My final exams were on Monday (Developmental Psych and Health & Healing) and Tuesday (that dreaded Health Sciences), and my clinical examination (OSCE) was Wednesday morning. I didn't think it was possible, but I actually made it through the week. Last week while I was madly studying (as all students really should do before exams, but who am I kidding, at this point of the semester everyone - including myself - looses all desire to study at all), I could have sworn time would just stand still and exams would never happen. But here we are, Friday night, and they are all done! Despite being quite ill and very very very stressed throughout the semester, I have done remarkably well. I exceeded any and all expectation I could possibly have had for my self, even if I was healthy. My marks are beautiful. More than beautiful. Despite all the unpleasant medical things going on and surgery looming close by, I worked so incredibly hard (in a way to tell the infection who really is boss... it can't get the best of me), and it paid off. I am waiting for the results of one more exam and also a small five percent project from several weeks ago, but given all the other grades my average will be in the mid nineties!
My arm continues to burn, sting, and itch. I don't know how much I had really updated over the past weeks. I apologize if I have already mentioned this - I am likely allergic to the PICC line itself. Sort story is, as I kid I could never wear rubber boots without my feet/legs breaking out in a itchy red bumpy rash. Rubber boots are made of polyurethane, the same material PICC lines are made of...
The insertion site continues to leak. I went to the ER in St. Catharines two Sundays ago. The doctor took off the statlock and stitches the PICC to my arm. We also started using dry dressings instead of of tegaderm (pro: no statlock, tegaderm, adhesive to react to, con: dressing change every 2 days rather than once a week, dressing slides down arm over the course of the day, less protection from bacteria, etc). The leaking from the insertion site gets trapped between my arm and the PICC line, causing blisters, irritation, etc. On top of that, the PICC itself causes skin irritation and breakdown, leading to blisters which burst and now won't really heal, so also leak fluid. It burns and itches and makes me cranky.
The is my left arm the day the first PICC was pulled out.
My arm a few days later...
Ice helps relieve the itch a bit.
Army of little blisters caused by the paper tape used to hold the dressing the ER but on after putting in the stitches.
All the blisters around the line. They have mostly healed now, but not after bursting and hurting like crazy.
Most of the blisters have completely healed now, but the site under the PICC is slowly getting worse. I was in the ER in Hamilton on Monday to deal with it. The stadd were amazing. They had now clue how to fix it, but agreed I am likely allergic to the PICC itself. The nurse and doctor I was assigned to asked pretty much every other nurse and doctor who walked by what they thought they should do. They called the IV nurse and PICC nurse down to have a look, and a PICC nurse at another hospital. They tried getting hold of my ID specilist, which didn't work, so called another one instead. Only options were to leave it in and live with the itch/blisters, or pull it and risk it with just oral antibiotics. They advised me to keep it, which I agreed to. My nurse had a really good idea to use this grid like sticky material - thread it under the PICC to keep it in place and provide some airflow so the skin could dry and heal a bit. We would have to clean under the PICC first, with sterile saline and a long cotton swab, but it was way to painful. I swore. Multiple times. Loudly. Before asking the nurse to stop. She said it looked like the PICC was embedded in my skin. So we couldn't go through with her super cool dressing idea that I think could actually have worked really well.
I was back in the ER on Wednesday after my OSCE because my line would not give blood return and had some resistance flushing. The ER waiting room was completely full. Here comes the plus side of being in the ER 8 times in a month: all the nurses know me. They jumped me to the front of the line and had me sorted out within ten minutes. Turns out the blue connection thing (see picture above) is incompatible with the PICC. We already remove the blue piece that comes with the extension tubing for this reason, but apparently this piece has the same issue. My nurse told me to throw a fit at anyone who tries to add another blue piece to my set up. The line also had a bit of resistence, so they flushed it really well with five or six syringes of saline until things went in smoothly.
Lo and behold, this morning there was not blood return (even though there was yesterday). But it flushed fine, so I will leave it a bit and see what happens tomorrow morning.
Infectious disease is on holiday somewhere or something, so I haven't heard back from her. Hopefully Monday or Tuesday. Open raw wet skin can only increase the risk of infection around the PICC line. Hopefully she can sort something out. I need the itch to go away.
And that is it for tonight. Still a bunch I want to catch up on (eight ER trips between getting the first PICC to now...). But I am knackered. Time to brush my hair (aka de-hedgehog myself) and get some sleep.
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