Monthly Archives: March 2012

Just another day

Ive neglected you again, my non-existant readers. I would apologize, but I dont know how much good that would do us!

Anyway. The obligatory medical updates.
Since last post, I went back to Cincinnati to see my doctor, get scopes, and have a permanent central line placed. It all went pretty well. We discussed the new diagnosis, talked about options and meds, and then figured out what we needed to do from there. I mentioned my continuing lower gut symptoms, but also made it clear I wanted to be able to eat a little, for fun. He thought that would be okay. Back when I was first seen at denver, my scope was actually pretty good, so he thought I could go back to those foods, as I could tolerate, assuming my scope was okay.
The central line placement went fine. I had a good time talking to my surgeon, who is an adventure athlete herself. She is more a mountaineer though (which I think is totally BA). She made sure to place my line in a way that would let me climb without causing any damage. I really apprecaited that part. I also realized just how handy having a central line was when they didnt have to stab me multiple times trying to get an IV going!
The scopes went well too. Totally different group of docs back in the OR with me, and they were super goofy. Everyone back there always thinks Im nervous because my HR is pretty high, but they dont know it just does that normally, so they try to make me laugh and relax (with jokes and meds 🙂 ). The anesthesiologist was telling me that I needed to watch him as they gave me the meds, because he would turn in to Tom Cruise, and then said Dr. P would turn into Angelina Jolie. Dr. P was quick to say he was going to turn into Brad Pitt instead though. I really love when it is relaxed when I go back. If I had any worries, I didnt after talking with all of them.
I think part of it is that they like having older patients from time to time. They can be goofy and not worry about an upset little one.

As for the results. We are switching me from amitryptaline to lyrica in the hopes that it will not make my POTS flare so much. They added levocarnatine to my TPN, as well as 1L of saline, because I have difficulty getting liquid in. My esophagus looked pretty good, with only very mild inflammation (meaning more foods!), and the rest of my gut looked decent, except for a portion of my colon, where I have active colitis. I dont really understand the description, but it was somewhere between nonspecific and crohns, with increased eosinophils but not necessarily EC. This is one of those times I just nod my head and get my new perscription, which is Pentasa. I have yet to start it because it scares me. The pills are huge!

 

The rest of life? Im back to climbing, which just makes everything better. I have a ways to go to get my endurance and strength back, but I have a feeling it will be well worth the effort. Ive gotten in two gym sessions and even got a pitch of trad in the last week. Sadly, I have not made much progress on the not being a whimp with my gear placements thing. I sewed up Kim’s crack pretty good this afternoon. Im really going to do my best to get in a good mental state for climbing though. I need to realize that a fall isnt the worst thing, that not trying or giving up because I am scared is not how I want to climb, or live my life for that matter. I need to figure out what really is important, and start doing all the things I want to do, in case Im not able to forever.

As much as I know all of you want to read one of my philosophy ramblings, I think I will save the rest for another day. However, I hope all of you nonexistant readers are able to take time, as the weather is turning, to do something you love. It really can make all the difference.

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“I wanted water but Ill walk through the fire/ If this is what it takes to take me even higher/ Then Ill come through, like I do, when the world keeps testing me, testing me, testing me” John Mayer Trio

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Spinning

My non existant readers, this week has been pretty crazy.
BE FOREWARNED: Im tired and on pain meds. I think this will probably just be a rant about my stay this week. Nothing too insightful or exciting… but then again, you should expect that, coming from me.

My new class schedule started the week on a good note. I slept a long time and generally just relaxed. Tuesday morning, though, I knew something wasnt quite right. I made it through my first class, but then was about passed out waiting for the next one. After a long debate with myself, I decided to go home and sleep, and not push myself too far. So I did, and after getting a decent nights sleep (8 hours), slept from 10 til just about 3. I started the laziness over, because I was still exhausted. After being a bit productive, I went back to my computer. I rested my head on my hands, and felt the heat. Not a big deal, I thought. My hands are always freezing. So I sat on them a while, checked again… definitely hot. I went and grabbed my thermometer and checked. I averaged out around 99.8. High, but not too bad… except my normal range is in the mid 96s. I decided to wait it out and keep checking. 20 minutes later, I was up to 100.4. Thats when I told my awesome house mates I was probably going to need a ride to an ER, since my car is broken.
*(for those of you who lack experience with a central line… in my case, I have a PICC… fevers are bad as they can indicate a line infection. General protocol is 100.5 and up is straight to the ER to start antibiotics)
I told them to take their time, and Id wait just a bit longer to see if it would dip back down. Nope. 100.7 and I packed my bag. I slept most of the car ride down to Fort Collins. When we got there, I went back to be triaged while the boys played magic in the waiting room. My temp was a little lower by the time I was there, but not much, and the car had been pretty cold. I gave the nurse the note from Cinci about fevers and central lines, and she got the doctor. After the general run down and getting hooked up to a bag of fluids (oh the joys of CLs), they decided there was potential for a line infection, so they got blood cultures. For some reason, though, they have to get two sets, one from each arm. Right arm went like nothing. They used ol’ faithful and it was done quickly. Left was more of a problem. After ample searching, he found one on the top of my hand… the same spot that had failed about a month earlier. I warned him, but he tried it. No dice. Started searching again, but both arms. Only one they saw? Ol’ faithful. As it turns out the second stick to a freshly bruised/punctured vein hurts a hell of a lot more. They tried one other spot in my left arm, and when that failed, they went to talk to the ER doc. They decided to just pull that side from my picc (R.I.P.).
I got in to a room upstairs around 11:30, after a fun stretcher ride. They settled me in with some fluids and vancomyacin. This is when I became experienced in Red Man Syndrome. Joey looked pretty puzzled and kept telling me how red my face and neck were getting. Then my hands started itching. It was not very fun. Luckily benedryl helped, and now I have to premedicate before I start vanc. The next morning, I got to hear more of the game plan. They needed to put in another IV so that they would be able to both have me on TPN and run antibiotics (you cant mix those). This is how I met the IV team. Because they had such issues in the ER, the floor nurses werent even going to try. Minus their job, the team was pretty cool. On the downside, they hurt my arm pretty good. Because the IV was going to be for antibiotics, it needed to be a decent size, ruling out hand and wrist veins. Which left my forearms. If you know me, the one place in my body I have muscle is my forearms. I think that only made the attempts hurt even more. Anyway. That IV went in second go. Not too bad, considering the future attempts. I had to keep heat on it, though, to try to help it survive as long as possible. One of the antibiotics had phlebotic potential, while the other had a nasty low pH. Luckily that one lasted through the night and into the afternoon. That morning, though, they figured out that my blood cultures had grown… and they had to pull my picc, which was sad both because it only needed to last another 2 weeks and it meant I needed another peripheral IV in the dead arm. They searched long and hard, and after a few attempts, I got the second fore-arm IV. (needless to say, my patience for sticks was gone at this point. I can do one or two every so often, but after that I just get upset). They were operating together for a solid 4 hours or so. Then we started another round of antibiotics, and it hurt more than usual. When I looked, the first PIV site was black and blue, warm, and cordy. I made the mistake of telling my nurse, who called the IV team, who pulled that PIV. That was my first experience with phlebitis. Im not a fan.
Then we had the issue of trying to find another access so that I could get both antibiotics and some nourishment. This is when the heavy artillery came out. The IV nurse brought up both a vein finder and an ultrasound. After searching both- arms, she found 3 deep sticks. For the first, we just went for it. No dice. For the second, we used lidocaine shots first, to see if my freaking out less would help. Still no dice. The third and final attempt, she tried with a baby needle. Still nothing, so she quit. I still had the other PIV, so it wasnt that big of a deal. We planned on taking a break and having my new favorite IV guy come in when he got on work.
In the interim, we were going to use my second PIV to  get some meds and get the antibiotic back running. Apparently karma was against me, though, and we quickly figured out that IV was dead too, meaning IV team had to come back. I got a few hours off until my favorite IV guy came back. He used the vein finder and ultrasound and found one decent one that was fairly close to the surface… but in my elbow. He got it first go, and my arm got strapped to a board. It lasted me that night and the next day.
Friday afternoon, I got scheduled for a new picc placement. Given the amount of pain the last one caused, I was pretty nervous. I went down, and they got it in and dressed in maybe 10 minutes. It was awesome. Maybe the pain meds and ativan were helping me, but it was much less of a big deal. My new picc is purple too 😀 (its the little things).
After a final dose of vancomyacin I was cleared to go home. Im now on two weeks of iv antibiotics and have to take it easy for a bit. Luckily, we talked to cinci, and my central line placement surgery on the 13 is still a go. Im excited to get climbing again.

Through the whole thing, I was utterly exhausted. There was also lots of time to think about everything that has been happening. I hope my life doesnt turn into a slew of hospital stays. I know it was just this once…  but its still kind of scary to think about.

For now, Ill enjoy being home and will keep counting down til I can climb again.

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“Take it moment by moment, and you will find that we are all, as I’ve said before, bugs in amber.” – Vonnegut

 

 

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