Tuesday, July 31, 2007

Additives for the PICC Line

Today my multivitamins and Pepcid arrived. Shelley, my nurse, came by and taught me how to add them to each new IV bag. I can't tell a difference yet but am hoping it will help. The multivitamins turn the IV fluid a lovely, pee yellow color - it is actually a bit disturbing. :)

Levi is moving and kicking like crazy. His new thing is kicking my ribs. You can feel and see exactly where he is when I am sitting or laying down. I love feeling him move around.

I have been reading stories about some of the women who experienced HG. Their stories are so much worse than mine. Many of them ended up terminating at least one of their pregnancies because it got so bad. Thank the Lord I haven't gotten that bad. It is shocking but the majority of doctors out there don't have any idea about HG. Personally, my doctor doesn't know what to do with me. Thank the Lord for Matria. They are the support I needed from the beginning!!

Sunday, July 29, 2007

Levi's Heartbeat

One of the fun things about having a nurse come weekly to change the dressing is that we get to hear Levi's heartbeat every week!! At the beginning of July John went out to visit his parents - so I stayed at my parents house while he was gone. Mom, dad and Kyle got to hear Levi's heartbeat! I never get tired of hearing that little one inside me!! (Since some of you asked...the line on my tummy is the scar from having the ovarian tumor removed in 97')

Saturday, July 28, 2007

I Am So Excited!!

After months of searching everywhere for the perfect crib bedding, we have found a winner!! When it comes to Levi's clothes and bedding I am so picky! I don't really like clothing or decorations with animals, characters, trains, bugs, etc on them. Most of what is out there has all of the above all over them!! I knew I wanted blue and brown with circles - and it was quite a search to find what I wanted!!

So here is the crib bedding! I absolutely love it!! Our crib set is black - this is a picture off the website.


When we first found out we were pregnant I looked forward to all the fun things that come along with it. Dreaming about our baby, getting their room ready, picking out names, registering, baby showers, my growing belly...so many fun, new things ahead. It has been hard because we haven't been able to enjoy this time like I hoped we would.

The invitations for the first baby shower went out over a week ago and we still hadn't registered. John hurt his back several weeks ago and still hasn't recovered - so heading out to register was the last thing on our minds. My friend Wendy and I were joking that we would have to go and both be in wheelchairs!!

We finally got the registering done at Target and Babies R' Us this last week and it is such a relief. However, it is so hard on my body when I am out. It was a really tough week for me physically. My nauseau level has been off the charts and I am exhausted all the time. Jen, my Matria nurse, is going to order some Multivitamins that will be added to the IV bags, as well as, Pepcid. This will give me some nutrients and hopefully help with the nauseau. I have been able to stay home and rest the last couple days so I am feeling a bit better now!!

Here are some recent pictures of me. I am 7 months now!! The due date is October 16th - we are hoping for an early induction though!! It will all depend on Levi's development!!

October 16th, 1997 I was a senior in college in California and was diagnosed with Ovarian Cancer - what an amazing miracle it is that our due date, October 16th, is the 10 year anniversary of the day I was diagnosed!! Levi is a miracle baby!!


I thought I would show what a PICC line is, what it does and how it all works together. This will be a little graphic so if you are on the queasy side, you may want to skip it. I had never even heard of a PICC line before this mess, but apparently they are very common for other things and are an expeditious route to deliver meds, fluids, and TPN. So this is my reality and the reality of women who are so much worse off with HG than me. Something I realized through chemotherapy 10 years ago and now is this: there is always someone WAY worse off!!

Here we are getting the line inserted:

My mom and John went to the hospital with me for support. While they were preparing me for the procedure mom and John were over in the corner discussing the remodeling he is doing on one of the bathrooms in my parents home. I finally had to ask them to come and pay attention to me and support me!! Those stinkers!!

A PICC is the acronym for a Peripherally Inserted Central Catheter. A PICC is a thin, long, soft plastic tube that functions as an intravenous (IV) line. A PICC is often placed in radiology by a radiologist and a PA.

Before insertion, the radiology tech measures the distance from your arm to your chest to determine the length of the catheter needed. The tech then uses an ultrasound device to assist with locating the large blood vessels (veins) in the upper arm and marks their location. Then, your arm is prepped with an anti-bacterial soap and betadine and then covered with a sterile cloth to prevent infection. All parties wears sterile attire for this procedure.

Once you are prepped, the tech places a tourniquet on your arm right and locates the large blood vessels. The site is then numbed (or numbed as well as possible) with Lidocaine. Then, the PA uses a needle to enter the vein, inserts the introducer wire, and guides the PICC line into the superior vena cava that feeds into your heart. Following the placement, an x-ray is taken to ensure that the PICC line is accurately positioned near your heart. The whole process takes around an hour.

Diagram of a PICC line placement. Mine is placed on the inside of my upper left arm:

A double lumen PICC before insertion.

My PICC line (fluids being run) - My color has really improved over the past few weeks.

Saline Flush (no needle kind) & Heparin Flush. Both lumens (ports) must be flushed daily and before and after any infusions with saline. Both most also be flushed daily with Heparin (an anticoagulent).

Nothing is to penetrate the plastic dressing. No water, no nothing. Here I am with my arm wrapped in saran wrap and taped up with a ziploc bag - I couldn't bend my arm so John had to help me wash my hair!!

The dressing is changed weekly with both the patient and the nurse wearing masks to avoid contamination. I don't look at the line when its uncovered to prevent breathing on it. My arm is always sore for a day or two after the dressing is changed. The have to move the line around to clean it up - it does NOT feel good.

Close up of my PICC: this is after 2 weeks of having the PICC inserted.

So that's that!! It was a really scary procedure for me - but I am so thankful to have it now. It has taken me awhile to sleep well with all these lines - but I finally am sleeping great at night.

Veins that "Blow" and IV's that are "Infiltrated"

My friend Wendy and I!! I am 22 weeks here. We have a homemade chocolate mask on!!

After a week of being on the Zofran pump and seeing no change - Jen, my nurse at Matria, suggested I begin IV's. I was having a lot of painful Braxton Hicks contractions - which are a direct result of dehydration. I was ecstatic to get hooked up to an IV!! The nurse came and poked me 3 times before she found a vein that didn't "blow" (the needle goes out the other side of the vein - because I was so dehydrated). The IV lasted 2 days before it got infiltrated (this means the IV started coming out of the vein, my arm hurt like crazy and my arm started to blow up like a balloon). I had to take it out. At this point my insurance wouldn't allow Matria to restart the IV until my ketones (something you test in your urine) showed that I was dehydrated again. After getting restarted 2 more times - and having traumatic experiences with my veins continuing to blow - Jen suggested a PICC line. This is a Peripherally Inserted Central Catheter that they insert into your arm - and you can leave it for up to 2 years!! This way I will be able to receive IV fluids and Zofran with one poke!! YEAH!! No more knots on my tummy and thighs!!

Morning Sickness? Hyperemesis Gravidarum? Zofran Pump?

I wish I had started this 6 months ago...there is so much ground to cover!!

The first 3 months I tried every remedy I had heard of with absolutely no relief (actually some of these remedies made me vomit more). I threw up everything I ate - between 5 and 10 times a day. Everyone told me that after 3 months I would feel great and have so much energy - I looked forward to that so much! After passing the 14 week mark we started to realize we were dealing with more than just average "morning sickness".

I was exhausted, John was frustrated and tired of his grumpy, sick wife (he also missed his homemade meals) - we were all at a loss. I lost 10 pounds and hardly looked pregant until I was in my 6 month. We realized I was suffering from Hyperemesis Gravidarum. It is a morning sickness disease that less than 2% of women have during pregnancy. Of that 2% of women most feel better after 20 weeks. To read more about HG I have added a link on the right.

I talked to the nurse at my doctor's office daily. I tried all the different anti-nauseau medicine available - Reglan, Phenergan, B6, Doxalymine...you name it, I tried it. None of them gave me any relief from the nauseau and vomiting - plus, they made me tired, spacey and I felt weird. The final medicine - which is the strongest available - is Zofran. This medicine is normally given to chemo patients to alleviate nauseau. It costs around $30/PILL and you need to take 3/DAY!! Each bottle cost around $900!! Praise the Lord we have group insurance and they cover it. Zofran took the edge off my nauseau - but I still threw up everything I ate and drank.

I was on oral Zofran for almost 2 months when I hit my breaking point. I was weak, tired and hungry - I was absolutely miserable. Finally the nurse at my doctor's office had me go into the hospital and get an IV. I was there for a few hours and got 3 bags of fluid. After a miserable weekend, I called the doctor again on Monday. At this point they suggested something called a Zofran pump. I was totally freaked out to get this and dreaded having something attached to me at all times. A company called Matria sends a nurse to your home and hooks you up. I had to put a needle in my thigh and hook up a syringe - the syringe went in a tiny contraption (the size of a remote) that slowly administers the medicine throughout the day. I have to carry the pump with me at all times.

Here I am with my Zofran Pump in my tummy and IV

Zofran is tough on the tissue and you get a hard red knot about 3 inches around that really hurts!! Once it starts getting sore & red I have to change the location to another spot on my thigh or tummy. The result: tons of 3 inch around hard, red knots all over my thighs and stomach. It was really hard to sleep with all those sore spots!

Matria is the most amazing company. This company specializes in high risk pregnancies. They come to your home and have a 24 hour call line available. A nurse calls you daily to check in with you. The nurse I talk to daily, Jen, is a lifesaver. She helped me figure out my "triggers". These are things that guarantee vomiting and nauseau. Here are my triggers:

1. Drinking any amount of fluid (yes, even water)
2. Eating more than 3 or 4 bites of anything at a time (there must be at least 30 minutes between snacking on anything)
3. Motion (leaving the house for anything, being in a car, working around the house)
4. Eating anything other than carbs (I eat crackers, fruit popsicles, toast, bagels and a few nuts)

Once we pinpointed these triggers - I finally gave up on trying to eat a normal meal. Going out to eat is extremely depressing for me. I told John that a couple weeks after Levi is born we are going on a date (without Levi) to an expensive restaurant and I am going to EAT!!!!! I miss eating and drinking!! I have decided that with all the things I am going through there are 2 things I should be allowed to do:

1: Drink Alcohol (if anyone needs alcohol it is me) :)
2: Cuss :) (Everywhere I go my tubing from my IV and Zofran gets caught on doorknobs, drawers - anything that sticks out at all!!)


As you all know the last 7 months have been very interesting with our son on the way!! I planned to start a blog once Levi arrived so that I could keep you all updated with pictures and stories - but decided now would be a good time to get things started! I am constantly sending out pictures and updates on my progress and thought this would be a better idea! This way if you don't want an update then you aren't subject to receiving one anyway!! :)