PICC lines and other adventures- 11/20/2009

Good morning!

Well, I'm feeling much better this morning after a great night's sleep. Yesterday was a whirlwind of activity!

(Oh, side note: I tested negative for H1N1, so I'm out of quarantine! Anyone wants to come say hi, I'm at UWMC, room 5250)

Night before last the doctors came in and noticed my hands and feet were really cold. I had noticed it too, but didn't pay any attention. Evidentally, that is a sign my heart wasn't pumping enough, so they decided to put me back on the smallest dose of Dobutamine (that IV med that helps my heart). Again, I can't go home on the drug, so this was a small step backwards, but their priorty right now is making my body work as easily as possible, so I can heal up from this cold. And the medicince did it's job- I felt much better that night.

So yesterday morning, I got a request for a 2nd year med student to come do a physcial exam and interview with me. If me and my case will live forever in medical school posterity, how could I say no?! So, Paul the med student came to interview me. As a side note, Paul was a swell guy, born in Alaska and was a carpenter before he decided to got to med school. He was so nice and interested in the story, and had very good bedside manner. A+ Paul!

Right after the interview, I took a little turn for the worse. I blame it on exhaustion due to my crazy interviewing schedule (much like that of Kristen Stewart on the New Moon press junket). I started feeling nauseaus (I should really learn how to spell that word) and tired and lightheaded. Saying I'm lightheaded is the trigger word that will get my vital signs taken right away ("Stat" if you're in the biz) and will get a doctor over to see me within minutes. I could totally use that as a powerplay, but I think I'll save that one for later.

They needed to get a PICC line in yesterday morning, so we started that process again. As a reminder, I had a PICC line during my last stay, and it was awful. A PICC line is a big wire (a little bigger than your headphone wires) that goes in my arm and snakes up a big vein around my shoulder and stops right outside my heart. We need it to draw blood, and the blood we get there allows the docs to measure a really important oxygen level of my heart. So it's important we get this PICC in.

Last time they tried 3 veins before they could get a wire in, and then the wire ended up going up my jugular vein instead of down to my heart. They used 30 syringes of saline to jostle it enough to make it go down towards my heart.

This time, they tried once and kept running into the problem they had before of the wire getting snagged before it got to the heart. So they dedcided to send me down to Interventional Radiology (IR) because those guys have imaging equipment so they can see exactly what they're doing.

So they wheel me down to IR. Silly me, I thought this was a little procedure they'd do in a office or something. Wrong. I get rolled into an ice cold operating room with Billy Joel's "Uptown Girl" blaring on the stereo. You think loud music in an operating room is only on TV? No, strangely, that is one of the most accurate representations out there. I automatically get a little scared, becuase this will be the 4th time I've been in an operating room, and everytime I've been in there I've cried from the pain. Yahoo.

So they get us all scrubbed up, and me draped with towels from head to toe, and they begin. The lodocaine didn't hurt this time, because I've learned a trick!! Ask for "buffered lodocaine" which has something like baking soda in it and it stops almost all the burning. I feel like a genious for knowing this now, and a fool for not knowing it sooner.

They go in through the little hole in my arm, and they inject contrast so they can see what they're doing on the xray. They they start to snake the wire in. And then I squeal. It seems my veins like to do what's called a "vein spasm". Yeah, essentionally my veins tighten up and squeeze the wire and won't let it move. And that hurts like crazy. So they would stop for a minute to let my vein chill out, and then start again. This is when the crying came in this time. But they finally got through the spasmy part and down closer to the heart, where they were able to get the wire in place using the imaging.

Afterwards, I was pretty tired from the painkillers, but I was comfortable. The whole morning did take it out of me, so I slept most of the afternoon.

The PICC nurse came in later that evening to tell us that the reason that they had so much trouble doing a PICC on me was 1) because of my spasming veins but also because 2) the vein that goes right outside my heart (the destination for a PICC line) is very narrrow. It is usually really wide. I asked if it was blocked, and they didn't think so, they think I may have been born with it that way. It won't cause too much trouble, it's just very important when they place PICC's in me going forward. I'm another medical mystery I suppose.

So at the end of the day, my doctor came in and we talked abuot when I can go home. Since I've had the little set back with Dobutamine, it will take a few days to get on some other meds to compensate for that. And they want to make sure I'm really done with this cold. So it's looking like Monday or so. Also, he said that he hopes this is just a cold that is causing this problems (which it totally could be). But if it is my heart getting weaker, we are going to need to talk about transplant pretty soon. So let's all pray, hope, and cross our fingers that this is just a cold! You with me? Yay!!

Ok, I've got to go have another cath (this one in my leg), so I'll update more later.
I love you all!!

Hannah Sales Wow! Where is House when you need him?! I swear they could do a whole episode just on you cause I feel like I'm watchin it when I read your updates! You are such a trooper and keep hangin in there. Love ya girl!

Allison Shoopman Hollis crossing fingers AND TOES!!!!!

Jillian McJannet Jana! what a day you had, girl! I'm going to try to make it by tonite for a visit. XOXO

Sandy Farrill Sorry for the little vein genes. Dad

Rosa Roberge Oh my gosh, what a day. Hugs and a big hope that this is just a cold.

Kathy Malvern Hi Jana. What a rough day you've had. (Okay, rough month, or more.) You're a tough girl!!! Fingers crossed for that pesty little cold. Hang in there.

Jo Carson Praying for you!

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