Before I was moved to IFU on Friday the cannula that had been put in on the A&E observation ward tissued. But because I had fallen asleep and nobody noticed, this is what happened to my arm. Half a litre of fluids had just continued to be pumped in and because it couldn't go into the vein it goes under the skin. And I can tell you it felt as sore as it looks.
I was so exhausted that when they stopped the fluids and took the cannula out I went back to sleep. And it must have been a really deep sleep because when I woke up I found that a nurse had cannulated me. I couldn't believe it. How could I have slept through someone sticking a needle into my hand? I have no idea. I must have been so out of it.
But that cannula didn't last long and then I became the human pin cushion again. The picture below shows the two attempts made on my arm but what it doesn't show is the other 2 made on the other arm, and the 4 on my feet! I've often thought as they're stabbing me that it's a good job I'm not frightened of needles. Could you imagine?!
As well as being pricked because they need to put a cannula into me, the doctors have changed some of my pain relief medication to be given sub-cut. This means it's given under the skin, but not injected into the muscles (that's called IM).
Because the pain has been so terrible I've been having to have a lot of pain relief. And that means a lot of injections. Mainly they've been going into my arms but then my arms started to get really sore. So sore that they couldn't put a blood pressure cuff on them so they ended up taking my blood pressure from my leg. Never had it done like that before!
So I've ended up with this...
It's called a Y-can and it's basically a small cannula. But instead of it going into a vein like normal cannulas do, this sits just under the skin so that the sub-cut medication can be administered through it. It hurts a little bit having it put in but it means that every time I have pain relief I'm not being stabbed and my arms are thankful for that!
My normal cannulas don't last for very long. Usually between 12-24 hours after they're put in they tissue (stop working) and have to be removed. Most of the nurses on the ward now refuse to attempt to put a new one in because they know how difficult I am to cannulate.
But it's not just me. Nearly all of the other 20 patients on the ward are the same. Our veins are scarred from repeated insertions (or attempts!) or we have rubbish veins due to dehydration or because we are very unwell. So the solution to that is the Vein Viewer (VV).
The VV is a portable machine that highlights your veins. It's kind of like an X-ray, but for veins instead of for bones. See the green patch on my leg? That's the VV doing it's magic.
The VV shines a green light on your skin and your veins are the black lines. Isn't it clever? I'm constantly amazed by the technology used in medicine and how it's constantly evolving.
This picture shows the machine. It's actually quite small and very portable so it can be taken to the patient rather than the patient having to come to it. It a fab bit of kit but it costs £5000!!!!
Because I'm so bloody difficult to get a cannula into the decision was made to put a central line into my neck. So here I am rocking my accessory.
Right that's enough about veins and needles. What else do I have to tell you? I'm in A bay on IFU ward and I've been very lucky to get a bed next to the window. So not only do I enjoy the views of wembley stadium and the city, I also get to feel the breeze. And boy do you need it because IFU is like a greenhouse.
The other ladies in the bay are lovely and that's a relief. It's nice to have people to talk to and have a laugh with. The other day we decided that we needed to do some washing. So we all put our stuff in the washing machine that we have on the ward. Afterwards we realised that most of the stuff couldn't go in the tumble drier so we did this...
When the ward sister came in the next day we were all in trouble though and had to take it all down straight away because of infection control. Didn't matter too much though because it had all dried overnight because the ward is so hot.
When I came up to IFU they took some blood from my line and sent it away to be cultured. This is a standard procedure and to be honest I didn't think anything of it. What I did notice however was that there was some yellowy gunk coming out of the Hickman line insertion site. I mentioned it to one of the nurses and they gave me a swab. When I changed the dressing later that day I swabbed the area that was red and yucky and gave it to the nurse to send off to the lab.
On Monday morning what I half expected to be told there was a little infection brewing outside the line but what I didn't expect was Dr8 to tell me that the blood cultures showed that I actually had another infection in the line.
I was stunned. How the hell could my brand new line be infected? It was 5 days old when I was admitted and had only been used twice. It couldn't be infected. If that was the case then surely the last infection couldn't have been cleared up properly and was still in my system. They should have checked that the last infection had gone before putting in a new line. All this was going round in my head.
And then it hit me.
Line infections require IV antibiotics. For at least 7 days. So that meant I would be in hospital for at least a week. My heart just sank. I had missed Big Fellas birthday party at the weekend. Now I was going to miss Big Girls flute concert at school. And I had made plans months and months ago to meet up with my oldest friends, friends from school, in London at the weekend and I probably wouldn't be able to do that either.
"How had this happened?" I demanded to know from Dr8. He was in theatre and had done some of the line insertion with Dr7 and he had no idea. Luckily Dr7 was due back from his running/cycling mountains thing the next day and maybe he could give some answers.
But in a strange kind of way if the pain was being caused by a line infection then it wasn't that bad. The antibiotics would clear it up and then I would feel better. Because the other options were not too appealing. There were 4 theories floating around as to what had caused the excruciating chest pain and the numb arm I was experiencing aswell.
1. The line was rubbing on my collarbone
2. The line was rubbing on a nerve.
3. When the vein goes round the corner to my heart the line doesn't quite follow the same path and is rubbing on the vein.
4. They hit a nerve when they inserted the line.
Options 1-3 would require a new line but there is a waiting list and so I could be sitting in here for weeks waiting to have a new line put in. Option 4 is the worst outcome because if a nerve has been damaged then it's irreversible. I could be left with a numb left arm to match my numb left leg! And the pain might not ever go away.
So you see, faced with those options, having a line infection wasn't that bad. But I needed to understand why I kept getting these infections. Why. Why!
When Dr7 came back on Tuesday afternoon he came to see me and I asked him some of these questions. He told me that the bug that caused my line infection a couple of weeks ago was a bug that was in my body and somehow, maybe because I was run down, my body couldn't fight it off and it got into my line. But the bug that had caused this new infection was a different bug. So it was completely unrelated to the last infection. So there was me cursing them for putting a new line in when they hadn't gotten rid of the lasy infection and actually that wasn't true.
The new line infection has been caused by a bug found on your skin. Dr7 thought that given how quickly I had become ill after having the line put in that the bug may have got in during the insertion.
"But the insertion is done in theatre, under sterile conditions, and the area around the insertion site gets cleaned and has that orange liquid stuff that's designed to kill all the bugs" I said to him.
"I know, I know" he said. But somehow some bacteria may have got in, he told me.
"Did you cough or sneeze all over me?" I joked with them. Because what can you say? It's just plain unlucky. And we can't know for sure how the bacteria got in there. Even if it was during the insertion then it can't be helped. They did everything properly, as it should be and they're just men. Yes, they're doctors, but they're not gods. They're not robots. Medicine is not an exact science. And being angry at Dr7 and Dr8 won't change anything. The line is infected, let's crack on and sort it out and get me home.
They also had an idea on how to keep my line bug free. I can't have the tauralock because I had the allergic reaction to it. So they are going to use an old practice of putting alcohol into the line. Same principle, that if the alcohol is in the line then the bugs can't be. They're going to try that next week so let's see if it works and let's hope I don't have any kind of strange reaction to that!
So it's been a hard week again. The kids are upset that mummy is in hospital again and that I'm missing out on some of the end of term stuff going on at school. Hubby is working his nuts off, trying to negotiate one of the biggest deals of his career, trying to rearrange a week long business trip to Eastern Europe all the time while trying to do the washing, the ironing, the cooking, the cleaning, homework with the kids and dealing with two stroppy children who want their mummy at home and are angry at him because he's not me. Oh and then he worries about me too! I'm constantly amazed by his ability to do all of this and not have a nervous breakdown or a heart attack!
And then I feel guilty that again I'm stuck in here seeing him struggle and being completely helpless to do anything about it. I wish I could get a cleaner to come and clean the house so he didn't have to. Or an ironing lady so he didn't have to spend hours doing the ironing. But the £70 ESA benefit I get won't stretch to it so it's hubby that gets stretched instead.
Guilt is a theme that resonates throughout IFU. Most people in here feel guilty for being in here and not at home or at work. Guilty for what they're putting their family through. Guilty for just lying around all day when we feel like we should be doing stuff. I saw this online and thought it was spot on.
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