One Year Gone

Today is exactly one year since I had this portrait made that sent me on this little adventure of the body and soul.

On one hand, it seems like much less time than that, but on the other it somehow seems to be the distant past now. The good news is that things are getting better since my last posting in February. My visits to Dr Z seem to have helped with the depression/anxiety/insomnia train. I think a big part of it was learning about these issues and how to deal with them. It's not over yet, but the frequency and intensity of the anxiety episodes has decreased. I'm also having fewer sleepless nights. Carol has been coming with me to some of my recent visits with Dr Z and I think it's been good for her (and me) to talk about how my surgery and recovery has affected her. I'm now seeing Dr Z every other week and I think soon we'll go to once a month. Also, my "Day Job" employer has granted me permission to work from home one day a week (Mondays) which helps lessen the pressure and anxiety in my life and now I look forward to Monday morning rather than dreading it. I have to say I really appreciate the support I've gotten from the people I work with, especially my direct supervisor. She's been nothing but helpful throughout this journey.

One of the real signs that I'm getting better is that I am once again making photographs with abandon. I'm getting out to shoot at every opportunity and making lots of new work. A few days ago I made this self portrait at Bridal Veil Falls located on Highway 50 on the way to Tahoe. I have photographed this waterfall many times over the years, but this was the first time with me in it. It's a time exposure of about a minute, during which I stood there for about half the time which made me blend in with the water quite nicely.

Click on the picture so you can see a bigger version of it. The shirt says "I Can Stand My Own Ground"; lyrics from a song by one of my favorite bands, Rise Against. This seems like an appropriate message of late as I am now finally feeling pretty good most of the time and back doing the things I love to do. At this point, I don't think I can ask for much more than that.

In a couple of weeks I will be teaching a workshop here in Placerville, then in June I'll be heading to Montana to teach for a week at The Photographer's Formulary. I'm finally looking forward to traveling again, after doing all I could to avoid it for a while. All signs that things are looking up. Life is mostly back to what I'd call "normal". In fact, I'm wondering if I should keep up this blog in the future. Perhaps it has run it's course. Let me know what you think. Maybe I'll morph it back into what it was originally intended - an outlet for my creative life. With that in mind, here are some more new photographs taken over the last couple of months:

Raley's Parking Lot

Pacific House, CA

Apple Hill

Rancho Seco

High Water in Sacramento

High Water in Sacramento

Tells Creek

Folsom

Sly Park Lake

In March I was lucky enough to have four of my best friends on the planet come to California for a long weekend of photography and mayhem in Yosemite.

Bill Schwab, Ike Eisenlord, Me, Clay Harmon and Matt Magruder

These guys are all fantastic photographers and just a hoot to hang out with. Sarah has dubbed us the Nerd Herd and we wear it with pride. I am lucky to have each of these guys in my life. Man, did we have a good time! And the weather was great. There's nothing like Yosemite with snow on the ground. There was enough rain and mist to make the photography great, but not enough to make photographing miserable.

Gates of the Valley

El Capitan

Merced River

Cliffs I Can't Remember the Name Of

Bridalveil Falls

The Ride Home - Highway 49

So I guess that's it for now and maybe this will be the pattern for the future. More pictures and less words. Thanks again for following along and all the good thoughts and vibes along the way. I've said this many times before, but it helps more than I can explain.

I am still a lucky man.

Another Great Sunset from Our Deck

Carol's Tulips in the Front Yard

Signs

"Sign sign everywhere a sign
Blocking out the scenery breaking my mind
Do this, don't do that, can't you read the sign"

- Five Man Electrical Band

Funny how time flies and drags at the same time. Two and a half months have already gone by since my last blog post, yet the road to healing seems to drag on.  January 9 was the six month anniversary of my surgery, or when the air hit my brain. It seems like only yesterday I was having staples removed from my scalp. In December I read this amazing book:

It's written by a neurosurgeon and it describes the process of becoming a brain cutter and his experiences treating a variety of patients. The title comes from something he was told by one of his mentors that "when the air hits your brain, you'll never be the same".  I'm not a big reader these days but I plowed through this book in two days. I recommend it to anyone who has been a patient or is considering going into medicine. Or anyone who likes to read a compelling and well-written book.

As for me, I'm still dealing with some anxiety/panic/depression and insomnia issues that I mentioned in my last post  in November. After meeting with my GP several weeks ago, we decided I should try some therapy so he recommended a psychologist that he likes. I had my first meeting with Dr Z January 10 and have been seeing her weekly. I am optimistic so far. I've never done any formal therapy before, so this is new ground for me. We are working on cognitive behavioral therapy (CBT) which "is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do." In other words, learning techniques to deal with anxiety (and other psychological issues) through how you think rather than just tamping it down with meds. I still have Xanax on hand as a backup, but am using it only when absolutely necessary. I am also taking a low dose of Wellbutrin to help with depression. This is a drug I used successfully about five years ago with no discernible side effects. I didn't realize how the depression had been affecting me since I've been so focused on the anxiety issues. I've only been on the Wellbutrin for a couple weeks, but it seems to be moving me in the right direction. Here's a sign:

That black stuff on my fingers is silver nitrate, the tell-tale sign that I've been making photographs using my beloved wet plate collodion process. This past weekend was the first time I've had the desire to do this process that I dearly love since September. Here are a couple of the results:

Carol and Tikis

The Scary Uke Duet (Sarah and her buddy Alana)

So the fact that I wanted, née needed, to do this is a good sign that at least the dark cloud of depression is beginning to lift. The anxiety comes and goes. Sometimes it is like a low-level hum of feeling on edge and anxious for no apparent reason. Sometimes it presents itself like a panic attack with chest pain and other unpleasantness (my heart is fine and I have the pictures to prove it). In psycho-babble it's not clear if I have a panic disorder or generalized anxiety disorder, but what it is is less important than learning how to deal with it.

Of course it is possible that these events are temporal lobe seizures although they are different than what I was experiencing prior to surgery. My neurologist tells me it's hard to say for sure, but the surgery may have altered but not "fixed" the problem. On the other hand, anxiety issues are very common for people who've gone through they type of surgery that I had and it can take a year or more for the brain to complete the healing process. Those little neurons and dendrites grow very slowly I'm told...

So for now, we will go on with the CBT therapy, anti-depressant medication and the occasional Xanax. If there is no perceptible improvement when I hit my one-year anniversary, we may consider going back on anti-seizure meds to see if that makes things better.

Another day at a time...

And now for your viewing pleasure, a few more recent pictures that I like:

Glimpsing the Rainbow

"Nobody ever had a rainbow baby, until he had the rain..."

-Jim Croce

I've loved Jim Croce's music since I was about 12. He was a great singer/songwriter who really knew how to use words. I've just recently started to listen to Big Jim again and can only wonder what he would have done with his life had it not been cut short at 30.

It's been about two months since my last post. It's been a frustrating and finally rewarding time. Lots of rain and not too many rainbows...

As of one month ago I am now off of the anti-seizure medication Tegretol, which is a good thing. In the mean time I've been battling some episodes of anxiety and insomnia. Not exactly panic attacks, but intense anxiety, especially at night after I go to bed. I'm not sure if they are related to coming off Tegretol or are related to symptoms I was having prior to surgery (I don't think this is the case) or perhaps some PTSD-ish stuff. Whatever is causing them, they're not fun. Also, I feel like my balance is off. Not exactly dizzy, but just a little off at times.

Initially my GP prescribed Paxil to help with the anxiety. I picked up my prescription, then decided not to take it after reading that coming off of Paxil can be difficult for some people. Because the anxiety wasn't happening every day, but maybe just a couple times a week, I asked if there was something I could take as-needed rather than a daily med like Paxil. So, the GP gave me Xanax instead. Xanax definitely calms my nerves enough to let me sleep when the anxiety gets bad. I've taken it about 6 times in the last month or so. It seems like the episodes are slowly becoming less frequent or less intense as time goes by. Or maybe I'm just learning how to manage it.

Whatever is going on, I am clearly not 100% back to the good old me. And perhaps this is the new me and I won't ever feel the way I did before all this started nearly a year ago. I feel different. It can be difficult to concentrate and sometimes I can't come up with the words I'm looking for. I also feel like it takes more effort to think and solve problems.  If this is the new me, I'm having a hard time accepting it. I suppose only time will tell and I'll just have to wait and see what the future brings.

Monitor Pass, July 2010

On a brighter note, the creative part of my life is slowly moving forward. In October I taught a planum printing workshop at my home to a small group of very kind people. That was a good warm-up for a 4-day workshop I taught in Yosemite in early November. The Yosemite workshop was fantastic. My dear friend David Eisenlord came out from Minnesota to help me with the workshop. It was great having him there. It's nice to have such good friends who "have your back" when you need it. The six students in the class were fun and enthusiastic. And they were kind enough to cut me some slack when I needed it. One of them happened to be a massage therapist, and that didn't hurt either. Well it did, but in a good way.

 

El Capitan, Yosemite

Bridal Veil Falls

El Capitan

Bridal Veil Falls

So, on I go. Always thankful to have my beautiful family who are there to prop me up when I can't stand alone and loving me, even if I'm not quite the same "me" that I used to be. And thankful for my friends who show their friendship in so many ways. To my friends that are going through your own health and medical issues, hang in there and don't be afraid to ask for help. I don't think I'll ever be able to repay all the kindness that has been sent my way, but I will try.

Happy Thanksgiving.

I am a lucky man.

Coming in for a Landing

Delicate Instrument Handle With Care

Last week I was given the OK by my neurologist to start tapering off the anti-seizure medication carbamazepine (aka Tegretol). I should be done with it by early October. I'm hoping once it is out of my system I'll feel better - less tired, more energy, etc. And I hope I will find that I no longer need it. As an added bonus, alcohol and extended exposure to sunshine are back on the table, two things I've had to avoid while on this drug. Of course, nothing comes without a price. Monday morning I woke up feeling VERY dizzy. I stayed home from work in the morning and spent a few hours watching Pawn Stars and American Pickers on The History Channel, two recently acquired guilty pleasures. It turns out that coming off these brain-altering medications can cause some of the same side-effects that occur when starting the meds. I'm hoping that is what caused my dizziness. By Tuesday morning I was feeling better, but still had some occasional dizziness.

On a brighter note, we had a GREAT time this past weekend. Saturday morning we drove to San Francisco to have lunch with one of my photographic mentors, Frank Espada and his wonderful wife Marilyn.

I took several classes from Frank in the late 80's through the now-defunct UC Extension program in San Francisco. It was his teaching that put me on the creative path I've been on ever since. Gayle came up from Santa Cruz to join us with a platter of red velvet cupcakes in hand. We had a great visit and enjoyed looking at Frank's prints and left with a few treasures. Frank will soon be turning 80 and you would never know it to meet him. He was a great documentary photographer and teacher for decades and for his recent work has pointed his camera to the coastal beauty of Fort Funston. Here's a pic that Frank took of us as we were getting ready to leave:

From Frank and Marilyn's house,  the girls headed to the maul (sic) to find Sarah a dress for the homecoming dance. I headed to my buddy Ron's house to hang out and enjoy the ocean view. Once the shopping task was complete, the girls joined us at the Goloubow's and we had a great visit and amazing meal made by Ron and his better half, Chris. We crashed at their house Saturday night, then got up early Sunday to deliver Gayle to Lake Merced where she competed in her first half marathon (second place in her division!) We cheered her on and enjoyed some people-watching under the gray San Francisco sky. Sunday afternoon we and the Goloubows went out for a delicious Thai lunch not too far from my favorite hospital. After lunch we said our goodbyes. We headed back to Placerville and Gayle pointed Horace (her car) south for her trip back to Santa Cruz where she will be starting her third year of classes this week.

So yeah, it was a great weekend spending time with very good friends. During our drive in, it occurred to me that this was the first time in a LONG time that we've driven to San Francisco without ending up at some sort of medical facility. I like it better this way.

Finally, thank you for all the supportive comments to my last post, both here and in the emails that were sent. I've said this before, but I don't think I can say it too often, your thoughts of support are appreciated more than you know. I think I'm finally learning what being a patient is all about: being patient. And I've never been very good at that...

"How Do You Feel?"

This is the question everyone asks when they see me. I know it's with good intentions, but I've found that I automatically answer "fine" because I think that's the answer people want to hear. Well, the truth is I don't always feel fine. It's weird because the first two weeks after surgery I was feeling good and seemingly recovering quickly, but the subsequent six weeks have been up and down. The truth is, I'm not sure how I'm supposed to feel 8 weeks after a craniotomy. Carol did some googling last night and it may take three to six MONTHS for full healing and recovery. In a way,this was a relief because I know I'm not 100% yet and it's comforting to know that this is probably "normal". Fatigue and lack of motivation are probably the main issues. I tire easily and often just don't feel like doing anything. I'm definitely sleeping more than I used to and that's probably a good thing since I used to sleep only four or five hours a night. Sometimes I just don't feel good - whatever that means - but I rarely feel like Good Old Me. And I think I'm a little depressed because I'm not 100% yet and things seemed to be getting better so quickly at first. I've been back at work for three weeks. The first week was a struggle as I came home exhausted every night.  The subsequent two weeks have been easier and I'm getting back in the groove again. I have a workshop coming up in October and have decided to postpone it a few weeks to give me a little more time to heal.

My hair is growing back pretty quickly:

August 29

And here's a new picture of Carol. I like this one:

August 29

So, don't be afraid to ask how I'm feeling. I appreciate your concern! But, I'm going to try and be more honest with my answers in the future. I'm hoping that soon enough "I feel great" will be what I answer most of the time.

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.