I seem to be doing better and better at the walking-without-a-cane business. Today at physical therapy I made it 360 feet non-stop. Sure, it was on a smooth and level surface with no obstacles, but I'll take what I can get.

There were a couple of moments when I almost lost my balance, but I was able to recover with a wee bit of fancy footwork — one of the first skills to escape me when my condition was becoming apparent almost two years ago. This is unexpected, but extremely encouraging.

Walking without a cane is very strenuous, much more so than walking with the cane. Moving forward isn't the problem; avoiding falling over to the left or the right is. With the cane, I can actually move pretty quickly for short periods. Without the cane, though, I have to rely solely on muscles that just don't work very well for the lateral support usually provided by the cane; I have to walk like a not particularly spry 90 year old — very slowly and cautiously, every step taken with deliberate forethought. No jokes, please, about walking and chewing gum.

I'm physically exhausted when I'm done walking, but it seems to be paying off.

Like pretty much everyone, I used to talk the simple act of walking for granted. Now that I'm out of a wheelchair and off crutches, even though it can be very difficult, I'm thankful for what little I can do, and hopeful that I might be able to do more in the future.

At PT today I walked 210 feet before I had to touch my cane to the floor to keep from falling over.

And then I did another 150 feet.

It pretty nearly wiped me out. By the time I finished the walking, I was utterly soaked in sweat.

The hardest part of walking sans cane is keeping my feet fairly close together, rather than shoulder-width apart. A narrow stance is inherently less stable, but I don't want to be accused of having a wide stance, ifyouknowwhatImean.

I won't be setting any land speed records any time soon. On the straightaway I'm slow, and when I have to turn around, I'm even slower.

Nevertheless, this is much better than I ever expected.

I had an excellent day at physical therapy today. I walked 120 feet without using my cane, and without falling down.

Ta daaaaaah.

It'll be really impressive, though, if and/or when I can do it over uneven ground. Pebbles remain a significant obstacle.

I've not written much about health matters lately, mainly because while there is improvement, it's no longer as rapid or as startling as it was early on. I've surpassed all expectations, so any further improvement is pure gravy.

Physical therapy continues twice weekly... or maybe I should say weakly. The focus remains on building strength in my legs, accomplished by adding more weighs or more reps to the exercises I do, and the addition of new exercises to work new muscles.

On top of that, I spend time walking. I can do 15 to 20 minutes now, using the cane. Monday, I did 4/10 of a mile, at an average speed of 1.5 miles/hour. That's the fastest and farthest I've managed since this whole thing began. I started out slow as usual, but halfway through the walk I made an effort to stretch out my stride, and I think for a while I was walking almost as fast as a normal human, maybe 3mph for a while there.

Best of all, at one point I picked the cane up off the floor and was able to walk maybe 30 feet without it. I was slow and shaky that way, but I did it.

By the end of the walk, though, I was completely blown. I was relying on the cane for support, whereas I usually use it mainly for balance.

I've discovered that my cane really sucks for support. It's strong enough, no doubt, but the handle is the shepherd's crook style, as opposed to the more wrist-friendly "fritz" T-top style. After ten minutes afoot, my wrist really starts to get sore.

I have no idea who Fritz is or was.

I only paid $10 for this current cane, so I really ought not to have expected perfection. And, hey, it's the first time I ever had to buy a cane. It's not something one spends one's life anticipating and researching.

It's done yeoman's service with nary a complaint, but since I anticipate needing a cane, well, forever, I think it's time for a new one — one that will be better on my wrist, will be tall enough for me, and will be sturdy enough for me.

Fortunately, there is a place I know where I can find what I need: Canes Galore. No fooling.

I like the Hercules. It's more than long enough, it can support me with one or two of my siblings' teenage kids on my back, and it looks like it could last a lifetime.

Shortly before going to bed last night (this morning, really) I came down with a fever and aches. Swell. At least it didn't wait until my weekend starts at midnight tonight. I can work through being unwell, but I hate losing my days off to illness. I have too much to do.

I think I need to have my shunt adjusted. When I occasionally cough or sneeze, I feel what might be described as a pressure spike in my head — a momentary pang, like a headache that comes and goes in a split second. I think there's still a bit too much pressure in there.

I keep making progress at physical therapy, and my reward is more weight on my ankles, or newer more difficult exercises.

The birds in my neighborhood are retarded. They start chirping about two hours before sunrise — right outside my bedroom window. The feathered buggers can make it hard to get to sleep.

A thunderstorm in the wee hours of the morning, however shuts them right up... and I have no trouble falling asleep if it's thundering or pouring rain.

The cats get a bit nervous, though. Kismet curls up tightly right against me, and Packet stretches out on the bed as well. Mycah would come up, but she rarely ever voluntarily approaches the lads.

They, on the other hand, continually try to make friendly with her. It's particularly noticeable at feeding time. I call "food!" and the cats know it's time to go downstairs. Packet races down to the bottom of the stairs and flops down. Kismet positions himself on the landing halfway down. Mycah follows behind me as I go down — she gives Packet a brief hiss and heads down past him... and he follows, batting at her tail. She then gets to the bottom of the stairs ahead of me, and has a few words with Packet, who lays there oblivious to her demand that he move out of her way. It's as if he is daring her to approach him... but he eventually gets out of the way.

Food seems to be the great unifier, though. When the hairball treats are being distributed, Mycah has no objection whatever to the lads' immediate presence. Once the treats are gone, though, the hissing starts again... but she's getting better. Eventually she'll tolerate the lads.

Work starts in a couple of minutes. Sundays are usually pretty quiet, but this week so far has been fairly heinous. I can work through the fever and headache... but I'd rather have a nice night where no part of the network breaks. Ya, right. We have 30,000+ routers under management — something will go wrong at some point.

OK, I just logged on and I see that it has been slow so far today. I guess we got most of it out of our system over the past week.

Have a good Sunday, folks.

Update: the Fates laugh at me. I just spent three hours trying to figure out a routing problem on the core backbone, and what to do about it.

Yes, I fixed it. Bloody nuisance.

I don't know what I was thinking.

Today being the day of the week I set aside for chores and errands, I got started at the crack of noon. Up, shower, dress, feed the cats, and depart to run errands.

I didn't have that many things to do — pick up cat food and litter at the Petsmart, get Mycah's meds and prescription food at the vet's office, and pick up some carpet cleaning supplies.

I think I bit off more than I could chew. Kitty litter and food are, of course, all the way at the back of the Petsmart.

Carpet cleaning supplies are all the way at the back of the Home Depot.

And since I was passing by, I stopped at the Target to pick up a cheap-o DIY bookcase, since I have way more books than shelf space.

Furniture is alllll the way at the back of the Target.

Then home... to unload all the crap from the pickup. And then take the trash out and wheel the bin down my treacherously steep driveway to the curb. Dragged myself up same driveway.

Then fed the cats again. Then hauled myself and my acquisitions up the stairs.

Going up stairs ought to be easier for me now than in February, but it isn't; I'm still having strength issues.

I've spent more time on my feet today than I have in a couple of years. I'm absolutely whupped, and I pretty much need to hit the shower again.

And I still haven't done any actual housecleaning. Sigh. I guess that's my day tomorrow.

At least I haven't fallen down.

I heard on the news today that Senator Kennedy had gone under the knife for the recently diagnosed tumor. Best of luck to him with that. I don't like his politics at all, but in this I can do naught but wish him well.

Of course, he's not going to need too much luck. He had the best neurosurgeon in the world.

I should know. He was my neurosurgeon, too.

The upside to my recovery: I can feel my feet again.

The downside: I can feel the gout again.

Ouch.

It's been a busy week here, and I find that the pace of my recovery, while slow, continues steadily. I'm walking a lot better with the cane, and haven't as much as touched my crutches in about two weeks. I'm not throwing them away quite yet... but I'm almost there. I can even walk very short distances without the cane.

Well, not so much walk as stagger. It's not the finest perambulation I've ever done, but it's better than I've managed in over a year.

Physical therapy continues twice weekly. Every time I get to be good at something, they go and add weights to my legs. I'm up to a whopping eight pounds around each ankle for the leg extension exercises.

Eight whole pounds. Inform the media.

I find that I'm using muscles that haven't been used in quite a while. They hurt, actually... but hey, at least I can feel them.

Part of what I've been doing this week has been preparation for the likely arrival of one or two — probably two — new young cats in the house. I've stocked up on all the essentials, food excepted. Since the shelter provides a bag of food with the cats, I can wait to see what it is they are used to.

On Saturday, before work, I'll be heading to the Cat Angels adoption facility to see if any of their available furballs will have anything to do with me. They have several pairs of young cats, about a year old. All the information I've seen points to the fact that when bringing new felines into a home with an older cat, it's best to get two, so they'll play with each other rather than pester the older cat incessantly. That works for me. I can give a good home to a couple of rescued cats.

How Mycah takes the news remains to be seen. I've been giving her lots of attention; I'm hoping she won't be too resentful of the time I commit to the newcomers over the course of the next couple of weeks as they get used to their new home and new Food Giver And Litter Scooper. I think she'll be very curious, perhaps a bit hostile, then annoyed, and finally indifferent.

And who knows? She might actually like the newbies. Young cats should not be threatening to her in any way We'll see.

While I was in the midst of my medical problems, I received a lot of support from quite a few people. Mom, of course, came and stayed here in NC — bored out of her skull most of the time, I don't doubt, between rounds of driving me to the doctors and doing those things around the house which I was incapable of doing for myself. My sister, too, made a few stops here to help. The two of them were invaluable; without their help, I'd have had to sell my house and move to some sort of single-story assisted-living facility.

No kidding. I was unable to fend for myself.

Many others provided moral support. I can't count how many emails I received, all full of encouragement. And there was at least one church congregation praying for me regularly.

The medical care I received was top-notch. My regular doc was and is as good a GP as I've ever dealt with. The neurologist I went to is one of the best in the country, and the neurosurgeon who drilled me is arguably the best neurosurgeon in the world. Plus, there were really cute nurses all along the way. Hey, I'm a man... you didn't expect me not to notice, did you?

Further, when I had a fundraiser going here to help offset my massive medical bills (which so far have added up to over a year's pay... egads) more than just a few people made donations to help out. It made a difference.

Now I'm in a situation where my past medical bills are all paid up, where the minor ongoing treatment (physical therapy, mostly) is relatively simple for me to handle... and I have my tax refunds in the bank.

I've always tried to be a charitable guy; I could do a lot better. I want to do better. So, I've recently seen a couple of situations where maybe I could directly make a difference, where I could give someone with insanely high vet bills some of the same sort of support that I was blessed to receive when I was down.

Moki is a tough little fighter with an undiagnosed neurological condition. If you think this reminds me of my own situation, you'd be exactly right.

LillyLu is another cat with enormous vet bills... particularly since her human is getting ready to have twins of her own.

Both those linked sites have orange "Donate" buttons in the sidebars. Go on, hit them. Every little bit helps. Big bits help, too.

For those of you who are charitably inclined, but feel the need to have tax deductability, there is the newly-founded Cat Friends Helping Friends. There are plenty of people-oriented charities, but as far as I know, there's just this one that helps people with big veterinarian bills. Go help them out.

Now that I can walk — not well, mind you, but a cane is usually sufficient to my needs — I haven't had a fall in almost a month, now — I'm really hankering to do something I haven't been able to do in well over a year: go to the rifle range and make holes in paper.

There's just one small problem: while I can walk, I cannot carry things particularly well. My balance* is not yet reliable enough, and those of you who've ever been shooting know that a trip to the range always involves a fair amount of toting.

I suppose getting groceries into the house might be considered good practice. Once a week, I order groceries online and pick them up a few hours later. The goods are deposited into my vehicle curbside at the store, but when I get home I have to schlep the week's acquisitions from truck to house. Fortunately, it's a short trip, and there are what amount to handholds almost every step along the way. And of course I don't try to carry the entire load in one trip.

Going to the range would be a different matter altogether, as far as portage is concerned. It's a longer haul, with a bigger load... and if I were to fall, there'd be no easy way to get up again, short of crawling back to my truck and pulling myself up. I can't yet get up off the ground without something to use as leverage.

Since I don't have any servants on staff, what I really need if I want to go to the range is to coordinate with someone for a meetup at the range.

You know, a play-date.

_{* It's not actually my sense of balance that is weak, it's the ability of my legs to keep me up straight, to react in a timely manner to keep me upright if I should happen to lose my balance.}

I'm really really glad I didn't have my surgery in Germany.

(Via AoSHQ)

I'm making good progress, recovery-wise. I still need crutches to handle a trip down my very steep driveway, but otherwise I'm makiing good use of my cane.

It's been three weeks since I've had a fall. I attribute this to my finally taking the advice offered to Luke by Han: don't get cocky. Since the surgery, every time I've fallen, it's been because I was trying to do too much, too fast.

Sure, it's incredibly geeky of me to mention the reference. But whenever I'm afoot and tempted to go faster than usual or to cross an obstacle, I hear that voice in my head: don't get cocky.

It's good advice. Falling hurts. More precisely, landing hurts... but the results are much the same.

Yesterday I was the subject of the latest iteration of the Taser test, wherein my legs were covered with electrodes, and varying levels of electrical current then applied, in order to determine the responsiveness and conductivity of the nerves in my legs.

Shocking, I can tell you.

On the plus side, I could actually feel the tingling induced by the lower level current, and the jolts induced by the higher levels.

On the minus side, the jolts hurt.

The result of the test seems to be that my remaining neuropathy is basically the same as it was the last time I had this tested, back in August. This isn't necessarily a good or a bad result; my overall condition declined severely after the last test, and has improved quite a bit since the surgery in December.

I've suspected for a while that there have been multiple problems occurring simultaneously, complicating the initial diagnosis of hydrocephalus. Well, that's been pretty well resolved through the surgery; what remains is anybody's guess.

There's a chance the neuropathy will resolve itself as my recovery continues, so we'll be watching and waiting for a few months. In the meantime, my progress has been pretty good. Regular physical therapy and exercise seems to be helping quite a bit. I still use the crutches for the most difficult walking conditions, but I'm hoping to dispense with them soon; the cane suffices for almost everything.

Speaking of PT, it's time for me to go....

It's been almost three months since my surgery. Since then, the news has been almost all good.

My recovery is proceeding, albeit slowly. I am walking almost exclusively with only (only, he said) a cane. It it only rarely I feel the need to resort to crutches — only on occasions when I think the walking is particularly treacherous... like walking down my very steep driveway to get the mail.

From a seated position, I can lift my feet straight up off the floor. I can and do negotiate the stairs in my house several times a day. I can walk without even a cane for short distances... though I don't like to take the risk. "Don't get cocky" isn't just a line from a movie, it's good advice for those, such as I, who wish to avoid face-planting on the carpet more than once a week.

I go to the physical therapist's office for the twice-weekly torture sessions, as there are some exercises and stretches I am as yet unable to do unassisted. My progress there is slow, but they keep adding weights to my ankles as I do the various routines. I'm up to a whopping four pounds per leg on the leg extension exercise, for instance.

I had a visit with the neurologist this week as well. After testing my reflexes and muscle strength, he pronounced himself very pleased with my progress... but he also scheduled me for a nerve conduction test.

Yes, another test. Since the surgery, I have regained the use of the muscles in my legs, but some are considerably weaker than they should be, and there is a remaining degree of peripheral neuropathy. In addition, some "wires" still seem to be crossed. For example, when whacking one knee with the little rubber hammer to test the reflexes, both legs react.

So, another test. This is the one I refer to as the Taser test. By sending an electric current into specific nerves and observing the muscle reactions, they can gauge the functionality of the nerves in question.

Of course, it involves being tazed repeatedly. It's not terribly fun, let me tell you. Really, though, I can take it. If it were being done to no purpose, I would object, but since there's a good reason for it, and might ultimately lead to a better fix for me, I can tolerate it.

So, to summarize: I'm doing a heck of a lot better than I was three months ago, and continuing to improve. I may not ever make it to 100%, but I am nevertheless very happy with how things are proceeding.

In what may be a sign of things to come, I made a trip to the office yesterday to get my new laptop configured with all the standard corporate software. The folks there at the office were rather surprised to see me — the last time I was there was a brief stop in June.

In what may be a further sign, the configuration appointment was cancelled by our helpdesk people, and I came home unconfigured to work my shift at my usual desk here.

So I have this nice shiny new laptop that is as yet unuseable for work purposes... and I'm not particularly interested in using it for anything else, either. It occurred to me today that I spend virtually every waking minute in front of a computer... and to be honest, it's getting pretty old.

It'll happen in due course, but I'd kill to be able to go out to the garage and do a little woodworking.

The config appointment is now rescheduled for tomorrow. Driving isn't hard at all, but it's still rather a difficult chore to get cleaned up, dressed up and packed up to go to the office, and will continue to be for a while, but the key thing is that it's getting easier.

Pain heals. Chicks dig scars. Glory... lasts forever.

Parts one and three of that quote (source) are pretty much true.

How about part two?

Chicks: I'm totally available. Ignore the thinning thin hair. Unless you think it's the sign of an exceptionally active brain, in which case, by all means, pay attention.

Just don't expect me to take you dancing quite yet.

Physical therapy proceeds apace.

Yesterday's session was productive, though painful. My legs felt (yes, I can feel them!! Woohoo!!) like limp noodles when I'm all done. "No pain, no gain" might be a cliché, but it is so only because it is so often true.

The highlight of the day was when I took ten steps — albeit shakily — without the support of either crutches or a cane.

Plus, I drove myself there and back; I have enough control and strength in my right leg to do that. Which means I can now drive my Mom to the airport and send her let her go home.

I may still be using a cane for a long time, but only for balance, not to hold myself up. Not a bad result for spending the better part of a year's income on medical care.

When I had my taxes done (yes, I have already filed — jealous much?) it turned out that I'm getting almost all my withholding back. And because I delayed payment for the surgery until after the start of this year, I'll get to take that as a deduction a year hence. The refunds won't (not by a very long shot, believe me) make up for the huge cash outlay, but they take away a bit of the sting.

I went to my first session of PT earlier today.

The BIG news is that I drove myself there — the first time I've driven since June. It felt good, really good.

The PT session was mainly an assessment of my current state. My leg muscles were described as "tight as a bowstring and weak as a kitten." Not an ideal combination, I can assure you. Particularly once the therapist went to work on me. Egads, that was difficult. If they did to prisoners at Gitmo what they did to me today, Amnesty International would probably have a conniption. Not that they don't already; like most of the Left, having conniptions is what they do.

Still, it's all to the good. Plus, compared to the rest of the bills I've paid, the bill for today's session was like a fart in a hurricane.

Yesterday I had my post-surgical followup appointment with the neurosurgeon at Duke. The point, as far as I was concerned, was to make sure that I'm ready for serious physical therapy, something I haven't actually been doing yet.

So, off to Duke. When we got there, we valet-parked the truck, and then proceeded from the front entrance of the facility to the Neurology Clinic — a distance we estimated at about two or three blocks. It's a big facility. For the first time, I covered this ground without using a wheelchair. That was easily the farthest I've gone and the longest I've been on my feet in a year.

I get around the house these days with a cane, but when out of the house I still use my crutches; it's a matter of safety, really. I'm still too shaky to get very far without three points of contact. But when walking, I don't actually lean too heavily on the crutches, if I can avoid doing so; I use them for balance — because falling down sucks like a nuclear-powered Hoover.

So I made it to the Neurology Clinic in one piece. The doctor poked at my surgical scars, had me take a few steps unsupported, and pronounced himself more than satisfied with my progress. Most importantly, he gave me the go-ahead to proceed with physical therapy.

I then made the trek back out of the clinic. I figure I covered perhaps half a mile yesterday; my legs, hips and butt are certainly complaining about it today.

Since the surgery, I've regained most of the feeling in my legs and control of most of the muscles I haven't been able to use for the past year. This is a huge improvement, but it does come with a downside: my legs hurt. Not all the time, but the muscles, particularly the hamstrings and calves, are as tight as a bowstring.

I've already made the appointment for my first PT session, on Friday. If I survive it, I'll try to describe it.

For those few folks who may have been wondering about how I'm doing since the surgery... well, I've been back at work (telecommuting, of course) since last week, since only five days after the second surgery, which might give an indication as to the relative rapidity of my recovery.

I have a pretty cool scar on my head, with lumpy bits of hardware underneath. It turned out that none of the installed hardware is any kind of memory upgrade. Dang. You'd think that a $5000 piece of hardware might have a little extra RAM thrown in. I guess not.

The entry point on my abdomen is healing up again after they "unzipped" it for the followup surgery. Still looks bad, but it should be fully healed in a week or so.

I'm walking around the house on just a cane about 95% of the time, reverting to crutches only when my legs are too stiff or sore or tired... none of which is really unexpected, given such a long period of non-use. I also still use the crutches when leaving the house, but that's mostly a safety issue; better to have them and not need them than to need them and not have them.

I can occasionally take a few steps unsupported. No, that's not quite right... I don't use the cane for support, but for balance, as a second point of contact when I pick one foot up off the floor. WIth the cane, I'm moving pretty well, but I'm still rather wary of falling over. So far, though, no accidents.

Basically, I'm back to where I was in about May of last year, and still improving. I don't know how much improvement there will be, but I really do not expect I'll ever be back to 100% — I suspect there is some nerve damage here. Still, I'm waaay better than I was five weeks ago, and improving rather than declining. I may end up (as I have sort of suspected I might) using a cane permanently, but I can live with that, considering the alternative.

Finally, my hair is growing back. Every time I cut it all off, I get a little concerned that it might just give up and refuse to grow back. Thus far, though, only the hair on the top of my head has done so. The remainder is coming along just fine.

Home is the sailor from the sea,
the hunter from the hill. *

And the computer geek from the hospital.

Yeah, try making that fit a rhyme.

Update: Maggie nails it in the comments.

Alternate title: "Dammit dammit dammit."

The visit to Duke today went about as expected, with a lot of hurry-up-and-wait-ing. Blood work, x-rays, and a cat scan. I forgot to bring Mycah with me, but fortunately, they had their own cats.

The long and the short of it is, the tube that runs from my head down my neck, over my collarbone, down to the area of my liver, and thence into the peritoneal cavity has in fact not stayed inside the peritoneal cavity. The imaging today showed that it retracted out and is neatly coiled above my liver, which accounts for the softball-sized swelling there.

How it did that, I don't know. Maybe they neglected to take into account the fact that I'm way taller than average.

Because the fluid is deposited between the skin and the muscle, it can't be disposed of as effectively as if it were being dumped in the abdomen, so it builds up. The pressure is about the same as in my head, so the cerebro-spinal fluid can't drain out, so my condition is much like it was before the shunt surgery.

The upshot is, they have to crack me open again and place the tubing back inside the peritoneum. My skull is fine, so they ought to be able to do this by unzipping the scar on my stomach.

Which they're doing first thing tomorrow morning.

Egads. I never seem to get a chance to plan ahead for these things.

It's a simple enough procedure that it could be out-patient work, but I'll probably have to spend tomorrow night in the hospital. Ugh. I hate the beds there. At least the nurses are cute.

There is an odd lump that's formed in my abdomen, above my liver, under the surgical scar. It's about the size of a softball, and pretty firm. I think it's the drain output, which ought to be inside the peritoneal cavity; this lump is outside.

I think it's causing a drainage problem, perhaps a back-pressure issue. I've lost some of the progress made since the shunt was installed — the legs exhibit returned muscle weakness, as well as some neuropathy, including numbness and an occasional spasm.

So, it's back to the hospital for me today — blood work, x-rays and a CAT scan. Hopefully it'll be a simple thing to remedy and the shunt flow can resume.

So, here's what the nugget looks like these days. The shaved look is much more fashionable, I think, than the partially shaved look.

OK... here's the photo...

And yes, yes, I know — there's more than a bit of thinning up top there... but I'll staple Mycah to my head before I ever wear a rug.

I get those stitches out this afternoon. I'm going to have a wicked cool scar.

Rather than merely bury a link in an update to the previous post, as I did originally, I'll add it here separately.

Yesterday while giving a status update, I asked the neurosurgeon for more information about the implant. It is a "Codman programmable shunt." Googling led to this website which describes the procedure.

Nifty. It there anything that isn't on the web?

I keep saying variations of "the doctors drilled a hole into my skull." In fact, they did a bit more than that. What follows may be a bit disgusting, but hey, you're only reading about it. I had it done to me.

Despite the plethora of road accidents — it was a black ice kind of day — we (Mom drove, of course) got to the hospital a few minutes after 7:30 that morning, and let the valet parker take the truck. I've never noticed valet parking at a hospital before, but it makes sense.

I plopped into a wheelchair and we headed to the part of the facility where the pre-operative screening is done. We waited for only about three minutes to be called; you'd have thought there was some sort of hurry. The nurse who did the screening had paperwork for me to fill out, and a lot of "are you allergic" and "have you ever" questions for me to answer. Blood was drawn at least once, and then we were off to Radiology, where X-rays were taken of my head. Interestingly, that was the first time since this whole thing began over a year ago that plain old X-rays were taken.

Then we were off to the pre-op waiting room. At Duke, this meant a trip by tram from one building, half a mile to the next. They're sort of spread out, there.

There were a lot of people at pre-op, waiting for whatever particular doom had summoned them to the hospital that day. Once I'd checked in at the desk, we (still Mom and I) waited with all the other folks, but I was getting pretty uncomfortable; my legs were in a bad way. One of the nurses graciously asked it I'd like to go lay down, so at that point Mom and I parted — I didn't see her again until well after the operation.

The moment of fate had arrived. It was time to switch out of civvies and into hospital uniform: the standard ill-fitting and all-revealing gown, complete with footies that didn't come close to covering my size-15s. I was wheeled into the pre-op room, in which there were about a dozen other folks already on gurneys waiting for their respective procedures. I was set up with an IV jack in my hand (no actual drip at that point) and waited.

The anaesthesiologist dropped by, asked a few questions, had me fill out some paperwork. The surgeon dropped by and drew an X on my head with a magic marker. At least I think it was an X. It might have been a smiley face, for all I know — I'd removed my contacts by then, and in any event I could not (and, amazingly, still cannot) see my own scalp without a mirror.

Suddenly, it was time. A pair of burly orderlies came along, plugged a bag of something into my IV, and wheeled me off to the O.R. In under a minute I was on the operating table with a mask on my face being asked to take four deep breaths. I managed two before the lights went out.

This is where I would describe the procedure in minute detail, if I'd actually witnessed any of it. [Update: see my followup post.] The macro details, I can tell you about.

The shunt was installed above my right eye, at about the "one o'clock" position above my forehead. I haven't actually seen one, but it's a piece of hardware that feels like it's maybe 3" x 0.75". The big part is under the skin, flat against the outside of the skull; some smaller bits go inside the skull. The shunt is magnetically adjustable; they can increase or decrease the flow rate as needed without opening me up again. In case they ever need it, there's a facility for the extraction of cerebro-spinal fluid via syringe through the shunt.

As Steve notes, perhaps it would have been nice if they could have installed a device to allow the direct insertion of booze. I wish I'd thought of that.

From there, a tube was run under my skin back past my right ear. In order to get the tube to its final destination, a hole was made in the skin behind my ear, and using (I presume) some sort of long rod, the tube was driven down my neck behind the ear, then over my collarbone, down to my abdomen — all under the skin, of course. To get the tube into my abdominal cavity, the surgeons opened me up just under the ribcage, got the tube inside the cavity, stitched the muscles up, then glued the wound shut. It looks quite a lot like a gallbladder surgical scar.

I'll leave you with a photo of the aftermath:

[If I'd thought about it, I'd have asked them to shave my whole head, but they clearly shaved only what was necessary. The combover to handle such a tonsorial disaster hasn't yet been built, so once the bandage in the photo came off, I shaved the rest of my head to match.]

I woke up in the recovery room. My mouth was as dry as the Sahara after a particularly severe drought. I was, of course, rather fuzzy-headed; they had, after all, shaved part of it... but I was somewhat addled, too. After an hour or three — I have no idea exactly how long it was — they were relatively certain I wasn't going to be bleeding all over everything and everyone, so I was wheeled off to my room, where I was pumped full of antibiotics and kept overnight before being released. Mom was there waiting, the very soul of patience.

And so I was home. It's been a week, and I'm vertical most of the time now; I periodically get light-headed enough that I have to go lay down, but that's happening less and less often. I'm off the hydrocodone, and despite the dizziness episode a few days ago, I think I might actually be ready to go back to work in another week.

This is not something I would have wished on anyone.

Yesterday, I became the definition of pure suckage.

Things were going well, really well — I'd been up much of the day, my head and neck weren't hurting much.

Then, right after dinnertime, wham.

[No, I don't mean WHAM! — things were bad enough without George Michael and Andrew Ridgeley showing up on my doorstep.]

I began to feel a bit dizzy, so I headed back to my bed. In the time it took me to cover that 20 foot distance, I was barely able to stand at all. The room was spinning around me, and I fell onto the bed and lay there motionless, begging God to make the whole house stop spinning.

I have had an ear infection-based case of vertigo in the past, and this felt exactly like that... except I didn't have the pressure in the ear I associate with an inner ear infection. I did, however, have a fever and the sweats.

It was misery. I couldn't sleep, and for about five hours, I couldn't move a muscle without setting the entire state to spinning around me. Mom came in before going to bed herself, and did me the courtesy of locating a trash can next to the bed... just in case, if you take my meaning.

Around about 2am, what I was afraid would happen, happened: I had to get up to use the restroom. It was a rather short stumble from point A to point B, but I managed to come close to falling on my face about four times. By the time I made it back to my bed, the entire country was spinning around me.

I had to remain sitting up for a few minutes. My stomach had begun to rebel, and it was a very near run thing, I can tell you. I was certain I would not have been able to make it back to the bathroom in time.

Finally — perhaps an hour (spent mostly in Hell) later, I was able to lay down again with a reasonable certainty I wouldn't be making any untoward messes on my bedroom floor. North America continued to whirl around my brain.

I was as miserable as I think I've ever been... and I've had gout, as you may recall. My head hurt; my stomach, while not exactly rebelling, was not happy either; I was running a fever; I was sweating like a Kennedy under oath. The Western Hemisphere rotated inside my skull.

Finally, sometime I think around 4am, my fever broke, and I was able to sleep.

So ya, I had a pretty crappy day. And if I ever act like the world revolves around me, well, maybe I earned it for just a little while.

Recovery continues apace. By "apace" I mean that, despite having had a hole drilled into my skull, I haven't actually died, and am, in fact, continuing to improve, slowly but surely.

I'm still in a sort of "good day/bad day" mode. Wednesday was a pretty good day, and I was able to sit upright for as much as 90 minutes or so at a time. Thursday, on the other hand, pretty much sucked, and I spent the majority of the day face-down on the bed moaning... which I suppose makes it like most days, though this time I had a legitimate reason. It's only been a week, after all.

The drugs (Hydrocodone, 1 or 2 every 4 hours as needed) seem to be helping a lot, too. Woo... hooooo....

My bandage came off — it lasted a couple days longer than they predicted.

I am going to have an awesome scar.

Did anybody happen to get the license number of the truck that hit me?

No? Dang.

The operation seems to have gone well, since they let me come home the day after. There's a lot of recovering left to do, of course, but I can already tell there's improvement. I can control muscles in my legs I haven't been able to control in months. I still have to use crutches during my forays into verticality, mainly because the leg muscles are so weak, but partly because I seem to have lost a bit of coordination since the last time they all worked properly.

Right now, though, I can only sit or stand for about five minutes at a time. It's not actually my head that hurts; something in my neck is not quite right, and after just a couple of minutes upright, the pain is enough to force me to lay down. It's probably something to do with the way the surgeons had to contort me and strap me down in order to perform the operation, more about which later (with a post-op picture, even.)

At any rate, I can't spend much, if any, time at my desk/PC. Mom loaned me her laptop so I could write and post this entry from the comfort of my bed. Thanks, Mom.

In fact, without Mom being here to help, I'd be pretty well hosed. She's been a life-saver, figuratively and almost literally. Plus, her cooking is way better than mine.

More later... but probably not today.

I feel like I lost a fight with a Mack truck, but I'm home.

I was planning on continuing to do daily posts counting down the days over the next week leading up to my surgery. However, because of a call I got from the folks at Duke about an hour ago, that plan has to go by the boards.

They're drilling me tomorrow.

Check-in time: 0730. I should be home on Saturday, with a week or two of downtime after that. It seems pretty fast to me, but I suppose it's not all that complicated a procedure, as brain stuff goes.

I'll just take this opportunity to say thanks to all of you for your support during this... well, ordeal seems too strong a word, freighted with too much meaning. It's been a test, though, most definitely.

Later.

The dental crisis is over. A tooth was extracted — it couldn't be saved — and I had an appointment today to remove the stitches from my mouth. Today was the fastest and least expensive thing I've had done to me all year. $8.00 for 15 minutes work.

Compare that to the work done ten days ago, which involved about five hours in the chair, and left my wallet rather a great deal lighter and me feeling like I'd been hit in the face by a brick. At least I got codeine out of the deal. It was, unfortunately, necessary for a few days.

Now that the abscess has been removed eradicated destroyed dealt with, we're on track for a brain surgery date of December 13th, two weeks from tomorrow.

At least it's not on a Friday the 13th. Not that I'm superstitious, but I have to wonder if any of the people in the O.R. might be. I expect not, but you never know.

The countdown resumes.

While talking this morning with the Duke hospital finance people (when you pay out of pocket, it needs to be arranged in advance, apparently) I found, much to my displeasure, that my surgery date had been cancelled because of the dental issue.

It would have been nice if they had told me about it.

The fact that the dentistry problem — an abscess, you may recall — gets resolved tomorrow apparently has no bearing on the matter. They just up and cancelled me.

It would have been nice if they had let me know.

So now I have to reschedule the surgery — no telling how long that's going to take — AND I have to reschedule my outage from work, and so on.

It would have been nice if they had said something about it.

Dammit.

Dammit dammit dammit.

I think I've mentioned before that one of the things I've been inspired to do lately is to dispose of much of the accumulated cruft taking up space in my attic. Having been on the verge of being diagnosed with a fatal disease tends to put things in perspective.

Much of what I'm disposing of might be considered prime eBay fodder. So, yes, I'm selling things that some people would look at as collectible, some things it pains me a little bit to part with. Books, old hobby materials, and my huge collection of board-style wargames from the heyday of Avalon Hill and SPI.

Too bad. It's outta here. I'm de-complicating my life, and that means it all goes.

What no one ever said, though, was how much of a pain it is to list things on eBay. I mean, everything listed needs some sort of reasonably accurate description, and most of what I'm selling has to be minutely inventoried, to make sure the myriad small bits are present. So all day, I've been counting and counting and counting. Egads.

One really ought not to advertise something as being 100% complete if it really isn't.

Being tagged a fraud would be a very bad thing.

Unless one really is a fraud.

Which I'm not.

As the days count down to my date with a neurosurgeon, I still have things to get done. Foremost among them is getting this [expletive deleted] tooth fixed. If it's not fixed, I don't get to keep my surgery appointment.

So today I spent another afternoon in a dentist's chair, having small mallets whacking my teeth one by one. "TING! Does that one hurt?" "No." "How about this one? TING!" "No." And so on.

Apparently, the meds I got last week are having an effect, but they aren't a fix. I'm going to have to be re-root-canalled... and if that's not going to do the trick, I'll have to lose the tooth.

To keep my scheduled surgery date, I'd consider letting them pull all my teeth.

Just over a week to go until I let a masked man drill into my skull, and I'm still carrying on as usual. Or as usual as things have been over the past year, anyway. Another night at work, keeping the Internet running.

The only difference in my routine is that I answer a lot of "good luck, best wishes" messages. There really was no way to keep it quiet that I'm going to be away for a couple of weeks, since a call had to be put out for volunteers to cover my scheduled hours.

I figured pretty much everyone already knew that I've been having difficulties — I haven't worked a day in the office yet this year, for instance — but there are still people who come across as surprised. I've been in the hospital twice already this year, and people have had to be found to cover my hours both times. I think if one of my teammates was in my position, I'd remember it.

Then again, we are all geeks. Non-technical matters can go right past us. It's just the way we are.

Counting down the days until surgery, knowing it is finally going to happen, is probably going to make the wait seem interminable.

In the interval, I'll be carrying on as usual. Work, sleep, work, sleep....

Come to think of it, the two-week expected recovery time will make a nice little break from the ordinary routine. Not that I expect to be doing anything exciting, of course.

Except, perhaps, for throwing away my crutches.

It's official. I'll be having surgery to install a shunt on the Monday the 19th. Time to fire up the ol' power drill....

I'm eager to get it done for a lot of reasons. I'd like to be able to walk again, of course. Just standing up unassisted would be a huge improvement. It would be great if I could drive my own truck, too. As soon as I can drive my Mom to the airport, I will drive her there. She has been here for several months and both wants and needs to go home to Santa Barbara. I certainly cannot blame her.

Not that I don't appreciate her help over the past several months. I do. Boy oh boy, do I. I'd have a damnably difficult time of things without someone in the house to help out with the tougher tasks... like, say, cooking... or pushing a vacuum cleaner around, or going out to the mailbox. I just wish I could get these sorts of things done without imposing on my Mom.

At the same time, as a middle-age man, I really don't need my mommy living with me any longer than necessary. It reflects poorly on my adultness.

Is adultness a word? There must be a word out there that means "having the quality of being an adult," but these days I'm not quite as sharp as usual. That is one possible effect of hydrocephalus... or I could just be going senile in the ordinary way.

We'll see if my thinking improves after the surgery. Which I need like I need a hole in my head.

[Insert rimshot here.]

I think I get to own that joke in perpetuity.





Ten days, and counting.

As if I didn't already have enough to worry about, I've been hammered by a toothache this week. A trip to the dentist yesterday revealed that it's due to an abscess.

Feel free to joke. You'll not top this one.

When one's doctor turns out, as mine has, to be a world-renowned specialist, the concept of "as soon as humanly possible" doesn't necessarily mean "soon."

In this case, we're waiting to see if he can squeeze me into his schedule for surgery as soon as next week, but that remains iffy. There has to be some pre-surgical workup done, of course, though I don't really know the precise nature of what needs to be done pre-op.

When I do go in for surgery, it might be as quick as just an overnight stay. The surgery itself, I'm told, is pretty simple, as such things go. Thirty minutes to an hour, I hear. One day of recovery time in the hospital, and then home.

When the prospect of a shunt was first raised, one of the questions I asked was, how much downtime will be required afterwards? In short, how soon can I go back to work? The first answer rocked me back on my metaphorical heels — six to eight weeks. Holy smokes.

I explained that not only do I work from home, but that my work consists mainly of looking at computer monitors and typing, with only the occasional phone call. Armed with this knowledge, the docs told me that I can estimate a week or two of downtime at home. I could, in theory, be walking by Thanksgiving.

That presupposes that I can actually get onto the surgery calendar sometime soon. Maybe they can wedge me in next week. I surely hope so; this has gone on long enough.

The phone rang earlier today, and I was surprised (to put it mildly) to hear my neurosurgeon on the other end of the line. He was in his office catching up after returning from the annual conference (Research Update in Neuroscience for Neurosurgeons) for which he was Director, and was making calls so his desk would be clear on Monday. After a minute or two of polite conversation, he got to the point.

Based on testing and on my symptoms, a shunt is not a sure thing for a 100% fix, but it will yield positive results. The thinking is that there are probably two separate things going on in my central nervous system, and that surgery will alleviate one of them, allowing the other to be looked for without the complication of hydrocephalus.

Thus the doc's recommendation is that I have the surgery to install a shunt. Any other condition notwithstanding, it will improve my physical capability.

It may be brain surgery, but the decision to have it is, for me, not exactly rocket science.

I think we'll be scheduling this to happen as soon as humanly possible.

You might have noticed the button I've put up on the site.

And surely you're asking yourself, "why, in this day and age, would a person not have medical insurance to cover those costs?"

Long, convoluted story. Or maybe not so convoluted.

I'm a contract employee with no benefits; in the tech industry, this isn't altogether unusual. When my current medical crisis began, though, we all thought it was related to an old Army back injury, which would be covered by the Veterans Administration. Then last autumn, I was informed by my management that my employment status would be upgraded and converted to regular (benefitted) at the start of 2007.

In short, I had no need to buy insurance. I was covered for this. Then, two things happened.

First, the doctors changed their assessment of the cause of my medical problems. No longer could it be attributed to my VA-coverable injury, so naturally the VA will not cover my medical care. I don't begrudge them this at all; that's just the way things are. I checked this every which way; the only way I could receive treatment from the VA would be if I were unemployed and homeless, which isn't about to happen.

Second — and this is the irksome bit — someone at the VP level at my place of employment decided that the best way to make his budget numbers look good to his boss was to freeze all personnel actions. I'm not the only person who has been waiting since January to receive an overdue promotion or even conversion to "regular" status.

This, mind you, in an organization and at a company that professes to believe that its people are its most important asset. They sure have a funny way of showing it.

Me and a dozen of my coworkers have had our careers put on hold, just so a VP can maximize his annual bonus. I hope he chokes on it.

I'd have walked out the door to a new employer months ago, except for the inconvenient fact that I can't actually walk. As soon as I can walk, though, I will walk. But not before I visit the VP and leave him my crutches as a reminder that "personnel actions" have a human cost.

So that's where things stand. I'm at a job I can't afford to leave and at which I cannot afford to stay, and I can't get new employment until I can actually walk into a job interview.

Of course, I can't now get insurance to cover this now-preexisting condition. This is what is known as "slipping through the cracks." Or "bad luck." So be it. As I have noted before, if we had a Hillarycare-style system, I'd still be waiting to see a neurologist; indeed, it probably would have been illegal for me to get this far by paying cash.

In the meantime, I've run up tens of thousands of dollars in medical bills, all paid out of pocket. The total is likely to double before all this is over, however — especially if they're going to do this to me. My pockets only go so deep... and I've already reached the lint.

And that is why I've put the tipjar/begging bowl front and center, and right here: