This is Hip

I'm now about six weeks into recovery from hip replacement surgery on April 25. Here's the new hardware:

The device is made up of some exotic metals and other materials. Its press-fit in place, no screws or glue. The surfaces of the metal that are in contact with bone have a texture to them that closely resembles the texture of bone. Over time, the bone will grow into the metal helping to secure it in place. The ball is ceramic and it sits in a chrome-cobalt alloy socket that is lined with a super-durable polymer. Ceramic is smoother than metal so it causes less wear on the polymer lining resulting in a hip that will last me a long, long time (fingers crossed). The stem that goes into the femur is surrounded by a polyethyl etheyl ketone liner that allows the implant to be just a bit flexible and behave more like bone. At least that's what Dr Hip tells me. There are lots of different ways to do a hip replacement these days and this combination of materials seems to be the best choice for a (relatively) young hip patient, like myself. Dr Hip used the more traditional lateral-anterior approach meaning I have a vertical 8-inch scar on the side of my right hip. There are alternate "minimally invasive" approaches that result in smaller incisions and quicker recovery, but they have their own issues. The surgery took about 3 hours, a little longer than normal because, as Dr Hip told Carol afterward, I am built like a tank.

Amazingly, I was in the hospital for a total of 30 hours. We arrived at 6:30 am on Thursday and by 1:00 pm on Friday I was home in my own bed. The afternoon of the surgery, my surgeon and a physical therapist came to see how I was doing.

Doctor: "Do you think you can get out of bed?"
Me: "Um, well, yeah, I think so."
Doctor: "OK, do it."

Within hours after the surgery I was on my feet and shuffling a few steps across the room with a walker. On Friday morning a physical therapist took me for a longer walk around the floor and showed me how to safely go up and down stairs until I was healed. The surgeon came back around noon and said everything looked good, I had passed the physical ability tests indicating I could get around safely with some help (Carol took a couple weeks off of work to help take care of me). As long as the post-surgical pain was manageable with pills rather than stronger IV meds (which it was), I was free to go.

YES!! I've spent more than my share of time in hospitals in recent years, so the quicker I'm out of there, the better. The arthritis pain was now gone since those parts were replaced. There was plenty of post-surgical pain due to well, just look at the X-ray! I was on a steady diet of Norco for the first couple of weeks and have slowly tapered it down to just an occasional dose when I over-do it.

The first couple of weeks I had in-home physical therapy and in-home nursing care twice a week. I was on blood thinning medication after the surgery to minimize the risk of blood clots and blood samples I am doing physical therapy twice a week and exercises every day to heal and strengthen the muscles that were cut during surgery and have been neglected due to the arthritis pain that made it difficult to walk, stand, sit, etc. I managed to tweak my knee doing my hip exercises, so that set me back a bit. I can now walk short distances without a cane. The hardest thing is sitting for extended periods, so long car rides are out for the time being. My exercises are intended to both strengthen the muscles, but restore range of motion that became so limited due to the arthritis.

I have a second follow-up with Dr Hip tomorrow and I'll have a better idea of what's coming next. Probably more physical therapy. If things continue to go well, I expect to be back at work by the last week in June or first week of July.

A couple days ago we got copies of the billing from the insurance company (Blue Cross). The price for the implant and supplies was $90,000(!!), of which Blue Cross paid $15,000. Two days in a semi-private room was billed at $80,000(!!), of which they paid $8,000. The surgery itself was about $3,800 (which seems cheap by comparison), of which they paid $3,000 and anesthesia was $2,250, of which they paid $1,250.  So, all tolled, the bill was about $180,000 of which Blue Cross paid about $28,000. I don't really understand how they come up with these crazy numbers, I'm just glad we have good coverage.

Thanks to Carol once again for taking care of me through some rough days. And thanks to the capable hands of Dr Hip for putting me back together again.

I continue to be a lucky man!

What is Hip?

I grew up in Oakland, CA home of the funkiest band ever, Tower of Power:

This video is from 1973. I was 13, learning to play the drums and wishing I could play like Dave Garibaldi some day. Well, that day never came, but 40 years later I still love their music and they're still at it. It makes me very happy that our kids are also fans of the band. Maybe it's because the first concert we ever took them to was Tower of Power in Lake Tahoe when they were very young. There would always be plenty of TOP in the music rotation on family road trips. If you get the chance, go see them live and don't forget your dancing shoes because you won't be able to sit still.

This is also hip:

My right hip, to be exact. A normal hip has a dark gray area between the ball and socket of the hip joint. The dark stuff is cartilage which provides lubrication of the joint. The x-ray shows that mine is completely gone in my right hip - bone on bone. As I've mentioned before, I've been dealing with painful arthritis that was first diagnosed in 2008. It has slowly gotten worse over time and over the last year things have gone downhill quite a bit. I wanted to put it off as long as possible, because artificial hips only last so long and it's likely I'll need a revision before I'm done with my time Here. I'm at the stage now where the pain is constant, I am having to use a walking stick most of the time and am very limited in what I can do. I've finally had enough and am now on the path to get a full hip replacement on April 25. I'm expecting to be off work for about two months while I go through healing and rehabilitation after this major carpentry project. I'm having the surgery here in Placerville at Marshall Hospital by a relatively young surgeon I'll call Dr. H (for hip, get it?) I first saw him about my hip about a year and a half ago. At the time he said he'd be happy to do it then, but I should try to hang in there for a while for the reason I mentioned above. I can't say I'm looking forward to being sawed, hammered, routed and stitched up, but I am looking forward to being able to walk, sit, drive, photograph and live without constant pain. Maybe I'll even be able to play the drums again and pretend I'm Dave Garibaldi with Tower of Power cranked way up LOUD on the stereo.

Wish me luck. This isn't going to be fun, but like my friend David says who is fighting brain cancer, "getting old is not for pussies".

Peace and good health to you all.

-Kerik

Year Three Begins

Time is the coin of your life. It is the only coin you have, and only 
you can determine how it will be spent. Be careful 
lest you let other people spend it for you.

-Carl Sandburg

I am sitting at the dining table of our dear friends  Liz and Carl Radford near Glasgow, Scotland. We are winding down a wonderful trip of three weeks in England, Scotland and Switzerland and will be heading home on 12 July.

An entire year has passed since my last posting and it's been a busy one. In the fall I had an exhibit of my photographs at the Ansel Adams Gallery in Yosemite. I was lucky enough to have several good friends attend including Bill Schwab from Michigan and David "Ike" Eisenlord from Minnesota as well as Carol and Sarah.

Ansel Adams Gallery Exhibit

I taught a number of workshops and was lucky to have teaching assistance from Ike as well as my daughter Sarah. Gayle graduated with a degree in health sciences from UC Santa Cruz and Sarah graduated from El Dorado High School and is heading to UC Santa Barbara in the fall. Sarah turned 18 in April, I turned 52 in May, we celebrated Carol's 55th in the Swiss Alps four days ago and yesterday we had a wonderful birthday dinner for Gayle's 22nd at a fantastic Thai restaurant in Glasgow. So many changes and life continues to roll along at an ever faster pace. Each year seems shorter that the one before.

Yesterday was the two year anniversary of my brain surgery. Being in Scotland is significant because on the day of my surgery we had been scheduled to fly to Scotland and being here now completes that loop. Overall, I am doing well. It's clear that anxiety attacks and bouts with depression are with me for the long haul. Whether they are a sign of getting older or the result of having my brain slightly rearranged can't be known for certain. Luckily, I've learned how to manage them fairly well with the help of a good therapist, an occasional pharmaceutical and a loving life partner. I continue to feel lucky things have worked out as well as they have as I've lost a couple of friends over the last year and another is now struggling with brain cancer.

Unfortunately, I have arthritis in my right hip that has gotten significantly worse over the last year and has made getting around more difficult. It looks like a new hip is closer on the horizon than I had hoped. Arthritis runs in the Kouklis genes. My dad had both of his hips replaced in his lifetime and I always remember my grandfather's arthritis-induced shuffle and his hands gnarled by the disease. We're lucky to live in times that such major surgery is routine, but of course, I still dread it. In discussing the surgery with my GP, he recalled observing hip replacement surgeries in med school and thought they always seemed a bit like carpentry with all the sawing and hammering and power tools. Yes, he has a bit of a warped sense of humor and that's one of the things I like about him. For now, I've had a cortisone shot and take some meds to ease the pain. I also have a walking stick (I refuse to call it a cane because those are for old people) that I use when the pain is bad.

We're now mostly packed and ready to leave our beloved friends and bonny Scotland in the morning. I was hoping to make time to write some more, but I want to finish this post while we're still on this side of the pond. As ever, I am grateful to the friends and family that have stood by and lent a hand or a shoulder when needed. And please know that I am here to return the favor whenever it may be needed.

Love and peace to you all.
-Kerik

A few pictures from this trip:

Workshop at The Clocktower in England's Lake District

Hooligans (With Carl Radford and Tim Soar)

My new Celtic Ink

Sister Harry Potter Tats

In Edinburgh with Carl and good friend Clay Harmon from N. Carolina

Bothwell Castle, Scotland

Swiss Alps at Sunset

Clouds over the Alps

 Trummelbach Falls in the Swiss Alps

Glacial melt near Grindelwald, Switzerland

Gayle and Sarah are happy about lunch at Wagamama in Glasgow!

Need I say more?

Day 366

"What a long, strange trip it's been..."

Yep, I made it. It's one year today since the air hit my brain. It has been a circuitous and unpredictable road, but I am learning how to negotiate it. Most of the time. Not too much has changed since my posting in April. Still dealing with some anxiety issues, still working on it with Dr Z and Carol and still making photographs. Last night I decided to have Carol buzz my head in honor of the one-year mark. I didn't go for the full shave-down because it's just too much hassle. I wanted to see my scar again and having this short, short hair feels good!

Me by Sarah

In May I made this photograph to represent the portion of my skull that was removed during my craniotomy:

It's What's on the Inside That Counts

Recently I've gotten into making time lapse videos. I'm still figuring it out, but we decided to have a little fun with my haircut:

I've recently done a little traveling for the first time in a year. In early June I gave a talk about my work to The Photo Alliance in San Francisco.

In mid-June I spent a few days in Olympia, WA attending a seminar for my day job. The Northwest is so beautiful. I could live there some day...

Towards the end of June I went to Montana to teach a workshop at the Photographer's Formulary. Sarah came along as my assistant and Carol joined us mid-week. Following the workshop we spent a long weekend with good friends Besty and Michael in Missoula. If you've not been there, Missoula is a pretty cool town!

 An Hour in the Darkroom

Carol, Me, Michael, Sarah and Betsy

Every Time I Go to Montana, I Get More Attached

Under the Big Sky

World's Best Darkroom Assistant

The View from Our Room at The Formulary

Here are few more new photographs since my last posting:

Thursday was Carol's Birthday

Happy Birthday My Love!

Ravinder and Tony

Tony can COOK!

Long Exposure from Our Deck

Long Exposure from Our Deck

Long Exposure - American River

Tomorrow Gayle turns 21. It's hard to believe because in my heart I still feel 25 (although not in my arthritic hip). Happy birthday, Gayle, and bon voyage. You make me a proud papa!

My Little Girl

 Always looking forward to what the future will bring:

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