In ICU July 2014

In ICU day 2 …

So I have just returned from an unexpected week in hospital. Last week I had an awful chest infection and was at home in bed, resting as much as possible, but essentially doing OK. Unfortunately, my medication pump alarmed suddenly on Wednesday and after quickly changing the line, the pump and then even the medication cassette we realised that the central line must be blocked. This all took place in under 10 minutes. If the pump is stopped for longer than that it can have very, very severe consequences. So as soon we realised that the central line in my chest may be the issue, Lizzy – our incredible nurse and friend – and Mom had to insert an emergency IV in my arm to keep the drug flowing. Thank goodness they were both there!

We called an ambulance and I was rushed to UCT Academic Hospital and into the ICU. There were a couple scary moments where my blood pressure dropped and whatnot, but everything was under control. I spent about a week in hospital, after inserting a PICC line in my arm that could continue to deliver my drugs through a catheter that ran up and into my chest until we could sort out my central line. It was a tough week, with many setbacks and unexpected logistical issues. As always though, I took comfort in knowing that my Mom was in what I like to call “lioness mode” – where nothing is impossible and nothing ever gets in the way of her arranging exactly what I need. I stayed in ICU for a bit and was then moved to a general ward, where the medical team kept monitoring my chest infection and my condition. On Monday the new central line was inserted, and all went well. The following day I was deemed well enough to return home.

So that’s a quick summary of the reasons for my hospital stay. There are longer and more dramatic stories to tell, and some moments were really difficult – such as the procedures to insert the PICC and central lines, both of which were done with only local anaesthetic, to avoid stressing my system.

As always, my coping mechanism in difficult medical scenarios is an ironic, and occasionally morbid, sense of humour. Snappy comments help me remain calm, involved and clearheaded through the hard parts. With that in mind, there were some genuinely amusing moments as we all tried to muddle through the week. My amazing doctors demonstrated their incredible capabilities when faced with my very complex disease and unique treatment challenges in the middle of the night, with only a couple hours sleep between them. It is testament to their skill and bedside manner that I was able to laugh, despite the discomfort and pain of that bizarre situation. Some of my favourite quotes come from them, some from the nurses, and some just from random observers.

Some particularly unforgettable comments are –

 “What a beautiful lesion! Just beautiful”

“You know what I like to do in these scenarios? Just nick the skin. Just give it a little nick or three.”

“I love seeing so much blood – it means we hit the vein!”

“Jenna, you have absolutely no veins in your left arm. None!” (This one worried me a bit)

“Ok, try turning it upside down – I’m not sure it will fit that way”

“That’s it – right to the hilt, just push harder.”

“Jenna, you have tough skin to break through” to which I replied, affronted – “No, it’s young and supple – are you calling me thick skinned?”

“What do you think this one does? I’ve never seen one before! Maybe there’s a description in the instructions?”

“Don’t worry Jen – one way or another, everyone stops bleeding eventually”

I get that it’s a bit odd to find humour in these statements but to be honest, sometimes all one can do is laugh… and that night my poor abused little arm and I took great comfort in it. I think that I may have learned that from Natalie, my young cousin and inspiration in dealing with all things medical. Any hospital visit always renews my appreciation of the basics that Natalie taught me, such as her rules for nursing of any kind.

The two I feel most strongly about are “one thing at a time” and “tell me before you touch me.” These behaviours may seem like common sense, but actually in a hospital scenario, very few people enact them. When I am very sick and weak and struggling to move or breath, having two people simultaneously doing different things on different parts of my body – even simple things like drawing blood on one arm and removing an IV on the other – can be overwhelming. Similarly, people moving, poking, pricking, feeling or even affectionately stroking/patting any part of me without my permission feels invasive. Giving up control of one’s body to strangers is a necessary evil in hospital, and I truly hate that. My control and privacy are very important to me. So if there’s anything to take away from my experiences, it’s that those two rules help sick people retain their dignity, and are worth remembering.

All in all, I won’t say I’ve had a pleasant week, but I’m home now and filled with endless gratitude to my family and friends for making things a little more bearable. So for the moment, all is well, and I think I shall spend the next while getting reacquainted with the joys of being tucked up in my own bed.