So, a lot happened for me in medical land the last couple weeks. I had a PICC line placed, a stimulator check and started Total Parentral Nutrition all in the last week and a half.Crazyiness. As a result I have become home bound in order for my insurance to cover the nursing care I need to make it all work.
PICC Line Placement
A PICC line is a type of central IV. It is placed in the upper arm using ultrasound guidance. The catheter is snaked up and over into a large vien near the heart. The most painful part of the placement was when the nurse injected Lidocaine to numb my arm. It took about half an hour. I have what's called a double lumen power PICC. This just means that my line can handle a fastish infusion rate and has two endpoints. One is used to infuse my TPN every day. The other is used for blood draws. The things I wish I'd known before I got my line are that you need to protect the line when you shower, and long sleeved shirts should be banished from your wardrobe while you have line. The showering thing proved tricky for a while until I found a cast cover I can do myself. The t-shirt thing took me all of two minutes to discover after wearing a long sleeved shirt the day I had it placed. The longer the sleeve, the more it catches on stuff.
Stimulator Check
The afternoon of my line placement, I also saw Dr. B. to check my stimulator. Since Dr. B. works at an academic medical center, there seems to always be a new medical student for me to teach. This time, oh man. I always refer to my stimulator as a pacer when explainiung it to new people. It's just easier to understand than calling it a stimulator. So, I explained it that way to the med student. I even let him feel where my generator is. He was surprised to learn that I have been nauseous daily since October. I know you're new to the story man, but read my chart. Dr. B. was outside my exam room and the med student presented me to him. Every time the student told him I was there to check on the pacer, he very sternly corrected him. "Stimulator!" It was quite amusing. Dr. B. came in to "interrogate the generator" his words for using a programmer to check the stimulator's settings and battery life. Everything looks good. He did finally explain why he has yet to turn up the settings. My nutrition status is so poor that the device has no chance of working right now. I need to get to a better place in that regard before we can hope to get the device to work at all.
We also talked about my MALS repair. It's been six months since that surgery. Hard to believe. Anyway, when I go in to get my stimulator checked in April, I'll have another ultrasound of the celiac artery just before. He doesn't think any possible compression is causing my current decline. If the artery is compressed again, I may have an aniogram. to try to clear it. Related to the study I'm part of, he gave me the six-month post-op questionaire. The whole first page listed various phyiscal activities and asked me to rate how much my health has affected my ability to do them. Those were all things I've never been able to do. The next two asked about my emotional and social life . These were more applicable to me. The very last question was very funny. It read "My health is excellent", and asked me to agree or not. I did not.
Starting TPN
Four days after I got my line, my infusion pharmacy called and said that my TPN orders had come in and I'd be starting that day! I could look forward to feeling better and to having energy. Wednesday night, my home health nurse came and hooked me up. The solution is a nutritionally complete mixture of protein carbohydrates and fats. I get 50-ish MLs an hour hour over 18 hours. Three days a week I get some multivitamins mixed in,and take oral vitamins on the off days. Eighteen hours is a long time to move around while attached to a line and pump. I have found good ways to do things already. Aside from needing my formula changed so that I got enough dextrose, and the last couple of days of awful nausea and fatigue, I've done pretty well. Who knows what I'll see in the next several weeks.
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