Monday, August 10, 2009

Clinic visit.

So I had a visit with the CF clinic today. They took a new chest x-ray and it looks better than the one from the ER last week. I asked to see my CT out of curiousity. I saw my chest CT in May at Denver so I even had something recent to compare it to. On this one there was a HUGE blob of gray covering about 1/3 of my lung. That would of course be the infection/collapse. I was kind of shocked by it, even though all the docs had been telling me how bad it was.

Last night I had some trouble flushing my PICC. One lumen wouldn't flush at all, the other one was sluggish. So I called the on call nurse with my infusion company. He said to flush the one that was slow several times, and do it hard. That got it going again but the other one was still slow. So today I saw the PICC nurse at clinic. She wasn't able to get any blood return from it so she put TPA in it. TPA is an enzyme that dissolves blood clots. It had to sit in there for a while so mom and I went and got lunch while I marinated. We got back to clinic and we were able to get blood out of it!!! YAY!! So she told me to flush it hard with 2 or 3 flushes after every infusion. I'll also be using hepperan (sp??) twice a week to keep it clear.

I'm going to go in for follow up PFTs when I'm done with my antibiotics. And the big news from clinic is that I am getting a port!!!!! YAY!!!! I had planned on asking for one at this visit anyway and having this PICC gave me more amo to throw at the doc. My veins are very small which makes it hard to insert the PICC and once I've had a PICC in a vein that vein can never be used again. Plus they've never been able to get one in my right arm except for the first time. So the doc agreed with me that a port is a good idea. I'm going to get it sometime after I am done with this round of IVs. They want me feeling good before putting my body through anything else, which I agree with.


Amy said...

I use heperain after every course is over. So I am using it 4 times a day. Never had any issues. Not saying it would work for you just surprised that you only use it twice a week. It's just a 5ml flush I do after flushing with saline.

Good luck with the port! I keep saying I am going to ask for one but then I chicken out...I'm just not ready LOL!!!!

<3's :)

Tara said...

I'm the same as Amy. I use heparin after every single dose, on each line (of the double lumen) whether it was used or not. I have to fight for this in the hospital (just as simple as doctors orders) because it's not standard protocol in the hospital. It definitely helps, however I still have had sluggish and non-responsive lines. Sometimes it's not a clot, but a positional thing. Did they teach you the sling shot move? You fill a syringe half full of saline, then pull back on the plunger all the way (it's very difficult to do) then release it like a sling shot. Do this as many times as you need to get it flushing again. All of these tips may be useful to finish up this round of IVs.

Princess Jess said...

I've NEVER had a problem with sluggish PICCs before. I'll have to remember that sling shot thing though Tara. If I still have issues even with the heparin twice a week they will up it. But the nurse said too much hep. isn't really a good thing.