Day 23

OK, everybody, sit down for this news! My platelets are now at 53! And--they're mostly mine, not those southern accented imposters (who I am very grateful to, but still there's no platelet like one's own platelet). This means my little snap dragons are spewing out the blood elements. My ANC is still 0 with a total white count of 0.7 and my hemoglobin is holding at 7.5. But--today--platelets, tomorrow--who knows? I am hopeful that this means I'll be home for next Monday.

Mary: first native blood, coming soon to a house in Exeter.

So here's that lesson in well informed patients that I promised earlier today. Three weeks in a row I have had my PICC dressing changed (my PICC is my semi-permanent IV that hands out of my arm and gets blood drawn and things infused). Three weeks in a row, I have felt like my PICC hurts more after the dressing change and been worried that my PICC site may have been infected. Three weeks in a row, I complain to my nurses who page the IV team who come and look at it and assure me it's fine. Something different happened this (third) week. When the IV examiner came she pointed at this little disk surrounding the actual opening in my skin where the plastic line goes in and said, "Did you know that disk is impregnated with chlorhexidine?" (cholorhexidine is an anti-bacterial or something that stings a lot when applied to open skin) "No, no one ever mentioned that to me before."

Of course that's why it stings after they change the dressing! How simple, a little tiny piece of information and I understood why it hurt. I would probably still have asked for the IV team to look at it, given how vigilant I am for any potential complication that can be seen lurking on the horizon, but I may not have asked them to come the second and third week if some one had mentioned it the first week. Either way, I would have been much less worried.

One never knows what the patient does or doesn't know. One never knows what little piece of information will make the difference between a sleepless night spent imagining sepsis and time in the ICU and a peaceful night knowing that the anti bacterial barrier is quietly at work. More information is almost always better, provided it is relevant to the patient at hand.

I'm going to see how my platelets feel about the NYT crossword puzzle now. I hope your native grown platelets as well as native grown blueberries, spinach, beets and whatever else is coming up are all healthy and hearty.