Today was a day dominated by logistics. I got yesterday's dose of chemo through a peripheral IV but they don't like to do that because it's kind of hard on the vein and can lead to scarring so the vein can't be used again for anything else. Also, things like leaking are more likely to go wrong with peripheral IVs so they wanted a PICC in me as soon as it was logistically possible. I wasn't sure when it was going to happen so I spent my day getting little updates from people. The PICC inserter asked me to consent you so maybe you're next, etc. My friend John from induction came by to say hi, but then had to leave because the cafeteria makes a very small collection of vegetarian food on Saturday and he is a strict vegetarian. Soon after the notice that I was next for the PICC came and I got my ativan. Then Ira came by and I was a little out of it and they came to take me away for my PICC before we could get to talk much at all.
You may recall getting my PICC last time was a tough proposition. They stuck me 4 or 5 times and concluded that my veins were very spasm-y and that ativan would be just the ticket for me. I must admit my nose was a little out of joint, feeling like they thought I was "just a crazy woman," but I would give it a chance because if they were right I'd have a painless PICC and if they were wrong I'd have a great blog post. I did not calculate out what I would do if they were in the middle and it still took 4 sticks, but this time it was because my anatomy is tough. Evidently all my veins instead of getting bigger and coalescing on the way to my heart, divide and get smaller on the way up until they get to my armpit, then they unite and form a vein big enough to put a PICC in. One would not want a PICC right in the armpit for infection control reasons due to sweating and skin bacteria and the difficulty of keeping a mobile place like that clean so she kept trying for a spot in my upper arm that was big enough. She found one on try four. I, of course, wonder what connection the spasms and size of my blood vessels have. I did notice that today's inserter seemed to be slower and more gentle as she pushed the catheter in and to wait longer before advancing it again. I don't know what effect if any this might have had either. I really wonder, of course, if the ativan made any difference at all.
At any rate, she said next time I should not even bother with the RN PICC crew and just plan on getting it done in interventional radiology. Each time I get a PICC they up the ante. I am excited to find out what the interventional radiologist will suggest. I'm guessing a different kind of device or maybe amputation.
After the PICC which although I didn't do anything besides lie there and be distracted by the radiology tech totally exhausted me, I came back and jumped in bed. Then my nurse gave me benadryl with the predictable response. I asked them to keep my room door open while I napped because I prefer feeling like life is going on around me while I nap. The nurse's station is about 10 steps from my door and I was not aware of anything that happened there. When I woke at 5:30, some one had delivered dinner which I didn't even wake for. Eventually I ate, went for a nominal two mile walk on the fifth floor and am trying to decide for my next activity if I should watch Daria DVDs or read the new blood transfusion recommendations.
Choices. Choices. I'm lucky to have some good ones. May you too.