This long drawn out battle with a pseudomonas infection might perhaps be coming to an end, but first it is not without some grand adventures.
After struggling to get an appointment with interventional radiology for nearly a week, I finally had everything setup to get my peripherally inserted central catheter (PICC) line. I was a bit nervous about the procedure. My last PICC line was quite painful. Scar tissue has built up in my veins, making my veins very narrow and hard to access. Usually my PICC lines have been placed while hospitalized. A very specialized nurse would show up at my bedside, create a sterile work field and in 20-30 minutes, a PICC line was inserted. This time, I was having the procedure done outpatient. This should be a better experience, right? Instead of having one person work in the tiny confines of an ICU room, this procedure was going to be done in a spacious radiology room with multiple people assisting a physician. Everything should be sunshine and lollipops. I wish that were true...and I wish I would have been given a lollipop for enduring this procedure. It might have helped ease some of the pain.
When the technician is preparing me for the procedure, she uses ultrasound to scan my arm for viable veins to insert the PICC line. She scans and scans. She continually askes her colleague to adjust the depth on the ultrasound. Around and around my upper left arm she goes. “Well, that is odd. I can only find one vein. I am going to get the doctor and ask if we can use this vein. It’s the brachial vein, and we don’t usually use this vein.”
The doctor is summoned. Around and around my left upper arm he goes. “Well, this would be a beautiful vein to use, but unfortunately it’s the brachial artery. Look at how beautiful it is. And what a perfect position it is in too.” He continues searching my arm, but the only vein he can find is the brachial vein. He finally gives up and states he will just use the brachial vein for the PICC line.
The doctor leaves the room. The radiology teams suits up into sterile gowns, gloves and masks. I am strapped down to the radiology table and suddenly feel as though I am going to endure some horrible event. A large sheet is spread over my entire body and covers my head. The right upper corner of the sheet is tented to allow some light to enter my visual field. My left arm is fixed on a board which extends at a 90 degree angle away from my body. A small hole is cut in the sheet to expose my left upper arm.
My left arm is prepped for the procedure. It is drenched in a solution which sterilizes my arm. Between the chemicals in the solution and the freezing cold temperature of the radiology room, I feel my body temperature plummet. I am very grateful at that moment that my exhalation valve on my ventilator is underneath the sheet and is resting on my chest. The heater on my ventilator cranks out warm air around 100 degrees Fahrenheit. With my right hand, I clutch tightly my exhalation valve, trying to shield the warm air from escaping into the room.
As I am lying on the radiology table, I am struggling to breathe. I have my cuff on my tracheostomy tube deflated so I can speak. I cannot breathe on my own while lying flat, and now that I have my cuff deflated, which breaks the circuit in my ventilator and thus only provides about one third the support needed to fill my lungs with air, I am using a large amount of energy to breathe. I desperately want to inflate my cuff, but I know if I do so, I will not be able to speak. If something happens during the procedure, I will need both hands to use a syringe to deflate my cuff. Since my left arm is out of commission, there is no way I can inflate/deflate my cuff during the procedure. I decide it is better to keep the cuff deflated and pray the procedure goes quickly—before my body uses up too much energy and/or before my carbon dioxide levels go too high and cause me to pass out.
After all the preparation is complete, the physician enters the room. He gowns up and gets ready for the procedure. He walks to the side of the radiology table and uncovers the instruments needed for inserting the PICC line. The procedure begins.
(Link to Part Two, click here)
No comments:
Post a Comment