My veins are not playing ball. According to one Nurse they are spidery, superficial and collapse as soon as a needle comes near them. This is the accumulation effect of the Carfilzomib drug and not unexpected. I had hoped this side-effect may take a bit longer to kick in but hey I want the drug to work so I will take some of the after effects! For each needle insertion attempt that fails – is it Bad Karma? Maybe for my veering off course with my plans… the odd coffee, sip of alcohol, not enough rest…a fabulous slice of chocolate fudge cake on hubby’s birthday (hey I’m only human!).
On the first day of my veins playing ‘hide and seek’ (Nurse L’s description) and after two Nurses had taken two to three pin cushion moments on my arms (with my permission) they called in K. As he and Simon bantered about K being the ‘big gun’ and having a ‘big probe’, I discovered what K had brought with him was an ultrasound machine, and that he is one of the few (possibly only) Nurse trained on the Chemo day unit) in using ultrasound for finding veins. In that moment, I loved K; he found a vein quickly and had the cannula in my arm in a flash. The hours of trying to find a vein were not in vain!!
So yesterday when Nurse L said, ‘I’ve come to make friends with your veins’ I said ‘absolutely’ thinking that just because it been hard to find them last week didn’t mean it had to be hard again this week. Unfortunately, that was not the case and the ever-cautious Nurse L was wonderful and genuinely sorry it wasn’t going smoothly. My next request was, could we not muck around any further today please, and get K and his ultrasound. This is when I found out K wasn’t in. K of course is allowed a day off (or two!) however I was unimpressed that only one person can use the machine I need. I imagined that given they know of the accumulation effect of Chemo, I am not the first person to have elusive veins.
Nurse G said he was rusty on using the ultrasound but he’d give it a go. He showed me the images of my veins disappearing as soon as a gentle pressure from the probe was applied in my arm. He abandoned it and said he wasn’t confident enough to use it successfully. Good news though; he checked the back of my left arm and said he could see a vein. He checked whether it be ok to try otherwise they would probably have to insert a PICC line. I didn’t want a PICC line before absolutely necessary so I gave the go ahead, hoping like hell it would work. I could have kissed him, straight in, a little sore but the needle didn’t escape the vein; Si and I escaped the Chemo unit by 5pm.
Kicking in to rationale mode, I started thinking;
- It’s not my fault I need an ultrasound, or that only one Nurse seems to be able to do it; I will always need that Nurse to be available on my Chemo days
- The scenario above is not the Chemo Unit Nurses fault
- It is an unacceptable scenario
- I shouldn’t have to have a PICC line earlier than necessary just because it’s convenient for staff
Moving into problem solving mode; I decided I need to
Ask my consultant;
- How to resolve this; is there another nurse from another team who can be scheduled/ available?
- Can K be scheduled for my Chemo days (cover when he’s on leave)
- How quickly can another Nurse be trained to use ultrasound?
Also ask my consultant about below…
- How much does a private Nurse with right skills cost, can they attend NHS site, can they bring ultrasound machine or use NHS equipment (liability, insurance, clinical trial, other
PICC lines are peripherally inserted central catheters (long, flexible tubes) that are put into a large vein above the bend in the elbow, threaded into a vein until the tip sits in a large vein just above the heart. PICC lines can make things easier for Nurses and for me; it means there is always a line into a vein (with a removable cap) that enables a bag of intravenous drugs to be easily attached; there would no longer be a need to poke around with needles to put a cannula in or to take blood.
On the flip side, PICC lines stay in, require a local anaesthetic and chest X-ray (to check positioning) which are no big deal but are more procedures, and insertion may need to be done multiple times to get the right position. PICC lines get in the way of clothing, need cleaning and re-dressing weekly (Mondays would become even busier visits to hospital), the lines stay in for weeks or months, non-Chemo weeks would then involve visits to hospital. Finally, they are another daily reminder that I have cancer and how my life is different now. I knew i would happily have one when it’s necessary; it just doesn’t feel necessary yet when ultrasound searching for veins has worked.
Today was also a case in point for deferring PICC for as long as possible. I kept my arm and hand warm all morning, under two thermals and a glove. Nurse L found a vein first time. Lovely.
I was in and out of hospital in under two hours.
A tough week ended in A GOOD DAY!
Image: Macmillan information sheet on PICC Lines
Illustration (Scaredy Vein): Sapphire Weerakone
© 2017 Janine Hayward www.psychingoutcancer.com. All rights reserved.