For those of you who are interested in my PICC line experience:
I think that I'm my Dr.'s first patient with persistent (entire pregnancy) HG. At least, his first patient with HG who doesn't respond to any medication or combo of medications. The last few appointments he has seemed completely baffled at what to do with me. Fortunately, I have friends with HG who have shared their experiences and that has helped me with my Dr. and getting the treatment that I've needed. Don't get me wrong - I think my Dr. is fantastic. But my experience is definitely out of the "norm."
Anyway, I had to be pretty persistent to get my PICC line in. It was first brought up when I was around 4 months pregnant. The decision to not put one in at 4 months was based on the risks of infection with having a PICC in for 5 months and not knowing if my HG would go away (for a lot of women with HG, the symptoms go away around 22-25 weeks). So I continued to blow through veins to get IV hydration in the ER, triage, and Labor and Delivery. Around 5 months, my Dr. told me I had to cut back on IV hydration because I was blowing out my veins. So, in order to get hydration and justify having nurses poke me 6-7 times (because I have think skin and crappy veins), I had to be desperately dehydrated. Finally, at 6 months and trying a billion combinations of drugs and being chronically dehydrated and miserable for a month, I got my PICC line placed.
I had to travel down to Sacramento Kaiser to get my PICC placed. D drove me (because I am a hot mess and have been too sick to drive) and stayed with me while they placed the line. Unfortunately, it did not go as easily as the nurse had promised me it would. The line has to be placed in a sterile environment, so D and the nurse were both masked. I just looked away because I didn't want to watch! The nurse did an ultrasound on my right upper, inner arm to find the best vein to place the line in. She had no problem finding the vein and initially opening it. However, once the opened the vein, she couldn't advance the PICC line catheter (the catheter is placed up the arm, across the shoulder and then down to right above the heart). I started throwing up while she was trying to place the line. The nurse kept telling me to relax so she could advance the line, but try as I might, I couldn't stop throwing up and relax. Out of no where, I hear a crash and looked over to see D out cold on the floor with his head bleeding. When I looked over, I also saw my arm gushing with blood, my nurses hands soaked in blood, and everything around my arm soaked in blood. Still throwing up, and now freaking out, I didn't know what to do. They took D up to the ER to treat the cut above his eye (he hit a tray leg thing on his way down to the floor) and I started worrying like a crazy person about my husband - I wanted to go with him! I got so close to saying "Forget the line! I want to go with my husband!" Meanwhile, the nurse is still yelling at me to relax my arm. Crying, throwing up, freaking out; I don't know how, but finally the nurse was able to advance the line. They sent me up to x-ray to check the placement of the catheter. It was too low, so I was sent back down to infusion to have them adjust the line. Then back up to x-ray. Then back down to infusion for another adjustment (the line was still too low). All without D, and without knowing how he was doing or anything. Finally I said, "Can you please call the ER and see how my husband is doing??" One of the nurses called down and then told me "He's not in the ER." So of course I start freaking out more wondering where in the heck he is! Thankfully, he showed up in infusion just a few minutes later. His eye was a little black - turns out he had really really low blood sugar and that's why he had passed out - but I was so grateful to see him! He took me back up to x-ray for the last time and everything was good, thank God. Here's the kicker - once everything was good with the PICC line, I pretty much begged the nurses at Sacramento's infusion center to give me fluids - I had lost so much blood and been throwing up so much and was already dehydrated when we came in. They refused. Awesome.
We go home, I'm sobbing, D is wiped, and we both look at each other like you have got to be kidding me. D pulled it together and made me go to Labor and Delivery to get fluids. Thank goodness he did - talk about being desperately dehydrated!! My nurses and Dr. at L&D were life savers - they gave me tons of fluids and kindness. My Dr. also totally went to bat for me and, with one of the nurses in the Women's Triage Center, put together a serious game plan for me for the rest of my pregnancy. She was the best!
Now, I get 2 liters of D-5 with lactate ringer and 4g of IV Zofran every Tuesday and Friday in Roseville at the Infusion Center. Additionally, my PICC line has been used for blood tests to check my hormone and sugar levels. I also am going to be doing the 3-hour glucose test with my PICC line at the infusion center. The PICC is not at all uncomfortable and I haven't felt like I have been limited or anything by it. The first couple of nights after it was placed, my right shoulder was a little sore. I also felt a fluttering type sensation in my heart when I would lay down, which was alarming at first, but after some research I found out that the sensation was normal and a couple of days later the sensation went away. I have been able to sleep like normal (even on my right side - where the PICC is placed) and use my arm like normal (not that I was really doing anything with it to begin with...).
Being able to stay hydrated (for the majority of the time - the day or so before hydration, I'm usually getting pretty dehydrated) has made a huge difference in my pregnancy! I've gained 4 pounds in the last 4 weeks, which is incredible because I was down 10+ pounds pre-PICC line and had been unable to gain weight for months. It has also made a difference for my baby boy - he has had plenty of fluids and has been so much more active as a result!
I will say this about my PICC line - the most difficult part of having the PICC line in is the dressing. I've had allergies my whole life and a sensitivity to certain adhesives. The dressing placed over the PICC line has been quite itchy and uncomfortable. My nurses have been great at mixing up the the placement of the dressings to try and give different parts of my skin time to heal. However, this last week I broke out in serious hives under and all around the dressing placement. This has been the most challenging part. I can't itch the dressing, I can't put any type of topical treatment on the hives because it could affect the site, etc. I keep ice strapped to my arm almost 24-7 to try and alleviate the itching.
I will be grateful to have the PICC removed and to not spend at least 2 days a week in the hospital getting fluids, but I am so so grateful for my PICC line! I would do it again in a heartbeat. I'd pray for a different placement experience, but I don't regret the decision to have a PICC placed for the last 3 months of my pregnancy. It was made the HG much more bearable. I still have bad days, I still throw up a ton and eat only potatoes, but D-5 with lactate ringer and IV Zofran have been life, and vein, savers!
I think that I'm my Dr.'s first patient with persistent (entire pregnancy) HG. At least, his first patient with HG who doesn't respond to any medication or combo of medications. The last few appointments he has seemed completely baffled at what to do with me. Fortunately, I have friends with HG who have shared their experiences and that has helped me with my Dr. and getting the treatment that I've needed. Don't get me wrong - I think my Dr. is fantastic. But my experience is definitely out of the "norm."
Anyway, I had to be pretty persistent to get my PICC line in. It was first brought up when I was around 4 months pregnant. The decision to not put one in at 4 months was based on the risks of infection with having a PICC in for 5 months and not knowing if my HG would go away (for a lot of women with HG, the symptoms go away around 22-25 weeks). So I continued to blow through veins to get IV hydration in the ER, triage, and Labor and Delivery. Around 5 months, my Dr. told me I had to cut back on IV hydration because I was blowing out my veins. So, in order to get hydration and justify having nurses poke me 6-7 times (because I have think skin and crappy veins), I had to be desperately dehydrated. Finally, at 6 months and trying a billion combinations of drugs and being chronically dehydrated and miserable for a month, I got my PICC line placed.
I had to travel down to Sacramento Kaiser to get my PICC placed. D drove me (because I am a hot mess and have been too sick to drive) and stayed with me while they placed the line. Unfortunately, it did not go as easily as the nurse had promised me it would. The line has to be placed in a sterile environment, so D and the nurse were both masked. I just looked away because I didn't want to watch! The nurse did an ultrasound on my right upper, inner arm to find the best vein to place the line in. She had no problem finding the vein and initially opening it. However, once the opened the vein, she couldn't advance the PICC line catheter (the catheter is placed up the arm, across the shoulder and then down to right above the heart). I started throwing up while she was trying to place the line. The nurse kept telling me to relax so she could advance the line, but try as I might, I couldn't stop throwing up and relax. Out of no where, I hear a crash and looked over to see D out cold on the floor with his head bleeding. When I looked over, I also saw my arm gushing with blood, my nurses hands soaked in blood, and everything around my arm soaked in blood. Still throwing up, and now freaking out, I didn't know what to do. They took D up to the ER to treat the cut above his eye (he hit a tray leg thing on his way down to the floor) and I started worrying like a crazy person about my husband - I wanted to go with him! I got so close to saying "Forget the line! I want to go with my husband!" Meanwhile, the nurse is still yelling at me to relax my arm. Crying, throwing up, freaking out; I don't know how, but finally the nurse was able to advance the line. They sent me up to x-ray to check the placement of the catheter. It was too low, so I was sent back down to infusion to have them adjust the line. Then back up to x-ray. Then back down to infusion for another adjustment (the line was still too low). All without D, and without knowing how he was doing or anything. Finally I said, "Can you please call the ER and see how my husband is doing??" One of the nurses called down and then told me "He's not in the ER." So of course I start freaking out more wondering where in the heck he is! Thankfully, he showed up in infusion just a few minutes later. His eye was a little black - turns out he had really really low blood sugar and that's why he had passed out - but I was so grateful to see him! He took me back up to x-ray for the last time and everything was good, thank God. Here's the kicker - once everything was good with the PICC line, I pretty much begged the nurses at Sacramento's infusion center to give me fluids - I had lost so much blood and been throwing up so much and was already dehydrated when we came in. They refused. Awesome.
We go home, I'm sobbing, D is wiped, and we both look at each other like you have got to be kidding me. D pulled it together and made me go to Labor and Delivery to get fluids. Thank goodness he did - talk about being desperately dehydrated!! My nurses and Dr. at L&D were life savers - they gave me tons of fluids and kindness. My Dr. also totally went to bat for me and, with one of the nurses in the Women's Triage Center, put together a serious game plan for me for the rest of my pregnancy. She was the best!
Now, I get 2 liters of D-5 with lactate ringer and 4g of IV Zofran every Tuesday and Friday in Roseville at the Infusion Center. Additionally, my PICC line has been used for blood tests to check my hormone and sugar levels. I also am going to be doing the 3-hour glucose test with my PICC line at the infusion center. The PICC is not at all uncomfortable and I haven't felt like I have been limited or anything by it. The first couple of nights after it was placed, my right shoulder was a little sore. I also felt a fluttering type sensation in my heart when I would lay down, which was alarming at first, but after some research I found out that the sensation was normal and a couple of days later the sensation went away. I have been able to sleep like normal (even on my right side - where the PICC is placed) and use my arm like normal (not that I was really doing anything with it to begin with...).
Being able to stay hydrated (for the majority of the time - the day or so before hydration, I'm usually getting pretty dehydrated) has made a huge difference in my pregnancy! I've gained 4 pounds in the last 4 weeks, which is incredible because I was down 10+ pounds pre-PICC line and had been unable to gain weight for months. It has also made a difference for my baby boy - he has had plenty of fluids and has been so much more active as a result!
I will say this about my PICC line - the most difficult part of having the PICC line in is the dressing. I've had allergies my whole life and a sensitivity to certain adhesives. The dressing placed over the PICC line has been quite itchy and uncomfortable. My nurses have been great at mixing up the the placement of the dressings to try and give different parts of my skin time to heal. However, this last week I broke out in serious hives under and all around the dressing placement. This has been the most challenging part. I can't itch the dressing, I can't put any type of topical treatment on the hives because it could affect the site, etc. I keep ice strapped to my arm almost 24-7 to try and alleviate the itching.
I will be grateful to have the PICC removed and to not spend at least 2 days a week in the hospital getting fluids, but I am so so grateful for my PICC line! I would do it again in a heartbeat. I'd pray for a different placement experience, but I don't regret the decision to have a PICC placed for the last 3 months of my pregnancy. It was made the HG much more bearable. I still have bad days, I still throw up a ton and eat only potatoes, but D-5 with lactate ringer and IV Zofran have been life, and vein, savers!
Note to self:
ReplyDeleteNever complain about pregnancy again. When thinking about complaining, just think about Landon's experiences.