Back in Aspen

It's been a hectic two weeks in the Nitti family, as this post finds us 2,000 miles away from the previous.

On August 8th, Lauren and I loaded up the trusty Subaru Outback (side note: Please buy all of your Subarus at Nitti's Subaru, so my family can eat again. Now with two convenient locations!!) and started the 30-hour trek back to Aspen, Colorado.

The trickiest part of the packing process was convincing Maci to leave her comfy new digs atop her grandparent's front porch. She spent the better part of the summer surveying the world from this vantage point, and she was in no hurry to abandon it.

As you can probably imagine, saying goodbye proved a bit more difficult this summer than in years past. I never thought my parents would be called upon to care for me in this manner again, but they sure haven't lost their touch. They literally nursed me back to health, and I am forever in their debt. Lauren and I discussed it, and we've decided that if they should ever need us to return the favor and care for them in their advancing years, we'll gladly discuss possibly putting the deposit down on a nice full-care facility somewhere.

Shortly before our departure, in an elaborate ceremony befitting the Beijing games, I awarded Angelo and Mary their well-deserved "Parents of the Year" medals. Sadly, my father had to return his a week later when he failed the mandatory drug test.

Thirty hours of driving and seventeen McDonalds' Chipotle wraps later, we pulled into our home in Aspen completely spent. Upon arriving, we noticed that for the first time since last Thanksgiving, the entire valley wasn't under 30 feet of snow. So there's that.

Here's two exhausted members of the Nitti family, trying to adjust after not getting our requisite 17 hours of sleep per day we'd averaged over the summer.


Our first week back was spent reacclimating, both physically and mentally. I returned to full-time work for the first time since surgery, which wasn't nearly as bad as it sounds. Lauren took care of some workshops, prepped her classroom, and caught up with some old friends. Together we kept up our every-other-day running schedule, and slowly got used to the 8,000 foot altitude difference between Aspen and Long Beach Island.

This past weekend, we let our proverbial hair down a bit and reminded ourselves why we live in a place where gas is five bucks a gallon. Saturday morning, we hiked the Ute Trail, which while gaining only 1,050 feet of elevation, involved roughly 1,050 feet more climbing than we'd done all summer. So needless to say, we suffered a bit. But as usual, the views were expansive and beautiful. Here's a view of Mt. Sopris, still holding some snow, but not nearly as much as it was on this day.

Lauren and Maci at the top of the Ute Trail. It's hard to imagine that I was skiing this route just five months ago. Maci, as you can see, was finally asked to pull her weight. With her dad still recovering, she's going to have the play the role of Sherpa this fall.

Lauren atop Ute Rock. Previous photos of this same location can be found here and here.

Once we'd descended the Ute, we decided it was only fair to allow our porter some recreation time. So we headed over to the fountain on the Mill Street pedestrian mall, and let Maci loose to do her thing.

That evening, we scrapped some camping plans due to ominous weather and opted instead for a block party at my buddy Jeff's house, complete with bad cover band, moon bounce, badminton, and numerous sporadically-manned barbecues. A good time was had by all, though I'm fairly sure more than a few people went home with a food borne illness. Word of advice? Pork loin at a block party is never a good idea.

Midway trough the evening, the skies opening up with a brief storm, but as the weather passed, the colors came out to play.
It's good to be back.

The Dog Days of Summer, Indeed

We sure are fond of our Maci around these parts. With the first Nitti baby still but a twinkle in my eye, Lauren and I have been able to lavish an awful lot of attention on our one-and-a-half year old yellow lab pup.

This summer, with my own athletic activity brought abruptly to a standstill, I've been forced to live vicariously through my dog. Which, I must say, has been rather entertaining.

As proof, behold the Top 5 Maci pictures of the Summer of 2008:

5. My sister Karen and her husband Rob are proud owners of Zoe, a beautiful 7 year old chocolate lab. Zoe, for all her strengths, is a tad overweight; ironic since her parents are both lean exercise junkies. I guess when you've got three little girls in the house dropping food all day long, you tend to pack on some extra pounds.

Anyhoo, Maci and Zoe became good pals this summer, and their play sessions in Barnegat Bay are responsible for shaving a good 5-10 pounds off Zoe.

4. Every day Maci has spent on LBI this summer has essentially followed the same format: wake up, follow me around the house until I take her to the bay, swim until exhaustion, then sleep all day. Here she is after my nieces got a hold of her during some REM sleep.

3. See my vest, see my vest... While not made of real gorilla's chest, Maci has fallen in love with her new Ruff Wear life vest. The vest serves three purposes: it allows Maci to swim alongside Lauren and I when we kayak without us having to worry about her, it allows her to swim with me when I swim in the bay, and it allows us to pick her up onto the dock at 9th street without having to get in the water.



2. I've gotta say, Maci has certainly won over the grandparents this summer. They've got an unspoken mutual agreement: Maci doesn't poop in the house, and in exchange she gets a piece of my mom's bagel every mornning. But the first day Maci doesn't get that bagel, look out...

1. The picture of the summer. For full effect, click on it to enlarge. It took Maci and I most of the summer to work out the toss so that it matched her considerable pace when hitting the bulkhead. The video below gives the full speed look.

Summer's just about over for Lauren and I here in New Jersey. Lauren celebrated her 31st birthday on Saturday, August 2nd, and after spending the next few days tying up some loose ends, we're heading back to Aspen next Saturday morning.

It's been an interesting summer to say the least, and while I'm very grateful to have spent it back in New Jersey with friends and family, it's about time we headed home and got busy living.

Catching Up

Hello. My apologies for the long break between posts, particularly when that break included the six-week check-up with the surgeon I was so eagerly anticipating.

I've run into a couple of people recently who've suggested that I'd grown "tired" of keeping up the blog, and I'd like to clarify that this is not the case. To the contrary, I rather enjoy writing, and I imagine I'll keep posting random pictures -- like this one of Maci exacting her revenge on an effigy of convicted dog-fighter Michael Vick -- for a long, long time.

So why the absence? It turns out my six-week check-up stirred up a number of emotions that needed sorting out. But I'll get to that in a bit. First, the medical updates:

June 20th: Lauren and I finally got our audience with our surgeon to see how things were progressing. At this point, I'd stopped taking pain meds, but still didn't feel like "myself." The nurse and surgeon were kind enough to keep things simple for me. In short, my recovery was progressing perfectly, but it will be a full year before the cloud lifts and everything feels like it once did. In the meantime, the following time-table was provided.

Starting immediately, I could walk.

Apparently, the medical profession does not hold the cleanliness of New Jersey's ocean in the highest of regards. To avoid infection, we had to wait a couple more weeks until the incision scar was completely healed before I could swim.

No lifting or anaerobic activity for eight more weeks. That meant none of this for the first summer in a long while.

• No activity that could result in a blow to the head for six months. So this was out as well.
  

Most importantly, I was cleared to start the process of ridding myself of these seizure meds. The surgeon was certain that 1,000 mgs a day of high-powered anti-seizure medications were likely the cause of my daily fog, but they're not something you can quit cold turkey. Instead, I had to pass an EEG to prove that I had no seizure activity, then go through a two-week weaning process.

Lastly, because the surgical clipping process is so "permanent," no diagnostic follow-up would be necessary for 5 years. Essentially, I was a free man. More on this later.

June 20th, afternoon: Lauren and I go for my first walk on the beach. Just weeks removed from my father having to hold my arm while I took shuffling steps around the backyard, it felt rather liberating to be moving under my own power.

June 26th: Took and passed my EEG. Now I just needed the OK from the surgeon to start weaning off the meds.

June 27th: I slowly started to re-introduce sections of running into my walks. My head handled it well, my body...not so much.

July 3rd: Got the thumbs up from the surgeon to back off the meds. A couple more weeks and for the first time in months I'd be able to drink a couple of beers and drive a car, though preferably not at the same time.

July 4th: The prior week had seen some great gains in my overall strength. As a result, on the holiday I declared my independence from Lauren's tyrannical reluctance to admitting my scar was fully healed, and went for my first swim in the bay. If I continued to wait for Lauren's approval, it may well have been 2014 before I was allowed in the water.

July 5th: I tried to take Maci -- resplendent in her new Ruff Wear life vest -- into the bay to join me on a half-mile swim. Bad idea. Not because she couldn't handle it; to the contrary, the sad reality is that my dog is actually a stronger swimmer than I am at this point. And since she insists on climbing on top of me whenever we're in water together (some sort of rescue response, I'm told), about halfway through the swim the experience got significantly less enjoyable. Here's Maci, hawking me from behind.

July 7th: Funny thing about the human body. It's taken me just nine weeks to make great strides in recovering from brain surgery, yet it's been over two years since I could run on the road without pain due to a minor soft tissue injury in my knee. Go figure. But if there's been one silver lining in the six weeks I spent on the couch, it's that my knee has gotten some much needed rest. To test its recovery, Lauren coerced me into joining her for a road run. The knee held up wonderfully, but even better was the chance to run side by side with my wife, who started running shortly after my surgery for the first time in years. For me: my favorite moment in the recovery process. For Lauren: a chance to crush me with her enhanced fitness and taunt me mercilessly as I finished well behind her.

And that pretty much takes us to today. I'm back working, and trying to get in a run or swim every day. More importantly, I'm ready to move on.

And that, more than anything, is why I've stopped updating the blog. To be able to process hearing a surgeon tell us three weeks ago that everything is fine and I can return to a normal life, after everything we've been through, takes an element of faith. Faith that this was the end of something, rather than the beginning.

And in my mind, in order to procure that faith, I need to look forward rather than back. I need to accept this aneurysm for what it was: a medical condition that, while terrifying and potentially life-threatening, has been properly treated. Only then can I stop defining myself by what I've been through, and start living again like I did four months ago: excited for every day to come rather than apprehensive of what may go wrong.

It won't be easy for me, but I know it can be done. Soon, maybe sooner than I realize, a day will come when no one will ask me how I'm feeling. And I look forward to that day more than you can imagine. I've spent three months as the glutton of sympathy, and while I appreciate greatly everyone's concerns, it is not a role I embrace.

So please, if you've been reading this site throughout this process, know that I am eternally grateful for your positive thoughts and prayers. I needed them more than you will ever know. Feel free to stop back, but don't expect to hear about the aneurysm or the recovery process. Trust me, I have a full apprecation for the miracle that's occurred, for just how lucky I am to be alive, let alone to have the opportunity to return to my pre-operative state, to feel closer with my friends, my family, my wife...but again, it's time to move on. I want to think significantly less about the prior few months, and more about the good times that await. More friends, a family of my own, and watching Maci do silly things like fall asleep with her nose through my visor.

So if that sort of thing interests you, by all means, stop on back. In the meantime, I've always wanted an excuse to end something I write with quasi-cheesy song lyrics, and this seems to be as good a time as any. These seem particularly apropos, and they come courtesy of one of my favorite song writers, Roger Clyne:

"While the moon wanes and waxes, surely death and taxes, are lurking out there.

Life is grand, love is real, beauty is everywhere."

Dude, You're Out There!

Sorry about the lack of health updates as of late, but here's the situation in a nutshell: when I feel great, as I have for much of the past week, I don't feel much like writing about it, as instead I tend to get a bit giddy and spend all of my time up and about trying to get my legs back under me. And when I have really bad days, as I have for the past two, I really don't feel like writing about it, as then I become that guy that pisses and moans about his medical plight on the interwebs. I finally meet with my surgeon this Friday, and I'll know much more about how my progress is coming at that point. So that's that.

Apropos of absolutely nothing, I watch an awful lot of The Simpsons. Which, by definition, means I watch an awful lot of the Fox Network.

Now, twenty years ago, The Simpsons was just about all Fox had to offer, causing the network to implement a programming strategy that can best be described as "let's throw a bunch of sh*t at the wall and see what sticks." Thus was born truly atrocious television like Get a Life, starring Chris Elliot as a 30-year old paperboy, and of course Herman's Head, starring, well, who knows. (Don't ever let anyone lump Parker Lewis Can't Lose into this category. That show was groundbreaking.)

But now Fox has some legitimate hits; House, Family Guy, the whole American Idol phenomenon...you would assume that the network was beyond train wreck television.

You would be very, very wrong. This week, while flipping through the channels, I stumbled upon the network's latest gameshow/abomination/sign of the apocalypse "Moment of Truth," in which morons prostitute themselves by answering increasingly personal and incriminating questions in exchange for 15 minutes of "fame" and a chance to earn moderate amounts of cash.

Maybe you've already seen it, but if not below is a brief sampling.





Now she's not hate-able at all, is she? I'm assuming these are actors, as nobody could possibly be willing to destroy many lives, including their own, just to make an appearance on TV. But if not, these people are worse than Hitler. *

What infuriates me the most, however, isn't even the smug manner in which the woman answers the questions, it's that the entire concept was blatantly plagiarized from a HI-larious Mr. Show skit. If you're gonna' do the lie detector bit, at least do it right.




*Not actually worse than Hitler

Monday Update

Stupid modern technology. I've got this fantastic video of my biggest accomplishment of the week -- teaching Maci to launch into my sister's pool while catching a bounced tennis ball at its apex -- and I can't upload it using the weak wireless Internet I'm currently pirating from my parents' neighbor.

/angrily shakes fist at house next door

Luckily, we thought to shoot some stills, so my little time spent outside the house this week wasn't completely for naught.

Maci, readying for take-off.


In mid-flight, ball snagged at its highest point.

Lauren with a great head-on shot. Click if you care to enlarge.

I don't want to jinx myself, but I'm currently in the midst of a fantastic three-day stretch of feeling stronger and stronger. I've started to work from home a bit each day, and even took a two block walk down the beach this weekend completely solo. It doesn't sound like much, but its a long way from my first few weeks out of surgery.

With my lovely wife attending the wedding of one of her college roommates this weekend, I took a ride down to LBI with the folks so I could briefly attend the college graduation party for one of my best -- if unlikeliest -- of friends.

Meet "Scuba" Steve Welc: recent Summa Cum Laude graduate from UNC-Wilmington, defending island champion in the 1,000 foot singles row, my hand-picked apprentice in useless Simpson's trivia, and three-time winner of the LBI Clam Chowder Cook-Off. *

We met my first year back on the stand, in 2003, when Steve was a scrawny high-school kid, I was a 28-year old graduate student, and he was the one with the direction in life. Lauren and I both took a liking to him immediately, and he won a place in our hearts at the end of that first summer when he bought Lauren a thoughtful going away gift: a giant novelty sombrero. I mean, who doesn't need one of those?

Ever since then, Lauren and I have grown to look at Steve as a younger brother. Of course, that would make Lauren and I brother and sister, which is kind of, you know, gross.

*Last accomplishment may not be true

Decisions, Decisions

If I've learned anything during my two years in Aspen, it's that sometimes it's a long, long road...

to get where you want to be.

Four weeks in today. I'm feeling much better but each day, at some point, I get a reminder of just how far I still have to go.

It also just dawned on me that with how quickly everything moved the week of the surgery, many people I spoke to in the initial days after my diagnosis are probably confused as to how I ended up with a craniotomy.

Not to get all Grey's Anatomy on you, but there are essentially three options one has when diagnosed with an aneurysm: do nothing and monitor, have the aneurysm "coiled," or have it surgically clipped shut.

The first option is rather self-explanatory, and was simply out of the question. The two weeks or so we lived with the knowledge that the aneurysm was there were the longest of my life. While the aneurysm has likely been in my brain for the majority of my life, things undeniably change once you're told that it's there; there's this omnipresent awareness of one's mortality. Even though the odds are in your favor that it won't rupture, you're also painfully aware that if it does, your odds of survival are less than 25%. That's no way to live.

Now the coiling is where things get interesting. This is a remarkably non-invasive procedure that involves going in through the femoral artery in the groin, running a small catheter all the way through the body, to the brain, and to the aneurysm, than running a small wire coil through the catheter up to the aneurysm. At this point, the aneurysm is filled with the wire coil, the coil is cut off once the aneurysm is filled, and all is well. The patient walks out of the hospital a day or two later with nothing more than a band-aid on the groin and a headache. While there are small percentage risks of stroke, seizure, and death with the procedure, the recovery time is relatively short since the skull is untouched.

As Lauren and I did our post-diagnosis research, we just assumed coiling would be my answer. Why open up your skull when you didn't have to?

Well, as we continued to dig, we found out some interesting things.

First, because the coiling is such a new technology, the long-term results are still unknown. Would the coils, if properly placed, last 30 years for an active person? There had been studies that revealed that nearly 30% of patients needed to be re-coiled, as the coils had compressed, allowing more blood to enter the aneurysm. Even worse, in some cases the metal coils had actually slipped free and entered the artery itself, causing a stroke.

In addition, the up-keep for coiling is a major pain in the ass. Angiograms (similar to coiling, they go through the groin and administer dye to the brain so they can see the vessels and arteries) are required at the 6-month mark and annually after that. Now, angiograms are an all-day affair, and they carry a small chance of stroke and death with each procedure as well.

So as I waited for the results of my diagnostic angiogram on Thursday, May 8th, I found myself surprisingly scared. Scared that the surgeon would push coiling and that it wasn't necessarily what I wanted.

As the surgeon sat down with Lauren, my parents and I, he explained his findings. Most importantly, my aneurysm had developed a secondary weak spot; a bubble on top of a bubble if you will. This meant that whatever we did, it had to be done in a hurry.

The surgeon then went on to say that based on everything he saw -- size, shape, location of the aneurysm, as well as my age and good health -- he recommended going in surgically and taking care of this thing once and for all. The disadvantage of the surgical clipping as compared to the coiling is the increased risks of surgery and the prolonged recovery from the invasive nature of the procedure. After all, a clipping involves making a large incision in the head, cutting away part of the skull, and placing a small titanium clip over the bulging aneurysm, effectively curtailing any blood flow into the aneurysm and further growth. The advantages? Once you've made it through the surgery and recovered, the aneurysm is, for all intents and purposes, gone forever. You are completely healed, the up-keep is minimal and the threat of recurrence is no different for you than anyone else on the planet. You can return to your normal life -- whatever your normal may be -- free from restrictions.

I was rather surprised to hear one of the few surgeons in the world trained to do both procedures recommend the more invasive of the two, but I understood what he was getting at. If you want to live the rest of your life -- really live the rest of your life -- would you sacrifice three months of recovery time to do it? To just be done and move on and not spend the rest of your days wondering if the quick fix is holding? I think you would.

And so would I.

What has Two Thumbs, Just Celebrated His 33rd Birthday, and Recently Underwent Brain Surgery???

THIS GUY!!!


That's an old picture of Cathedral Lake, and I'd bet dollars to doughnuts that the peaks right behind that lake are providing some epic skiing right about now. But, of course, there will be other years for that...

This was a big week for several reasons.


First and foremost, on Tuesday I was able to get off my ass long enough to stop by work and say hello to everyone. These are people I only get to see a handful of times each year, so in a perfect world our meeting would have been under better circumstances, but it was still awesome to see everyone and thank them for their genorosity. There's been a steady stream of cards and get-well gifts coming to the house from co-workers, and while all of them are tremendously meaningful, I have to give credit where credit is due: one of my firm's partners did one hell of a job nailing Maci's likeness with her card...

To be fair, Tuesday through Thursday were rather rough days for me. I don't know whether I was paying the price for being on my feet too much last weekend, or if I was going through a new stage in the healing process, but the head pain and swelling seemed to get decidedly worse over those three days. Just as my frustration was peaking, I woke up Friday feeling fantastic, and had far and away my best day post-op. I have a strong feeling it's going to be two steps forward, one step back until I'm fully recovered.

Lastly, Friday night my family came over to my parent's house for my birthday dinner. It's been a tough month for everyone, so it was rather meaningful to be able to sit down and celebrate what we've been through. What many people don't realize is for someone like me, the leading cause of a brain aneurysm is hereditary in nature, so each of my siblings has to undergo an MRA to make sure they're clear. So far we're one for one clean results (my sister), but awaiting the results for my two brothers certainly adds stress to the situation.

Having everyone over (and having the Phillies pound their way into first place) is a perfect way to take your mind off of the otherwise monotonous recovery process. While it's not quite the way I celebrated my birthday last year, again, there will be plenty of time for that.