September 8, 2013, Cincinnati Children’s Hospital, Intensive Care Unit
PICC line (Peripherally inserted central catheter)—It is a long, slender, small flexible tube that is inserted into a peripheral vein (from an extremity), typically the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access.–PiccLineNursing.com
Cory and his PICC line knew each other really, really well. He’d had one coming out of his arm through much of his first cancer treatment and had one placed in his arm for the past 6 months of his Leukemia and Bone Marrow Transplant treatment. When he was admitted in the hospital, it was hooked up to his Pole and all the lines that came from it. When he was out of the hospital, he gave himself his needed medication through the PICC Line. Most of us stopped noticing it because it was always there, covered by a piece of cloth.
Everything went into Cory’s body through this access point—chemo, antibiotics, blood, platelets, pain meds and TPN….whatever the needs of the day might be. He was being fed and hydrated intravenously at this point in the ICU. (TPN was a solution containing all the required nutrients, is injected over the course of several hours, into a vein. TPN provides a complete source of nutrients for patients who cannot consume a normal diet.–medical-dictionary.com)
And it was really important to keep the area around the PICC line clean & sterile because everything went into that larger vein near the heart….easy for the little Evil Creepers (bacteria, fungus, and virus) to make their way into Central Control. Special nurses came in every couple days to change the dressing covering the PICC Line. It looked like a surgical procedure with all the gloves and mask hand outs to anyone in the room…just to change a bandage. We stood way back, as if someone was dismantling a bomb, but it was to protect him from us…not the other way around.
Due to skin breakdown from his GVHD(Graft vs. Host Disease), his skin around the site literally began to peel off from the bandages and tape. Peeled off, not as in a sunburn peel or flaky dry skin. Layers of skin, some an inch in width, strips of skin–gone. It was one more pain-full thing for him to endure….more open wounds, more pain meds, more healing to be done.
The To-do list keeps getting longer…
Starting to feel a little like shoveling snow in a snowstorm here in the PICU.
Witnessing the Changing of the Bandage was excruciating to watch, along with many subsequent encounters with Pain he endured over the following 6 weeks. (I’d become a quiet crier by now, though. Tears with no change in facial expression, no uncontrollable weirdness of my upper lip, no sobs, no shock. Just feelings of helpless empathy. Charlie or Dave or Mom, patted my back in solidarity or I them, as they often welled up with powerless parent tears of their own during moments like these. That said, witnessing doesn’t hold a candle to experiencing—I still can’t imagine what all the Pain felt like for Cory. I will forever be in awe of his mettle.)
They eventually began to use a short-term anesthetic to get him through what would normally be a simple, painless procedure.
Then the wounds started to show signs of infection(a.k.a. bacteria), which were right next to his PICC line, which went into his bloodstream, soooo….they changed the site of his PICC line all together. They took it out of his arm and inserted a new one near his groin.