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:

1. 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.
2. 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.
3. 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?

All of these issues were pushed roughly to the back of my mind as I set out Wednesday to brave the hazards of DC's traffic thoroughfares. 35 minutes into it, and I'd just left DC. "This drive is longer than I remember...", I recall thinking. Eventually, the colossus of my employer's main campus swung into view, and I relaxed as I settled back into the start of a very familiar daily routine.

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.

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.

Anyhow, I am very grateful to have had such a speedy recovery, and to basically be in as good shape as I was a month ago, despite having such an rare injury. I will be even more grateful when I have my next meal. Tonight, Page and I are going out for dinner - there's a little Italian place down the street that we like, and it has great tiramisu to boot. In the meantime, though - I might order some lunch. There's a good sushi takeaway place down the street...

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

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.

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 :)

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.

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.