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.

Problems w/ PICC

Just a little update for those that are interested in my life and PICC line.

So July 17, 2008 I received the PICC Line. The first couple of weeks were so extremely painful that I thought "Just pull the damn thing out. I'd rather deal with weekly tries of IV's that end unsucessfully."

Rob had to help me slowly put on my shirt. Rob had to bathe me. Rob had to brush my hair. Rob had to get me comfortable in the bed with pillows so I could rest though I never would fall asleep. I had to use my left hand for eating b/c I couldn't move my right hand up to my mouth. I would miss my mouth completely because my eye hand coordination was so off. It was hard to drive b/c I couldn't use my right hand.

Finally there was a break through. I pushed through the pain to put on my own clothes. I pushed through the pain to brush my own hair awkwardly and to even wash my own hair leaned over in the bathtub. I was more able to do things with my left hand and things started getting better. THEN ... the blisters happened. I went in for a dressing change ... which is painful in itself and upon removing the dressing, they saw the blisters. Eventually those blisters started leaking and I was beginning to think that the PICC would get pulled because they were not looking good at all. I had it changed 3 times in 7 days.

What is a dressing change you ask? Sounds simle enough, but it's a somewhat complicated process. I go into my nurse's office. She gathers supplies that are all sterile. She has to wear a mask to protect my body from her germs. She has to wear sterile gloves. She pulls off the old dressing and removes the gauze from my skin. She then begins to clean the area with an alcohol swab, betadine and other skin prep. This process hurts. Sometime during this she removes what is called the "stat lock" which keeps the PICC line from coming out during the week and puts on a new stat lock. She then replaces with new sterile gauze and new clear dressing. Then she changes the tip with a brand new tip. Voila. It's done.

Well a week or two ago when we discovered the blisters, we figured that I must be allergic to some part of the dressing change. So we left off some parts of the cleaning ..a nd moved the stat lock a bit to give the blisters a break. Then on the 3rd change of the week, we changed the dressing so where the gauze was partially left exposed so air could get under there and dry out the blisters. The blisters have stopped oozing so we'll see what they look like on wednesday when I go in for a new dressing change.

The pain you ask? It is much improved. However if I lift something too heavy or lift too much .. then I feel it later and a heating pad is required to lessen the pain. Last week was a tough week b/c I thought I was able to do more and I realized very quickly that lifting a baby was NOT a good idea. Tylenol and a heating pad were my friends that night along with benedryl to stop the itching. I felt one night that I was just gonna scratch my arm off. Since July 16th, I have gotten a total of four nights of decent sleep.

Those of you that know me in real life, know that this is very difficult for me as I am used to sleeping 9 or 10 hours a night. So this lack of sleep has left me severely depressed. I think the last two weeks I have cried every day. It is very difficult because I do not want to go back to the days where I cried every day. That was a tough time in my life and I don't wanna go back there. There is a difference between now and then. Now I am getting treatment. I know I will get better. I know I am mentally strong. Then, I had no diagnosis. I had no treatment plan and I was extremely weak.

The most difficult part of all of this is accepting my limitations and having others accept that I can not do the things that I used to do. The other part is that I want to be able to do things with my best friends, but I am torn. Do I want them to see me like this? Do they want to see me like this? Do I care if they see a tube hanging out of my arm? Do they even care (that they have to see it)? Or do they just want to see me no matter how I am feeling or how many meds they have to watch me take or how many tears I shed while they are there?

My blisters had completely healed and my arm was looking great. I went in for one of my treatments and a dressing change and we cleaned arm thoroughly. That night it began to give me problems. It itched, it hurt, and it was oozing. That night, I had Rob get that dressing off of my arm to replace it with a new dressing because I had ooze completely through what was done that morning. By that morning, it was nasty again. I rushed to the doctors and had the nurse look at it again. She changed the dressing again. That afternoon I had an appointment with another lady there and it was oozed out so we changed the dressing one more time. This was time number 4. I was up there every day that week getting my dressing changed and my husband even changed it a couple times. Leading to 9 dressing changes in a very short period of time.

Stay Tuned: the hospital visit.

P.S. My blisters look better now. There was no oozing this last week and the blisters had dried up. :)