Doing IVs at home at first sounded nuts. I mean, come on! Me, my parents, messing with strong antibiotics, sterile needles and dressings, and all that goes with IVs, at home? What were they thinking ? They were thinking it would allow me to go to school, save the insurance company money, and teach us some fun new things! (OK, I don't know if the last one was in their minds, but we suuuuure did.)
It was the summer after 8th grade when I had my first home IV course. Children's has a great Home Care service, so we used them. Nurses can come out to the house, someone's on call 24 hours a day if there's a problem, etc. And you get all your supplies and stuff from them. I was only in the hospital for two days or so, so we could make sure I was on the right drug cocktail to treat the current infection. And then, we were home...
It was a few days before Fourth of July, and I remember that because Anne and I were running through her yard with sparklers (which I tried to light at the wrong end and burned my fingers in the process....OK not very smart). We got through, amazingly, about 8 days with the first IV, and then it infiltrated during the Wimbledon Men's Semis. Niiice. If you've never had an IV infilrate (med speak for "decide not to work anymore"), it's not a lot of fun. Lots of swellin at the site as the liquid that's supposed to be going into your vein goes into the surrounding tissue. And to go along with that, pain, of course. So we called homecare and had nurses come out to attempt to get a new line started at our kitchen table. That took, um, a few tries. (I have small veins, what do you want?) And I don't care who you are, there are only so many times you can be poked with needled before you start to cry, especially when you're a fourteen year-old girl. Now I didn't thrash around and act like a little kid or whatever--I was a quiet crier--but dude, that hurt. And when you're small, like I am, those needles get awfully close to bone, especially around your wrist. Eventually a doctor friend of my dad's from college suggested EMLA cream, which is a topic anethestic, so we would use that, but the problem is it can shrink the veins. But at least you've found one, you know where you're going, and I can relax because it doesn't hurt as much (although it never really seemed to work totally). We had a lot of fun with peripherals over the years, including one that was in the back of my hand that decided to infiltrate overnight, making my hand swell up like a surgical glove filled with water. We were instructed to pull it and put a hot wash cloth on it to get the swelling down. That was fun, let me tell you. My left hand kept getting bigger and bigger, the skin stretched taut and tight. By morning, though, it was somewhat normal-looking.
Through the years we got really good at home IVs--I think we did a course about every 18 months before I went to college. With the invention of PICC lines, deep vein IVs that go into the veins of your upper arms, we could doa three-week IV course without issues. That is, until the night my PICC line bled out before my Algebra II final my Junior year. I woke up in the middle of the night to find my t-shirt, and the pillow case under my arm, wet. So of course, I freaked out when I realized it was blood. That was a very funny thing, in retrospect. It was like the Three Stooges. My parents called homecare (again) and they told us to change the PICC dressing. Now the thing about PICCs is that keeping them sterile is really, really important, since the end of the PICC tubing is right near your heart (it's a deep vein IV, after all). So you really have to keep the sucker clean, and there are stitches on the surface, holding everything in place (two little ones). So I was a little freaked to have my parents changing the dressing at 2 a.m. in my bedroom. After some parental swearing (which the nurse on the phone heard, naturally) at the line and each other, we managed to get that done, but I was totally frazzled. Fortunately my Algebra II teacher let me take the exam later and I managed to do OK. But go figure--what other junior tries to postpone an exam because her deep vein IV bled out during the night?? I guess it happens all the time. But I can still see the wrappers and sterile (OK, not so much) gauze sheets on my coverlet, the bloody Limited t-shirt....my dad looking at the dreessing like it was something from his beloved Star Trek ....I think part of the problem may have been that when you're on deep vein IVs, or whatever, you don't want the blood to clot and stop up the line, so the doctors prescribe baby aspirin as a blood thinner. I guess it worked too well!
After this incident, I was never totally comfortable with PICCs. But that didn't really matter, because eventually there weren't any veins left for them, and if you check out the insides of both my arms, you'd believe it. They are covered with pale scars from where myriad and multiple PICCs resided over the years.
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