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Sunday, July 25, 2010

Ports and Irritation...

Friday, July 16th - Sunday July 18th:

I was very ticked off at John last weekend. I write about the good, the bad, and the ugly on this here  blog and frankly, I was not pleased that John left the day after Niki was discharged from the hospital. However, before you all think he's a total douche for leaving on a trip, you have to understand that he's the Best Man for his cousin's wedding. This trip (bachelor party) was planned well before Niki's Broviac infection and bumped-up surgery date. So, really, there was no avoiding it. Even though I know John would never leave if Niki was in terrible condition, I was still very perturbed once he finally landed in Las Vegas. Niki was fine, but I was NOT.

So, I did what any scorned woman would do -- I gave him hell the entire weekend.

John checked in with me as best he could, but everything he told me about his trip was absolutely annoying. I can't explain why I was sooo irritated off of everything he said, but if you're a woman then I'm sure you can *totally* understand where I was coming from. Here he was living it up in Las Vegas for four days and three nights, while I was stuck at home lion taming on my own. John was VIP in the club/strip club while I was VIP (very important parent) at home. (Strippers don't bother me because they're just doing their job, but the idea of drunk, random slutty girls *possibly* interacting with John in Vegas DID bother me. A LOT.) John didn't interact with random slutty girls, but nevertheless....I was a big ol' bitch the entire weekend. I'd rather not dwell in the past, but let's just say it took me a few days to get over my anger/annoyance. I'm clearly understating my anger that from weekend because I've REALLY calmed down since then. 

Moving on...

My one-on-one teaching session with Nurse Richard went pretty well on Friday 7/16. I practiced port access on "Chester Chest". (Chester is an old friend -- "he" is basically a dummy chest with a Broviac and a port.) John and I "met" Chester when we had our Broviac teaching in the NICU. So, I felt completely comfortable with Chester and was actually able to access the port on the first try. Yay, me! The resistance I felt from de-accessing (removing the needle) is akin removing a thumbtack out of a wall. I wasn't expecting it to feel so "stuck". Nevertheless, learning how to access the port was a piece of cake. Even though I am but a lowly Medical Assistant (not by choice might I add), my health care background serves me well in these situations. I have no problem with the medical stuff. The only thing that causes me anxiety is anticipating how Niki will react to being held down while a needle is coming at her chest.

No matter how hard I try to shake my anxiety, I'm Niki's Mom before she's my "patient".

A picture of what Niki's port looks like...

 Chester Chest (R side has a Broviac/L side has a port under the skin)
Chester's chest peeled back (to reveal the port I learned on)

The plan was to leave Niki accessed (with a needle in her port) until she was due for her next factor dose on Sunday. Then, I would de-access her port (remove the needle) on my own until our next  teaching on Tuesday 7/20. That Tuesday would be the first day that she was poked with a needle.  I felt pretty comfortable with that plan when I left the office that day. However, as it turned out, my session with Chester and Nurse Richard served me very well on Saturday morning because....

The gauze that covered Niki's port site was very bloody and there was condensation underneath the Tegaderm dressing.

Niki must have slept on it wrong and caused a bleed. I called the on-call Hematologist because I knew there was no way that I could keep it accessed in that state. What if she got an infection?! Blood has the potential to harbor all sorts of nasty bacteria that could cause an infection. So, with the blessing of the on-call MD (Dr. G), I de-accessed Niki's port and I decided that I would try and access it myself (to administer her factor) on Sunday night when John returned from Vegas. That way he could help me hold Niki down while I poked her. Her factor dose would be a late, but it was better than getting no factor at all. The plan sound fine and dandy until I got off the phone and actually had to do it. My irritation with John resurfaced as I literally sweated bullets while removing Niki's dressing. I really wished I wasn't alone when that bleed happened.

Man, was I STRESSED.

I tried my best to keep Niki still since I had no one to hold her down. I put on Niki's favorite Barney video on Netflix and that worked for about the first five minutes before she got antsy again. There was a lot of gauze and Tegaderm that had to be carefully peeled off before I could remove the needle. She still had Steri Strips holding the incision together and some of those strips were connected to the Tegaderm. So, it's not like I could have haphazardly peeled the dressing off. It probably took me a good 10-15 minutes to remove everything without causing injury. Whew! Meanwhile, Boo tried to help me distract Niki with my iPhone, but he ended up playing photographer instead. (That kid loves taking pictures.  You should see what he takes pictures of on my iPhone. Lol!) Most of the pictures were blurry, but here the a few that turned okay.
 After all the layers were peeled off...
 De-accessing the port...
Residual blood...
A picture of some of the bloody gauze..

I was glad that Boo took those pictures because they were the first thing that I showed John when he got home. Haha, the guilt-infliction never ends, does it ladies? ;-)

I gave Niki a dose of factor before I withdrew the needle. And let me just say that my first attempt at de-accessing a real port was interesting. I felt like I had to slightly wrench it out of her chest. The silicone does wonders on keeping the needle stable. The surgeon used a 20 gauge needle (it's a little thick) to keep Niki's port accessed so there was quite a bit of bleeding after I removed it. Niki bled for close to 20 minutes despite my applying pressure afterward. Other than that, all was well in the world again once the bleed stopped.

And eventually, my irritation with John's absence dissipated too.

In case you haven't been following my blog, the last couple of weeks has consisted of nothing but hospitals, doctors office visits, and work. (Aside from two reprieves that occurred before Niki's surgery date that I'll write about later.) After the whole bloody port fiasco, the rest of Saturday was filled with utter relaxation and good times. I attended my cousin-in-law's birthday celebration and my 10-year high school reunion later that night.

At first, I was *very* nervous about going. I haven't done jack shit except get pregnant for the last 10 years. One of my classmates is a doctor now! Gawd, how I wish I at least invented Post-Its. Nevertheless, I had a blast catching up with old folks from high school and of course, hanging out with two really good girlfriends that I barely see. All three of us won the raffle (I won sake, a Wii game, a Zagat guide, & some other goodies) and John & I won the award for being "married" the longest.

I was really embarrassed about the awards being that we're not married. (We won two -- the sweethearts award pictured above and "married the longest" award.) Basically, I fucked up on the reunion registration survey and I gave off the impression that John and I were married. So, in essence, I placed a "false advertisement" according to my friend J. Lol! But shoot, we're common law and I've bore 5 of his children -- legal or not, we murried. ;-) Another reunion highlight? I reconnected with an old buddy "R",  who used to join me in my "rebel" let's-smoke-cigarettes-in-the-girls-bathroom days. Good times! (Shout out to you if you're reading this.) Even though I was totally sober and initially had difficulty loosening up, I still had a lot of fun. I've always been kind of a wallflower anyway.

Nothing like a night of "being young again" to rejuvenate the ol' soul.

The next day (7/18), I picked up John from the airport. Things were still sketchy between he and I (ie.I was still pissed off), but we eventually worked it out. (He could have at least brought me souvenirs though.)  Despite our issues, we had bigger fish to fry. Niki was going to get poked and I only practiced on Chester once. It was absolutely nerve-wracking, but I did it on the first try. Whoever invented EMLA is my new idol. Niki didn't even flinch from the poke. The only thing that made her slightly whine was the fact that John was restraining her. But...other than that she did fine and we all survived our first official  port access. Yay us!

Taken just minutes after she got her first poke...
The poke (I did the one on top)...

I'm also VERY happy to report that we only needed three in-clinic sessions of port teaching. (Which was really just us being supervised while we administered Niki's factor.) Nurse Richard was very impressed that we picked up so quickly. Actually, he said the last two sessions of "port teaching" were essentially not needed because we already accessed on our own on Sunday. :) More good news...Niki has yet to cry from the pokes thanks to EMLA.  She's been poked 5 times and hasn't shed a tear. Her only "beef" with port access is the fact that she is being restrained. However, John and I are trying to find a way to modify that portion of the process. Either way....

My daughter is amazing. :)

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