We had a rude awakening this morning with the phone ringing just before 6am (about 5 minutes before the alarm was due to go off). It was Becca's night nurse saying that Becca was due down in intraventional radiology at 7am if we were planning to go down with her. She was scheduled to have another PICC line placed in the other arm.
We were astounded as we had not been told that another PICC line was being placed. Apparently the orders came through yesterday around shift change time for the nurses so the orders must have slipped through the cracks. Regardless of whether the nurses did a whoopsie we were not consulted at all on this by any of the doctors before the order was even put in!
We told the nurse that called that we did not want Becca getting another PICC without a consult and that she shouldn't be taken down to radiology.
Discussions with our neuro have since taken place
We talked about the PICC line saga and he said that he had had a call from the practitioners asking whether he had any adversity to the running another PICC for the easier administering of the antibiotics and blood draws. He said that he told them he was fine with it thinking that once he had approved they would get back to us and discuss another PICC option. He thought they were just getting their ducks in a row before approaching us. He was really annoyed that it hadnt been discussed with us and he was going to make sure that they were "told" about their lack of communication with us.
He doesnt see that another PICC will do any harm in essence as far as the clots are concerned, but he understands our concern about her developing another clot especially as her non PICC arm is already showing signs of bad circulation.
He says the normal procedure with clots is to pull the line whilst having the heparin (a much larger dose which Becca cannot have)and the clots usually dissipate faster without the line being there and there are no problems, but in Becca's case he knows that option has been explored and dismissed as she runs the risk of the clot ending up in her brain if it is dislodged.
We have left it so she can have more IV's placed if needed (she will need because her existing one is on its way out I think) and hold the PICC for now as all it was being placed for was to save sticking her with needles. He says if we change our mind about the PICC we can let him or someone know but he believes that carrying on with the IV's for now is workable as long as Becca is able.
Hopefully this will only be for a few more weeks, if her brain gets the all clear we should be able to go onto oral anti-coagulants.
Dr Grondin was just in.
We talked about the PICC line saga and he said that he had had a call from the practitioners asking whether he had any adversity to the running another PICC for the easier administering of the antibiotics and blood draws. He said that he told them he was fine with it thinking that once he had approved they would get back to us and discuss another PICC option. He thought they were just getting their ducks in a row before approaching us. He was really annoyed that it hadnt been discussed with us and he was going to make sure that they were "told" about their lack of communication with us.
He doesnt see that another PICC will do any harm in essence as far as the clots are concerned, but he understands our concern about her developing another clot. He says the normal procedure is to pull the line whilst having the heparin (larger dose) and there are no problems but in Becca's case he knows that option has been explored and dismissed.
We have left it so she can have more IV's placed if needed (she will need *** this one is on its way out I think) and hold the PICC for now as all it was being placed for was to save sticking her with needles. He says if we change our mind about the PICC we can let him or someone know but he believes that carrying on with the IV's for now is workable as long as Becca is able.
Hopefully this will only be for a few more weeks, if her brain gets the all clear we should be able to go onto oral anti-coagulants.
The oral anti-coagulant will only come into play once he feels her brain doesnt need anything else doing to it. He feels that he needs another few weeks to establish whether or not she will be drain free. The oral meds mean that he would have to wait much longer for them to clear out of her system once on a regular dose and heparin would still have to be used as a bridge and then the heparin would have to be stopped too, a long process to wait through if she has to have any procedure on her brain.
So we are in a holing pattern just for now. The PICC hasnt totally been ruled out but we would like to try and hold out.