Well, we headed into the hospital for our routine blood draw for CBC and vitals, and ended up in there an extra 3 hours.
Typically the way the blood draw works is this: the nurse flushes her Broviac line with Heparin to prevent coagulating, and then with part of a syringe of saline. Once the saline is in, they start to draw back on the plunger and see if any staining happens, meaning blood is in the line and ready to be drawn. That’s the goal.
Instead, we often end up pushing an entire syringe of saline in, then go through a dance where Michelle or I move Zoe’s limbs up and down, pumping her like a little old fashioned water well, or roll her over and around trying to find a position where the blood will enter the line.
This isn’t the way it should be, but we have just learned to deal with it. She’s very small and so is her line.
Today, we did exactly that, except there was no staining in the saline, no matter what we tried. The nurse proceeded to push a 2nd syringe of saline in, and still nothing showed. She pumped the syringe for awhile, and then one of us pulled Zoe’s shirt back, Michelle I think, because she noticed some liquid. Turns out the saline was escaping the line and Zoe now had a huge bubble of fluid boiling up under her skin just above the Broviac.
Now, we’ve come to have a decent level of calm in these visits, but this was a real challenge. The lump was really big and quite startling. It was a reminder of how quickly something can happen and upend our sense of calm, potentially putting us back in the hospital unexpectedly.
My first thought was not pretty — I was a little irritable at the amount of saline pushed in so quickly — but I’ve learned to restrain myself a little to wait and see how the doctors react before reacting too strongly myself. We stopped the attempted blood draw, got the doctor in, and had a look. Her first remark when she saw my face was, “oh don’t worry it’ll be reabsorbed, she’ll be ok”. I would have liked to see my face just before she said that, I’m sure it was priceless.
Soon we were settled in a room waiting for the surgeon to come take a look. When he arrived an hour later the bump had disappeared, the fluid absorbed. He reassured us that the Broviac issue was not something to be terribly concerned about, but that we would want to put in a new line. It’s necessary not only for easier blood draws, but for administration of Zoe’s VP-16 chemotherapy.
This line was no longer needed, however. So what do we do? Pull it out. Right there on the little exam table, let’s yank out the direct line into her heart that took a 2hour procedure and anesthesia to put in!
I would never have been cut out for medicine, I realize now. There is an old wives tale about fathers passed out on the floor of the hospital whenever there is blood, and I’ve begun to wonder if it’s not a wives’ tale so much as a cautionary story.
The removal went fine, of course, the surgeon was not concerned and I’m sure he pulls tubes out of babies hearts all day long, but boy it was a little nerve wracking on our end. He held a bandage over the hole in her chest for a few moments, announced it was all set, and they applied the new dressing. Apparently it closes so quickly there is not need to worry about blood leakage or other problems. What a relief!
We’re on track for another long day on Thursday, Zoe will get her LP, her new Broviac, and a four hour drip of VP-16.
Vitals for the day:
- WBC: 2.4
- RBC: 3.0
- Hemo: 9.0
- Platelets: 613
- Sodium: 132 (a little low still)
- Creatinine: .1 (normal is .3-.7, this is a marker for kidney function and the doctor felt it was fine)
HLH Journal 