Bubble gum

IV clogage Part 2

The home-care nurse came by at 10 this morning and administered "Cath-flow" to breakup to clots on the tip of the PICC line which worked perfectly taking only a few minutes to start the flow again. Based on how quickly they clogged yesterday I'll now be flushing both lines every 4 hours instead of every 8. We hope this will prevent future clogging.

This week I get the stitches removed from both feet and because of that hope to get back into regular Physical Therapy.

IV clogage

I was up this morning at 6am to complete my second IV session. It's much harder to do it right when you are tired. Twice I has to stop to re-wash my hands after rubbing my eyes in an attempt to wake up. My PICC line is actually a pair of small lines inside a single outer cover. After successfully using one line to administer the medication, I found the other line totally blocked. I tried to flush but couldn't get anything to go through. I discussed the problem with the on-call nurse who recommended waiting until the previously scheduled 2PM visit by my home-visit nurse to resolve it.

When she arrived at 2 not only was the first line still clogged but the other line become blocked as well. These blockages are typically caused by blood clotting at the tip of the line. Heparin is a drug commonly used after flushing to prevent this kind of clotting. Unfortunately I developed Heparin Induced Thrombocytopenia (HIT) to while I was in the hospital so I can't use it. They are going to provide another drug to attempt to breakup to clog - I'm waiting for it's delivery right now.

The nurse temporarily inserted a traditional IV into my wrist so i can take the antibiotics on schedule until the blockage is resolved. Without heparin its easy for the new line to become blocked like the PICC, so tonight (and maybe for the rest of the weekend) I'll be flushing it every 2 hours until the PICC blockage can be resolved.

The phrase "Nothing is ever easy" rings in my ears at times like these.

First IV done

No problem -- everything went perfectly. Since the antibiotics are stored in the fridge the contents were a little cold and felt pretty weird going in. Ready for the next one tomorrow...

Success - PICC line installed

After yet another hospital stay, the PICC line is in and I'm ready to start self-administering IV antibiotics. With the medication itself and all the flushing I'll be using 4 syringes, 4 alcohol wipes and two sterile PICC caps for every session. Not exactly ecologically sound.

Training and practice took about an hour and they provided this really cool tray to help organize everything.

Organization

I'll be doing sessions at 7am, 3pm and 11pm everyday with each session taking 10-15 minutes.

Since I had a PICC line the entire time I was sick I'm more than a little familiar with hospital staff using and maintaining the line and it looks like it will be relatively easy to do it myself. Given the alternative to this treatment was to remove more of my feet and toes, IV antibiotics is an easy choice.

Infection

Infection -- the great fear following any surgery. After removal, my toes were tested for infection and came back positive for Staph. A couple of MRIs confirmed that in fact that toes on both feet are infected. This was unexpected. This infection means another surgery to conduct a biopsy on three toes and another set-back in healing. The surgery was completed last week and verified Staph in both feet.

This left me with a choice between taking off more toes and a multi-week course of IV antibiotics. I went with the latter. I'm hopeful that the antibiotics can treat the infection and we don't have to take off any more toes. So on Friday I'm going to get another "PICC" line installed so I can self administer the IV at home.

This is a huge set-back and will further delay recovery. I'm now back in bed, both feet wrapped in bandages waiting for the PICC line. In a week or so the stitches should come out and I can finally get back to Physical Therapy and healing.

Compression

As part of the therapy to heal my feet I’ve been spending 90 minutes a day in a hyperbaric chamber. This treatment involves 90 minutes in a pressure chamber at 2 atmospheres while breathing pure oxygen and is supposed to increase to amount of oxygen in my system and speed healing of my toes. I was pretty skeptical when I started – the operators make some bold claims about the benefits – but after a couple of weeks of therapy I think it has really helped.

The "Chamber"

Each session starts with selecting a movie to watch during treatment. The chamber has a DVD player, a small video screen in one of the portholes and a little speaker inside so you can watch a movie. Nothing is allowed in the chamber so I have to remove my watch, wedding ring and empty my pockets before climbing in. Once inside I get a couple of blankets and pillows and a bottle of water and get sealed in.

This is not for claustrophobics. Once sealed in the pressure starts to increase causing your ears to pop much like SCUBA diving. It takes about 10 minutes to reach 2 ATM. The increasing pressure causes the temperature of the air in the chamber to rise making it feel nice and warm. During the session I wear a little oxygen mask the whole time to maximize the O2 intake. After 90 minutes at pressure the operator opens a valve and slowly decreases the pressure back to one atmosphere.

Jackson says "welcome back"

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