I don't know if anyone is still reading this blog. Perhaps some of you are using a RSS reader, and you'll be notified that there's a new post. In any case, I felt it was time to revisit this moribund blog and commemorate the passing of the one-year mark since the Big Accident.
It's hard to put into words everything that's transpired since March 20th, 2008. Now that life has returned to a state of normalcy comparable to what I enjoyed before the event, it's a little jarring to look back and recall the month spent in a hospital cot, struggling at first to survive, and later, to remain engaged and look forward to a life outside of a hospital. It's a trope of medical reminiscences to mention how all of life's 'petty cares' were swept away by the tidal force of a life-changing event, like a serious neck wound, but I think there's no shame in returning to the same cares you carried even after you survive. These days, I worry about my job, my goals in life, the state of my 401k and my relationship with my girlfriend. Those are the things that shape the quality of my life on a daily basis, not the half-remembered hours spent in a specialist's ward. This blog has been a travelogue of my own physical recovery, but I'm happy to say that I'm studying and writing about issues that surround all of us, and not confining my attentions to my internal world. The accident seemed important at the time, but I've been more profoundly interested by the last presidential election and the vagaries of the economy.
That said, I won't dwell too long on medical issues. I haven't spoken with Dr. Smith since my final followup appointment in June of last year, and I'm kicking myself weekly for having forgotten to send him a Christmas card. I will be sending him a card on my birthday in recognition of the anniversary, and to thank him for saving my life. I might schedule a followup appointment, just to see what his professional outlook is after all of these months.
Page and I are still together. We laugh nervously about the accident. She bore the stress of it well during my hospital stay, although in later months we were both on edge and inexplicably angry. I wish I hadn't put her through the kind of experience that she had during that first week. I've promised to ring in my 31st birthday with a nice dinner instead of a hospital trip, so perhaps I can make up for last year. Her craft business is succesful and thriving, economic downturn nonwithstanding.
Gentle Fluffy, who cried himself to sleep nightly whilst I was away, is now fatter and happier than before. As the winter months give way to spring in Washington, the temperature steadily rises and Fluffy seems to rejoice in shedding great tufts of fur that waft throughout the house and aggravate already-aggrieved sinuses. It's good to have my little buddy back.
I haven't attempted to swallow a sword, juggle knives, eat fire or any other stunt since last year. After I got back on my feet, Page and I resumed our weekly visits to the Palace, where I briefly enjoyed a kind of celebrity as a spectacular failure, but most importantly, a spectacle. Later in the year, our attendance slowed, and I haven't been back in weeks. We have new venues to socialize in, as the lustre of the carnival life has dimmed somewhat.
I'm spending more time on the road and in the office than at home, and in some ways that's a good thing. During the runup to the Christmas holidays, one of my coworkers staged a 'team building' activity. Each of the staff members was asked to submit a fun fact about themselves, and the rest of the team would have to guess who submitted the fact during a luncheon. My fact was 'This team member used to perform on stage as part of a carnival show.' To my surprise, no one guessed correctly when my fact came up. After the activity, several people asked what my act was, and I replied blithely that I had been a sword-swallower. It took most of the group a few seconds to make the connection and cast hurried glances to my neck, still bearing a livid scar, to my face, and back again to the neck as the realization set it. Most people were curious. My boss admitted that there had been suspicions that I'd been involved in some kind of elaborate suicide attempt, but he was relieved to learn I had simply been collossaly foolish. Since that day, no one asks about my scar, and the accident was ignored in my year-end review.
I'm in pretty good shape, physically. The scar will probably never fade, but that's fine. My throat feels mostly normal - no problems eating or drinking. When I left the hospital, I was at a frightening 179 pounds. I've since ballooned up to 190, but I attribute that to approaching every meal since I left the hospital as if it were my last.
To be continued tomorrow - life is interrupting!
Saturday, April 4, 2009
Thursday, May 15, 2008
Benefit Show in DC Tonight
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.
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.
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.
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