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

Written January 8, 2023, at 39.26° N, 106.03° W. Also known as Alma, Colorado, USA.

Hello Everyone. I’m not one normally prone to procrastination, however this final post from an epic journey which began for me in late September, and for Christine in late October, is written more than a month after we returned to the United States. 8 weeks spent hiking Portugal, Spain, and sailing crossing the Atlantic Ocean… I just needed a break. Still, there are no real excuses, just my apology for the delay.

We departed Rio de Janeiro and headed back out to sea the afternoon of November 27^th. November 28th and 29^th were our final “at sea days”. We were given instructions for our final disembarkation which would occur on December 1^st at port in Buenos Aires, Argentina. Reality was setting in and took the form of assembling, organizing, and packing our belongings, saying goodbyes to shipboard friends and also to the accommodating staff that had seen to our every need. Many acquaintances were made, but with the unspoken understanding that it was unlikely our paths would cross again. There were a few goodbyes which carried with them the hope, if not the promise, that we would meet again someday.

Included among the latter were Bob and Ann along with Paul and Shirley whose staterooms were immediately down the hall from ours.

There was Vicki and her husband Dell. Vicki, one of the fastest walkers I have ever encountered, slowed down in order that I might join her for conversation as we put in daily miles walking the ship’s promenade deck.

Finally, there was Saba and her husband Wes who celebrated his birthday aboard ship.

We shared dinners, drinks, and our personal stories with each of these good people and we truly hold hope to see them again someday.

In 21 days on the ocean a level of familiarity built between us and certain of the ship’s crew. As I mentioned in an earlier post, the courtesy extended to us by these gracious workers was flawless. Our stateroom was attended to three times daily by Alex and his partner Agus.

Evenings usually included pre-dinner drinks forward in the Explorers Lounge.

We developed a special fondness for Alexandra and Arturo who each served us. When time allowed, they also exchanged pleasant conversation with us. My only regret is the lack of an opportunity to just sit and visit with each of them at length.

What is the shipboard experience like for them, what have they seen, and what does the future hold, are just a few of the things I would have liked to explore with each of them.

Even on the last day at sea there was still time for some riotous fun. Over the course of the sailing various groups of passengers had assembled with the task of creating “ships” from discarded items. They would be judged for artistic merit, seaworthiness (in the swimming pool), and the ability to transport “cargo’ consisting of cans of soda. Many floundered and sank, but a few were more than equal to the task.

Early morning on November 30^th we entered the port of Buenos Aires, Argentina. This ultra-modern city houses a metro population of nearly 16 million.

It also houses social and economic problems that I will touch upon.

We were booked on a boat excursion to parts of the Parana Delta. A one-hour drive from the port and city center delivered us to the dock. One would have thought that 21 days at sea would have satisfied any urge for more boat rides, but this was different and unique.

The Parana Delta is one of the largest in the world. It is also the only river delta that opens to another river (the Rio de la Plata River which at 140 miles from shore to shore is the widest river in the world) rather than the sea. Measuring 5,400 square miles, this labyrinth of small islands houses both permanent and vacation homes which are accessible only by boat. Some of these residences are decidedly upscale, and others are not.

Schools, resorts, and recreational activities are evident as is commerce in the form of riverboat “stores” that deliver groceries, supplies, mail, fuel, and most importantly, drinking water.

The rivers and streams flowing through the delta are fished but the brackish waters are not considered potable.

A modern Coast Guard facility stands juxtaposed to derelict vessels that have been abandoned to time and the elements.

It was an excellent excursion with our guide providing a wealth of practical information not included in most tourist pamphlets. She gave us guidance on navigating the generally safe city proper. She also educated us to the challenges of surviving in an economy wracked by nearly 100% annual inflation. The largest Argentine denomination is the 1,000-peso bill. When we were in Argentina in 2019 one dollar bought 50 pesos. During this visit the conversion had deteriorated to 175 pesos to the dollar. More confusing was that these rates were “official bank rates”… what one would receive in exchange at a bank, ATM, or for a credit card transaction. However, there was a thriving “blue market” where scores of ordinary citizens stand throughout the tourist areas calling out, “Cambio, Cambio, Cambio…” in hopes that they can exchange their declining value pesos for stable currency (dollars and euros), offering 250 pesos to the dollar while we were there. Our tour guide carried her own hefty bundle of 1,000-peso notes which she offered to exchange at the “blue market” rate. She had takers in the group and we were among them. A 1,000-peso note barely buys a Big Mac and French fries!

After the tour concluded Christine and I had time and the opportunity to wander solo in the heart of the city. We headed to July 9th Avenue, an expansive thoroughfare that runs for three kilometers in the city center.

It is named in honor of Argentina’s Independence Day, July 9, 1816. It features beautiful green spaces, upscale shopping, four-star hotels, and the iconic 221-foot obelisk in Plaza de la Republic which was erected in 1936.

Overlooking all of this is the image of still venerated Evita Peron who died in 1952.

Tomorrow we would be staying in a hotel along this boulevard for our final night in Buenos Aires.

On the afternoon of the 30^th the entire community was holding its breath, seeking every opportunity to view television screens. Police assembled around store windows where televisions were mounted facing out to the street. Taxis cabs stopped, as did pedestrians to join law enforcement as spectators while bars and restaurants thronged with patrons glued to the television sets in those establishments.

The entire city could be heard to alternately cheer with glee and gasp in horror. Argentina was playing Poland in a lead up match to the 2022 World Cup Final. Argentina was down at the half but ultimately came back to win not only that match but later the coveted World Cup itself. Lionel Messi is a God in Argentina. His jersey, emblazoned with the number 10, could be seen on men, women, and children everywhere. To put world soccer or “Football” as it is more commonly known outside of the United States into perspective, America’s Super Bowl commonly attracts around 100 million television viewers. The World Cup final, held every four years, is a magnet for over 10 times that number, well over a billion viewers worldwide.

We returned to Viking Jupiter and the less than pleasant task of final packing in preparation for the morning debarkation. Fortunately, Viking has that task reduced to a science. Passenger bags which clogged the ship’s hallways that night had disappeared by the morning of December 1^st.

Ship’s crew had removed them to a huge dockside facility where they were organized in such a way as to make retrieval a snap of the fingers. By 10:00 AM that morning we were through customs, bags in hand, and shortly thereafter riding in a cab which transported us to our upscale hotel.

Check in time at the Hotel Grand Brizo is normally 3:00 PM. However, at the hotel desk we were informed that our room was ready and we were welcome to occupy it immediately. This was a stroke of real luck, as was our 6^th floor room which commanded a stunning panoramic view of July 9th Avenue. Our first look took in a political rally that was taking place on the street below.

That evening Christine and I enjoyed a leisurely walk with views of the “Times Square-esq” surroundings.

An exceptional steak dinner at a nearby restaurant put the finishing touches on a perfect day.

We had originally planned to spend five nights in Buenos Aires after departing the ship. However, we had each been gone from home long enough that the urge to return to family and friends in Kansas City overrode those earlier plans. We had canceled the earlier reservation in favor of the single night and a departing flight the evening of December 2nd.

Though we were at the Hotel Grand Brizo for only one night we were treated like royalty. Staff delivered to our room a surprise morning treat with wishes for a safe journey.

At checkout the hotel placed our bags in storage. We sat down to brunch where an immediate friendship was made with the hotel’s delightful and incredibly charming hostess, Normi.

She had greeted and spoken to us in the hotel lounge the prior evening. We learned that she was the genesis of the morning treats which she arranged to be delivered to our room. We would like nothing better than to have her as a guest in our home should she ever venture our way.

With the hotel holding our bags secure, and our flight not set to depart until late that evening, we had a full day on our hands to further wander the environs of Buenos Aires. We were not disappointed. Less than 100 yards from the hotel a huge protest was brewing.

Throwing caution to the wind we wandered in and among the protesters who asked for nothing more than fair treatment and fair wages for a fair day’s labor.

The remainder of December 2nd was spent taking in a coffee here, window shopping there, and reflecting upon the extraordinary experiences we had each enjoyed over the past weeks.

Not so long ago we had given serious consideration to booking an around the world cruise as an early celebration of our 50th wedding anniversary. It would entail 139 days aboard ship with over 90 ports of call. We have not entirely abandoned the idea, but having experienced ocean sailings of 15, 22, and 21 days over the past four years we are mindful that cruise fatigue can set in. The continuing risk of COVID and a challenged economy are additional factors which may militate against such an excursion.

In the meantime, 2023 presents us with more exciting frontiers. This coming spring, after spending some time in Colorado, we are departing for six weeks in the United Kingdom, three of which include hiking from the west coast to the east coast of England, following the 2000-year-old Roman ruins known as Hadrian’s Wall. Midway we will celebrate my birthday by lodging 2 nights in the royal chambers of a 14^th Century castle.

Here is a link to the Langley Castle website: The Langley Castle Hotel

We will sightsee in Carlisle, Newcastle, and Liverpool, after which I will take command of a 62-foot-long narrow boat for 3 weeks on the canals of central England and Wales.

Our dear Kansas City neighbors, Charlie and Mary Murphy, will be joining us for one of those weeks, taking their own turns at the tiller and managing the locks and drawbridges that date back to the late 18th century.

This link will provide an overview of our first canal experience from 2019:  Canals of the UK, Our Journey

Mid-year I will be undergoing brain surgery to address a lifelong inherited condition, Essential Tremors, which has grown increasingly bothersome in my later years. The Decision

In the fall Christine and I will ship out on another Viking cruise. Departing from Fort Lauderdale, Florida, we will proceed into the Caribbean, through the Panama Canal, up the west coast of Central America, and conclude 18 days later in Los Angeles California. Panama Canal and the Pacific Coast.

 A world cruise in the future? Only time will tell.

Peace Everyone. Pete