Dec 20, 2011

No PICC, need a plan

Monday was the official day that said he's "clear" of the yeast and bacteria in his blood.  They've had only hand IVs during the past week or so.  This is because if we introduced another central line, the remaining yeasts would have found it and set up house again on it.  So they went with peripheral lines instead.  Problem is ... those only last so long, especially if PPN (Similar to TPN) is going through the veins. 

On the 13th, we got two GREAT IVs started and by miracle, they lasted.  Well, the right one started showing troubles late on Friday so we stopped using it.  Which puts extra pressure on the left hand. 

By Monday, he was in severe pain from the IV on the right and they pulled it.  His hand was swollen, had a cut on it from the catheter, etc.  It was time for that sucker to come out. 

So now that only left us with one IV ... one that is over a week old and has had PPN constantly.  So it's just a matter of time until it blows.  They called the infectious diseases doc to see if we could get a PICC (that's the one in the upper arm that can last about a month or so).  And she said yes. 

About 4pm, the IV team has us go down for the PICC placement. 

Long story short, by about 7pm, we were headed back to the room with no PICC. 

What happened?  His veins are "sick".  Apparently, there is literature that shows antimicrobials and antifungals can cause veins to go hypotonic and not hold.  Sepsis also does a number on your veins as well.  Throw in that he's already a VERY difficult stick and that he's been in the hospital for almost a month (needing frequent blood draws), there were very few viable veins. 

But the team tried.  They gave versed and let me stay in the room to keep him calm.  For each attempt at a PICC line (starts with a large needle), they gave a shot of lidocane.  By the end, he'd had 5 shots of lidocane, 5 attempts at a PICC (3 on one arm and 2 on the other) and they decided he'd had enough.  Within seconds of getting into the vein, it would clot off.  One trouble after the other.  The IV ladies were just sickened that they couldn't get it ... but I know they did their darndest!  If I'd not been in the room, I might have wondered ... but I SAW it with my own eyes. 

Kids visiting Manny's Ipad, er .. I mean visiting Manny!

So what's the plan from here?  Wednesday they will probably try again for a PICC.  If they can get it, we might even be able to go home on Friday or Saturday with IV antibiotics.  If not, then we'll have to wait until the end of his treatment and then get his broviac placed on Monday and go home Tuesday. 

And truthfully, I'm torn about the whole thing.  With the PICC, we go home sooner but have to come back in about a month for a broviac then.  But with the Broviac, we only have to be here a few extra days and don't have to come back in a month.  Praying for wisdom on that whole thing since there's no way I could possibly know which is the "better" option.  Either way, they say we will have a couple hour "Day Pass" on Sunday to leave the hospital and spend time with family. 

Today (Tuesday), he's been very scared any time the door opens to our room.  He cries until he sees who it is.  There are people he knows never hurt him (like Doc and Carmen, the cleaning lady).  But everyone else sets him off.  He cries until they prove themselves not scary or they leave.  (Sooo not like him.)  The ones that try to win him over by trying to talk to him actually succeed.  Those who patronize him (Like "You're fine." or "I'm not hurting you.") just continue to get the screams.  I'm sorry for all the trauma he's been through. 

And me?  People wonder how I'm holding up?  Truthfully ... I'm hanging in there but by the skin of my teeth.  Like I am sleeping but wake up sore.  I got my heating pad from home but it's not helping.  I woke up this morning with my knee so "twisted" feeling that I couldn't put pressure on it for most of the day.  Tonight it's just a bit sore.  (I've never injured this knee so who knows where this came from.)  I'm eating decently but feel like I've gained tons of weight.  (I've never been a "scale" person ... but go by how my clothes feel and they're getting tight.)  Just makes me feel uncomfortable.  My tooth is still not fixed ... I have an offer of a dentist to help me but just haven't been able to leave here long enough to do it.  Seems that every day he has a procedure where I have to be there. 

Then this afternoon, I noticed I felt a bit hot and sure enough, a low grade fever.  Sore throat. Headache.  Drinking tons of water, eating fresh oranges, taking my vitamins but still ... we're in a hospital surrounded by very sick kids.  I talked to the doc about it and he felt like there was nothing that could be done about it since anything I have Manny has already been exposed to anyway.  So no need for me to leave. 

Tonight, the fever is already gone and the rest I think will be better with a good night sleep.  (Hoping that happens.)  Amazing all the way stress manifests itself in a body, even when you THINK you're doing a decent job of controlling it. 

Another concern for the night is ... his one IV he has left is on it's last leg.  It's on day 8 and it's starting to show signs of phlebitis.  It hurts when it's moved or flushed.  Hopefully it can last the night.  Because if not, they have to try an IV stick in the middle of the night without the aid of the IV team.  (shiver).  Even the night nurse is sending up prayers for this IV tonight I think. 

One way or the other, we have to have another line tomorrow.  New IV, maybe a PICC.  Still rethinking what will be the best idea. 

1 comment:

  1. Oh, Lord Jesus ... such a hard, messy thing Manny and his Mama are having to endure. And Manny needs a line for his nutrition and meds. Please, Lord ... let the current line hold for the night and let some inspired thing happen tomorrow, with regard to a solution. Lord, I pray that You would cause Beth to rest and recover a month's worth of stress in a single night (tonight) half-sleep. Please heal her body and Manny's, too. To You alone be the glory!! In Jesus' name ... Amen.