Wednesday, August 11, 2010

Emergency Room Visit

I thought I was getting better...but, I wasn't. I woke up on Tues morning feeling dehydrated. I honestly hadn't been drinking too much. I was doing the best I could. It's very difficult to drink when you just feel like you will reflux it back up. After managing a shower, I had a nice discussion with my mom (how has been my main caregiver at home recently) about going to the infusion center for IV fluids. She had legitimate concerns that I wasn't drinking enough and she wanted me to go. I, however, did not want to leave home. So, we called in the tie breaker. Jonathan got a phone call and gave me an ultimatum...I had to finish a 32 oz of Powerade within the next 2 hours or he wanted me to go. So, without putting up a fight I managed to the family room recliner and started my fluids consumption. I did pretty well too. Even moved on to the next clear liquid beverage and even had some chicken broth.

Then what do you think comes next...I have to go to the bathroom. Yeah good working kidneys. Only then did I realize how heavy and tender my right arm felt. Plus, with better looking lighting in the bathroom, I noticed a slight discoloration. So, I say to myself "keep an eye on it". I mainly said this because this wasn't the first time my right arm has hurt since I had the PICC line put in on June 2nd. Plus, the chemo makes my fingertips feel numb with less sensation. So, I didn't know how much was chemo related, slept on it funny, or something else. However, it didn't get better. It got worse and continued to hurt. Now, I'll be honest and tell you why my concern. I was worried about a blood clot from the PICC line.

Now my DVT (deep vein thromoemboli) awareness:
Signs of a DVT: redness, swelling, pain, tenderness, fever, warmth
Most commonly found in legs, can can occur anywhere there is a foreign body (something that is in your body that shouldn't normally be there, ie picc line). Diagnosed with an ultrasound and treated with blood thinners. Please more at risk are those with poor ambulation (hence why you may find it in your seat back brochure on airplanes), post surgical patients, any patient hospitalized, cancer patients on chemotherapy, patients with blood clotting disorders, patients on hormone therapy, and patients with a foreign body.
*Please excuse any missing information as I have typed this off the top of my head and not used any formal resources.

So, off to the emergency room I went last night with my 'high index of suspension' for a blood clot. The Carilion staff was great. (Shout out!!) We got blood work drawn and I received a much needed liter of IV fluids after the nurses got a great IV in my left arm. (Yes, mom won out in the end with the IV fluid battle.) Then, we found out that the vascular lab that does the ultrasounds had left for the day and they don't take call. So, I was given a dose of Lovenox and sent home to come back today for the ultrasound.

I awoke this morning with my arm still hurting and discolored, but no worse for wear. Went to the infusion center. Had my next to last chemo infusion through my left peripheral IV and had the right picc removed by the doctor there. Yeah!! I'm so happy it is gone. Then went to the vascular lab to confirm that yes indeed there is a nice size clot sitting at the junction of my subclavian vein. So, all in all the morale of the story is to have a good 'index of suspicion'. Know the signs and symptoms of DVTs.

My only frustration know is the need to be on Coumadin (commonly referred to as rat poison) for the next 3-6mons. The worst part of being on blood thinners is needing routine lab monitoring to make sure your getting enough and not too much or too little of the medicine. Plus, you gotta protect yourself from any accidents or injuries that could cause bleeding. I'm not really wanting to have to limit my lifestyle right now. But, you do what you gotta do and this is what I gotta do.

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