Thursday, February 20, 2014

February In The Hospital

I came home from the hospital in January just long enough to receive my new clothes in the mail, turn right around, and be readmitted to St. Mary's. All I had done was explain to my doctor that my gastric output was too much to reinfuse with the saline I was to run into my tube, that I couldn't run my tube feedings, and having only being home for two days was instructed to come back into the arms of the ER team. High doses of Dilaudid and Zofran and seventeen attempts at an IV later, I was taken up to my home away from home.

4 Medical

I wasn't sure how I felt about the warm reception I received. I am grateful that I am well liked and cared for with such care, but becoming a fixture here has never been a goal of mine, and I guess it has sort of happened.

I came in for feeding intolerance, severe malnutrition, dehydration, and pain control. The IV that was so painstakingly placed in ER (which took two hours) failed when I got up to the floor. Another nurse was called up from a critical care wing to give it a go, and all that she could place was a neonatal line in another odd spot. When my doctor saw the damage (and the fact she used to be a nurse), and felt around for a vein herself to place a larger needle, she shook her head and said

"You have to have a central line. And it needs to stay".

To recap, I had horrible line infections that led to septic shock and almost ended my life. There was no way I would ever go near a central line. Except now, all of my veins have been burned, scarred over, or are now otherwise useless. In ER, I was informed that if they could not get the access needed quicker then we had no choice but to drill into the bone marrow, which is way more dangerous than a line.

So later that day, I was fitted with a single lumen PICC line

And started TPN.

Except there was one problem: the PICC nurse that placed this line did so in about 20 minutes. Think about that. In 20 minutes she supposedly created a sterile environment, and somehow successfully threaded this line in a large vein near my heart?

Not exactly. Much to all of our horrors, I ended up with fungus in my blood. It only took a week. It then led to sepsis (a potentially life threatening blood infection).

In order to get rid of the fungus (Candida) we first had to pull the line, and tried to place a normal IV. My nurse that day, one of the best on the floor, spent an hour and made ten attempts. All it made were three very blown veins (where the tissue bubbles up) and a bunch of puncture wounds. From there, an ER nurse (Terry), who is one of the most experienced nurses in the whole hospital, came to try. He went for the legs and go at all. He said he couldn't feel anything (am I now bloodless? Have I crossed the otherworldly realm and become something sub human?), so then the ICU manager came in to give it a whirl. Between you and me, I do not like her. She's the one that placed my PICC line in 20 minutes and apparently didn't do a very good job.

She came in and aggressively stabbed four vein (because, after all, it is best to beat the daylights out of any life force in order to command it to cooperate...).

From there she ordered a TVC line. Here's the problem. With a severe blood infection, you CANNOT PLACE A CENTRAL LINE. That was the WHOLE POINT of stabbing me for hours on end.

So instead, I was sent to anesthesia lab. The anesthesiologist used an ultrasound to try to find a vein in my right arm...and there aren't any. He tried 14 times. Losing his patience, he then turned my head to the side and jabbed an larger IV into my neck. This is called an EJ. I didn't take a picture, because they hurt and that's just messed up anyway.

When the Candida cleared and sepsis passed, my nurse buddy Bob from Oncology came to place my triple lumen PICC line. It took an hour and a half, and we compared notes on our diagnoses. It turns out we have a lot in common. It was simply exhilarating to find that someone else is a clinical basket case, with no real treatment for his illness, yet holds a job he loves and is one of the best nurses I know.

Here's the lovely line :eye roll: line he placed

Nice, right? The tip internally is probably in the best spot of all my PICC lines. This will be my companion for the next month or so before we introduce a surgical line.Sorry about the lanky oily hospital hair. I forgot my dry shampoo and I've been here for a month. Those shampoo caps only do so much.

Don't worry, I'm only coming home with the Medusa of PICC lines. I'm not bringing the gown home as a souvenir...

...besides. There'll be a point where I'll be back. Just illness progression...though in my heart and my very being I have the highest hopes for one day shirking the gown for good, shedding these diagnostic labels, rising out of my wheelchair and dancing in the summer rain, and enjoying the thrum of a body maybe frail, but not in possible danger any longer.

Know what? I believe I can.

And I believe I will.

There is so much we don't get to control in this life. And those of us with and those caring for loved ones with a chronic condition, it's too easy to miss the small, bright lights in a single day that may be otherwise morose and grey. But I plead with you, do not give up that hope...ever.

Because you never know, that one day maybe the most wild of your own dreams may come true.

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