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Thursday 31 January 2013

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 veinbasilic 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.

Friday 11 January 2013

Tall Stories at Bristol Zoo

Ahh! What's all this?

Recently our zoo in Bristol ran a series of successful TV advertisements inviting visitors to see their extensive range of dinosaurs.  I'm not sure how the other more authentic animals got on with them, or even how long they survived, but the advertisement advised us to visit NOW before the dinosaurs became extinct.  I thought that this was a very clever piece of marketing which I found amusing, since it appealed greatly to my rather over-developed sense of humour.  However, I passed on the invitation, preferring to visit later when a swarm of taxidermists had time to stuff them all, rendering them harmless.  

This all brought back lots of memories for me - not of the dinosaurs because I am not that old I hasten to add, but memories of the zoo itself with it's large collection of animals and beautiful grounds.

We are most fortunate in Bristol to have such an impressive zoo.  Although I have not visited for a number of years when I was younger I did enjoy many a warm summer's day there.  When I was but a small boy some inspirational stroke of genius possessed me to buy my mother a small wooden model of a hippopotamus.  She was not at all impressed when I handed it to her when I returned home, as you may imagine, wondering why I had chosen that particular ugly and vastly obese creature when there were lots of far more feminine and attractive wooden animals from which to choose.  I rather think she wondered whether there was some hidden message I was attempting to convey to her.  Needless to say the creature never appeared on display since it was unworthy of a place alongside her other more flattering and appealing ornaments.

On another occasional my sister, Maggie, and our cousin Sylvia had high drama in the bird house with a large red and yellow parrot.  It took one look at the bracelet Sylvia' was wearing, belonging to her mother and supposedly in her safe custody whilst on holiday with us.  It swooped from it's perch like grease lightening, taking us all by surprise, and grabbed the bracelet proceeding to roll it into a small silver ball and fighting us violently when we tried to get it back whilst shouting at it to let it go.  In reply it just imitated us in a high screech, "Let it go! Let it go!" and clawed at us until we had to give up.   We were horror struck, particularly Sylvia, who wondered what she would say to her mother about the strange demise of her cherished bracelet.  Of course I did not help matters because even in my youth my keen sense of humour prompted me to send Sylvia, now at home in Nottingham, a photograph of the parrot calling it TELECARB RETAE which spelled backwards read BRACELET EATER.  I was rather proud of this title since I thought it quite plausible as a Latin name for that species of parrot and to me this name looked entirely authentic. I do not think her mother ever cracked the code, but Sylvia did and we enjoyed the joke for many years and I continue to smile about it sometimes even to this day.  What Sylvia said to her mother about the missing bracelet remains unknown.

Well these memories exercised my chuckle muscle and actually I was inspired to write them up when I read about an article appearing in The London Times, featuring Bristol Zoo and a missing car park attendant.  No I do not think he was eaten by a dinosaur or even a lion - he just vanished.

Here is the article in full:

From The London Times: 

Outside the Bristol Zoo, in England, there is a parking lot for 150 cars and 8 coaches, or buses. 

It was manned by a very pleasant attendant with a ticket machine charging cars 1 pound (about $1.40) and coaches 5 (about $7). 

This parking attendant worked there solid for all of 25 years. Then, one day, he just didn't turn up for work. 

"Oh well", said Bristol Zoo Management - "we'd better phone up the City Council and get them to send a new parking attendant..." 

"Err ... no", said the Council, "that parking lot is your responsibility." 

"Err ... no", said Bristol Zoo Management, "the attendant was employed by the City Council, wasn't he?" 

"Err ... NO!" insisted the Council. 

Sitting in his villa somewhere on the coast of Spain, is a bloke who had been taking the parking lot fees, estimated at 400 pounds (about $560) per day at Bristol Zoo for the last 25 years. Assuming 7 days a week, this amounts to just over 3.6 million pounds ($7 million). 

And no one even knows his name.

What a clever chap!! I say, and for sheer ingenuity and cheek this chap deserves to get away with it, in my book!!  No, folks he was not me!! . . . just in case you were wondering.   Apparently, a few days after the article appeared, no less than 20 bogus car park attendants turned up at Bristol Zoo, sporting ticket machines, peaked hats and large money bags.  They proceeded to argue violently with each other as to who arrived first and who should claim the pitch when the real car park attendant arrived and sent them all packing.  Apparently the whole thing was a giant hoax.  Bristol Evening Post newspaper had made some investigations about the article and discovered some joker had sent this bogus story to The London Times - no folks, again it was not me, but boy did I laugh when I read this. Hope you enjoyed the stories - excuse me while I dash to find a suitable and promising pitch for my would be very lucrative car/bus ticket collecting operation. Now let;s see - I wonder where I should first try!! GOT IT!! NOT TELLING but don't look for me in Spain!!  BYE!  LOL.