Oct 9, 2013

Destination Nashville

Before I share the next adventure, Just for fun, How about a picture of each of the kids?
Haven't they grown??  

Jacob 15, Kaley 13, Sam 12
Luke 10, Zoe 8 and Manny 4


Destination Nashville ... 

Manny, Kaley, Zoe, my friend Ann and I went on a road trip.  Nashville was the destination.  We decided we would just drive until we needed to stop.  Our goal was north of Atlanta.  Once we got there, we decided we’d head on towards Chattanooga.  

By the time we got there, Manny was having troubles with his central line.  What kind of trouble you ask?  

OK you know how he is on TPN for 20 hours and off for 4?  He can’t go much longer than that or his blood sugars will crash.  Well, it was at the end of the 4 hours off and the line was “blocked”. It just wouldn’t flush at all.  Like cement.  

So decisions had to be made.  FAST.  We could stay at a hospital in Chattanooga ... but I needed to be in Nashville.  The last time this happened with his line, it was 3 days before we could use it again.  I didn’t want him admitted in a different city.   

Nashville was 2 hours away.  We decided to push it.  Go!  Drive fast but not so fast we get a ticket.  At least this way if he’s admitted, we will be in the city where I needed to be.  

During the next two hours, I was praying, asking others to pray.  I was troubleshooting all the things I knew to do.  I even contacted the Vascular Access team and asked if I’d missed any steps.  They said we needed to get to the ER and recommended Vanderbilt Children’s.  

We got to the ER and the intake person didn’t even understand what a Central Line was.  She just wrote “feeding tube clogged”.  Well ... let’s just say THAT would not be a life threatening emergency.  By this time, I figured Manny’s sugars would be starting to drop ... but they weren’t yet.  (Shocking).  

When we saw the triage nurse, he understood the severity of our situation and got us right back to the nurse.  She got us right back to the “Critical Area” and gave us the Charge nurse.  So yes, they got it. 

He's not even bothered when he's in a hospital he doesn't know.  Wow. 

I also loved that the staff gave me the respect to make the calls about how we proceeded.  For example, I knew that he would need an IV of sugar if his blood sugars started to crash. That would mean a peripheral IV stick (not as easy as that sounds).  But if they could unclog the line, we could avoid all that.  They left it to me to make the call.  So I held off.  

They asked why I was there in Nashville. I was there to be a keynote speaker for the Vascular Access National Convention.  I was in town to talk about stuff ... like this!  Ironic, no? 

Well, the prayers worked.  It was only a few hours and it worked!  It was about midnight by then and we still had no hotel but at least we were all in the right city and not admitted!  His sugars never crashed. That’s amazing all in itself.  

I’ll write a whole blog post about the Nashville Conference soon.  I’m waiting for a few links before I can post that.  Very cool.  

We were super duper careful with his line while in Nashville and the trip home.  We got home on a Monday.  Tuesday I took him to our local ER to get the line repaired. I laughed because I’ve got to be one of the only people who actually “plan” the ER visits.  Sounds crazy, huh?  

OK well, he gets off his TPN around 1pm.  He will be off for 4 hours.  The repair for the central line takes 4 hours of dry time.  See where I am going with this?  If I time it perfectly, he won’t have to have a peripheral IV.  But if we don’t plan this, it could end up being an admission and be lots of hours of poking for an IV site needlessly.  

So I got to the ER about noon.  Got through the check in process and triage.  By the time we were settled in a room and the vascular access team could be there, his TPN was ending.  

The repair went flawlessly.  We were sent home.  And just like clock work, I hooked him up.  All ER visits should be this calm! LOL  

This was the 4th repair on this line.  As I write this, however, his line is 20 months old.  It’s truly amazing how long it’s lasted without a central line infection.  I still celebrate the 7th of every month.  I am sure I’m not the only one who celebrates the “birthday” of a central line!  
Right before the Repair. Doesn't he look too comfortable in a hospital environment? 

This is a picture of him during a central line repair. You might have some questions about the line repair. The white piece coming out of his chest is his broviac central line. There was a part on it that got blocked and was causing it to balloon out. This means it would break any time.  

The IV team cuts the line and basically glues a new piece on the end. It's held together by silicon glue. 4 hours dry time. Then voila! Good as new.
 But trust me, when they cut that line, it always sucks the air right out of the room.  If for some reason they can't get it repaired, he'd need surgery and a whole new line.

This picture is right after the procedure but before she put the dressing (bandage type thing) over it to keep it sterile.

Like I said, this was the 4th repair on his line. Why so many? The thing keeping him infection free is Ethanol lock therapy but it's hard on the line. It's a trade off and worth the issues to me! 20 months and counting! 

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