cholesterol, blood pressure, cardiovascular health… these define a physical characteristic but do not reach to the core of who one is. The possibility of poor neuropsychological test results not only threatened my decision to go forward with surgery but presented a threat to the definition of who I am. Fortunately, the testing revealed no deficits. I remain a candidate to go forward with DBS surgery.

Reading between the lines, I hope it is evident how fortunate I am to have the support of Christine, my wife of 45 years. She has remained at my side, patiently listening to my concerns and allaying my fears. DBS surgery has an excellent track record and predictive efficacy for tremor reduction of from 60 to 90%. Nevertheless, it is brain surgery, and the risks cannot be ignored.

To this point the most difficult step has been the decision that I reached last October. It is my intention to further update my progress and it is my hope that this will be helpful to others who are contemplating seeking relief from their own Essential Tremors.

Peace Everyone. Pete

PS. I had the opportunity to schedule surgery much earlier in the year. However, Christine and I have planned a six-week journey in England this spring. Beginning in late March we will fly to Manchester England and then train to the town of Carlisle on the west coast just south of the border with Scotland. We will then hike 100 miles from the west coast to the east coast, following the route of Hadrian’s Wall which was erected in the 2nd Century CE by Rome under its Emperor Hadrian.

After sightseeing in cities such as Newcastle, Manchester, and Liverpool, we will proceed to Middlewich England where we will take command of a 62 foot “Narrow Boat” which we will pilot for three weeks upon the canals of England and Wales.

Kansas City friends will join us for part of the canal voyage. This will be a reprise of a similar journey which I detailed in posts on this website:

The Canals of England, our 2019 Journey

It is my intention to again regularly post pictures and a running commentary which all are welcome to follow. Pete