Thursday, December 15, 2011

The leaky vein gets the i.v.

Morning has brooo-ken, like the first moooooorning. Alarm bells are riiiiinging soon after dawn. IV is beeeeping, nurses aren't coo-oooming. Roommate complain-ing, over and o'er.

I love retrofitting songs to my liking. Maybe a bit too much. :) Anyhoo....

My arms reject i.vs. I've touched on this fact before, but it never ceases to amaze me when the nursing staff seems surprised that I've been warning them that my veins are going bad and then they do. It seems like a novel concept, like I'm psychic and can predict it. Either that, or since I'm the current occupant of my body, I know when things feel off kilter sooner than their technology does.

Morning of day four started out like every other morning. Obnoxious blood draw at unholy hours, residents rounding before 7am, asking you the same questions the residents had asked day before (and prompting me to bite my tongue from replying 'read my chart for the answers and let me sleep, will ya?'), and the arrival of the ever present clear liquid assortment tray. I don't know what I can stomach less, though, the thought of more tepid apple juice having to be sucked down to prove that i could hold down liquids or my roommate chewing loudly, belly aching that her coffee wasn't hot enough, her french toast wasn't perfect enough, and her eggs tasted a bit overcooked. Hello, I'm not allowed to eat. Could you keep your complaining about your legitimately solid food to yourself?

Shortly thereafter, the nutritionist showed up and asked what and how much I had eaten for breakfast. I pointed to the mug of beef broth and said, "What do you think?" "Well, haven't they sent you any solid food?" "Nope, I haven't been approved for anything yet by the doctors." "Well, how do they expect you to go home if they don't know if you can keep down/process through solid foods?" "Beats me."

She leaves. Day four begins like normal, with Mom coming over from the hotel attached to the hospital and starting the day. I had a whole new staff during this day, with not one nurse I'd had before on the previous 3 days. My nurse came in, took one look at my arm and said, "Does it hurt? It's quite swollen and hot, and it looks like your i.v. is going bad." Had it not been her first day with me, I would have blinked and said DUH, but considering this was her first look at my arm, I acknowledged that my arm was indeed hurting and swollen to about double the size it should have been.  Jasmine (my nurse) decided to run the rest of the bag that I had on the line, and then change it afterward.  After that, she was going to take it out and put in a new iv, even knowing how difficult my veins are.  The swelling just wasn't going to get any better and we both knew it.

Because my veins tend to be....fragile...Jasmine went and got a hot pack and wrapped my arm in a towel to get the blood flowing. I had ivs in both arms, so though we were taking one out of the arm, it had to go back into the same one again. The amount of bruises and bad spots already were making it difficult, and they couldn't put it above the one they had just taken out, or it would have continued to pump fluid down in the already blown section of the vein.  So Jasmine manages to find a small but functional vein, takes out the old iv and runs a new one with a bit of difficulty, but at least it will give my already overtaxed vein a break.  She notices on my other arm that the iv that was there was also swollen and hot, and asks if I want to replace that one as well.  I told her no, since that was strictly for the pain bolus that I wasn't using, and that I was going to try to keep that one intact for as long as possible to prevent yet another iv being run.  Thankfully she understood, and just let me keep it for the time being. 

The day progressed without incident.  The roommate was yelling at the nurses and sleeping with her tv on as usual.  I went for two laps around the floor with my trusty walker, UGGS for stability, and much to the envy of the floor, did NOT flash the general public.  We had rigged up a system a few years back with my original surgery (thanks to Carrie) with my black watch plaid boxers over the catheter and up on my legs covering my bum so that I didn't have to try to balance with a walker, a gown open in the back and flashing, and another gown draped on my shoulders to attempt to keep me modest. It was a beautiful system that served me well as I trudged along the corridors and made fun of the decor.  I did notice when I stood up to do my walk that my bladder felt full and my catheter collection bag seemed empty, but pushed the thought aside for the time being, just proud of myself for progressing as quickly as I was.

Upon getting back to bed (ooooh, fresh sheets, and they don't smell and aren't covered in my hair [I shed like a dog in springtime after surgery]) I was visited by a resident, who informed me that there was no reason I had to still be on clear liquids, and that the next morning I'd be delivered a food tray with real ::gasp:: food on it! As happy as I was to hear it, I had to refrain from informing her that going from clear liquids to a 'normal' diet isn't the best thing for my intestines, and figured that I'd just order things that were a bit easier on my system. I laid back down and was in pain, something I hadn't really felt in about 24 hours. It wasn't just pain, though, but pressure too, and no amount of rearranging my body seemed to be making it better. DING! My bladder was killing me. Again, I had reached the point in the hospital stay where my catheter had stopped emptying my bladder, and it was all backed up inside of me. Considering all that had been cut, stretched, pulled, unbent, and rearranged inside of me, a full bladder putting pressure on it all surely didn't feel like a hug from the Snuggle bear. Rather, it felt like a little gnome was trying to poke his way out of my bladder with a dull butter knife.

I paged and the afternoon tech and nurse came in. I explained my pain, and that I've dealt with it before. They seemed a bit incredulous, until they started manually manipulating the tube and surprise! it filled the whole catheter collection bag right up. The one guy seemed fairly amazed that 1, my bladder could hold that much at one time and 2, the catheter really didn't seem to be working. He graciously told me that if it happened again, to just page him and let him know, and he'd be back down to empty my bladder again. The rest of the day finished without incident, mom went back to the hotel, and I got ready for what I hoped would be a good night's sleep.

BEEP. BEEP. BEEP. Page #1 to nurses station that my i.v. was beeping and I needed a fluid change. This was around 2am, and the response time was slow. Page #2 about 10 minutes later, and I was assured that my night nurse (who I hadn't yet met) would be there to fix it in a jiffy. BEEP. BEEP. BEEP. About 15 minutes after it began, my lovely roommate pages the nurses station screaming about how my i.v. won't let her sleep. After me having to deal with her tv at all hours of the night and morning, after all of her complaining about everything, she really had the nerve to call the nurses station and complain about me? In rushes my nurse, who speaks very little English, doesn't turn on the lights and just starts pressing random buttons.

Oh. My. Good. Gracious. Know the bad i.v. that was still in my left arm? The one that we were nursing? The one that was only for the pain bolus and nothing else? Well, the nurse blew my vein. Instead of stopping the beeping on my other i.v. like I was trying to tell him, he just kept repeating "you in pain?" and hit a big bolus of the pain meds. Have you ever bruised yourself? Like a good whack on the forehead or arm, and you instantly feel the pressure as the bruise expands? Add in severe pain into an already bruised vein and I literally felt it blow in my arm. I started yelling, he panicked, and I insisted on him getting someone else after he told me that he could run a new i.v.  There was no way, considering he couldn't even understand what he had done wrong, that I was going to trust him to to put a new i.v. in my arm.  He sent out an urgent page for an i.v. tech, and in the meantime stopped the rest of the bag from going in.

Know what the kicker was in all of this?  Roomie was complaining, very loudly, that the lights were on over my bed and they were disturbing her sleep.  UHHH.....REALLY?!?  If she hadn't have paged for the urgent attention of my nurse, he wouldn't have rushed in and pressed a bunch of wrong buttons and blown my vein.  And if he hadn't blown my vein then there wouldn't be an i.v. tech in there at whatever hour of the morning with the lights on running a new i.v.  So thanks, roomie.  And by the way, you have NO room to complain.  None.  So suck up the lights being on for a half hour since you're the one that caused it.

Rant over.  Stepping off of my soap box.  But you get the point.

Once the new i.v. was run, my nurse put his tail between his legs and slunk away, sending in assistants the rest of the night when my catheter needed to be drained, too afraid of me yelling at him again.  I can't say I was too happy to have the new i.v. in, as I hadn't been using the bolus of pain meds anyway, but considering it was the middle of the night they couldn't get orders to discontinue the line.  Eventually, catheter re-drained and new i.v. run, I passed out for a mere few hours until the residents came in to do their rounding.    

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