Tuesday, August 18, 2009

PICC line and ER

The new hospice RN visited this morning because I was worried about blood in Steve's catheter line.

Because Steve doesn't have any pain related to the catheter, she thinks the blood is simply from irritation and will resolve in a day or two.

While she was here, she was going to change the PICC line dressing on his right arm. Before that, she tried to flush the line with saline.

She couldn't get the line to flush. She said it wouldn't budge. We've never had trouble with the line since it was inserted in January, so I didn't know what we'd do next.

The nurse wasn't sure, either, so she called a fellow nurse who said the only options were to remove the line or to go to the ER to get additional help in a more controlled environment.

We talked about the choices for a few minutes. We're still not willing to give up the line, as long as it stays free of infection, knowing that if Steve needs IV therapy for an infection or needs blood drawn quickly, the line is our best bet. It's just too difficult to access his veins with a needle.

After we'd agreed to keep the line, we needed a way to get to the hospital. Steve is no longer able to safely get in and out of a car. An ambulance is the only option. But I didn't want to call 911 -- we didn't have a true emergency.

Instead, I called our local fire station. The guys there know us pretty well by now. I explained our situation, and they agreed to pick up Steve at 1 p.m. and take him to Plano Presbyterian.

I then called Betty, who drove up from North Dallas to take care of Cooper and Katie. Teresa, Katy and David from church had already planned to spend the afternoon playing at our house, so they were here, too.

Steve was seen quickly in the ER. And the nurse was able to flush his line immediately.

Great news! (Though I sure wish we had known that before we forced Steve to endure an afternoon going to and from the ER.)

Then our only trouble was how to get home. The Frisco paramedics couldn't take Steve home -- they can only deliver you to the ER. So we hired a private ambulance service and waited for more than two hours.

We were home just before 5, thankful for a happy ending (and happy to be home in time for a visit from Jessica, Steve and baby Sebastian).

Steve has no new symptoms this week -- just variations of the regular ones. His voice is almost nonexistent today, apparently a combination of extreme shortness of breath and weakened vocal chords.

Whenever there's a new medical team member -- paramedic, nurse, doctor -- looking after Steve, I'm quick to point out that he's unable to talk well but that he understands everything. I don't want him to feel excluded from decisions or conversations even if I have to speak for him most of the time.

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