For readers in the DC/NoVA area, please consider coming out to the Palace of Wonders tonight to support Charon and Johnny Henning, two friends of mine for whom a benefit show is being held this evening. Charon is a fellow performer who suffered an injury very similar to mine, and in addition to the medical costs of that misfortune, is now struggling to meet the expenses of treating her husband Johnny. Johnny was seriously injured by another driver in a motorcycle accident last year, and has endured a number of very expensive surgeries and procedures in an ongoing struggle to repair a shattered leg.
A number of very talented magicians and other variety performers will be on stage tonight to raise funds for Johnny's care. Page and I will be in attendance; in fact, Page will be mixing with the crowd tonight as the official donation collector for the show. The cover is only $10 for several hours of entertainment, so please consider coming out, having a good time, and meeting some very unique member of DC's performing arts scene.
The Palace of Wonders is located at 1210 H St., NE. Ample streetside parking is available nearby. The show starts at 9, but consider arriving early to secure a good view of the stage.
Thursday, May 15, 2008
Tuesday, May 13, 2008
Intermission
Sorry, I've been busy with work since my last post. No new adventures to report, although the roses continue to thrive. These days, I'm struggling with more prosaic challenges, like finding the cheapest gas in DC and rearranging my apartment for a change of pace.
More to come eventually. Thanks for stopping by!
More to come eventually. Thanks for stopping by!
Wednesday, May 7, 2008
Surplus, or: Fun Ways to Repurpose Medical Waste
One of the things I'm left with after this ordeal, besides a funny-looking neck and some substantial medical bills, is a collection of medical surplus. After my 'jailbreak' from the hospital nearly a month ago, I've received weekly deliveries of medical supplies to my house to assist me with my TPN and antibiotics applications. From what you've read, you might suppose the packing manifest for that sort of thing to be pretty straightforward. "OK, big bags of goopy sugar water, one week's supply. Check. A bunch of antibiotics packets. Check. What else is there?" Well, quite a lot, actually.
When I was in the hospital, 95% of my social interaction was with nurses. Every hour or two at first, and then every few hours, a nurse would come in, check my vital signs, inject me with painkillers or something to clear my IV line, and check my various support devices and bring me buckets of ice cubes. I rapidly developed a serious sense of respect for these men and women who, for very low pay, tended to my every need, no matter how basic, and managed to keep up a cheery outlook and remain supportive, no matter if I acted petulant, or if it was three o'clock in the morning and I was still up watching late night wrestling whilst in a stupor and demanding extra ice, another blanket and possibly a fresh pillow. They were very patient with me.
Naturally, I started asking questions about their jobs, what they liked most about the experience, and eventually started wondering if I had what it took to be a nurse myself. I didn't feel any particular inclination towards the job, although I liked the selflessly helping others angle, but I'm a curious person and like to know what makes others tick. Most of the nurses were happy to talk, and so I got the gist of the role from most of them. The best part was helping others, especially when the patients got better; the worst part was seeing a patient not recover, followed by the frustration of dealing with excessively demanding patients or doctors.
By the end of my stay, I considered what I'd learned, and decided that nursing would not be the profession for me. Not because I lacked in patience or empathy (some of you who know me can stop laughing now, thank you), or because I was especially squeamish around gross physicality. Rather, there was one fundamental reason why I'd not last in the profession very long, and this is it:
I'm a big slob.
Well, I'm not as big of a slob as I was in college, or immediately thereafter. These days, I have a cleaning service so I don't have to worry about the issue at all - it's like being able to hire a substitute mom to come by and pick up your clothes and dust off the mantle. Actually, I'm reasonably tidy for a bachelor living in a cheap apartment in a squalid section of DC, but I think I'd need at least a day, possibly a whole weekend, to clean up my place if I were expecting reputable company. I don't have a particular aversion to leaving a couple empty soda cans out on my desk if I've been busy, and my cat has been known to strew socks and cat toys and bits of yesterday's newspaper all over the floor, and I have been known to not bother to pick any of that up until several weeks has passed and I'm starting to notice that I no longer have room for a new soda can on my desktop, but nonetheless I don't think I'm embarrassingly lax about my housekeeping tendencies.
The point of this whole conversational roundabout is that I was thoroughly unprepared for the actual responsibilities involved in taking care of myself after my excuse from the hospital. "I can't wait to get out of this sterile environment," I moaned to myself. In retrospect, that should have been a worrying sentiment, considering that I was about to take my medical care into my own hands. "This'll be simple," my line of thinking continued, as I lay in bed hours before my release. "They just come in and change a bag of medicine every couple hours, I have all the lines in me already, I'll just plug in the antibiotics and other stuff and it'll be a cinch. I can't wait to get out and see all of my friends and go to the movies and do everything I'd normally do, and I'm sure everything I need will fit in a small backpack."
Well, of course it turned out to be much more involved than that. My first delivery of medical supplies came in a box that would have housed a modest refrigerator. Surprised, I lugged the box up two flights of stairs (my first mistake that weekend), and opened it up to see exactly why they'd used such a huge box for a couple of packs of TPN fluid and saline solution.
"Well, this is interesting...", I thought. I pulled out a yellow sheet - the delivery manifest. On it was written line items like this:
As days passed, I realized that the answer was probably pretty simple: the pharmacy had simply been a little lazy. Instead of counting out exact amounts of everything I'd need, plus perhaps one or two spares of each item to account for the chance of accident, I'd been given bales of prepackaged items that met or exceeded my actual requirements. A good third of the items I'd been sent served no apparent purpose. I didn't need heparin, nor had it ever been prescribed; I was genuinely doubtful I needed ten sterile wipes just to change an IV line (I bathe daily, that should serve), and I really had to wonder why I'd been given the equivalent of do-it-yourself IV insertion kits, when I was already chock-full of needles and rubber hosing. By the end of the first week, I'd only used about two-thirds of the supplies I'd been sent. I amused myself by squirting saline solution from spare syringes at my cat when he'd attack my IV lines.
The second week, TWO giant boxes appeared. I suspected that there was a plot afoot to help me rebuild my lost muscle mass by forcing me to lift ever-increasing amounts of useless medical supplies up to my third-floor apartment, in addition to my ever-present TPN sack. As before, I had been granted a total excess of everything. My room was starting to get a little treacherous - in addition to having to navigate all of my usual junk, I had to sidestep bins full of medical supplies whilst trailing IV lines and TPN supplies, and hope my cat wouldn't elect to pounce on a vulnerable tube and cause me trip and fall over an economy-sized pack of sterile wipes.
After the second delivery, I mentioned the plenitude of supplies to my outpatient nurse, Jean. I was happy that I wasn't being shortchanged, but even though I'm not exactly known for being thrifty, I was a little concerned at the excess. She assured me that she'd mention it to the pharmacy.
Later that week, I got a call from the pharmacy. I explained the situation, and we went line-by-line over the manifest. I identified each item in turn, and stated when I felt I'd stockpiled enough to last me through the following week. The pharmacist agreed, although she expressed doubt that I really didn't need all of the sterile wipes they'd provided, and I ended the conversation with the understanding that the next delivery would only contain what I needed.
Well, that was the case. The next delivery came in a small box, and only held antibiotics and a few bags of TPN fluid (as I was going off the IV feeding regimen mid-week.) I felt a little forlorn, actually. In a way, I'd looked forward to my weekly deliveries; it was like getting the craziest collection of Christmas presents ever. Who knows what I'd receive? Wasteful as it was, I liked searching each box for the odd medical accessory that had absolutely nothing to do with my situation, and had contemplated building a mighty fort out of the manifold cardboard boxes that were now lining the wall of my apartment. I could have held the whole thing together with spare IV tubing and paste made out of powdered antibiotics and saline fluid.
Unfortunately, it looked like the mad pharmacist in charge of my case had finally managed to restrain his or herself, and I was only receiving the bare essentials of my case. I got over it, of course; I was happy to not have to move my bookshelf to accommodate another two boxes, and the week passed as I medicated and rested.
Unfortunately, the brief interlude of sanity appeared to be a passing phase. The following Wednesday, I returned home to find TWO more boxes of supplies. I wasn't even on TPN anymore, so how much could I need? Inside, the contents were all too familiar: boxes of sterile wipes and saline flushes, and packet after packet of antibiotics.
A few days later, as I recounted in my last post, I had my PICC line removed, and I was officially off the IV lines and done with my therapy. Via the outpatient clinic, I learned that the pharmacy would be discontinuing my deliveries. "Good," I thought. "I can start working on my fort now and not have to move my exercise bike to accommodate an extra wing." Returning home after my last appointment, I took stock of the leftovers.
At this point, I am left with (perhaps) 20 packets of IV antibiotics, several hundred sterile wipes, at least fifty or so saline flushes, bales of heparin (I don't even know what heparin *is*), two boxes of 500 rubber gloves apiece, a bunch of miscellaneous caps and tube fittings, at least two my-first-IV-line kits, and assorted IV tubes and flow controls. In addition, I ended up with four useless sacks of TPN fluid, which have just been sitting in the downstairs fridge aggravating my roommates who would at least prefer that if I decided to hog an entire shelf of the fridge with my food, it could be food that they could mooch and eat normally, instead of inject via a little pump and IV line.
I called the pharmacy up and asked what exactly was I supposed to do with all of this stuff. "Give it to a veterinarian or a walk in clinic," they suggested. I was taken aback. A vet, I could understand. I'm not surprised quality controls are looser for animals than they are for people. But a walk-in clinic? I've *been* to those, when I couldn't schedule an appointment with my regular doctor. Did they really take donations of antibiotics and other supplies off the streets? I recoiled at the thought. Didn't the FDA, or AMA or somebody regulate this kind of thing?
I'm still left with all of this stuff. Since the IV lines are out, I don't have cause to annoy my cat with the saline flushes. I guess I'll take everything to a local clinic, and hope that no one has a seizure because of my off-the-back-of-a-truck heparin doses.
I was particularly reluctant to dispose of the leftover TPN fluid. I sensed that it might have potency beyond sustaining human life; a lot of thought and care went into concocting this special blend of substances that was calculated to provided the maximal amount of nutrition and support that a liter-sack of fluid could provide. If I could no longer benefit from it, what could?
Well. What if I fed it to my roses?
I mean, it's sugar, water, fat, and vitamins. What living thing doesn't thrive on those things? (Note: I was a solid C student in biology in high school. Don't mock me if I'm totally off the mark on that assumption.) I was reluctant to feed it to my cat, since he's already, ahem, plush enough without concentrated doses of fat juice, and *I* wasn't interested in eating it, since I now had dumplings and sushi and peanut butter milkshakes to content myself with. It seemed a waste to put it down the sink, since a nurse had told me each daily dose cost *$200* to prepare. $200!! I had to do something with it.
There is a giant rose bush in my neglected front yard. Every month, the landlord comes by, mows the grass, picks up some trimmings, and that's the extent of our lawn care routine. Every so often, one of us gets it into his head that he's going to remake the lawn, turn it into a shining example of horticulture and beauty in an otherwise despoiled neighborhood, and the impulse lasts for exactly one weekend before we decide that it's really too hot to muck about in the dirt outside, and it would really be a lot more satisfying to go play XBox until night falls and the temperature is something bearable again.
The rose bush is always late in blooming. I can't say we've done much to help it along. Nonetheless, it struggles, and each summer a few blossoms appear, shockingly vivid against the lawn's expanse of patchy green and the brown bricks of our shared home. I don't feel like we really deserve it's beauty, but we've never done anything to prevent it from thriving, either. Except this time.
Armed with several sacks and a pair of scissors, I decided to perform an experiment upon the unsuspecting rose bush. My hypothesis: that fed a potent mixture of water, fat, sugar, multivitamins, and sunlight, my giant rose bush would thrive and bear blossoms early. This was a totally unscientific experiment, of course; there was no control group, no repetitions of the study (I only had one rose bush and a few TPN sacks), and my recollection of previous years' rose performance was the closest I had to historical data. I was pretty sure that no matter what, the rose wouldn't *die*, exactly. At worst, I guess I might choke it a little; I had no idea how plants tolerated a fatty diet. Do plants even get fat? Again, this is why I was a journalism, not a biology, major.
I spent fifteen minutes spraying white TPN fluid all over the rose bush. Neighborhood children sidled past, staring as I heaved giant clots of fat and sugar all over the lawn. I was thorough, and had several liters of material to work with; the rose bush was thoroughly coated in a slime of nutritional mix that, although it had been calibrated to my precise requirements, might also benefit a shrubbery. I do not care to brood on the implications of that statement, should my hypothesis be correct.
Two days passed. And then, one day on the way out the door to work...
"A-HAAAA!", I chortled. Two days prior, there had only been barren leaves, with a few limp buds, but now full roses blossoms were visible. Excitedly, I decided to be late for work (traffic was bad anyhow), and I stooped to examine the Frankensteinien results of my mad experiment:
"IT'S ALIVE!", I exclaimed. More than alive, in actuality; full, vibrant, saturated with color and clearly better off than the average weed or dandelion in my neglected garden. All over the rose bush, blossoms existed where none had 48 hours earlier.
I cackled as I examined all sides of the plant. The distribution of healthy roses seemed approximately even. Surprisingly, I found one rose unlike all of the others:
I don't remember having an *orange* rose. Maybe it's a mutant? Perhaps it's part Rex, part Rose, a weird hybrid saturated with enough fat and nutrients to become an exemplar of its species and something else besides. Well, before I get too far ahead of myself, it's probably just a rose. But it looks pretty good, odd color regardless.
So, my experiment appears to have been a resounding success. The rose bush bloomed early, and our lawn looks much better for it. Unfortunately, I really doubt there's anything else out there that would benefit from my medical leftovers; I don't think saline fluid, heparin, or powdered Unacyn is going to replace Miracle-Gro anytime soon.
If anyone here is a doctor or knows one, please let me know what I should do with this stuff. If it's OK to give it to a clinic, I will do that, but I am a little uncertain, particularly with regards to the prescription stuff like the antibiotics.
Well, it's time to find something to eat - preferably less fatty than what the roses had. Thanks again for reading - RL
When I was in the hospital, 95% of my social interaction was with nurses. Every hour or two at first, and then every few hours, a nurse would come in, check my vital signs, inject me with painkillers or something to clear my IV line, and check my various support devices and bring me buckets of ice cubes. I rapidly developed a serious sense of respect for these men and women who, for very low pay, tended to my every need, no matter how basic, and managed to keep up a cheery outlook and remain supportive, no matter if I acted petulant, or if it was three o'clock in the morning and I was still up watching late night wrestling whilst in a stupor and demanding extra ice, another blanket and possibly a fresh pillow. They were very patient with me.
Naturally, I started asking questions about their jobs, what they liked most about the experience, and eventually started wondering if I had what it took to be a nurse myself. I didn't feel any particular inclination towards the job, although I liked the selflessly helping others angle, but I'm a curious person and like to know what makes others tick. Most of the nurses were happy to talk, and so I got the gist of the role from most of them. The best part was helping others, especially when the patients got better; the worst part was seeing a patient not recover, followed by the frustration of dealing with excessively demanding patients or doctors.
By the end of my stay, I considered what I'd learned, and decided that nursing would not be the profession for me. Not because I lacked in patience or empathy (some of you who know me can stop laughing now, thank you), or because I was especially squeamish around gross physicality. Rather, there was one fundamental reason why I'd not last in the profession very long, and this is it:
I'm a big slob.
Well, I'm not as big of a slob as I was in college, or immediately thereafter. These days, I have a cleaning service so I don't have to worry about the issue at all - it's like being able to hire a substitute mom to come by and pick up your clothes and dust off the mantle. Actually, I'm reasonably tidy for a bachelor living in a cheap apartment in a squalid section of DC, but I think I'd need at least a day, possibly a whole weekend, to clean up my place if I were expecting reputable company. I don't have a particular aversion to leaving a couple empty soda cans out on my desk if I've been busy, and my cat has been known to strew socks and cat toys and bits of yesterday's newspaper all over the floor, and I have been known to not bother to pick any of that up until several weeks has passed and I'm starting to notice that I no longer have room for a new soda can on my desktop, but nonetheless I don't think I'm embarrassingly lax about my housekeeping tendencies.
The point of this whole conversational roundabout is that I was thoroughly unprepared for the actual responsibilities involved in taking care of myself after my excuse from the hospital. "I can't wait to get out of this sterile environment," I moaned to myself. In retrospect, that should have been a worrying sentiment, considering that I was about to take my medical care into my own hands. "This'll be simple," my line of thinking continued, as I lay in bed hours before my release. "They just come in and change a bag of medicine every couple hours, I have all the lines in me already, I'll just plug in the antibiotics and other stuff and it'll be a cinch. I can't wait to get out and see all of my friends and go to the movies and do everything I'd normally do, and I'm sure everything I need will fit in a small backpack."
Well, of course it turned out to be much more involved than that. My first delivery of medical supplies came in a box that would have housed a modest refrigerator. Surprised, I lugged the box up two flights of stairs (my first mistake that weekend), and opened it up to see exactly why they'd used such a huge box for a couple of packs of TPN fluid and saline solution.
"Well, this is interesting...", I thought. I pulled out a yellow sheet - the delivery manifest. On it was written line items like this:
- TPN fluid, one day's supply - x7
- Ampicillin/Sulbactam (Unacyn) - x30
- Dosi-Flo IV tubing - x7
- TPN tubing - x7
- Alcohol wipes - x200
- Saline flush injectors - x50
- Heparin injectors - x50
- Multivitamin additive - x7
- Syringes & needles - x10
- End tubes - x10
- Sterile gauze bandages - x30
- C cell batteries (for the TPN pumps) - x20
- Rubber gloves - x500
As days passed, I realized that the answer was probably pretty simple: the pharmacy had simply been a little lazy. Instead of counting out exact amounts of everything I'd need, plus perhaps one or two spares of each item to account for the chance of accident, I'd been given bales of prepackaged items that met or exceeded my actual requirements. A good third of the items I'd been sent served no apparent purpose. I didn't need heparin, nor had it ever been prescribed; I was genuinely doubtful I needed ten sterile wipes just to change an IV line (I bathe daily, that should serve), and I really had to wonder why I'd been given the equivalent of do-it-yourself IV insertion kits, when I was already chock-full of needles and rubber hosing. By the end of the first week, I'd only used about two-thirds of the supplies I'd been sent. I amused myself by squirting saline solution from spare syringes at my cat when he'd attack my IV lines.
The second week, TWO giant boxes appeared. I suspected that there was a plot afoot to help me rebuild my lost muscle mass by forcing me to lift ever-increasing amounts of useless medical supplies up to my third-floor apartment, in addition to my ever-present TPN sack. As before, I had been granted a total excess of everything. My room was starting to get a little treacherous - in addition to having to navigate all of my usual junk, I had to sidestep bins full of medical supplies whilst trailing IV lines and TPN supplies, and hope my cat wouldn't elect to pounce on a vulnerable tube and cause me trip and fall over an economy-sized pack of sterile wipes.
After the second delivery, I mentioned the plenitude of supplies to my outpatient nurse, Jean. I was happy that I wasn't being shortchanged, but even though I'm not exactly known for being thrifty, I was a little concerned at the excess. She assured me that she'd mention it to the pharmacy.
Later that week, I got a call from the pharmacy. I explained the situation, and we went line-by-line over the manifest. I identified each item in turn, and stated when I felt I'd stockpiled enough to last me through the following week. The pharmacist agreed, although she expressed doubt that I really didn't need all of the sterile wipes they'd provided, and I ended the conversation with the understanding that the next delivery would only contain what I needed.
Well, that was the case. The next delivery came in a small box, and only held antibiotics and a few bags of TPN fluid (as I was going off the IV feeding regimen mid-week.) I felt a little forlorn, actually. In a way, I'd looked forward to my weekly deliveries; it was like getting the craziest collection of Christmas presents ever. Who knows what I'd receive? Wasteful as it was, I liked searching each box for the odd medical accessory that had absolutely nothing to do with my situation, and had contemplated building a mighty fort out of the manifold cardboard boxes that were now lining the wall of my apartment. I could have held the whole thing together with spare IV tubing and paste made out of powdered antibiotics and saline fluid.
Unfortunately, it looked like the mad pharmacist in charge of my case had finally managed to restrain his or herself, and I was only receiving the bare essentials of my case. I got over it, of course; I was happy to not have to move my bookshelf to accommodate another two boxes, and the week passed as I medicated and rested.
Unfortunately, the brief interlude of sanity appeared to be a passing phase. The following Wednesday, I returned home to find TWO more boxes of supplies. I wasn't even on TPN anymore, so how much could I need? Inside, the contents were all too familiar: boxes of sterile wipes and saline flushes, and packet after packet of antibiotics.
A few days later, as I recounted in my last post, I had my PICC line removed, and I was officially off the IV lines and done with my therapy. Via the outpatient clinic, I learned that the pharmacy would be discontinuing my deliveries. "Good," I thought. "I can start working on my fort now and not have to move my exercise bike to accommodate an extra wing." Returning home after my last appointment, I took stock of the leftovers.
At this point, I am left with (perhaps) 20 packets of IV antibiotics, several hundred sterile wipes, at least fifty or so saline flushes, bales of heparin (I don't even know what heparin *is*), two boxes of 500 rubber gloves apiece, a bunch of miscellaneous caps and tube fittings, at least two my-first-IV-line kits, and assorted IV tubes and flow controls. In addition, I ended up with four useless sacks of TPN fluid, which have just been sitting in the downstairs fridge aggravating my roommates who would at least prefer that if I decided to hog an entire shelf of the fridge with my food, it could be food that they could mooch and eat normally, instead of inject via a little pump and IV line.
I called the pharmacy up and asked what exactly was I supposed to do with all of this stuff. "Give it to a veterinarian or a walk in clinic," they suggested. I was taken aback. A vet, I could understand. I'm not surprised quality controls are looser for animals than they are for people. But a walk-in clinic? I've *been* to those, when I couldn't schedule an appointment with my regular doctor. Did they really take donations of antibiotics and other supplies off the streets? I recoiled at the thought. Didn't the FDA, or AMA or somebody regulate this kind of thing?
I'm still left with all of this stuff. Since the IV lines are out, I don't have cause to annoy my cat with the saline flushes. I guess I'll take everything to a local clinic, and hope that no one has a seizure because of my off-the-back-of-a-truck heparin doses.
I was particularly reluctant to dispose of the leftover TPN fluid. I sensed that it might have potency beyond sustaining human life; a lot of thought and care went into concocting this special blend of substances that was calculated to provided the maximal amount of nutrition and support that a liter-sack of fluid could provide. If I could no longer benefit from it, what could?
Well. What if I fed it to my roses?
I mean, it's sugar, water, fat, and vitamins. What living thing doesn't thrive on those things? (Note: I was a solid C student in biology in high school. Don't mock me if I'm totally off the mark on that assumption.) I was reluctant to feed it to my cat, since he's already, ahem, plush enough without concentrated doses of fat juice, and *I* wasn't interested in eating it, since I now had dumplings and sushi and peanut butter milkshakes to content myself with. It seemed a waste to put it down the sink, since a nurse had told me each daily dose cost *$200* to prepare. $200!! I had to do something with it.
There is a giant rose bush in my neglected front yard. Every month, the landlord comes by, mows the grass, picks up some trimmings, and that's the extent of our lawn care routine. Every so often, one of us gets it into his head that he's going to remake the lawn, turn it into a shining example of horticulture and beauty in an otherwise despoiled neighborhood, and the impulse lasts for exactly one weekend before we decide that it's really too hot to muck about in the dirt outside, and it would really be a lot more satisfying to go play XBox until night falls and the temperature is something bearable again.
The rose bush is always late in blooming. I can't say we've done much to help it along. Nonetheless, it struggles, and each summer a few blossoms appear, shockingly vivid against the lawn's expanse of patchy green and the brown bricks of our shared home. I don't feel like we really deserve it's beauty, but we've never done anything to prevent it from thriving, either. Except this time.
Armed with several sacks and a pair of scissors, I decided to perform an experiment upon the unsuspecting rose bush. My hypothesis: that fed a potent mixture of water, fat, sugar, multivitamins, and sunlight, my giant rose bush would thrive and bear blossoms early. This was a totally unscientific experiment, of course; there was no control group, no repetitions of the study (I only had one rose bush and a few TPN sacks), and my recollection of previous years' rose performance was the closest I had to historical data. I was pretty sure that no matter what, the rose wouldn't *die*, exactly. At worst, I guess I might choke it a little; I had no idea how plants tolerated a fatty diet. Do plants even get fat? Again, this is why I was a journalism, not a biology, major.
I spent fifteen minutes spraying white TPN fluid all over the rose bush. Neighborhood children sidled past, staring as I heaved giant clots of fat and sugar all over the lawn. I was thorough, and had several liters of material to work with; the rose bush was thoroughly coated in a slime of nutritional mix that, although it had been calibrated to my precise requirements, might also benefit a shrubbery. I do not care to brood on the implications of that statement, should my hypothesis be correct.
Two days passed. And then, one day on the way out the door to work...
"A-HAAAA!", I chortled. Two days prior, there had only been barren leaves, with a few limp buds, but now full roses blossoms were visible. Excitedly, I decided to be late for work (traffic was bad anyhow), and I stooped to examine the Frankensteinien results of my mad experiment:
"IT'S ALIVE!", I exclaimed. More than alive, in actuality; full, vibrant, saturated with color and clearly better off than the average weed or dandelion in my neglected garden. All over the rose bush, blossoms existed where none had 48 hours earlier.
I cackled as I examined all sides of the plant. The distribution of healthy roses seemed approximately even. Surprisingly, I found one rose unlike all of the others:
I don't remember having an *orange* rose. Maybe it's a mutant? Perhaps it's part Rex, part Rose, a weird hybrid saturated with enough fat and nutrients to become an exemplar of its species and something else besides. Well, before I get too far ahead of myself, it's probably just a rose. But it looks pretty good, odd color regardless.
So, my experiment appears to have been a resounding success. The rose bush bloomed early, and our lawn looks much better for it. Unfortunately, I really doubt there's anything else out there that would benefit from my medical leftovers; I don't think saline fluid, heparin, or powdered Unacyn is going to replace Miracle-Gro anytime soon.
If anyone here is a doctor or knows one, please let me know what I should do with this stuff. If it's OK to give it to a clinic, I will do that, but I am a little uncertain, particularly with regards to the prescription stuff like the antibiotics.
Well, it's time to find something to eat - preferably less fatty than what the roses had. Thanks again for reading - RL
Monday, May 5, 2008
Is It Over?
After a week of silence, I hope you're still here. Last week, I talked about mobility; traveling to New York City, buying a camera and traipsing around the city taking shots. Well, that describes the interim. I've been trekking across DC, rediscovering the fact that I haven't got a lick of compositional sense, but I haven't let that deter me from taking hundreds of photographs since then. I'll post a few as soon as I decide a few aren't too amateurish to display.
I had three appointments last week. One, the typical Monday appointment with the Homecare facility. Homecare provides me with nurses who change my IV line dressings and manage my pharmacy deliveries - the Monday appointment never holds any surprises. I get a new bandage, gossip with the nurses for half an hour, and then I'm off after some bloodwork.
Tuesday's meeting was unusual. For the first time, I met with - we'll call her Dr. Garcia - Dr. Garcia, who consults on my case at the hospital. She's an infectious diseases specialist, and was responsible for prescribing the various antibiotics and other anti-infection medicines that I've been receiving daily via an IV since my accident. As my last post suggests, I feel a great debt to her, since I think she managed to treat more than just the infections and illnesses arising from my primary wound site. Anyhow, the purpose of this visit was to review my condition, and to decide if any changes were needed in my treatment.
Dr. Garcia is a pleasant doctor. Her bedside manner is better than that of Dr. Smith, whose candor is sometimes indistinguishable from mere bluntness. My bloodwork is excellent - I'm tolerating the drugs well, and seem to be in excellent health otherwise. The only item of concern at this point is my recurring stomach aches, which Dr. Garcia seems to be convinced are caused by a specific infectious agent empowered by the die-off of bacteria in my gut precipitated by the weeks of antibiotic megadoses. I disagree; I think it's merely the consequence of having had 'Thai-hot' crispy fried duck for lunch the previous day. In any case, Dr. Garcia pledges once again to test me for the presence of c. difficile, the suspected bacillus.
Dr. Garcia seems optimistic about my case. Upon hearing that I've been tolerating drink and solid food without major complication over the past week or two, she's willing to move to oral antibiotics instead of an IV regimen. I'm silently thrilled; I'm tired, literally, of getting up every six hours to tie myself to an IV line. Eight hours of uninterrupted sleep would make my day.
With that, I'm dismissed. Dr. Garcia feels this is the last time we will meet, since I am so close to recovery, or at least a state so approximately close to normalcy that further treatment would be unwarranted. I thank her warmly - I have a soft spot for doctors who don't belittle their patients, and can smile when the situation warrants it.
The following day, I have a fluoroscopy scan scheduled, as well as an appointment with Dr. Smith. The scan will be the first in two weeks; I think it will be my sixth overall. I'm on a first name basis with the radiology staff, and have figured out how the interface to the CT machine works. I can evaluate the results as fast as the technicians, and this is good since the doctors are spared some of the awkwardness when they need to tell me that my esophagus is still mildly disfigured. I see it for myself before a word is said. We did things a little differently today, rotating my body more to gain a fuller view of my throat. I can see small divots lined with glowing gastrograffin, the thick fluid that provides the contrast for the scan. It's a fascinating few seconds, watching the scan replay itself and I see how my throat has handled a gulp of liquid since I was able to swallow.
I had an hour to kill before meeting with Dr. Smith. I bought a newspaper and breakfast, and tried to make the best of a plate of hash browns and bacon. My throat was hardly acclimated to solid food, despite the past week. Some things, like soups, or liquids, passed without incident. Other foods - not all - seemed to lodge firmly in the center of my throat, causing me to cough and carry an uncomfortable sense of fullness behind my Adam's apple for the next 15 minutes until the sensation passes. I can't tell - is the feeling that of an angry injury site, rough with scar tissue and confused about how to interpret these new sensations, or have I truly injured myself, and the food is lodging somewhere in the hollows of my reshaped throat? I can't tell. Everything feels new, even more than it did when I took my first few hesitant nibbles of food and sips of water.
I meet with Dr. Smith, who invites me back into his office and begins his examination. My neck is dimpled and textured with livid suture points and tube sites, but Dr. Smith nods approvingly, noting that the wounds were healing after my improvised self-surgery a few days earlier. I assure him that I'm in no pain, but eating is a strange affair, since half the time I feel fine, and the other half I feel like the food won't go past the injury site. He nods, and then we take a look at the printouts of today's scan.
Most of what we review is obvious. I have a slight 'dent' in the back of my throat, less than a centimeter or so long and much less deep, from where I stabbed myself with a blunt sword a month earlier. I continue to be a mystery, since typically the tension of the bands of esophageal muscle would push the tissue back into shape, closing the injury and recreating a smooth passage. It's this curious condition that kept me in the hospital for as long as I was there; it was difficult to tell from the scans that I had actually healed, despite the odd healing progression.
Dr. Smith has some surprising news that I believe explains the previous mystery. "Well," he begins, "we changed the scan around and looked at more of your throat than we did before. And the type of injury you're left with - a diverticulum, an outcropping into the muscle of your throat - is usually harmless, but you're unusual in that it's not the first one you've had." I blink. "You have a dip in the back of your throat. It's not leaking, you won't get an infection, and you've shown you can eat and drink. I'd call it a diverticulum, at this point, since there's a naturally occurring condition just like what you have. In fact, you seem to have had one already." Pointing at one of the printouts, I realize something I'd missed in the radiologic lab - this is an image of a dent in my throat, a small hole progressing into the muscle wall, but it's not in the same place as my injury.
Dr. Smith continues. "Usually we see these in men later in life, around 50 or so. It's not medically significant unless it's symptomatic; sometimes people have trouble eating or swallowing, since food can get lodged in that space. If that's the case, we can fix it with surgery." I ask the obvious question: What do you do with people in their 30s with this kind of condition? Do you sew them up to? Dr. Smith smiles and replies, "There's still a good chance your primary injury site will close up, just in more time than we expected. If it doesn't cause you problems in the long run, we can consider it sufficiently healed. Otherwise, we can do surgery - we'll have to make another incision through your throat, and you'll have to come back to the hospital." I'm a little shocked, as I stare at the scans below me. Two injuries, nearly identical! One I caused, and one that happened spontaneously. I thought back over the past few years. Had I had trouble swallowing or eating? In truth, I had started coughing a little after big meals - I remember mentioning to page months earlier. It hadn't been a problem, though - merely a memorable anomaly I filed away in the back of my mind. The two 'pockets' in my throat were at the same level; one in the very back - the injury - and the older one on the left.
I had a funny feeling, then, as I started to wonder. The 'naturally-occurring' diverticulum had been caused by a weakness in the band of muscle at that level of the esophagus. Perhaps that prior weakness explained why my new injury hadn't healed normally? If I'd injured myself any higher or lower, would the wound have resolved in a week, the tissue pushed back into place by stronger tissue? I wondered, and kept my hypothesis to myself. It seemed to make sense.
In the short term - what could I do? Dr. Smith, as he had been when we first met, was reluctant to perform any surgery he could avoid if I had a reasonable chance of recovering on my own. We agreed to the following: Regular scans, followed by a final decision at the end of the year. I would return in June - six weeks away - for another scan. I'd return again later in the fall for a second scan. If the injury site failed to continue to shrink, and if I was experiencing consistent dysphagia - that's fancy talk for difficulty swallowing - we could revisit surgery. It'd be a much more dramatic procedure than the one I endured in the hospital, since I'd have to have my neck cut open and the 'divots' sewn up - but I'd be able to repair both diverticula at once. I wasn't anxious to return to the hospital, though, and I would have about a week of recovery time afterwards.
In the meantime, I wait. I experiment with different foods. Pizza aggravates my throat and makes me feel like I'm choking, whereas sushi is a dream to consume - I enjoy it as much as I did before. I thank God profusely for the simple fact that I can eat Chinese dumplings without hesitation - but a mouthful of rice seems to come to rest at the bottom of my throat and refuses to pass without a glass of water. Trial and error seems to help identify problem foods, but as the week goes on, I'm doing better. I'm not sure whether I'll have a chronic or long-term problem at all, especially as every day I feel a bit more normal, more adjusted to the notion of being a typical person without functional limitations. I am terribly glad for two things, though. One - my injury is now in the same category as other very well understood, naturally-occurring conditions. Two - if I should tire of all of this, if I don't recover satisfactorily on my own - there is the surgical option. I can fix it all, and in fact be better than I was before, if I am willing to accept the cost and risk. Much like anything in life, really.
In the meantime, I continue to shed the apparatus of my medical misadventure. Today, I had the PICC line in my arm removed - a foot and a half of white rubber tubing running from my right mid-arm to the arteries of my heart. I expected it to hurt, but the procedure was painless and took moments. As is commonplace these days, I had a totally new and unexpected emotion - the satisfaction of knowing I was whole again, simply myself and not augmented with weird additions that felt parasitical, despite providing a valuable medical function. I was happy to be untethered and unconnectable, with not one valve or drain to hook up to a machine or injector or other device. In short, I was on my own again, and independent in a way I hadn't been since early March.
While at the outpatient facility, we received a call from Dr. Garcia, letting us know that the PICC line was unnecessary, and that any additional medication I needed could be provided by a local pharmacy. So, my involvement with the outpatient facility was at an end. My exit was actually a little emotional, since I'd been so well attended to by the two nurses who staffed the office, and I'd enjoyed talking with them about their interests as well as the interesting details of nursing and my own care. I'll miss our Monday appointments - they were educational.
At this point - I'm done, for now! I'm on my own. No more medicines, no opiates, no appointments, calls, or deliveries. I have about three boxes of surplus medical supplies to deal with - I need to find a local clinic to donate them too. I still have two TPN pumps to return to the pharmacy - I want them off my hands, since they're ridiculously valuable. The IV stand has been folded up and retired to the closet. My cat is a little disappointed, since I'm no longer trailing fun cables for him to capture. I can move about, and don't have a fixed schedule to attend to for my own care.
I can't believe this whole experience lasted only six weeks.
I'm left with a few unresolved emotions about the whole experience. Firstly, and perhaps most importantly, I have a sense of empathy for individuals who are dependent on long-term medical care every day for their continued comfort and survival. I saw a few people like that in wards next to me in the hospital, and Dr. Smith never failed to mention how he had patients who were committed to a lifetime of the treatment that I could expect to forget in a month or so. Being young and whole, I can walk unassisted in society, head outdoors, take photographs and indulge my interests as I see fit in my healthy, although reconfigured, body. However, I suspect there's a 'shadow' class of people, young and old, enduring conditions worse than anything I've encountered who will never have the certainty of recovery I was given, and might not be able to manage their own care outside of a hospital setting. What was their lot? I was thrown back into a familiar life, full of typical middle-class cares and all the comforts I could afford. I feel like I'm looking over my shoulder more now. There's a world of unpleasant possibilities out there - I'm not sure what I should do with the constant awareness that there are quite a few people who haven't been able to walk away from their health problems as quickly as I did, besides try to stay appreciative. I feel a little guilty for being better, and not having done anything in recognition of it, especially since I practically asked for the injury I received. We'll see.
That's all for now. I'll update this post later with scans from my fluoroscopy printouts, so you can see the conditions I'm describing. In the meantime, I'll be on a 'normal' schedule again, going to work, coming home, and seeing my friends. That's what I wanted to come home to - right?
I had three appointments last week. One, the typical Monday appointment with the Homecare facility. Homecare provides me with nurses who change my IV line dressings and manage my pharmacy deliveries - the Monday appointment never holds any surprises. I get a new bandage, gossip with the nurses for half an hour, and then I'm off after some bloodwork.
Tuesday's meeting was unusual. For the first time, I met with - we'll call her Dr. Garcia - Dr. Garcia, who consults on my case at the hospital. She's an infectious diseases specialist, and was responsible for prescribing the various antibiotics and other anti-infection medicines that I've been receiving daily via an IV since my accident. As my last post suggests, I feel a great debt to her, since I think she managed to treat more than just the infections and illnesses arising from my primary wound site. Anyhow, the purpose of this visit was to review my condition, and to decide if any changes were needed in my treatment.
Dr. Garcia is a pleasant doctor. Her bedside manner is better than that of Dr. Smith, whose candor is sometimes indistinguishable from mere bluntness. My bloodwork is excellent - I'm tolerating the drugs well, and seem to be in excellent health otherwise. The only item of concern at this point is my recurring stomach aches, which Dr. Garcia seems to be convinced are caused by a specific infectious agent empowered by the die-off of bacteria in my gut precipitated by the weeks of antibiotic megadoses. I disagree; I think it's merely the consequence of having had 'Thai-hot' crispy fried duck for lunch the previous day. In any case, Dr. Garcia pledges once again to test me for the presence of c. difficile, the suspected bacillus.
Dr. Garcia seems optimistic about my case. Upon hearing that I've been tolerating drink and solid food without major complication over the past week or two, she's willing to move to oral antibiotics instead of an IV regimen. I'm silently thrilled; I'm tired, literally, of getting up every six hours to tie myself to an IV line. Eight hours of uninterrupted sleep would make my day.
With that, I'm dismissed. Dr. Garcia feels this is the last time we will meet, since I am so close to recovery, or at least a state so approximately close to normalcy that further treatment would be unwarranted. I thank her warmly - I have a soft spot for doctors who don't belittle their patients, and can smile when the situation warrants it.
The following day, I have a fluoroscopy scan scheduled, as well as an appointment with Dr. Smith. The scan will be the first in two weeks; I think it will be my sixth overall. I'm on a first name basis with the radiology staff, and have figured out how the interface to the CT machine works. I can evaluate the results as fast as the technicians, and this is good since the doctors are spared some of the awkwardness when they need to tell me that my esophagus is still mildly disfigured. I see it for myself before a word is said. We did things a little differently today, rotating my body more to gain a fuller view of my throat. I can see small divots lined with glowing gastrograffin, the thick fluid that provides the contrast for the scan. It's a fascinating few seconds, watching the scan replay itself and I see how my throat has handled a gulp of liquid since I was able to swallow.
I had an hour to kill before meeting with Dr. Smith. I bought a newspaper and breakfast, and tried to make the best of a plate of hash browns and bacon. My throat was hardly acclimated to solid food, despite the past week. Some things, like soups, or liquids, passed without incident. Other foods - not all - seemed to lodge firmly in the center of my throat, causing me to cough and carry an uncomfortable sense of fullness behind my Adam's apple for the next 15 minutes until the sensation passes. I can't tell - is the feeling that of an angry injury site, rough with scar tissue and confused about how to interpret these new sensations, or have I truly injured myself, and the food is lodging somewhere in the hollows of my reshaped throat? I can't tell. Everything feels new, even more than it did when I took my first few hesitant nibbles of food and sips of water.
I meet with Dr. Smith, who invites me back into his office and begins his examination. My neck is dimpled and textured with livid suture points and tube sites, but Dr. Smith nods approvingly, noting that the wounds were healing after my improvised self-surgery a few days earlier. I assure him that I'm in no pain, but eating is a strange affair, since half the time I feel fine, and the other half I feel like the food won't go past the injury site. He nods, and then we take a look at the printouts of today's scan.
Most of what we review is obvious. I have a slight 'dent' in the back of my throat, less than a centimeter or so long and much less deep, from where I stabbed myself with a blunt sword a month earlier. I continue to be a mystery, since typically the tension of the bands of esophageal muscle would push the tissue back into shape, closing the injury and recreating a smooth passage. It's this curious condition that kept me in the hospital for as long as I was there; it was difficult to tell from the scans that I had actually healed, despite the odd healing progression.
Dr. Smith has some surprising news that I believe explains the previous mystery. "Well," he begins, "we changed the scan around and looked at more of your throat than we did before. And the type of injury you're left with - a diverticulum, an outcropping into the muscle of your throat - is usually harmless, but you're unusual in that it's not the first one you've had." I blink. "You have a dip in the back of your throat. It's not leaking, you won't get an infection, and you've shown you can eat and drink. I'd call it a diverticulum, at this point, since there's a naturally occurring condition just like what you have. In fact, you seem to have had one already." Pointing at one of the printouts, I realize something I'd missed in the radiologic lab - this is an image of a dent in my throat, a small hole progressing into the muscle wall, but it's not in the same place as my injury.
Dr. Smith continues. "Usually we see these in men later in life, around 50 or so. It's not medically significant unless it's symptomatic; sometimes people have trouble eating or swallowing, since food can get lodged in that space. If that's the case, we can fix it with surgery." I ask the obvious question: What do you do with people in their 30s with this kind of condition? Do you sew them up to? Dr. Smith smiles and replies, "There's still a good chance your primary injury site will close up, just in more time than we expected. If it doesn't cause you problems in the long run, we can consider it sufficiently healed. Otherwise, we can do surgery - we'll have to make another incision through your throat, and you'll have to come back to the hospital." I'm a little shocked, as I stare at the scans below me. Two injuries, nearly identical! One I caused, and one that happened spontaneously. I thought back over the past few years. Had I had trouble swallowing or eating? In truth, I had started coughing a little after big meals - I remember mentioning to page months earlier. It hadn't been a problem, though - merely a memorable anomaly I filed away in the back of my mind. The two 'pockets' in my throat were at the same level; one in the very back - the injury - and the older one on the left.
I had a funny feeling, then, as I started to wonder. The 'naturally-occurring' diverticulum had been caused by a weakness in the band of muscle at that level of the esophagus. Perhaps that prior weakness explained why my new injury hadn't healed normally? If I'd injured myself any higher or lower, would the wound have resolved in a week, the tissue pushed back into place by stronger tissue? I wondered, and kept my hypothesis to myself. It seemed to make sense.
In the short term - what could I do? Dr. Smith, as he had been when we first met, was reluctant to perform any surgery he could avoid if I had a reasonable chance of recovering on my own. We agreed to the following: Regular scans, followed by a final decision at the end of the year. I would return in June - six weeks away - for another scan. I'd return again later in the fall for a second scan. If the injury site failed to continue to shrink, and if I was experiencing consistent dysphagia - that's fancy talk for difficulty swallowing - we could revisit surgery. It'd be a much more dramatic procedure than the one I endured in the hospital, since I'd have to have my neck cut open and the 'divots' sewn up - but I'd be able to repair both diverticula at once. I wasn't anxious to return to the hospital, though, and I would have about a week of recovery time afterwards.
In the meantime, I wait. I experiment with different foods. Pizza aggravates my throat and makes me feel like I'm choking, whereas sushi is a dream to consume - I enjoy it as much as I did before. I thank God profusely for the simple fact that I can eat Chinese dumplings without hesitation - but a mouthful of rice seems to come to rest at the bottom of my throat and refuses to pass without a glass of water. Trial and error seems to help identify problem foods, but as the week goes on, I'm doing better. I'm not sure whether I'll have a chronic or long-term problem at all, especially as every day I feel a bit more normal, more adjusted to the notion of being a typical person without functional limitations. I am terribly glad for two things, though. One - my injury is now in the same category as other very well understood, naturally-occurring conditions. Two - if I should tire of all of this, if I don't recover satisfactorily on my own - there is the surgical option. I can fix it all, and in fact be better than I was before, if I am willing to accept the cost and risk. Much like anything in life, really.
In the meantime, I continue to shed the apparatus of my medical misadventure. Today, I had the PICC line in my arm removed - a foot and a half of white rubber tubing running from my right mid-arm to the arteries of my heart. I expected it to hurt, but the procedure was painless and took moments. As is commonplace these days, I had a totally new and unexpected emotion - the satisfaction of knowing I was whole again, simply myself and not augmented with weird additions that felt parasitical, despite providing a valuable medical function. I was happy to be untethered and unconnectable, with not one valve or drain to hook up to a machine or injector or other device. In short, I was on my own again, and independent in a way I hadn't been since early March.
While at the outpatient facility, we received a call from Dr. Garcia, letting us know that the PICC line was unnecessary, and that any additional medication I needed could be provided by a local pharmacy. So, my involvement with the outpatient facility was at an end. My exit was actually a little emotional, since I'd been so well attended to by the two nurses who staffed the office, and I'd enjoyed talking with them about their interests as well as the interesting details of nursing and my own care. I'll miss our Monday appointments - they were educational.
At this point - I'm done, for now! I'm on my own. No more medicines, no opiates, no appointments, calls, or deliveries. I have about three boxes of surplus medical supplies to deal with - I need to find a local clinic to donate them too. I still have two TPN pumps to return to the pharmacy - I want them off my hands, since they're ridiculously valuable. The IV stand has been folded up and retired to the closet. My cat is a little disappointed, since I'm no longer trailing fun cables for him to capture. I can move about, and don't have a fixed schedule to attend to for my own care.
I can't believe this whole experience lasted only six weeks.
I'm left with a few unresolved emotions about the whole experience. Firstly, and perhaps most importantly, I have a sense of empathy for individuals who are dependent on long-term medical care every day for their continued comfort and survival. I saw a few people like that in wards next to me in the hospital, and Dr. Smith never failed to mention how he had patients who were committed to a lifetime of the treatment that I could expect to forget in a month or so. Being young and whole, I can walk unassisted in society, head outdoors, take photographs and indulge my interests as I see fit in my healthy, although reconfigured, body. However, I suspect there's a 'shadow' class of people, young and old, enduring conditions worse than anything I've encountered who will never have the certainty of recovery I was given, and might not be able to manage their own care outside of a hospital setting. What was their lot? I was thrown back into a familiar life, full of typical middle-class cares and all the comforts I could afford. I feel like I'm looking over my shoulder more now. There's a world of unpleasant possibilities out there - I'm not sure what I should do with the constant awareness that there are quite a few people who haven't been able to walk away from their health problems as quickly as I did, besides try to stay appreciative. I feel a little guilty for being better, and not having done anything in recognition of it, especially since I practically asked for the injury I received. We'll see.
That's all for now. I'll update this post later with scans from my fluoroscopy printouts, so you can see the conditions I'm describing. In the meantime, I'll be on a 'normal' schedule again, going to work, coming home, and seeing my friends. That's what I wanted to come home to - right?
Tuesday, April 29, 2008
One Month, One Week, and Two Days Later
It's hard to believe that it's been five weeks and change since the accident - life before the injury sometimes seems like the distant, foggy past, only partly remembered and not entirely authentic. I don't mean that in a miserable, pitying way - actually, a lot of things have changed for the better since the accident.
As you know, I've been on MASSIVE antibiotics since late March. At first, I was on all sorts of anti-bacterial and anti-fungal medications, but I've been on Unacyn since I left the hospital. Unacyn is a combination of Ampicillin, a general anti-bacterial antibiotic much like Amoxicillin, and Sulbactam, which is an additive that protects the Ampicillin from certain bacteria that can destroy it.
The interesting thing, which I haven't blogged about yet since I've been waiting to make sure I wasn't imagining it since I exited the hospital, is that I feel much better overall for having been on a variety of medications. I had a few health problems before my accident. The chief one was some kind of occult sinus pain, which has haunted me since my mid-20s - literally, I've had a case of sinusitis for over half a decade. I've tried everything from oral antibiotics to steroids to inhalers to air purifiers to home remedies to... well, you get the idea - and almost none of it made any difference. I took prescription Sudafed on a daily basis for about a year before my accident, and it was the only thing that granted me any relief. I have no idea why, really, especially when so much else failed. The entire situation was particularly galling as x-rays and CT scans revealed only the mildest of abnormalities, suggesting only slight inflammation that was hardly proportionate to the discomfort and headaches I lived with on a constant basis.
Since I left the hospital, things have been markedly better. Not fixed - I still have an achy face - but not nearly the kind of pain that I would have expected before the accident. I guess some combination of medicines got whatever it was that was causing my discomfort, and killed enough of it to make a big difference in my comfort level. It's really nice walking around and having a headache all the time to distract me. I think also I might have exacerbated the problem by clenching my teeth, which I do at night, and a month of forced relaxation may have helped with that. I'll have to talk it over with my PCP and see what he thinks.
I'm also breathing better. When I was younger, and more foolish (yes, I realize that's an amusing statement given my 'adult' hobbies like eating swords), I was a heavy smoker. For about five years, i.e., throughout college and off and on for a year or so afterwards, I smoked a lot of cigarettes. If some people have a genetic predisposition towards alcohol consumption, then I must have had a parallel susceptibility to nicotine addiction. Anyhow, during that time, my girlfriend and I smoked two packs a day or so. It was no wonder I never had any money. Eventually, I came down with a horrible case of bronchitis or pneumonia - I forget which - but I had to stop smoking for a month because it hurt too much otherwise. When the course of medications ended and I was back to normal, I'd found that circumstance had accomplished what I couldn't do of my own free will - force me to withstand withdrawal and experience life without the crutch of having cigarettes to set the pace for my daily routine. After that, I might have a cigarette or three when out with friends who hadn't quit, and even backslid into daily use for about six months at one point, but in the long term, the spell was broken.
Unfortunately, just because one is finished with a bad habit, the consequences of said habit may be late in arriving. Since that time, I was always aware of the fact that I'd likely permanently compromised my health through five or six years of constant abuse. Although I could look forward to vastly improved health over the coming years as my lungs repaired themselves, I'd still never be at par with those who'd forgone smoking entirely. Indeed, I spent most of my twenties with breathing capacity that wasn't as great as others my age, and my weight skyrocketed and stayed excessive as I ate more to compensate for the lack of a pleasant vice and the elimination of the appetite suppression that cigarettes produce. In addition, I'd probably set the stage for my later sinus problems by allowing myself to live in an indoor environment where smoking was permitted, and by associating with others who smoked as well.
Cut forward several years to the twilight of my twenties, just before my accident. I felt fine. However, after a month of antibiotics and other treatments, I'm breathing better. Something was fixed, subtly - I realize now that there had been a mild, persistent discomfort in my chest that vanished sometime during my stay, and now I could breathe easier and deeper. I have a friend whom I've known since I started college, and we were both heavy smokers - he much longer than I. He quit several years ago as well, but just a few months ago had to go through intense antibiotic treatment for some kind of persistent bronchitis that had endured in his ravaged chest well past his actual smoking days. I suppose I might have been in a similar situation - perhaps my lungs had never quite cleared themselves out entirely, and I was enduring a mild infection or irritation that, without treatment, I would carry for years. After a month of professional care, I was feeling better in a way that simple abstention from cigarettes hadn't been able to produce.
Other health benefits include the obvious weight loss that came with a liquid diet, although that benefit is rapidly vanishing as I stuff myself full of everything that looks appealing and is within reach. Page and I split a giant box of donut holes this weekend, and today I had a foot-long Italian sub. Oh well - I can put on a few pounds, but I hope I can retain my newly-chiseled features for a while.
I'm finally in the home stretch of my recovery, I think. Food and drink aren't a problem, although I can feel them 'sticking' a little in the back of my throat. I think that's just because of some scar tissue. The drainage valves in my neck are gone! They've been gradually removed by Dr. Smith at the hospital, but I think they must have been shorter than we recalled, since one managed to work it's way entirely out overnight this weekend. It was a little gross, but it was a relief since my neck was sore and stinging, especially whenever the drains were disturbed. Having one out meant the wound could heal and I could be less careful with my collar positioning.
The second one popped out today. I called Dr. Smith, since I now had two bits of medical detritus safety-pinned to my neck. After a quick discussion, I dug out a trusty pair of surgical scissors - I was given a collection of tools when I was discharged, in case I needed to perform self-surgery of this kind - and carefully removed both. I'm now suture free, and I'm hoping my neck will look a lot smoother and less angry in a week when the wounds start to close up.
Now, all that's left is the PICC line in my arm. I'm only using one of two lines, since I discontinued TPN. I met with my infectious diseases specialist today, who is managing my antibiotics treatment and stomach issues. Since I'm tolerating food and water, she may recommend that I switch to oral antibiotics at the end of this week, which would mean I'd off the six-hour IV schedule for good, and could take out the IV line. I am very hopeful that this will be the case, since I'd like to not have to keep waking up once or twice a night to set up the IV line.
One sort of holistic benefit of all of these improvements is that I'm much more mobile. I feel strong enough to get around and be active, even though I have to pause every six hours to apply some medicine. Page and I decided to have some much-needed fun and adventure by driving from DC to Brooklyn, NYC this past weekend.
If traffic's light, the DC-NYC trip takes about four hours each way. We set out in the morning, and hit enough traffic that the first leg of our trip took over five hours. We took turns driving, which worked well, and we improvised an IV stand by hooking my antibiotics pack to the ceiling hook of the passenger side of my car. The IV drip took a VERY long time to complete, since it's dependent on gravity and the pack was barely elevated above me, but it was a five hour drive.
We spent the afternoon shopping at outdoor flea markets and indoor craft shows. Page is a crafter by profession - she makes handmade purses for a living - so I was constantly being introduced to artists and other business people. I didn't buy much - a key chain and a belt buckle - but we had a great time browsing and being in an unfamiliar city.
The drive back was a bit of a challenge. It turned out that the hospital had robbed me of my night-time driving ability, in addition to the other deficits it inflicted. I can usually drive for hours, nonstop, in daylight or at night without problem. After a busy day on our feet, I was exhausted, and couldn't manage more than two hours on the road at a time before fatigue kicked in. Well, that's one more thing to work on - it'll be a while before I take any major roadtrips, I think.
This week involves more medical activity - I have another scan and a meeting with Dr. Smith on Thursday - and getting caught up at work. Things had been quiet during my absence, but now that I'm back, we're back to schedule on our various projects. I won't have a free minute through Friday, I think.
That's all for now - thanks again for reading. I know there are ongoing issues with the comments, so if you'd like to get in touch with me, I set up an email account for just that purpose if you don't already have contact info for me. You can write me at rex.libris.blog@gmail.com. I'm also on Instant Messenger as rexlibris2008, in case you're bored and would like to say hello.
As you know, I've been on MASSIVE antibiotics since late March. At first, I was on all sorts of anti-bacterial and anti-fungal medications, but I've been on Unacyn since I left the hospital. Unacyn is a combination of Ampicillin, a general anti-bacterial antibiotic much like Amoxicillin, and Sulbactam, which is an additive that protects the Ampicillin from certain bacteria that can destroy it.
The interesting thing, which I haven't blogged about yet since I've been waiting to make sure I wasn't imagining it since I exited the hospital, is that I feel much better overall for having been on a variety of medications. I had a few health problems before my accident. The chief one was some kind of occult sinus pain, which has haunted me since my mid-20s - literally, I've had a case of sinusitis for over half a decade. I've tried everything from oral antibiotics to steroids to inhalers to air purifiers to home remedies to... well, you get the idea - and almost none of it made any difference. I took prescription Sudafed on a daily basis for about a year before my accident, and it was the only thing that granted me any relief. I have no idea why, really, especially when so much else failed. The entire situation was particularly galling as x-rays and CT scans revealed only the mildest of abnormalities, suggesting only slight inflammation that was hardly proportionate to the discomfort and headaches I lived with on a constant basis.
Since I left the hospital, things have been markedly better. Not fixed - I still have an achy face - but not nearly the kind of pain that I would have expected before the accident. I guess some combination of medicines got whatever it was that was causing my discomfort, and killed enough of it to make a big difference in my comfort level. It's really nice walking around and having a headache all the time to distract me. I think also I might have exacerbated the problem by clenching my teeth, which I do at night, and a month of forced relaxation may have helped with that. I'll have to talk it over with my PCP and see what he thinks.
I'm also breathing better. When I was younger, and more foolish (yes, I realize that's an amusing statement given my 'adult' hobbies like eating swords), I was a heavy smoker. For about five years, i.e., throughout college and off and on for a year or so afterwards, I smoked a lot of cigarettes. If some people have a genetic predisposition towards alcohol consumption, then I must have had a parallel susceptibility to nicotine addiction. Anyhow, during that time, my girlfriend and I smoked two packs a day or so. It was no wonder I never had any money. Eventually, I came down with a horrible case of bronchitis or pneumonia - I forget which - but I had to stop smoking for a month because it hurt too much otherwise. When the course of medications ended and I was back to normal, I'd found that circumstance had accomplished what I couldn't do of my own free will - force me to withstand withdrawal and experience life without the crutch of having cigarettes to set the pace for my daily routine. After that, I might have a cigarette or three when out with friends who hadn't quit, and even backslid into daily use for about six months at one point, but in the long term, the spell was broken.
Unfortunately, just because one is finished with a bad habit, the consequences of said habit may be late in arriving. Since that time, I was always aware of the fact that I'd likely permanently compromised my health through five or six years of constant abuse. Although I could look forward to vastly improved health over the coming years as my lungs repaired themselves, I'd still never be at par with those who'd forgone smoking entirely. Indeed, I spent most of my twenties with breathing capacity that wasn't as great as others my age, and my weight skyrocketed and stayed excessive as I ate more to compensate for the lack of a pleasant vice and the elimination of the appetite suppression that cigarettes produce. In addition, I'd probably set the stage for my later sinus problems by allowing myself to live in an indoor environment where smoking was permitted, and by associating with others who smoked as well.
Cut forward several years to the twilight of my twenties, just before my accident. I felt fine. However, after a month of antibiotics and other treatments, I'm breathing better. Something was fixed, subtly - I realize now that there had been a mild, persistent discomfort in my chest that vanished sometime during my stay, and now I could breathe easier and deeper. I have a friend whom I've known since I started college, and we were both heavy smokers - he much longer than I. He quit several years ago as well, but just a few months ago had to go through intense antibiotic treatment for some kind of persistent bronchitis that had endured in his ravaged chest well past his actual smoking days. I suppose I might have been in a similar situation - perhaps my lungs had never quite cleared themselves out entirely, and I was enduring a mild infection or irritation that, without treatment, I would carry for years. After a month of professional care, I was feeling better in a way that simple abstention from cigarettes hadn't been able to produce.
Other health benefits include the obvious weight loss that came with a liquid diet, although that benefit is rapidly vanishing as I stuff myself full of everything that looks appealing and is within reach. Page and I split a giant box of donut holes this weekend, and today I had a foot-long Italian sub. Oh well - I can put on a few pounds, but I hope I can retain my newly-chiseled features for a while.
I'm finally in the home stretch of my recovery, I think. Food and drink aren't a problem, although I can feel them 'sticking' a little in the back of my throat. I think that's just because of some scar tissue. The drainage valves in my neck are gone! They've been gradually removed by Dr. Smith at the hospital, but I think they must have been shorter than we recalled, since one managed to work it's way entirely out overnight this weekend. It was a little gross, but it was a relief since my neck was sore and stinging, especially whenever the drains were disturbed. Having one out meant the wound could heal and I could be less careful with my collar positioning.
The second one popped out today. I called Dr. Smith, since I now had two bits of medical detritus safety-pinned to my neck. After a quick discussion, I dug out a trusty pair of surgical scissors - I was given a collection of tools when I was discharged, in case I needed to perform self-surgery of this kind - and carefully removed both. I'm now suture free, and I'm hoping my neck will look a lot smoother and less angry in a week when the wounds start to close up.
Now, all that's left is the PICC line in my arm. I'm only using one of two lines, since I discontinued TPN. I met with my infectious diseases specialist today, who is managing my antibiotics treatment and stomach issues. Since I'm tolerating food and water, she may recommend that I switch to oral antibiotics at the end of this week, which would mean I'd off the six-hour IV schedule for good, and could take out the IV line. I am very hopeful that this will be the case, since I'd like to not have to keep waking up once or twice a night to set up the IV line.
One sort of holistic benefit of all of these improvements is that I'm much more mobile. I feel strong enough to get around and be active, even though I have to pause every six hours to apply some medicine. Page and I decided to have some much-needed fun and adventure by driving from DC to Brooklyn, NYC this past weekend.
If traffic's light, the DC-NYC trip takes about four hours each way. We set out in the morning, and hit enough traffic that the first leg of our trip took over five hours. We took turns driving, which worked well, and we improvised an IV stand by hooking my antibiotics pack to the ceiling hook of the passenger side of my car. The IV drip took a VERY long time to complete, since it's dependent on gravity and the pack was barely elevated above me, but it was a five hour drive.
We spent the afternoon shopping at outdoor flea markets and indoor craft shows. Page is a crafter by profession - she makes handmade purses for a living - so I was constantly being introduced to artists and other business people. I didn't buy much - a key chain and a belt buckle - but we had a great time browsing and being in an unfamiliar city.
The drive back was a bit of a challenge. It turned out that the hospital had robbed me of my night-time driving ability, in addition to the other deficits it inflicted. I can usually drive for hours, nonstop, in daylight or at night without problem. After a busy day on our feet, I was exhausted, and couldn't manage more than two hours on the road at a time before fatigue kicked in. Well, that's one more thing to work on - it'll be a while before I take any major roadtrips, I think.
This week involves more medical activity - I have another scan and a meeting with Dr. Smith on Thursday - and getting caught up at work. Things had been quiet during my absence, but now that I'm back, we're back to schedule on our various projects. I won't have a free minute through Friday, I think.
That's all for now - thanks again for reading. I know there are ongoing issues with the comments, so if you'd like to get in touch with me, I set up an email account for just that purpose if you don't already have contact info for me. You can write me at rex.libris.blog@gmail.com. I'm also on Instant Messenger as rexlibris2008, in case you're bored and would like to say hello.
Monday, April 28, 2008
Brief Update
Hello everyone - I haven't posted in a few days, as you know. It turned out to be a busy weekend. Unfortunately, I've had very little sleep in the past 72 hours because of an apparent stomach ailment, so my posts are going to be a little terse until that clears up. Nonetheless, thank you for continuing to check in, and I promise a more substantial update in the next 24 hours. The brief summary so far is that I'm perhaps 90% of the way to physical normalcy; Page and I took a daylong tour of Brooklyn, NYC Sunday on a whim, and I've been busy getting back to work while bouncing between doctor's appointments (as usual).
Thanks to everyone for the kind emails.
Thanks to everyone for the kind emails.
Thursday, April 24, 2008
Back to Work
As much as I've enjoyed this impromptu summer vacation, whiling away the hours in bed watching television and corresponding with all of my lovely readers, I was eventually forced to admit that if I wanted to continue receiving paychecks whilst in absentia from my dimly-remembered day job, I would have to clean myself up, put on a collared shirt, and trek an hour or two out to Ashburn and reconnect with my employer. I was a little wary of returning to the office for a few reasons:
Once inside, I was greeted warmly, and (predictably) peppered with questions. I'll credit my coworkers; they were polite, friendly, apparently only concerned with my immediate wellbeing, and unabashedly curious about the swaths of gauze and tape I'd hurriedly affixed to my surgery site that morning. Unfortunately, I'd been a little too quick; the bandages were poorly taped, and I later realized the ugly valves and angry red wounds had been peeking through the whole morning.
I was given the morning to get settled, and I was left to myself as I checked email, reoriented myself in my cube, and set up IV stands and my TPN sack. Some of my closer colleagues asked questions about my hospital experience and the purpose of my medical accessories. I was happy to talk about the superficial details of my situation, but by mid-day, I could observe a change in the expressions of some of my coworkers. "So," I thought..."do I tell them?" I decided to be honest; if anyone asked me to tell them exactly what happened, I'd reward their boldness and tell them. Otherwise, I'd simply had an accident. A bad cutlery accident. I doubted it was very convincing, but what did I owe anyone? The specifics of my case were mine to share only at will, and anyone who knew me well enough would know of this blog already.
In the end, no one did ask. There was a little confusion, but I think most people gathered that I'd slipped and cut myself badly with a kitchen knife. I feel a little bad for not being as honest with them as I have with almost everyone else in my life, but I couldn't honestly invent a reason why any of my coworkers - almost all of which are virtual strangers, no matter how blandly friendly - needed to know the whole strange story. I think it would have confused them, and possibly done more harm in the long run to my reputation. It's a very conservative work environment.
In hindsight, my only troubling thought is that a coworker might suspect I'd attempted to take my own life. I truly hope no one suspects that, but I doubt I'll ever have a chance to set the record straight unless confronted on the issue.
Overall, it was an easier return than I thought it might be. Life went on without me, but there's still a place for me, and I have enough work to jump back in and stay occupied for a very long time. I am a bit of a strange sight, with my IV stand and collection of medical tchotchkes littering my desk, but there's a simple comfort in having a task to perform. Paradoxically, work can be relaxing after a long, troubled rest.
- I'd probably have to actually do work again. As rotten as my hospital experience had been at times, I was never pestered to meet any of my job obligations - a huge credit to my boss.
- I'd have to resume commuting five days a week. Without going into a lot of discussion about it, my drive to and from work requires about 2.5 hours a day. You think swords are dangerous? Try risking your life on the DC -> Ashburn 66/Dulles Toll Road corridor every day.
- There would be Questions. I wasn't sure how or if I'd explain what really caused my absence. Did I want to be known as Rex Libris around the water cooler?
Once inside, I was greeted warmly, and (predictably) peppered with questions. I'll credit my coworkers; they were polite, friendly, apparently only concerned with my immediate wellbeing, and unabashedly curious about the swaths of gauze and tape I'd hurriedly affixed to my surgery site that morning. Unfortunately, I'd been a little too quick; the bandages were poorly taped, and I later realized the ugly valves and angry red wounds had been peeking through the whole morning.
I was given the morning to get settled, and I was left to myself as I checked email, reoriented myself in my cube, and set up IV stands and my TPN sack. Some of my closer colleagues asked questions about my hospital experience and the purpose of my medical accessories. I was happy to talk about the superficial details of my situation, but by mid-day, I could observe a change in the expressions of some of my coworkers. "So," I thought..."do I tell them?" I decided to be honest; if anyone asked me to tell them exactly what happened, I'd reward their boldness and tell them. Otherwise, I'd simply had an accident. A bad cutlery accident. I doubted it was very convincing, but what did I owe anyone? The specifics of my case were mine to share only at will, and anyone who knew me well enough would know of this blog already.
In the end, no one did ask. There was a little confusion, but I think most people gathered that I'd slipped and cut myself badly with a kitchen knife. I feel a little bad for not being as honest with them as I have with almost everyone else in my life, but I couldn't honestly invent a reason why any of my coworkers - almost all of which are virtual strangers, no matter how blandly friendly - needed to know the whole strange story. I think it would have confused them, and possibly done more harm in the long run to my reputation. It's a very conservative work environment.
In hindsight, my only troubling thought is that a coworker might suspect I'd attempted to take my own life. I truly hope no one suspects that, but I doubt I'll ever have a chance to set the record straight unless confronted on the issue.
Overall, it was an easier return than I thought it might be. Life went on without me, but there's still a place for me, and I have enough work to jump back in and stay occupied for a very long time. I am a bit of a strange sight, with my IV stand and collection of medical tchotchkes littering my desk, but there's a simple comfort in having a task to perform. Paradoxically, work can be relaxing after a long, troubled rest.
Tuesday, April 22, 2008
More Good News
Met with Dr. Smith today. Highlights of the visit:
- The lower drainage tube was removed completely.
- The other two tubes were partially removed, and now only about an inch and half remain inside. These are draining anything around the main suture site.
- The sutures were removed from the lengthwise incision, so now I just have a ruddy scar.
- I can eat solid food! Dr. Smith cautioned me to start with soft foods, like pasta, and avoid anything crunchy and seeds until we're sure solid food doesn't irritate my throat.
- I can stop using the TPN later this week when I feel comfortable with food. I'm going to call Dr. Smith on Friday, let him know how I'm doing, and probably stop TPN use that day.
- I am officially a medical anomaly, on account of the weird way that my throat has healed. I hope to see myself written up in the New England Journal of Medicine in a few months.
Regarding Comments
I checked the blog settings and it looked like you had to be a registered Google user to leave a comment. I changed that, and now I think anyone can comment without registering. Please let me know if you have any problems.
Thanks! - Rex
Thanks! - Rex
Monday, April 21, 2008
The Week in Recap
I'm back! Sorry, I've been too busy gorging myself on ice water and soup to post lately. I do have a lot to relate, though.
First, an administrative note. I received a few emails from folks who were a little freaked out by the animated sword-swallowing image, as well as some of the medical content. I don't want to make anyone sick while reading this blog, so from now on, if I have content that might be considered graphic (particularly medical stuff), I'll post a link to it so you can click through if you're feeling brave. I will not post anything that I'd consider in poor taste, nor anything especially graphic, but I will try to keep the blog free of unpleasant visual surprises.
That said, here's the update on my condition. I survived Soup Weekend 2008, and after several liters of tomato soup and chicken broth, plus uncounted cups of water and lemonade, I am happy to report that my esophagus is apparently not a porous material, as nothing leaked out of me. In fact, after the first bowl of warm soup, my throat feels almost entirely normal. There was a slight stiff spot in the back of my throat where the injury had been, but by today (Monday), that sensation has vanished.
As you might imagine, I was filled with trepidation when I had that first glass of water. I didn't try it alone; I actually drove to Page's apartment, invited up a friend, and the two of them watched me while I drank. The fear, of course, was that I'd swallow a gulp of water and a moment later it'd pour out of the side of my neck as I started gurgling horribly, and then I'd have to be driven to the hospital and the whole hospital affair would repeat. Fortunately, that wasn't the case. My throat was as tight and stiff as you'd expect after a month of disuse, but everything worked out.
About that administrative note: If you're curious, I posted a picture of the drains and valves that I keep mentioning on a separate site. The picture is a little gross, so fair warning.
I feel very good, overall. I am still a little weak from inaction, but I've been able to lug my supplies around without problem, and can drive without limitation. Not all is perfect, though. I have a slightly sore throat, which I'll ask Dr. Smith about tomorrow, and the valves and drains on the side of my neck continue to be a source of discomfort. They stick out about an inch from my body, and although usually hidden and protected by gauze padding, they tend to ache a great deal. This is because they are being gradually removed by Dr. Smith, as he pulls a little more tubing out of me and replaces the valves each time we meet, and because I tend to roll over and sleep on my sutured side. I don't know how I manage the latter, since the area around the valves is sore to the touch.
Jumping backwards - prior to Friday's announcement, the big highlight was my return to the Palace of Wonders. The Palace, of course, was the scene of my injury.
Page and I had kept up with our friends from the bar and DC performance scene during my hospitalization, and it worked out that the April Weirdo Show - again, the monthly variety event at which I was slated to perform in March - was being hosted this past Thursday, just a few days after my release. The Show always attracts a good crowd, and since the lineup tends to be packed, half the crowd is comprised of that night's performers, or friends of a performer. I knew Professor Sprocket, the MC who had visited me in the hospital, would be there along with other friends, and the chances were good that I'd know the bartenders that night as well. Unfortunately, I still couldn't drink, so I'd have to pass the time with a glass of ice instead of a soda or a beer, but that was fine.
I was nervous to return for a few reasons. Firstly, because I'd suffered trauam there, and the embarrassment of having to withdraw from a show. I felt my gut tighten as I stood in Page's apartment before we left. How would I feel when I saw that stage again? Secondly, there was not just the issue of the place, but the people. Seeing friends was the important thing, but how would they see me?
Before my accident, I'd heard stories of what happened to performers who'd incurred serious injury on the job. Those who recovered returned to hugs and well-wishes from fans and fellow performers alike, but a few faced a kind of chill from spooked colleagues and fans. All of us are daredevils, to varying extents: the appeal and challenge of most of our acts lies in the potential for physical harm, no matter how remote or overstated the actual risk might be. Swords can cut, fire can consume, nails can pierce. Although a little nick or scrape here and there can be an advantage, since we're working hard to convince the audience that it's not witnessing an illusion, neither I nor anyone else in our unusual brand of show business wants to be really harmed. Unfortunately, we're not exempt from the same rules of chance or fate that govern everyone's lives, and occasionally - as in my case - an accident does occur that doesn't resolve in a few minutes, or with the speedy application of a Band-Aid. My accident was easy for me to deal with, since I was too preoccupied with surviving and staying comfortable to brood on the larger implications, but my friends and family didn't have that luxury. Sometimes watching is the hardest task, since you may be required to consider that despite one's best precautions, chance, or fate, or God if you prefer, may intervene to alter your life forever - or end it sooner than you planned.
I don't mean to sound maudlin, since I'm not. I'm supremely glad to be alive, and give credit where it's due to my friends and family, and the superior medical staff of my hospital. Others might not be so philosophical, though, and just as some people recoil from graphic photos of medical injuries, how would people react to me? I was a walking reminder of mortality, if one thought it through, and the last thing I wanted was to dull people's enjoyment and appreciation of my peculiar craft by showing up torn and thin, alive but visibly scarred.
It was appropriate, then, that the first two people I should meet upon walking back through the doors of the Palace for the first time in a month were the two other performers in the area who'd suffered the same injury as I. Charon (pronounced like Karen) Henning and Alexander Kensington were the first sword-swallowers I ever met. Indeed, Charon inspired me to take up this mad pastime; she's the performer who rebuffed my first inquiries about the craft, as I described in my earlier entry, 'The Palace.' Charon had endured the same slashed esophagus I had, although her injury occurred during a taping for a radio segment; she didn't even have an audience to witness her near-death experience! Alex had a similar injury and suffered massive internal bleeding, but lived to see another day. We all have the same scars, long slashes down the front of our throats. As I stood in the entranceway, sunlight streaming down upon my neck as I saw friendly faces push towards me from the back of the bar, it felt like the best company I could be in.
It was great to be back. Charon and Alex had spent most of the past months on tour, so I rarely saw them under any circumstances. We traded tales of our struggles, and Charon mentioned she'd passed my name along to Dan Meyer, president of the Sword Swallowers Association International (SSAI). Sword swallowers are rare, and individuals with esophageal perforations doubly so, so I may be in touch with him to discuss my experience and add to the shared knowledge about explaining these types of injuries to triage personnel and strategies for dealing with the recovery process. I may still join the SSAI, as I'd hoped to do after the Palace show. I've paid my dues, after all.
After meeting with Charon and Alex, I greeted Professor Sprocket, the MC and my supporter in the hospital, and Karen Mitchell, Sprocket's partner in producing the Weirdo Show and a great email correspondent of mine. It was fantastic to see them again and support their show. Other friends present included Malibu and Silver Raven, two fantastic fire performers who appear regularly at the Palace, and dancer Bambi Galore, who works for Page on occasion and produces her own line of headwear for performers.
The rest of the evening was simply fun. I was a conspicuous sight, with my bandaged neck and wrapped arm dangling with IV plugs. Page and I met up with a crowd of gawkers who showed up hoping to see sword-swallowers. They would be disappointed if they expected to catch an act, but I enjoyed a few minutes of minor celebrity as I regaled the bar with tales of my horrific injury and struggle to survive. Sprocket greeted me from the stage mid-show, which validated me, both to myself and to the audience. One of the audience members asked for my number; she's a photographer and wants to shoot some pictures of me in costume with my scars. I could use some publicity shots.
The rest of the week held other highlights after the joyous return to a normal social life. I spent days sipping drinks and tasting soups, happy to have an alternative to the feed bag for nutrition. Page and I made peanut-butter cup milkshakes last night, which was heavenly. I'll have to make more of those... I don't care if I put all that lost weight back on!
The last bit of big news is that I finally procured my late birthday gift to myself. I usually buy myself something nice for my birthday, and since I hadn't spent any money in the hospital, I had a little extra to spend this year. I've decided to take a little hiatus from performing, or skydiving, or wrestling bears or anything else remotely dangerous (besides the usual risk of living in Washington, DC), so I chose something relatively innocuous:
That is a picture of my new Nikon D40 digital SLR camera. I have a little point-and-shoot digital camera which is fine for basic shots outdoors and for recording VHS-quality video, but I wanted something with more control and better overall image quality. This camera came well-recommended by some photo enthusiasts I know, and I got a great deal on it from Photocraft. If you're in the Northern Virginia area and need photo equipment, I recommend them based on their prices and very friendly and knowledgeable staff. I bought the Nikon body and a Tamron 18-250 lens, which I think will be a great everyday lens that will serve me well until I need something more specialized.
Unfortunately, it's been raining every day since I bought the camera, so I haven't had a chance to get outside yet and take pictures with my new toy. All of my indoor shots are of cats, predictably, which I won't bore you with. Hopefully, I'll be able to visit the Arboretum soon and shoot the bonsai for practice.
Well, that's it for tonight - I'll post more tomorrow after my big meeting with Dr. Smith. Hopefully my mouth will be full of food when I post next.
First, an administrative note. I received a few emails from folks who were a little freaked out by the animated sword-swallowing image, as well as some of the medical content. I don't want to make anyone sick while reading this blog, so from now on, if I have content that might be considered graphic (particularly medical stuff), I'll post a link to it so you can click through if you're feeling brave. I will not post anything that I'd consider in poor taste, nor anything especially graphic, but I will try to keep the blog free of unpleasant visual surprises.
That said, here's the update on my condition. I survived Soup Weekend 2008, and after several liters of tomato soup and chicken broth, plus uncounted cups of water and lemonade, I am happy to report that my esophagus is apparently not a porous material, as nothing leaked out of me. In fact, after the first bowl of warm soup, my throat feels almost entirely normal. There was a slight stiff spot in the back of my throat where the injury had been, but by today (Monday), that sensation has vanished.
As you might imagine, I was filled with trepidation when I had that first glass of water. I didn't try it alone; I actually drove to Page's apartment, invited up a friend, and the two of them watched me while I drank. The fear, of course, was that I'd swallow a gulp of water and a moment later it'd pour out of the side of my neck as I started gurgling horribly, and then I'd have to be driven to the hospital and the whole hospital affair would repeat. Fortunately, that wasn't the case. My throat was as tight and stiff as you'd expect after a month of disuse, but everything worked out.
About that administrative note: If you're curious, I posted a picture of the drains and valves that I keep mentioning on a separate site. The picture is a little gross, so fair warning.
I feel very good, overall. I am still a little weak from inaction, but I've been able to lug my supplies around without problem, and can drive without limitation. Not all is perfect, though. I have a slightly sore throat, which I'll ask Dr. Smith about tomorrow, and the valves and drains on the side of my neck continue to be a source of discomfort. They stick out about an inch from my body, and although usually hidden and protected by gauze padding, they tend to ache a great deal. This is because they are being gradually removed by Dr. Smith, as he pulls a little more tubing out of me and replaces the valves each time we meet, and because I tend to roll over and sleep on my sutured side. I don't know how I manage the latter, since the area around the valves is sore to the touch.
Jumping backwards - prior to Friday's announcement, the big highlight was my return to the Palace of Wonders. The Palace, of course, was the scene of my injury.
Page and I had kept up with our friends from the bar and DC performance scene during my hospitalization, and it worked out that the April Weirdo Show - again, the monthly variety event at which I was slated to perform in March - was being hosted this past Thursday, just a few days after my release. The Show always attracts a good crowd, and since the lineup tends to be packed, half the crowd is comprised of that night's performers, or friends of a performer. I knew Professor Sprocket, the MC who had visited me in the hospital, would be there along with other friends, and the chances were good that I'd know the bartenders that night as well. Unfortunately, I still couldn't drink, so I'd have to pass the time with a glass of ice instead of a soda or a beer, but that was fine.
I was nervous to return for a few reasons. Firstly, because I'd suffered trauam there, and the embarrassment of having to withdraw from a show. I felt my gut tighten as I stood in Page's apartment before we left. How would I feel when I saw that stage again? Secondly, there was not just the issue of the place, but the people. Seeing friends was the important thing, but how would they see me?
Before my accident, I'd heard stories of what happened to performers who'd incurred serious injury on the job. Those who recovered returned to hugs and well-wishes from fans and fellow performers alike, but a few faced a kind of chill from spooked colleagues and fans. All of us are daredevils, to varying extents: the appeal and challenge of most of our acts lies in the potential for physical harm, no matter how remote or overstated the actual risk might be. Swords can cut, fire can consume, nails can pierce. Although a little nick or scrape here and there can be an advantage, since we're working hard to convince the audience that it's not witnessing an illusion, neither I nor anyone else in our unusual brand of show business wants to be really harmed. Unfortunately, we're not exempt from the same rules of chance or fate that govern everyone's lives, and occasionally - as in my case - an accident does occur that doesn't resolve in a few minutes, or with the speedy application of a Band-Aid. My accident was easy for me to deal with, since I was too preoccupied with surviving and staying comfortable to brood on the larger implications, but my friends and family didn't have that luxury. Sometimes watching is the hardest task, since you may be required to consider that despite one's best precautions, chance, or fate, or God if you prefer, may intervene to alter your life forever - or end it sooner than you planned.
I don't mean to sound maudlin, since I'm not. I'm supremely glad to be alive, and give credit where it's due to my friends and family, and the superior medical staff of my hospital. Others might not be so philosophical, though, and just as some people recoil from graphic photos of medical injuries, how would people react to me? I was a walking reminder of mortality, if one thought it through, and the last thing I wanted was to dull people's enjoyment and appreciation of my peculiar craft by showing up torn and thin, alive but visibly scarred.
It was appropriate, then, that the first two people I should meet upon walking back through the doors of the Palace for the first time in a month were the two other performers in the area who'd suffered the same injury as I. Charon (pronounced like Karen) Henning and Alexander Kensington were the first sword-swallowers I ever met. Indeed, Charon inspired me to take up this mad pastime; she's the performer who rebuffed my first inquiries about the craft, as I described in my earlier entry, 'The Palace.' Charon had endured the same slashed esophagus I had, although her injury occurred during a taping for a radio segment; she didn't even have an audience to witness her near-death experience! Alex had a similar injury and suffered massive internal bleeding, but lived to see another day. We all have the same scars, long slashes down the front of our throats. As I stood in the entranceway, sunlight streaming down upon my neck as I saw friendly faces push towards me from the back of the bar, it felt like the best company I could be in.
It was great to be back. Charon and Alex had spent most of the past months on tour, so I rarely saw them under any circumstances. We traded tales of our struggles, and Charon mentioned she'd passed my name along to Dan Meyer, president of the Sword Swallowers Association International (SSAI). Sword swallowers are rare, and individuals with esophageal perforations doubly so, so I may be in touch with him to discuss my experience and add to the shared knowledge about explaining these types of injuries to triage personnel and strategies for dealing with the recovery process. I may still join the SSAI, as I'd hoped to do after the Palace show. I've paid my dues, after all.
After meeting with Charon and Alex, I greeted Professor Sprocket, the MC and my supporter in the hospital, and Karen Mitchell, Sprocket's partner in producing the Weirdo Show and a great email correspondent of mine. It was fantastic to see them again and support their show. Other friends present included Malibu and Silver Raven, two fantastic fire performers who appear regularly at the Palace, and dancer Bambi Galore, who works for Page on occasion and produces her own line of headwear for performers.
The rest of the evening was simply fun. I was a conspicuous sight, with my bandaged neck and wrapped arm dangling with IV plugs. Page and I met up with a crowd of gawkers who showed up hoping to see sword-swallowers. They would be disappointed if they expected to catch an act, but I enjoyed a few minutes of minor celebrity as I regaled the bar with tales of my horrific injury and struggle to survive. Sprocket greeted me from the stage mid-show, which validated me, both to myself and to the audience. One of the audience members asked for my number; she's a photographer and wants to shoot some pictures of me in costume with my scars. I could use some publicity shots.
The rest of the week held other highlights after the joyous return to a normal social life. I spent days sipping drinks and tasting soups, happy to have an alternative to the feed bag for nutrition. Page and I made peanut-butter cup milkshakes last night, which was heavenly. I'll have to make more of those... I don't care if I put all that lost weight back on!
The last bit of big news is that I finally procured my late birthday gift to myself. I usually buy myself something nice for my birthday, and since I hadn't spent any money in the hospital, I had a little extra to spend this year. I've decided to take a little hiatus from performing, or skydiving, or wrestling bears or anything else remotely dangerous (besides the usual risk of living in Washington, DC), so I chose something relatively innocuous:
That is a picture of my new Nikon D40 digital SLR camera. I have a little point-and-shoot digital camera which is fine for basic shots outdoors and for recording VHS-quality video, but I wanted something with more control and better overall image quality. This camera came well-recommended by some photo enthusiasts I know, and I got a great deal on it from Photocraft. If you're in the Northern Virginia area and need photo equipment, I recommend them based on their prices and very friendly and knowledgeable staff. I bought the Nikon body and a Tamron 18-250 lens, which I think will be a great everyday lens that will serve me well until I need something more specialized.
Unfortunately, it's been raining every day since I bought the camera, so I haven't had a chance to get outside yet and take pictures with my new toy. All of my indoor shots are of cats, predictably, which I won't bore you with. Hopefully, I'll be able to visit the Arboretum soon and shoot the bonsai for practice.
Well, that's it for tonight - I'll post more tomorrow after my big meeting with Dr. Smith. Hopefully my mouth will be full of food when I post next.
I'm Still Alive!
Hi everyone - just a quick note to let you know that I'm still here and will continue to update the blog. I have a lot to post about the past weekend, and will have new entries up tonight and tomorrow. In the meantime, feel free to leave comments under posts you enjoyed!
Thanks, Rex :)
Thanks, Rex :)
Friday, April 18, 2008
Oh Happy Day
As I type this, I am eating a tasty bowl of chicken broth and sipping on a tall goblet of ice water. Mmmm, water...
Dr. Smith called this evening - after five, which was surprising - with some interesting news. He'd been in consultation all week with some other doctors about my case, and had come to a surprising conclusion. His review had been prompted by the fact that I was four weeks into recovery from an injury that should have been relatively healed in half that time.
Apparently, my throat wound is doing something that, in Dr. Smith's words, he'd never encountered during his medical career. Instead of healing from the outside-in - that is, from the outside of esophagus in towards the center - my wound had scarred over from the inner surface, and was healing in reverse. I was thus left with an injury that was basically encysting upon itself and shrinking slowly.
Then came the big news: "Well, Justin, I think you can start drinking again. Try some ice water, maybe avoid carbonated beverages, and call me if there are any problems or bad drainage. You can have soup, but just broth, no chicken." My heart stopped, and then leapt - it was a chaotic three seconds of emotion - and Dr. Smith continued: "You can skip next week's scan. Come in on Tuesday, and if everything went well this weekend, you can try solids. I know you're anxious to get off the TPN." Solid food!
What solid food means to me:
Chinese dumplings
Pizza
Salmon steaks
Tortellini with alfredo sauce
Quesadillas
Those little sausages wrapped in crispy dough
Steak tartare
Sushi... spicy tuna rolls... wasabi... octopus...
Bacon
I can't wait!
So, I had my first meal in a month tonight - pictures are forthcoming. I started simply - a glass of water and a bowl of soup. I didn't choke, or cough - there was no pain. Everything works normally, although my throat feels tight. I can feel a small spot in the back that must be the injury site, but it's hardly noticeable.
Tomorrow's plan: Stock up on soups! Soups and drink mixes - I might make lemonade for the hot weekend. Ah, it's like a new world. More to come.
Dr. Smith called this evening - after five, which was surprising - with some interesting news. He'd been in consultation all week with some other doctors about my case, and had come to a surprising conclusion. His review had been prompted by the fact that I was four weeks into recovery from an injury that should have been relatively healed in half that time.
Apparently, my throat wound is doing something that, in Dr. Smith's words, he'd never encountered during his medical career. Instead of healing from the outside-in - that is, from the outside of esophagus in towards the center - my wound had scarred over from the inner surface, and was healing in reverse. I was thus left with an injury that was basically encysting upon itself and shrinking slowly.
Then came the big news: "Well, Justin, I think you can start drinking again. Try some ice water, maybe avoid carbonated beverages, and call me if there are any problems or bad drainage. You can have soup, but just broth, no chicken." My heart stopped, and then leapt - it was a chaotic three seconds of emotion - and Dr. Smith continued: "You can skip next week's scan. Come in on Tuesday, and if everything went well this weekend, you can try solids. I know you're anxious to get off the TPN." Solid food!
What solid food means to me:
Chinese dumplings
Pizza
Salmon steaks
Tortellini with alfredo sauce
Quesadillas
Those little sausages wrapped in crispy dough
Steak tartare
Sushi... spicy tuna rolls... wasabi... octopus...
Bacon
I can't wait!
So, I had my first meal in a month tonight - pictures are forthcoming. I started simply - a glass of water and a bowl of soup. I didn't choke, or cough - there was no pain. Everything works normally, although my throat feels tight. I can feel a small spot in the back that must be the injury site, but it's hardly noticeable.
Tomorrow's plan: Stock up on soups! Soups and drink mixes - I might make lemonade for the hot weekend. Ah, it's like a new world. More to come.
Wednesday, April 16, 2008
Wednesday Update
In brief - no apparent change. Still waiting to talk to Dr. Smith to get his opinion on things. So, we'll see what happens. Looks like I'll be back on Tuesday, though.
Good news is that TPN schedule is being moved from 24 to 16 hours on the feeding IV today, so I'll have a window where I'm untethered for a while. If 16 hours works out, I should be able to move to 12 pretty soon.
I was going through some papers this afternoon and found some printouts of my CT scans. These images were taken from the series of CT snapshots taken during my weekly fluoroscopy scan. For all of you who have borne with me during this long struggle, here is a picture of the problem that started it all, taken during the first week of my hospital stay:
You can discern the vertebrae on the right and the area where my chin meets my chest (my head was tipped forward) easily. The central white column is my esophagus - it's brighter because of the gastrograffin fluid that I swallow during the snapshot.
You can see a slight gouge, or dip, in the back of my esophagus. That's the wound. The perspective is off on this shot, because the injury is actually a little to my right, but you get the idea. It's a pretty small injury site, but it was problematic enough, obviously.
It's smaller now, and I presume is getting smaller every week. I'll be meeting with Dr. Smith in a few days (after my next scan, which will be a little earlier) and hopefully he can give me some perspective on how my recovery is coming along.
Good news is that TPN schedule is being moved from 24 to 16 hours on the feeding IV today, so I'll have a window where I'm untethered for a while. If 16 hours works out, I should be able to move to 12 pretty soon.
I was going through some papers this afternoon and found some printouts of my CT scans. These images were taken from the series of CT snapshots taken during my weekly fluoroscopy scan. For all of you who have borne with me during this long struggle, here is a picture of the problem that started it all, taken during the first week of my hospital stay:
You can discern the vertebrae on the right and the area where my chin meets my chest (my head was tipped forward) easily. The central white column is my esophagus - it's brighter because of the gastrograffin fluid that I swallow during the snapshot.
You can see a slight gouge, or dip, in the back of my esophagus. That's the wound. The perspective is off on this shot, because the injury is actually a little to my right, but you get the idea. It's a pretty small injury site, but it was problematic enough, obviously.
It's smaller now, and I presume is getting smaller every week. I'll be meeting with Dr. Smith in a few days (after my next scan, which will be a little earlier) and hopefully he can give me some perspective on how my recovery is coming along.
Tuesday, April 15, 2008
Cat Attack
Not much to report at this time. I'm settling into a schedule of IV treatments, rest, and projects. The big news is that my cat, Fluffybear (not his real name) came home yesterday:
Above: Gaze into the eyes of innocence. Gentle Fluffy is home again.
I hadn't brought him home immediately since I had a lot of organization and cleaning to do, and I was concerned about interference while I was getting used to the IV routines. I was a little nervous yesterday... Fluffy can be a gentle creature, but he likes to roughhouse, and I was a little worried that our fun games of chase-the-wand would lead Fluffy to think that the various IV lines dripping off me were fair game for chewing. Worse, one of Page's cats found a spot on my shirt where a droplet of TPN fluid had falled, and had licked at it incessantly until I forced him away. If Fluffy knew that I was carrying around a bag of tasty sugar water, full of fat and protein, he might try to attack the bag!
We had a few rough patches where Fluffy's animal instincts got the better of him, and he would gnaw and slobber on my IV lines until pushed aside. On one occasion, his exuberance at being home nearly had tragic consequences. A typical evening at home involves Fluffy dragging one or more of his toys to my feet in an invitation to play. This is fine, of course, but Fluffy dragged over one of his wands, which is a stick attached to a length of string with a toy at the end. Fluffy managed to gallop around my feet and under my chair, wrapping the wand's string around my feet and the IV lines. He leapt with joy under my desk and to the window, and I nearly fell completely out of my chair yelling as my PICC line was pulled to the floor. It took about five minutes to untangle the crossed lines, and then I still had to play with the cat, who was doubly-excited now that he was trying to help me untangle the lines (by batting at them, of course.)
After an hour of testing on Fluffy's part and reprimands on mine, I think we reached a compromise: Fluffy was content if allowed to simply sit on the IV tubes. I suppose that was tantamount to 'capturing' the prey without actually destroying it. This arrangement has proved mutually beneficial as I can position Fluffy to pin the line down in specific places, thus preventing the line from lying in the path of my rolling chair (which can snag the line and crimp it.)
I'd had a busy weekend, so I decided to take it easy and retire early. I had to move the TPN backpack onto the bed with me and hide the cables under the sheet, but part of the line would be exposed so long as my arms were above the sheets. I was exhausted, and decided to wake up only long enough to set up the antibiotic IV infusion, and then return to sleep instead of waiting for it to complete. This meant that I would have an IV line running from a stand down to my arm all night, and a bag of refuse next to the bed where I would drop wrappers, spent saline syringes, etc. If there's an annoying activity Fluffy loves more than chewing on things and people, it's rooting through boxes and bags.
I was a little nervous after setting up the midnight IV. What if Fluffy pulled the whole stand down, shattering vials and spilling antibiotics everywhere? What if he chewed through a tube and infused himself with a megadose of Ampicillin? What if he nibbled through my TPN feed line and put himself into a sugar coma? All of these worries nagged at me, but I was too tired to do much. I fell asleep...
I awoke at 6 AM. I was amazed - all of the IV lines were undisturbed. Fluffy hadn't attacked the sack of refuse next to the bed. Instead, he was happily curled up atop the blue bag, back to my side. I don't know how he managed to resist so many temptations, but he was perfectly behaved. He even limited his usual nighttime prowling, seemingly so as not to disturb me any more than necessary. In fact, I realized that his perch atop the TPN backpack had an advantage for me: he was keeping my food warm.
As I type this, we are both still in bed. I am not getting up until my noon IV infusion - I can work on my computer in bed just as well as I can work at a desk - and neither is he. I have to wonder how he knew not to bother certain objects - I suppose he is a more resourceful and considerate cat than I'd thought. Welcome home, kitty!
Above: Gaze into the eyes of innocence. Gentle Fluffy is home again.
I hadn't brought him home immediately since I had a lot of organization and cleaning to do, and I was concerned about interference while I was getting used to the IV routines. I was a little nervous yesterday... Fluffy can be a gentle creature, but he likes to roughhouse, and I was a little worried that our fun games of chase-the-wand would lead Fluffy to think that the various IV lines dripping off me were fair game for chewing. Worse, one of Page's cats found a spot on my shirt where a droplet of TPN fluid had falled, and had licked at it incessantly until I forced him away. If Fluffy knew that I was carrying around a bag of tasty sugar water, full of fat and protein, he might try to attack the bag!
We had a few rough patches where Fluffy's animal instincts got the better of him, and he would gnaw and slobber on my IV lines until pushed aside. On one occasion, his exuberance at being home nearly had tragic consequences. A typical evening at home involves Fluffy dragging one or more of his toys to my feet in an invitation to play. This is fine, of course, but Fluffy dragged over one of his wands, which is a stick attached to a length of string with a toy at the end. Fluffy managed to gallop around my feet and under my chair, wrapping the wand's string around my feet and the IV lines. He leapt with joy under my desk and to the window, and I nearly fell completely out of my chair yelling as my PICC line was pulled to the floor. It took about five minutes to untangle the crossed lines, and then I still had to play with the cat, who was doubly-excited now that he was trying to help me untangle the lines (by batting at them, of course.)
After an hour of testing on Fluffy's part and reprimands on mine, I think we reached a compromise: Fluffy was content if allowed to simply sit on the IV tubes. I suppose that was tantamount to 'capturing' the prey without actually destroying it. This arrangement has proved mutually beneficial as I can position Fluffy to pin the line down in specific places, thus preventing the line from lying in the path of my rolling chair (which can snag the line and crimp it.)
I'd had a busy weekend, so I decided to take it easy and retire early. I had to move the TPN backpack onto the bed with me and hide the cables under the sheet, but part of the line would be exposed so long as my arms were above the sheets. I was exhausted, and decided to wake up only long enough to set up the antibiotic IV infusion, and then return to sleep instead of waiting for it to complete. This meant that I would have an IV line running from a stand down to my arm all night, and a bag of refuse next to the bed where I would drop wrappers, spent saline syringes, etc. If there's an annoying activity Fluffy loves more than chewing on things and people, it's rooting through boxes and bags.
I was a little nervous after setting up the midnight IV. What if Fluffy pulled the whole stand down, shattering vials and spilling antibiotics everywhere? What if he chewed through a tube and infused himself with a megadose of Ampicillin? What if he nibbled through my TPN feed line and put himself into a sugar coma? All of these worries nagged at me, but I was too tired to do much. I fell asleep...
I awoke at 6 AM. I was amazed - all of the IV lines were undisturbed. Fluffy hadn't attacked the sack of refuse next to the bed. Instead, he was happily curled up atop the blue bag, back to my side. I don't know how he managed to resist so many temptations, but he was perfectly behaved. He even limited his usual nighttime prowling, seemingly so as not to disturb me any more than necessary. In fact, I realized that his perch atop the TPN backpack had an advantage for me: he was keeping my food warm.
As I type this, we are both still in bed. I am not getting up until my noon IV infusion - I can work on my computer in bed just as well as I can work at a desk - and neither is he. I have to wonder how he knew not to bother certain objects - I suppose he is a more resourceful and considerate cat than I'd thought. Welcome home, kitty!
Monday, April 14, 2008
Home Care
Hi everyone - I haven't posted much in the past few days because of my busy schedule and need to rest. It's also a little harder to sit down and concentrate on projects like this - I didn't have a lot of distractions in the hospital.
Today, I'll try to describe the medical procedures and supplies that I will be responsible for until early May. As you know, I was released from the hospital on Friday, April 11, with an unhealed esophageal perforation. Well, not completely healed, but sufficiently so that I was deemed fit for home care.
The overarching concern for someone with my kind of injury is avoiding infection. This is achieved by:
Because of this, I have three rules to observe while my wound is considered unclosed:
#2 and #3 aren't hardships, but they are inconvenient. We'll start with the TPN.
TPN, or "Total Parenteral Nutrition", refers to the delivery of nutrients via intravenous catheter. It's used when someone has an injury or condition that prohibits normal food intake. In my case, my doctor has developed a mix of proteins, lipids, various vitamins and other healthy things into a bag of white slop that I consume daily. You can see my typical TPN bag below:
If you look closely, you can see things like the various ingredients of the TPN mix, the dosage and infusion rate, and other details. Each pack of TPN mix is dispensed over 24 hours, and must be kept refrigerated until 2 - 4 hours before use. It's important that the TPN bag be taken out of the refrigerator several hours before use, or I could put myself into shock by infusing icy liquid into my veins.
Before use, each TPN bag has to be injected with additional vitamins that my doctors feels I need. Once the TPN bag is ready, I connect it to a small, battery-powered pump that manages the rate of TPN infusion:
This pump attaches to special sensors on the line from the TPN bag, and alerts me if there is anything blocking the line, or when my dosage is complete. The pump is very easy to use, and comes preprogrammed from the pharmacy, so I don't have to worry about altering infusion rates or other settings.
Right now, I change the TPN bag around 6 PM, but that may change to better accommodate my schedule. I may also be able to have the infusion rate doubled, so that I will only be connected to the TPN pump for 12 hours a day instead of 24.
Preparing the TPN for use takes about 10 minutes. Without going into all of the steps, I have to flush my IV lines, add the vitamins to the TPN, attach special tubing to the TPN line and connect the tubing to the pump, change the pump batteries, sterilize everything, and connect the TPN line to my PICC line and start the pump. Afterwards, everything runs without interaction unless there's a problem.
Conveniently, the TPN bag and the battery-powered pump fit inside a special backpack, which gives me some mobility:
Above: My stylish blue backpack. Note the TPN line running out of the side.
Although I managed to lose about 15 pounds while in the hospital, I think the doctors decided to help me regain my muscle strength by saddling me with 12 - 15 pounds of TPN fluid and equipment to lug around each day. I feel like some tragic Greek character who is being punished by the gods by being forced to carry around a heavy weight all the time.
I also have antibiotics to apply every six hours. This has been the really life-altering thing, since the rotation that I've settled on requires me to get up at 6 AM every day. For those of you who know me, this is unheard of. Prior to the accident, I could barely get out of bed at 8:30 AM. The antibiotics infusion only takes about 30 - 45 minutes, but unless it's the weekend, I don't see much point in going back to bed, especially since I'll be working again soon.
The antibiotics come in an unrefrigerated pack that looks like this:
The antibiotics are a little simpler to set up than the TPN. The picture is dim in places, but you can see the main body of the pack, a glass vial, and a plastic reservoir with a spike at the top that runs into the main pack. I start by mixing the powder in the glass vial with the fluid in the main pack by breaking the tip at the top of the vial, and the squeezing the pack to mix the fluid and powder. This activates the antibiotics, since the active mix denatures if left unused. Once that's done, I connect the plastic reservoir by inserting a hollow 'spike' into the pack, and then connecting the IV line which runs from the base of the plastic reservoir to my IV. Of course, in between there is much sterilization, and the line has to be cleared of air first. The line is shown below:
On the right is my arm, covered in a sheath to help me manage the excess of PICC cables. Moving away from the arm, we see a white block; that's a clamp that can be used to prevent fluids from moving along the line. Next is the actual PICC line valve, which is connected to the valve for the IV line. Past the line 'joint' is a yellowish object. That is actually a dial that lets me manually control the flow rate along the line. I can shut the line or open it completely; or set it to one of several preset rates. Being able to shut or open the line is useful when pushing air out of the line or draining excess fluid once infusion is complete; otherwise, it is set to a specific rate while I am hooked up to it. Once set up, I don't have to do anything but wait for a little while.
There aren't any real side-effects to either of these treatments that I've noticed. Everything else seems to work pretty normally.
I'll post more later, once I'm done with my doctor's appointment.
Today, I'll try to describe the medical procedures and supplies that I will be responsible for until early May. As you know, I was released from the hospital on Friday, April 11, with an unhealed esophageal perforation. Well, not completely healed, but sufficiently so that I was deemed fit for home care.
The overarching concern for someone with my kind of injury is avoiding infection. This is achieved by:
- Avoiding food and liquid intake by mouth ("NPO")
- Administering IV antibiotics on a regular basis
Because of this, I have three rules to observe while my wound is considered unclosed:
- I am not to eat or drink anything, but I may munch on ice or rinse my mouth with water, provided the fluids are spat out afterwards.
- I must administer TPN nutrition to myself every 24 hours, and keep the nutrition bag and pump on my person at all times.
- I must administer IV antibiotics to myself for 30 minutes every six hours, without exception.
#2 and #3 aren't hardships, but they are inconvenient. We'll start with the TPN.
TPN, or "Total Parenteral Nutrition", refers to the delivery of nutrients via intravenous catheter. It's used when someone has an injury or condition that prohibits normal food intake. In my case, my doctor has developed a mix of proteins, lipids, various vitamins and other healthy things into a bag of white slop that I consume daily. You can see my typical TPN bag below:
If you look closely, you can see things like the various ingredients of the TPN mix, the dosage and infusion rate, and other details. Each pack of TPN mix is dispensed over 24 hours, and must be kept refrigerated until 2 - 4 hours before use. It's important that the TPN bag be taken out of the refrigerator several hours before use, or I could put myself into shock by infusing icy liquid into my veins.
Before use, each TPN bag has to be injected with additional vitamins that my doctors feels I need. Once the TPN bag is ready, I connect it to a small, battery-powered pump that manages the rate of TPN infusion:
This pump attaches to special sensors on the line from the TPN bag, and alerts me if there is anything blocking the line, or when my dosage is complete. The pump is very easy to use, and comes preprogrammed from the pharmacy, so I don't have to worry about altering infusion rates or other settings.
Right now, I change the TPN bag around 6 PM, but that may change to better accommodate my schedule. I may also be able to have the infusion rate doubled, so that I will only be connected to the TPN pump for 12 hours a day instead of 24.
Preparing the TPN for use takes about 10 minutes. Without going into all of the steps, I have to flush my IV lines, add the vitamins to the TPN, attach special tubing to the TPN line and connect the tubing to the pump, change the pump batteries, sterilize everything, and connect the TPN line to my PICC line and start the pump. Afterwards, everything runs without interaction unless there's a problem.
Conveniently, the TPN bag and the battery-powered pump fit inside a special backpack, which gives me some mobility:
Above: My stylish blue backpack. Note the TPN line running out of the side.
Although I managed to lose about 15 pounds while in the hospital, I think the doctors decided to help me regain my muscle strength by saddling me with 12 - 15 pounds of TPN fluid and equipment to lug around each day. I feel like some tragic Greek character who is being punished by the gods by being forced to carry around a heavy weight all the time.
I also have antibiotics to apply every six hours. This has been the really life-altering thing, since the rotation that I've settled on requires me to get up at 6 AM every day. For those of you who know me, this is unheard of. Prior to the accident, I could barely get out of bed at 8:30 AM. The antibiotics infusion only takes about 30 - 45 minutes, but unless it's the weekend, I don't see much point in going back to bed, especially since I'll be working again soon.
The antibiotics come in an unrefrigerated pack that looks like this:
The antibiotics are a little simpler to set up than the TPN. The picture is dim in places, but you can see the main body of the pack, a glass vial, and a plastic reservoir with a spike at the top that runs into the main pack. I start by mixing the powder in the glass vial with the fluid in the main pack by breaking the tip at the top of the vial, and the squeezing the pack to mix the fluid and powder. This activates the antibiotics, since the active mix denatures if left unused. Once that's done, I connect the plastic reservoir by inserting a hollow 'spike' into the pack, and then connecting the IV line which runs from the base of the plastic reservoir to my IV. Of course, in between there is much sterilization, and the line has to be cleared of air first. The line is shown below:
On the right is my arm, covered in a sheath to help me manage the excess of PICC cables. Moving away from the arm, we see a white block; that's a clamp that can be used to prevent fluids from moving along the line. Next is the actual PICC line valve, which is connected to the valve for the IV line. Past the line 'joint' is a yellowish object. That is actually a dial that lets me manually control the flow rate along the line. I can shut the line or open it completely; or set it to one of several preset rates. Being able to shut or open the line is useful when pushing air out of the line or draining excess fluid once infusion is complete; otherwise, it is set to a specific rate while I am hooked up to it. Once set up, I don't have to do anything but wait for a little while.
There aren't any real side-effects to either of these treatments that I've noticed. Everything else seems to work pretty normally.
I'll post more later, once I'm done with my doctor's appointment.
Saturday, April 12, 2008
So Tired
This is going to be a brief post. After my first full day of being out in the world, I'm exhausted.
Today involved going through the routine of six-hour antibiotics applications, switching out TPN supplies, going to CVS and filling prescriptions and stocking up on household goods, moving most of my stuff from Page's place and the hospital back into my apartment (i.e., lugging it up three stories), getting started on cleaning up the house, starting laundry, organizing the medical supplies... etc., etc.
Those activities wouldn't be too draining if it weren't for the fact that my body is not exactly in the shape it was when I entered the hospital three weeks ago. When seated, I keep falling forward; apparently, my back muscles turned to mush during my many days reclined in a cot. My legs are burning after taking out bales of trash and moving suitcases and supplies around. Even though I may have lost 15 pounds recently, I gained them back in the form of a heavy TPN backpack that I have to carry everywhere.
Suffice to say, I'm going to sleep in little bit after setting up my final antibiotics IV of the night. I'll post more tomorrow - maybe when I get up at 6.
Today involved going through the routine of six-hour antibiotics applications, switching out TPN supplies, going to CVS and filling prescriptions and stocking up on household goods, moving most of my stuff from Page's place and the hospital back into my apartment (i.e., lugging it up three stories), getting started on cleaning up the house, starting laundry, organizing the medical supplies... etc., etc.
Those activities wouldn't be too draining if it weren't for the fact that my body is not exactly in the shape it was when I entered the hospital three weeks ago. When seated, I keep falling forward; apparently, my back muscles turned to mush during my many days reclined in a cot. My legs are burning after taking out bales of trash and moving suitcases and supplies around. Even though I may have lost 15 pounds recently, I gained them back in the form of a heavy TPN backpack that I have to carry everywhere.
Suffice to say, I'm going to sleep in little bit after setting up my final antibiotics IV of the night. I'll post more tomorrow - maybe when I get up at 6.
Day One in the Outside World
As you noticed, "yesterday's" posting was being updated until 6 AM this morning. "Yesterday" and "Today" don't have a lot of meaning in my new medical schedule, where I'm getting up every six hours to infuse myself with antibiotics, and I'm constantly lugging around a backpack full of nutritious paste.
The good news is that I've had a relatively comfortable experience so far. The TPN feed is keeping me hydrated, despite the warm weather; I have much more variety in my choice of sleeping positions, now that the drainage tubes have been removed, and the cats haven't taken too much of an interest in my medical gear. I think they sense something is amiss.
Today (Saturday's) immediate challenges are to document the procedures for using the antibiotics and the TPN, and set up the 24-hour TPN change, which will happen around 4 PM. Once I'm confident about both procedures, then I need to tackle the mammoth task of cleaning up my room, which somehow grew messier during my three-week absence, do laundry, clean up my desk, and generally make sure I have a comfortable nest in which to rest during the remaining weeks of my recovery.
I have another goal, which I haven't really paid much attention to, although it's the whole point of leaving the hospital in the first place: figuring out what to work on now that I'm home. On Monday, I need to get in touch with work, explain that I can't drive yet, and work out a work-from-home plan for the short term. I also need to get back to reviewing for the PMP exam. I'll still have the same challenge I had in the hospital (and before I entered the hospital, really) - how to fill my waking hours when I'm not working. I had plenty of hobbies and time-wasters before I entered the hospital, but I'm not sure how many of them are important, now.
I have been thinking of taking up amateur photography again. I haven't done much with it since college, but I think it would encourage me to continue getting out of the house, and I could take advantage of the natural beauty of the local National Arboretum. Friends of mine recommend the Canon Digital Rebel XTi and a Canon 50mm 1.4/f lens. We'll see - photography is a great money sink. On the other hand, I haven't spent any 'spending money' in the past month since I've been in a hospital and haven't had shopping as a high item on my list of priorities.
I'll update this later. For now, I'm going to keep watching episodes of 'Lost' and enjoy the cooler temperatures brought by today's overcast weather.
The good news is that I've had a relatively comfortable experience so far. The TPN feed is keeping me hydrated, despite the warm weather; I have much more variety in my choice of sleeping positions, now that the drainage tubes have been removed, and the cats haven't taken too much of an interest in my medical gear. I think they sense something is amiss.
Today (Saturday's) immediate challenges are to document the procedures for using the antibiotics and the TPN, and set up the 24-hour TPN change, which will happen around 4 PM. Once I'm confident about both procedures, then I need to tackle the mammoth task of cleaning up my room, which somehow grew messier during my three-week absence, do laundry, clean up my desk, and generally make sure I have a comfortable nest in which to rest during the remaining weeks of my recovery.
I have another goal, which I haven't really paid much attention to, although it's the whole point of leaving the hospital in the first place: figuring out what to work on now that I'm home. On Monday, I need to get in touch with work, explain that I can't drive yet, and work out a work-from-home plan for the short term. I also need to get back to reviewing for the PMP exam. I'll still have the same challenge I had in the hospital (and before I entered the hospital, really) - how to fill my waking hours when I'm not working. I had plenty of hobbies and time-wasters before I entered the hospital, but I'm not sure how many of them are important, now.
I have been thinking of taking up amateur photography again. I haven't done much with it since college, but I think it would encourage me to continue getting out of the house, and I could take advantage of the natural beauty of the local National Arboretum. Friends of mine recommend the Canon Digital Rebel XTi and a Canon 50mm 1.4/f lens. We'll see - photography is a great money sink. On the other hand, I haven't spent any 'spending money' in the past month since I've been in a hospital and haven't had shopping as a high item on my list of priorities.
I'll update this later. For now, I'm going to keep watching episodes of 'Lost' and enjoy the cooler temperatures brought by today's overcast weather.
Friday, April 11, 2008
Moving Out
EDIT: 4/12/08 - 6:54 AM. Well, this is what my life is going to be like for a month: preparing and applying antibiotics IV drips every six hours. Set up is simpler than I thought it would be, and it takes about 35 minutes for the pack to run through.
I slept better than I thought I would. I was concerned that with the hot weather and the lack of AC, I'd be dehydrated (since I can't drink anything!) I woke up feeling fine and only a little dry-mouthed - the feed bag is keeping me hydrated after all. That'll be the next challenge - making sure we can prepare and set up the TPN mix correctly at 4. At least that's only a once-a-day event.
EDIT: 8:54 PM - What a day. Released at 1:30. Dr. Smith removed the JP drains, which was a good sign - he doesn't expect any additional drainage. I am left with 'valves' in my neck which will come out when the fluoroscopy / scan comes back positive.
Much of the day was spent either slogging in traffic or in training at the outpatient IV facility. Page and I spent three hours learning how to operate my TPN (feeding) pump and my antibiotic courses.
Because of an oversight at the nursing station, I'm currently on 24 hour TPN - I was supposed to be on TPN 12 hours a day, so as to make getting around during the day easier. I'll discuss that with Dr. Smith on Monday and see if we can get that changed to 12 as discussed.
Today's training was grueling and complicated, or at least it seemed that way. I have to basically perform all of the day-to-day actions my nurses were performing. That means fetching ice (and making it, and crushing it), changing my sheets, hooking up my feed bag and antibiotics in a safe, sterile fashion, and in the case of the antibiotics, doing it every six hours; administering my own medication, doing my laundry, taking out my trash, buying my toiletries, and other tasks I haven't thought of yet.
Now I'm home, sitting on a couch with a bunch of cats at my feet, watching my favorite television show (Battlestar Galactica!) with Page. The air conditioning isn't so good here, and I don't have a magic button to push when I want something. Still, I think it will be better than just lying in bed another week, looking forward to nothing but a routine of medication and sleep. I'm happy to be back.
EDIT: 4/11/08 - 10:51 AM - My last nurse came in to update me. Everything seems ready to go, but he is making sure that everyone is clear on the schedule and expectations. Additionally, my representative from the Home Care organization came by to introduce herself, and give me her contact information in case I have any questions. Things are moving swiftly...
Well, today is the day. The nurses have already been in to check on me and let me know that last minute preparations are underway to get out of here. To my understanding, I'm just waiting on Dr. Smith to show up, maybe perform some last minute suture adjustments, and then Page and I will walk out of here around 1:30 to get on the road to Rockville so we can get IV training and pick up my supplies.
I'm excited! I am trying to transition myself to feeling like a normal person who walks and talks and goes places. It's going to be an interesting challenge just getting out of the hospital, and then enduring the drive to and from Rockville.
Until Dr. Smith arrives, my only tasks are to keep gathering belongings, and decide when to shower and get dressed (in street clothes, of course). Even though I still have a lot of restrictions on my life, like being tethered to an IV, covered in tubes and not being able to eat or drink, I really do feel like I'm breaking free and rejoining civilization. Hopefully, this coming Tuesday (or the next) will mean I can remove the feed bag, tubes, and start enjoying some real food and drink.
Thank you to all of my readers so far, I have been amazed at the letters and calls I've received over the past few weeks. I've really enjoyed being able to write back and answer questions about my progress and what my hopes are day-to-day. It's meant a lot to me.
Watch this space! I'll update this entry over the course of the day.
I slept better than I thought I would. I was concerned that with the hot weather and the lack of AC, I'd be dehydrated (since I can't drink anything!) I woke up feeling fine and only a little dry-mouthed - the feed bag is keeping me hydrated after all. That'll be the next challenge - making sure we can prepare and set up the TPN mix correctly at 4. At least that's only a once-a-day event.
EDIT: 8:54 PM - What a day. Released at 1:30. Dr. Smith removed the JP drains, which was a good sign - he doesn't expect any additional drainage. I am left with 'valves' in my neck which will come out when the fluoroscopy / scan comes back positive.
Much of the day was spent either slogging in traffic or in training at the outpatient IV facility. Page and I spent three hours learning how to operate my TPN (feeding) pump and my antibiotic courses.
Because of an oversight at the nursing station, I'm currently on 24 hour TPN - I was supposed to be on TPN 12 hours a day, so as to make getting around during the day easier. I'll discuss that with Dr. Smith on Monday and see if we can get that changed to 12 as discussed.
Today's training was grueling and complicated, or at least it seemed that way. I have to basically perform all of the day-to-day actions my nurses were performing. That means fetching ice (and making it, and crushing it), changing my sheets, hooking up my feed bag and antibiotics in a safe, sterile fashion, and in the case of the antibiotics, doing it every six hours; administering my own medication, doing my laundry, taking out my trash, buying my toiletries, and other tasks I haven't thought of yet.
Now I'm home, sitting on a couch with a bunch of cats at my feet, watching my favorite television show (Battlestar Galactica!) with Page. The air conditioning isn't so good here, and I don't have a magic button to push when I want something. Still, I think it will be better than just lying in bed another week, looking forward to nothing but a routine of medication and sleep. I'm happy to be back.
EDIT: 4/11/08 - 10:51 AM - My last nurse came in to update me. Everything seems ready to go, but he is making sure that everyone is clear on the schedule and expectations. Additionally, my representative from the Home Care organization came by to introduce herself, and give me her contact information in case I have any questions. Things are moving swiftly...
Well, today is the day. The nurses have already been in to check on me and let me know that last minute preparations are underway to get out of here. To my understanding, I'm just waiting on Dr. Smith to show up, maybe perform some last minute suture adjustments, and then Page and I will walk out of here around 1:30 to get on the road to Rockville so we can get IV training and pick up my supplies.
I'm excited! I am trying to transition myself to feeling like a normal person who walks and talks and goes places. It's going to be an interesting challenge just getting out of the hospital, and then enduring the drive to and from Rockville.
Until Dr. Smith arrives, my only tasks are to keep gathering belongings, and decide when to shower and get dressed (in street clothes, of course). Even though I still have a lot of restrictions on my life, like being tethered to an IV, covered in tubes and not being able to eat or drink, I really do feel like I'm breaking free and rejoining civilization. Hopefully, this coming Tuesday (or the next) will mean I can remove the feed bag, tubes, and start enjoying some real food and drink.
Thank you to all of my readers so far, I have been amazed at the letters and calls I've received over the past few weeks. I've really enjoyed being able to write back and answer questions about my progress and what my hopes are day-to-day. It's meant a lot to me.
Watch this space! I'll update this entry over the course of the day.
Thursday, April 10, 2008
Jailbreak Plans
EDIT: 8:59 PM. I got the news earlier, but just thought to update my blog this evening. I'll be leaving the hospital around 1:30 PM on Friday and will be traveling to Rockville, MD with Page to pick up medical supplies and receive training on the IV machines. Then we'll head back to Page's, where I will probably crash for the evening, reunited with my cat. I'm going to take Friday as easy as possible, and then think about getting my own apartment set up.
It's confirmed: I'll be released from hospital tomorrow, April 11th. Technically, I could get out of here tonight, but I want to make sure the various participants in my release (the social workers, the nurses, etc.) know their roles and the doctor's orders are correct and match up with my expectations before I bolt.
Once I'm ready to leave, it appears that I won't need to do anything until I get home. Sometime after my arrival at home (but within the current day), I'll get a call from the outpatient nurse who is working with my case handler. The nurse will arrange for delivery of my IV equipment and supplies, and then she'll set up a time to come over and train me. Page should be there for the training as well, so I will have a backup. From that point on, I will be on my own with some exceptions:
On the plus side, I'll have true privacy again, and the comfort of an area that is really set up to meet my needs. My apartment is spacious enough to accommodate an IV machine.
I was also told last night that they wouldn't be able to send me home with IV pain medication. It wasn't clear at first what alternatives I might have, since oral medication was not an option as long as my wound exists - but today I got an answer: I'd be given patches. Presumably the dosage will gradually taper off so I'm not left in the uncomfortable position of having to quit anything cold turkey.
I'm going to try to go into the office on Monday. I have no idea what shape I'll be in, but I need to get back to work, explain my situation, and figure out how to ease back into a normal work experience. As much fun as I'm having working on this blog, it's not going to earn me a paycheck anytime soon.
I'll have to start packing soon - this place is as messy as my apartment. Unexpectedly, I think I'll miss this place, or at least the nurses who have worked so hard to keep me comfortable 24 hours a day since my arrival in March. I'll return here once I'm better to thank everyone. For now, it's time to get ready to leave.
It's confirmed: I'll be released from hospital tomorrow, April 11th. Technically, I could get out of here tonight, but I want to make sure the various participants in my release (the social workers, the nurses, etc.) know their roles and the doctor's orders are correct and match up with my expectations before I bolt.
Once I'm ready to leave, it appears that I won't need to do anything until I get home. Sometime after my arrival at home (but within the current day), I'll get a call from the outpatient nurse who is working with my case handler. The nurse will arrange for delivery of my IV equipment and supplies, and then she'll set up a time to come over and train me. Page should be there for the training as well, so I will have a backup. From that point on, I will be on my own with some exceptions:
- A nurse will visit at least once a week to draw blood and check on me in general.
- I'll return to the hospital on Tuesdays for my weekly esophageal scan.
- I'll visit Dr. Smith on Thursdays to discuss my case.
On the plus side, I'll have true privacy again, and the comfort of an area that is really set up to meet my needs. My apartment is spacious enough to accommodate an IV machine.
I was also told last night that they wouldn't be able to send me home with IV pain medication. It wasn't clear at first what alternatives I might have, since oral medication was not an option as long as my wound exists - but today I got an answer: I'd be given patches. Presumably the dosage will gradually taper off so I'm not left in the uncomfortable position of having to quit anything cold turkey.
I'm going to try to go into the office on Monday. I have no idea what shape I'll be in, but I need to get back to work, explain my situation, and figure out how to ease back into a normal work experience. As much fun as I'm having working on this blog, it's not going to earn me a paycheck anytime soon.
I'll have to start packing soon - this place is as messy as my apartment. Unexpectedly, I think I'll miss this place, or at least the nurses who have worked so hard to keep me comfortable 24 hours a day since my arrival in March. I'll return here once I'm better to thank everyone. For now, it's time to get ready to leave.
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