Really, this wasn't funny. Nadine developed a blood clot related to her PICC (internal catheter) line, which had to be removed. She's still dealing with the clot. Apparently, this isn't uncommon.
Tthere was an AMAZINGLY gift to be grateful for. The PICC line lasted through the administration of 24 continuous hours of dangerous-to-the-kidneys high-dose methatrexate chemo, three-plus days of continuous bicarbonate for alkalinizing her urine (kidney protectant), and the leucovorin needed to flush out the methatrexate to protect her kidneys. If the line hadn't lasted, it could have been a real disaster, much worse than it turned out to be.
The full story -- On Friday July 3rd, Nadine's methatrexate level was almost down to hospital-release level -- freedom was in the air.
Unlike on Thursday, Nadine was no longer hurting all over, but she felt a lingering pain in her left arm where her PICC catheter line (for giving medication) was located. Chrisanne, one of the nurses, was right "on top of" it and measured Nadine's arm diameter -- it had gotten larger, and Chrisanne suspected a clot. Nadine got an ultrasound -- I was fascinated by the images of muscle (resembling sea water) plus bright-blue splotches for veins and red splotches for arteries.
However, I had a sick feeling in my stomach, feeling that something was wrong.
On Saturday July 4th we learned she had a CLOT. Happily, the methatrexate levels were down by then. Her PICC line was unceremoniously pulled out by the resident. I had hoped for the PICC team, but they were away for the week-end. Oh well, this really was a simple procedure, unlike its insertion.
Still -- a clot? This could travel. Who knew where it could go?
Nadine was crying in bed. She said she was overwhelmed. It was the first time I'd seen her cry for a long time. Somehow we'd learned to manage cancer, serious as it was, but having another problem on top of it seemed like the figurative straw on the camel's back.
I wanted to learn more both about the clot and how to deal with it. Nadine wanted to know how she could and couldn't move her body. We knew she needed some restrictions, but not which.
It was July 4th. Sickness doesn't take a vacation, but people do. There were few if any support staff and even docs/nurses, and there seemed to be many crises around us; I couldn't find people to answer questions. People seemed uncharacteristically curt and unresponsive. I felt our concerns were being "blown off " and regarded as frivolous. I finally learned she could walk, practice flute in small-ish increments, and not raise her arms suddenly or lift weights.
An itchy Nadine asked "Is it okay to raise my arm to scratch my head?" and sent me out to ask a doc. It took a while and the doc seemed exasperated, and also looked exhausted. The question might have seemed silly to them, and even silly when written about but darn it, it was important to her (and me).
Lingering doubts plagued me -- "bad mom" feelings added themselves to the stress. I didn't want my family to know how awful I felt, and began to pace the halls, feeling alone.
She'd need at least 30 days of daily injections of medicine (Fragmin) into the subcutaneous tissue near her navel. Fragmin stings. I feel bad for Nadine.
Nadine could choose to do her own injections or have me do them. She chose me. Nicole showed me on Saturday, and on Sunday Heather explained it again and I did it. It felt like a huge deal even with a self-retracting needle. Wash hands, swab her belly, open the pre-loaded syringe, pull off the cap (exposing the small needle), hold the syringe about an inch over her belly, quickly bring the needle in, push the plunger, release, count 5 seconds, release the skin. Finished. It felt clumsy the first time or two; after that I soon became a "pro".
I felt somewhat better when I learned later on that Denise, the head nurse, was going to be Nadine's nurse for the evening -- she reassured me she'd be there all night for her. I shared some of my concerns with her, and she responded positively, confirming that indeed my feelings and questions were normal.
I eventually learned that although her clot needed to be watched and treated, it wasn't the worst kind.
On Monday when Laurie, the nurse practitioner of Nadine's care tearm, was available for questions, I got more information on clots in general and Nadine's in particular and finally I'm able to take this, too, more stride. It's amazing how that happens.
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