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EFTA02598882

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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 t

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