EFTA01003126.pdf

From: "Jeffrey E." <jeeyacationggmail.com> To: JIM MILLSRfl Subject: Re: Monday Night Update Date: Mon, 22 Dec 2014 20:58:41 +0000 thanks a lot On Mon, Dec 22, 2014 at 4:38 PM, JIM MILLER wrote: Just got back in. I lack the technical report from the doctor so will just wing it. We were with Sultan last night and it was obvious to me that he had improved in 12 hours. His color was good, the edema-like swelling of his face after transport was gone and the rest clearly benefited him after almost 2 days of mayhem. After final review this morning he underwent surgery to stabilize fractures in the C2 and C3 vertebrae. This was done by inserting 2 approx 40mm screws into the vertebrae and entering vertically and up through the throat area. Time in surgery was about 3.5 hours and it was deemed "highly successful" by the Chief physician Prof. Dr. Ch. Jurgens who performed it. The C1 was in line and about the only thing that could be said was that Sultan was very, very lucky that the spinal cord was not touched. He is in a Halo Fixator fully intubated and he is breathing with the help of mechanical 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 fracture healing but also to aid in the reduction of the slight edema that is present in the spinal cord column around the injured areas. Doctors feel that it is this edema that was causing some reduced feeling in his right foot and 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 reduction in strength. The cause of his brief respiratory arrest is not known and Jiirgens is taking the conservative approach that it may have been a result of neurological damage to the "breathing control" centered at the C1. 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 by himself it is extremely difficult to intubate him with the Halo Fixator in place. I speculated in the middle of the night a 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 anyway). No other surgery is anticipated or required. Minimum stay in Hamburg is at least 4 weeks and they will attempt to hold him much longer. He will attempt to negotiate his way around this. At least I can get him back to Dubai in comfort with the BBJ once he is cleared. EFTA01003126  He is resting comfortably in ICU and for the moment there is not much to do. I have been coordinating the management of the treatment and our own internal PR damage control with his son Abdullah bin Sulayem. We have kept our communication to family members and top management vague and upbeat. As soon as Sultan is coherent and communicating we will work out the rest of the plan as he sees fit. As we are at a rest point tomorrow I will head back to Coronado for a week then return to Hamburg to set up a sort of Ops center for him as he rejoins the World. 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. BG Hospital Hamburg Bergedorfer Stralle 10 9inerz It I-. r., please note The information contained in this communication is confidential, may be attorney-client privileged, may constitute inside information, and is intended only for the use of the addressee. It is the property of JEE Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify us immediately by return e-mail or by e-mail to jeevacationOqzmail.com and destroy this communication and all copies thereof, including all attachments. copyright -all rights reserved EFTA01003127