Sunday, September 21, 2008

Grey's: PICC Line Style

Summary: Jennifer gets massive rash all over arm and winds up at the hospital for an evaluation. McJeff reprives his role as Funny PICC line guy along with McHotty for a technician and McMuscles as doctor. :)

Episode: On Thursday, Jennifer arrives very late at her doctor's office hoping that someone is there to assist with a new dressing on the PICC line. Fortunately though it was late, Nurse J was there. She spent 3 hours on the phone with Rex Hospital, Dr. J, Dr. W. and Nurse M. She also wrote notes out for the hospital staff, and changed the oozy drippy PICC line dressing. On Friday, Jennifer arrives at the Rex Medical Building at 3:01 to begin the waiting for registration and for seeing Doctor McMuscles, Techie McHotty, and PICC line guru McJeff.

After moving from the registration waiting room and arriving at the radiology waiting room, Jennifer arrives at the vascular radiology waiting room. Upon waiting in the third and final room, she helps a man when he asks where they are. "Uh the hospital." That was a lot of help she was sure, but apparently he needed more answers. "Uh the waiting room?" Apparently that wasn't good enough either. :) So Jennifer provided a more detailed way to get there. "Tell them to go the radiology main desk or radiology registration and a volunteer will bring them to the radiology waiting room." Jennifer pondered whether it appeared she was the leading expert in hospital waits since they chose to ask her instead of the 10 other people in the cramped waiting room.

Finally McGuyshethinksisthetech appears in the door way. "Mrs. A?" McGuyshethinksisthetech called. Jennifer grabbed her belongings which included 4 pages of notes, a purse, saran wrap and quickly scrambled to the doorway hoping McGuyshethinksisthetech didn't notice her drooling when she was dozing off. "Mrs. A I just wanted to let you know that we have another patient in x-ray right now. It will be a few more minutes. We just didn't want you to think we had forgotten about you." She felt dejected that she had to go back to the uncomfortable waiting room chair watching the other 12 folks in the waiting rooms either dozing in the chairs or on their cell phones. Finally after 10 more minutes, Jennifer gets called to the doorway by technie McHotty.

"How are you doing?" McHotty said.
"I'm here aren't I? I can't be doing so hot." Jennifer said.
McHotty laughed and said "let's see if we can see what's causing the problems."
Jennifer notices a huge sign that says "proper attire required beyond this door" and says "HEY I'm not wearing proper attire."
McHotty says "that's for the staff" and he laughs.
Jennifer thinks to herself that she at least got a humorous tech.

First McHotty looked at Jennifer's arm and then removed the dressing so he could see the insertion point. He grabbed Doctor McMuscles to come in to look. After looking at it for a few minutes, he said that he did not think the actual catheter was compromised. He took into consideration that Jennifer was still being able to infuse a treatment on the 3rd with no problems and still got good blood return with her heparin syringe on the 4th late at night. McMuscles believes that Jennifer is having a serious allergic reaction to something that Nurse M & J are using, but of course doesn't know what. McMuscles determined that Nurse M and Jennifer should figure out on their own how to clean it the best way without leaving an itchy, blistery oozy mess in future dressing changes.

Shortly afterwards, PICC line guru McJeff waltzed in to help change the dressing with McHotty and when he saw Jennifer uttered the phrase "OOoo not you again." He winked at her and McHotty said 'you know her?' and McJeff said "of course, she's my favorite nervous, but oh so hilarious patient." As they were changing the dressing, they all were cracking up. At one point, he was taking off the stat lock (which had deteriorated from all the yelllow ooze) and he said "what's this yellow stuff?" Jennifer said "my bodily fluids, shouldn't you be wearing gloves or something?" and he said "Oooo now you tell me" and winked at her.

McJeff and McHotty began to change the bandage quickly as Jennifer says, "How many techs does it take to change a dressing?" She would have continued with the rederick of "1 to hold the PICC line, 1 to cut the bandage, 1 to push it back in a bit, 1 to write the codes for insurance, 1 to find the doctor, 1 to apply the new dressing, 1 to calm the patient, 1 to ....," but they were finding all the necessary supplies for this delicate "operation."

The new dressing for Jennifer consisted of a sterile 2x2 gauze and a hypoallergenic dressing. Upon beginning the dressing change, McJeff winked and handed her two huge rolls of the stuff and said "this is between you, me, and that guy over there" while pointing to McHotty. He said that the hypoallergenic stuff would help it breathe a lot better and have a little more protection than gauze and paper tape. He laughed and said "Don't do that again," all while pointing at the dressing that was removed that was covered in yellow ooze. Jennifer laughed and told him that Nurse J had been instructed to cover the PICC line in that manor over the phone by a doctor at the hospital.

To try to figure out the underlying problem, McJeff (and no JEFF .. this isn't you .. the guy's real name is JEFF. ) asked how it was being cleaned. He showed Jennifer a variety of supplies and finally she pointed out out two she recognized. One looked like a condom on a stick and the other looked like a vial of blood. McJeff suggested it was the blood vial looking one that caused all the blisters and begin cleaning the site with the condom looking one. It immediately caused burning and a heat that Jennifer has never felt before during a dressing change.

She calmly stated "ooo that burns quite a bit" and speculates that it is because the skin is so sensitive with the oozing blisters of fun that is causing the burning sensation. McJeff said "I've heard that one before" and winked. (Jennifer is beginning to think that maybe she should suggest to McJeff that he has Lyme Disease. After all, twitching is a symptom). He stopped cleaning and mentioned that he didn't like to torture his favorite patients though it might be a little fun. He recommended that Nurse M might not want to use the condom one from now on.

As soon as he applied the new dressing, Jennifer's arm felt warm and itchy. She was thinking at the time that the dressing either ain't gonnna work or that the condom cleanser would cause another reaction. McJeff helped Jennifer put on her Lime Green Jacket and she said "You always help me put on my clothes. At least this time, you didn't have to put on my shirt."

McJeff said "I always help a lady put on her clothes after I've finished my business with her." They laughed hysterically and Jennifer thought to herself that this could be a sexual harrassment suit just waiting to happen with all the winking and statements that McJeff is using. :)

Jennifer arrived home in the pouring rain and immediately took 50mg of benedryl for the itching and to help dry out the blisters that were still there in all their glory.

Jennifer's arm is itching worse Friday than it did Thursday. The bumps outside the dressing are smaller, but there is more of them. Sooooo in order to prove or disprove that this new type of dressing is or is not causing the problem; Jennifer is going to conduct an experiment on herself. She is going to place a piece on her belly or my leg or my other arm or something. She already did this with the tegaderm type of dressing that she has by Nexcare and no rash showed up on her belly after 24 hours. Jennifer's McHusband bedadined the spot and also alcoholed the spot before applying the dressing. She also placed paper tape on her belly as well. She discovered no rash or redness appeared at either site.

Stay tuned as Jennifer goes through the weekend with itchy skin and dreams of McHotty, McMuscle and McJeff and hopefully has no more leakage of the blisters.


Vanessa said...

Dear Jennifer,
I just recently came across your blog while researching on what to do with my very own PICC line. I too suffer from chronic lyme and just recently got rid of bartonella. With the pain and stress of being a high school senior with chronic lyme disease, your blog really helped me find support and helped guide me through my recovery. Thank you and keep writing! ^-^

Jennifer said...

Oh Vanessa, I wish I had seen this comment before. If for some reason you are still reading, please make more comments!!!

I hope you are still reading and enjoying the blog. I hope you are feeling much better by now.