Friday January 16 I went to Kaiser Fresno for my first PICC line dressing change and blood draw. My mother-in-law Brenda drove the boys and me up there. I made sure to wear a mask and use lots of hand sanitizer to avoid contracting any infections.
My PICC line has two dangling connectors called lumens. The nurse flushed the capped red lumen that was supposed to be for blood and drew back the plunger on the saline syringe, but blood just wouldn't come. So she decided to switch my medication to the red lumen and try to draw blood from the purple one. She was able to pull blood back from the purple lumen. Then before drawing the blood for the labs, she decided to flush the line with saline. That gave me a surge of the dopamine which made me feel quite lightheaded and woozy. My blood pressure dropped down into the 80s over 40s.
After the blood draw, the nurse did the dressing change and repositioned my PICC line. Originally it had been positioned at a slight angle pointing to the outside of my elbow, and she made it more or less parallel with my arm and perpendicular to my elbow crease. As the week went on, I discovered this positioning yielded several problems. One, the lumens would form a scissor like shape in my elbow crease and pinch me repeatedly. Two, whenever I bent my arm, the portion of the PICC line between the lower anchor and insertion site would kink. Sometimes it would stay kinked long enough for me to get an alarm, but because I have a very slow drip, more often the kink would not be there long enough to trigger an alarm but would be there long enough to cause a buildup of dopamine in the line and the sudden surge of medication would cause a woozy feeling much like I had experienced when the nurse flushed the line on Friday.
As the week went on I felt steadily worse and finally just before 5:00 p.m. on Thursday called the heart failure clinic to check in. I feared that perhaps they would say it was time to admit me to Cedars Sinai to wait there as a Status 1A, but after discussing the situation, we deduced that the source of my woe was those kinked line medication surges combined with the fact that I had inadvertently reduced my sodium intake below what is optimal for me, which led to a too low circulating blood volume which made me more sensitive to the surges and also triggered palpitations which also can cause the same lightheaded symptoms. In the course of the conversation I told them about my reaction to the nurse flushing the medication line on Friday and they said to make sure no one ever did that again, as it could dangerously strain my heart!
Thursday at dinner I made sure to get enough sodium, and almost immediately I felt much better. The kinked line alarms and medication surges continued to occur, but I didn't feel them as intensely.
Friday it was back to the Kaiser Fresno Infusion Clinic for another dressing change and blood draw. This time I had a different nurse who was very meticulous and thorough. She positioned the dressing parallel to my elbow crease and I have had no more issues with the line kinking or getting medication surges.
So Friday, Saturday and Sunday I felt better than I had at any time since coming home from the hospital! With a clear head and renewed energy I was able to sort through the mail and other paperwork that had piled up on the table near the back door.
Today I have a bit of an upset stomach however. I think the blue cheese on the Wendy's apple pecan salad I had for lunch on Friday and the two bites of Adam's frozen yogurt swirl from Costco that I had on Sunday afternoon may be catching up with me. I'm pretty severely lactose intolerant but with daily probiotics can sometimes get away with small amounts of dairy. As reactions go this one doesn't seem too bad at least.
I have been wearing a mask to church on Sundays and when I go out in public in general. Not only does the mask help keep germs out, but a recent study has shown that keeping your nose warm can help your body fight off upper respiratory infections. Wearing a mask is a bit aggravating, but worth it if it will help me stay healthy and ready to respond to the transplant call which could come any time.
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