Blood Gusher for one and PICC line to the rescue for the other

Now that's a weird post title, no doubt causing the appearance of goose pimples for the squeamish and the pricking the of ears for the inquisitive and the well wishers.

The title concerns myself on the one hand and my dear wife, Mrs Bluelights, on the other. I may not have time to deal with my harrowing experience this time on account of my covering my wife's plight, but rest assured I shall deal with it next time, so watch this space.

As many know Mrs Bluelights has the misfortune to have secondary breast cancer.  I outlined the history of this on my previous post, see HERE.  She has been undergoing chemotherapy and has completed 5 from a course of 6.  After the first four she bounced back very quickly after the unpleasant side effects of the chemo and remarkably she was able to continue working at a local residential care home for three nights a week, with the exception of the actual weeks she underwent chemo.  Everyone, including the Oncology Consultants, were amazed at her ability and strength to do this, but let me tell you this gal is a real tough cookie and so strong and resilient, and it is really her way of dealing with the problem and to carry on as long as she can as normally as possible.

However, after chemo 5 things were very different this time - she never bounced back; in fact she got worse.  Her temperature kept spiking  at over 103 degrees F and she had two falls.  It was really worrying and we knew she must have an infection somewhere.  We rang for medical assistance and were advised to take her in to Accident and Emergency at our local, large hospital.  They confirmed she was in need of medical attention and she was transferred to Medical Assessment where she was diagnosed as having some form of infection she was unable to deal with herself because the chemo had severely compromised her immune system.  Her white blood cell count was very low, as was her red blood cells and therefore she was prescribed intravenous antibiotics plus a transfusion of 2 units of blood.  She was transferred to a ward where she was barrier nursed for a week.  I visited her every day, putting on a sexy yellow overall with complimentary bright blue rubber gloves.  At first was quite heartened by her gradual improvement.

The big problem was that because she has lymphoedema in one arm she could not have a cannula fitted there . . . . . and her other arm has had so many cannulas fitted, plus blood samples taken, plus chemotherapy injected, plus dyes injected for CT scans and a host of other things, that it was no longer possible to find another viein suitable for intravenous or IV treatment with liquid antibiotics. Honestly whenever a needle gets within a foot of her her veins run for cover and vanish, unlike me where they are very prominent.  The hospital medics did manage to fit one cannula as soon as she was admitted and this sufficed for the two transfusions and for a couple of IV treatments.  However the vein broke down and the cannula was ineffective after a few IV treatments, so her treatment stopped dead for 36 hours. Several senior nurses, a team of three doctors and an anesthetist all tried in vain to access a vein (forgive the pun) but all they managed to achieve was to cause a great deal of pain and to damage her veins even more - poor girl.  I wondered why no-one had progressed another avenue of fitting a PICC line which could be used for all purposes, except for CT scans.  Instead they eventually administered antibiotics in solid and oral form but still her temperature kept spiking and they were highly confused as to what exactly was causing the problem. In general her temperature appeared to be much lower by day but always spiked in the evening.  This situation remained until the end of the week when reluctantly they agreed to discharge her on the proviso that we would get her back to hospital if things got worse.

Well things did get worse - her temperature crept back to 102 F but early next morning (Saturday) we received a phone call from the hospital saying they had identified the culprit.  It was a nasty and very persistent UTI  (Urinary Tract Infection) which was resistant to all known antibiotics other than just one IV variety, and the solid antibiotics she had been taking were totally ineffective against it.  Fortunately she could return as a day patient for new IV treatment to Ambulatory Care. We had been very disappointed that her temperature was again high and it appeared we were back to square one so it came as a relief that for the first time light may be at the end of the tunnel.  We arrived and mercifully, after three goes, a lovely Nurse Practitioner managed to get a cannula inserted and began the treatment, returning the next day for the second. The bug is so vehement that it required 14 courses of antibiotics to knock it out and we all knew the cannula would not last that long, so it was decided to fit a PICC line after all and this was done today.

For those interested, a PICC line is a peripherally inserted central catheter and is fitted under a local anesthetic under ultrasound to enable access to deeper veins, entering near the inside of the elbow joint.  A PICC is inserted in a peripheral vein, such as the cephalic vein, basilic vein, or brachial vein and then advanced through increasingly larger veins, toward the heart until the tip rests in the distal superior vena cava orcavoatrial junction.  A cannula is attached to the lower end and easy access to it is available for all medical requirements, including blood for testing and intravenous injections.  The line can stay there for up to a year if required.  Mrs Bluelights had this fitted successfully and it was a Godsend because it was possible to have all further IV treatments at home by visiting District Nurses.  As I write we have one more IV tomorrow and then the treatment is completed.  The good news is that she feels very much better and the temperature problem is under control, being consistently normal.

We did have a slight disappointment in that because she was still having antibiotics and it was over two weeks delay from her scheduled 6th chemo treatment, the oncologist decided to cancel the last chemo because to have it so late would be completely ineffective.  So another CT scan has been arranged to see how and if the five chemo therapies have managed to deal with her cancer problem.

On the previous night before our appointment with the oncologist I had the shock of my life whilst taking a shower.  I must have nicked a vein and there was blood everywhere.  I'll explain exactly what happened next time, how it occurred  how I dealt with it alone, how I called emergency services, how I stayed up until 4.30 in the morning making sure I did not spring a leak again.  Suffice to say I am still here, alive and kicking and am pleased to say I even managed to save the carpet.  Watch this space!

But back to Mrs Bluelights, I am so grateful to all my bloggy pals who are praying with me for total and permanent remission for the cancer which is threatening her liver now.