Even for a Monday, today has got to be a real doozy. Ron said he woke up about 3:00 am and had to go to the bathroom. His scooter and his wound vac are both plugged in overnight to charge. He didn't call me because he thought he could do it himself. He didn't. Then at 5:00 am he had to go again. He still didn't call me and had more problems. Without making my poor husband seem really pathetic, or giving too much information, let's just say that the floor in the bedroom and in the bathroom needed a serious cleaning.
I got Ron's dressing changed, put a clean white sock on it, helped him re-dress and go back to bed. Got him up at 7:10 to do his IV. Hooked him all up and noticed that his PICC line was sticking out of his arm about 1/2 of an inch and the dressing wasn't attached at all. That didn't look good so I called the nurse. Luckily, I knew to not push it back into his arm (no telling what kind of harm that would do) so I just taped it to his arm and covered it with a stockinet. During the course of the IV, Ron needed to use the restroom again so I disconnected him, flushed with Saline and then followed with Heparin (2.5 ml). When he came back, I flushed with Saline again and restarted the IV.
In the meantime, the nurse returned my call so I explained the problem with the PICC and she said she'd come out this afternoon to take a look. I told her about stopping/re-starting the IV and asked if I needed to flush with Heparin again after the IV ended. She said yes, so I used another 2.5 ml.
His doctor's appt was for 8:45 and it takes at least 30 minutes to get there, so we headed out. We got a few blocks from home and I look down and noticed his white sock has a red foot. I vaguely thought, "I didn't know he had red footed socks" before I realized that he doesn't own anything but WHITE socks and the red was blood. Lots of blood.
I turned around and went back home to get new dressing and a couple of kitchen towels. I called the office and let them know that we would be late and why. I made it in record time (not much traffic today) and they took him right in. Strangely, even though his foot was covered in blood and the wound vac was full of blood, they couldn't tell where he had been bleeding from. They washed his foot really well and no more blood appeared so they redressed it with the wound material.
It took us between 10-15 minutes to get checked back out and for me to go get the car. Before Ron even got into the car I looked down as I was getting ready to help him and the sidewalk was very bloody, even more so than the floorboard of my car had been. I ran back in and told the receptionist that he was bleeding very badly again so they came and got him and took him back into a room.
Once they got the wound vac off of him they still couldn't find where the blood was coming from. The nurse cleaned his foot up again and then redressed it (this dressing is about a 15 minute procedure to make sure there's a good seal). You can read more about how this system works here: http://www.kci1.com/82.asp. This is the company we are renting from. (We got our first statement for 29 days of service. $7666.00. I don't know exactly what insurance will pay but at most, it will be 80%. That leaves the rest for us. Lovely thought, isn't it?)
Once we got home I added a diaper to the dressing. I sure didn't want to try to clean blood out of tan carpet if he started bleeding again.
It's really strange because he's not had any bleeding problems in the past but we've had three things change in the last week.
1. He started on 81 mg aspirin daily
2. They increased the vacuum pressure from 125 to 150 (and I don't know what that measurement means)
3. I gave him 5 ml of Heparin today instead of 2.5
I asked the doctor if any of those things could have caused the bleed and he didn't see how it was possible. For my own peace of mind, I had the nurse change the pressure back to 125. No bleeding.
I don't know but it was certainly a very stressful day.
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