EFTA02598882.pdf

From: JIM MILLER < Sent: Monday, December 22, 2014 8:39 PM To: Jeffrey E. Subject: Monday Night Update Just got back in. I lack the technical report from the doctor s= will just wing it. We were with Sultan last nigh= and it was obvious to me that he had improved in 12 hours. His color was =ood, the edema-like swelling of his face after transport was gone and the =est clearly benefited him after almost 2 days of mayhem. :=13r> After final review this morning he underwent surgery to stab=lize fractures in the C2 and C3 vertebrae. This was done by inserting 2 ap=rox 40mm screws into the vertebrae and entering vertically and up through =he throat area. Time in surgery was about 3.5 hou=s and it was deemed "highly successful" by the Chief physician Prof. Dr. C=. Itirgens who performed it. The Cl was in li=e and about the only thing that could be said was that Sultan was very, ve=y lucky that the spinal cord was not touched. He =s in a Halo Fixator fully intubated and he is breathing with the help of m=chanical ventilator. The intention is to keep him=sedated and in ICU for 2 to 4 days and monitor him. It may be as long as a=week. The primary issue is see that he does not move and affect the fractu=e healing but also to aid in the reduction of the slight edema that is pre=ent in the spinal cord column around the injured areas. Doctors feel that =t is this edema that was causing some reduced feeling in his right foot an= one arm during the neuro exam made on his arrival. I should repeat he was=able to move his hands, arms and legs with minimal difficulty but some red=ction in strength. The cause of his brief respira=ory arrest is not known and JUrgens is taking the conservative approa=h that it may have been a result of neurological damage to the "breathing =ontrol" centered at the Cl. He is going to be very cautious about bringing=him out of the induced coma and off the ventilator. The reason is this; if they remove the tube and he is unable to breathe =y himself it is extremely difficult to intubate him with the Halo Fixator =n place. I speculated in the middle of the night = couple of days ago that it might have just been sputum that triggered the=arrest but now I am not sure (and truthfully, what the hell do I know anyw=y). No other surgery is anticipated or required.<=div> Minimum stay in Hamburg is at least 4 weeks and th=y will attempt to hold him much longer. He will attempt to negotiate his w=y around this. At least I can get him back to Dub=i in comfort with the 881 once he is cleared. He =s resting comfortably in ICU and for the moment there is not much to do.</=iv> EFTA_R1_01785123 EFTA02598882 I have been coordinating the management of the trea=ment and our own internal PR damage control with his son Abdullah bin Sula=em. We have kept our communication to family members and top management va=ue and upbeat. As soon as Sultan is coherent and communicating we will wor= out the rest of the plan as he sees fit. As we a=e at a rest point tomorrow I will head back to Coronado for a week then re=urn to Hamburg to set up a sort of Ops center for him as he rejoins the Wo=ld. Other family members are coming to Hamburg in the coming days and when=he opens his eyes he will be with friends - very important as you know for=Arab families. All for now. <=iv>BG Hospital Hamburg 8e=gedorfer StraBe 10 21033 Hamburg mail-(at=buk-hamburg.de <= target="_blank" href="http://www.buk-hamburg.de/">www.buk- hamburg.de<=a> http://www.k-uv.de/en/facilities/bg-hospital-hambur= <http://www.k-uv.de/en/faciliti=s/bg-hospital-hamburg> / conversation-id 309818 date-last-viewed 0 date-received 1419280716 flags 8590195717 gmail-label-ids 2 remote-id 465713 2 EFTA_R1_01785124 EFTA02598883