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Friday, June 12, 2009

More Harm Than Good?

A Tiny History Lesson - April 2009 (101)

Megan's central line was placed back in April when it was suspected that Megan had Neuroleptic Malignant Syndrome - a side effect of two medications she was taking - and, finally, a confirmed case of para influenza mixed with it. She went through 8 IV's throughout the course of a one week period and over 20 tries to insert new ones. She had bruises all over her body. The last few people who tried to put them in said, "There are no good spots, but I think I can try here."

Those statements were made not only by the nurses on our unit, but by emergency room nurses, and anesthesiology residents. The problem wasn't really that they weren't reaching the veins, but that her veins blew as soon as they went to flush the newly placed IVs. I finally told them that they were done poking her and that it was torturous to put her through so many "sticks" and convinced them that she needed a more permanent type of access.

The last peripheral IV placed just prior to her central line was done in day surgery. Dr. K decided to place this tunneled central line so that Megan could use it at home for comfort measures because she was most likely going to need hospice care, if she made it home at all.

As we all know, Someone touched Megan's body and she recovered enough to go home and try to make a "new normal" for our lives. We did not end up calling the hospice service yet because it appeared that we might be able to find that "normal." The central line was our precautionary "Safety Net." It is not that we didn't trust God to take care of her, we just know what her ultimate prognosis is and things have been very rocky this spring. The doctors did not expect us to take her home at the end of April. Dr. K "had no idea" why her status changed so drastically in such a short period of time.

Fast Forward to Today

We spoke with the Infectious Disease (ID) team just moments ago. They are saying that the central line needs to be removed. Megan has a very weakened immune system and these bugs are finding the line and growing - causing havoc in her system. She still needs ten days of IV Vancomycin and Gentomycin after it is removed later today. The ID doctors are going to recommend placing a pic line to administer the antibiotics. It is uncertain whether or not we will be finishing the antibiotics in the hospital or at home and then take the line out immediately upon finishing them. It seems that Megan's system is not able to tolerate having the line if it is not being used daily for the IV pain medications we were expecting, but not needing, up to this point.

We have already spoken with a resident from the surgical team and signed consent to take the tunneled central line out and place a new "temporary style" central line. They have also ordered her to be NPO so that they can do the surgery today.

Megan's Current Status

Megan finally went to sleep about 1:00am this morning after fevering and being agitated most of the day yesterday. They gave her all the extra drugs she can have last night, and she finally fell asleep a couple hours later. She is currently still asleep and fever free. The diahhrea has already started from the antibiotics and they have added IV fluids to fix her electrolyte imbalance.

Please pray that the surgery will go as planned, Megan will have no trouble with the anesthesia, and we will be home as soon as possible to resume our new home routine. We did have a 12 day period where Megan seemed fairly stable on this routine. We were going to take her to church last Sunday but on Friday she started having symptoms from this new infection. Hopefully, when we are done with these antibiotics, we can get back to the way she was in that 12 day stretch and maintain it.

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