Sunday, August 15, 2010

Time Marches On

I see that it's been nearly three weeks since my last post and I'm now at five weeks and two days post-surgery. The rest of our time in Mammoth was pleasant and we spent one sunset evening at Mono Lake, a place we have visited many times as a family over the years.
Sarah took these pictures of me as the light was waning:

On Monday August 2, Carol took me back to UCSF for a follow up appointment with my neurosurgeon Dr X. My friend Tony joined us and it was good to have a visit with him while we were there.

Dr X spent a good amount of time answering my many questions about the procedure itself. His assessment was that I was healing very well, but he thought it would be a good idea if I took at least one more week off of work. It turns out that was a good suggestion, as I will describe later. The one question he couldn't answer was when could I drive again. His opinion was that decision was up to Dr Y, my neurologist who will be primarily responsible for my care as my brain continues to heal and I eventually try weaning off of the anti-seizure medication. So, Carol had to drive us home which sucked for her as she was fighting a migraine that day. We heard from Dr Y the next day and he said as long as I felt well enough, driving was A-OK.

On Wednesday the 4th, I had a visit from a new photographer friend from Vienna named Viktor. He was travelling around California and was interested in seeing a demonstration of the wet plate collodion process. We had a very nice visit and made a few plates. Meet Viktor:

That evening I came down with a fever. By Friday the 6th it had hit 103 and my local GP sent me to the ER for some tests (things happen faster in the ER, especially on Friday). They did blood counts and a chest Xray and all was normal. The main concern would be a post-operative infection, although that would be unusual 4 weeks after surgery. Apparently I had caught some kind of virus that was making me feverish, tired and weak. It persisted through the weekend,so I went in to see my GP on Monday. He sent me back to the hospital for another blood count and a blood culture to check for other possible infections. He also ordered a head CT which is something I was scheduled to do anyway as  follow up to my surgery. We also scheduled my follow up head MRI for Wednesday. He was considering admitting me to the hospital to be put on IV antibiotics, but he wanted to talk Dr X first.  By the time he talked to Dr X on Monday afternoon he had the blood count back and the head CT. The blood culture results would take a couple more days. Still, all looked OK and Dr X thought I should not be put on IV antibiotics unless there was some evidence of infection, which there was not. I was still getting a fever, mostly at night, although it was more like 100 to 101. I was still wiped out. Lots of couch time.

By Wednesday I was feeling better, but still had a slight fever. I went in for my MRI, then back to see my GP. The blood culture tests had come back negative and my MRI was "unremarkable" meaning there was no indication of infection at the surgical site. We decided to just let the thing play out and hopefully my body would heal itself. Every day I felt a little better and my fever (which was still mostly coming at night) kept getting lower. By Friday I felt well enough that I stopped by work to say hello to my colleagues and get mentally prepared to start work again tomorrow. Friday night the fever came back and Saturday I was just really tired most of the day, so more couch time. It's now Sunday and I'm feeling better. I'm still low on energy, but doing better than yesterday, and so far, no fever. I will go in to work tomorrow and do the best I can. I'll work as many hours as I am able, then come home and rest some more.

Now, for the pictures. Here is a side-view of my head taken during the CT scan. If you look above where my ear is, you can see a triangular-shape that is the piece of my skull that was removed during the craniotomy. You can also see three metal tabs with screws on each end that are holding that piece of skull in place. The grid-like material below the metal tabs is the titanium mesh that was used to cover the hole in my skull. It is also held in place with tiny titanium screws.
And you can see all the wonderful dental work I've had that has helped finance my dentist's nice car.

In this sectional view from the CT you can see the mesh material covering the hole in my skull. Even though this looks like the left, it is in fact the right side.

Here is the original MRI from April 19 that identified the lesion on my brain and started this whole thing in motion. (The light gray blob on the front of the right temporal lobe - the left side in this picture.)
April 19, 2010 (Before)
August 11, 2010 (After)

When I first saw this image I cried. It was the first hard evidence I had that what was once there was now gone. Not only do I feel better, I can look at this picture and know that the awesome Dr X had been in there working his magic. It wasn't just a surrealistic dream as it often seemed. It all really happened and it happened to me. 

I know that this isn't the end of the road. I still have to deal with coming off the anti-seizure medication and hope that my old symptoms don't return. Only then will victory be complete. But, for now, I look at the August 11 MRI and all I can think is that I've never looked so good