Wednesday, July 29, 2009

Mom's PICC line out AGAIN

It just never ends.

Dad told me that Mom pulled out her PICC line sometime in the early morning-- around 5AM. She rolled over in bed and tapped him on the shoulder; Dad "felt something plastic" in the dark, and knew right away that disaster had struck again. He has since been calling to schedule Mom for another short-stay clinic berth to get her PICC line reinstalled. The clinic has yet to respond with a firm schedule. Dad's hope is to get Mom into a berth after her radiotherapy is done; for the moment, he's not too worried about how she's doing, as she doesn't seem to be manifesting any problems, like hemorrhaging. Dad measured the PICC line, and its length matched the stats he had been given during our hospital visit last week: the entire PICC line had again come out. Nothing remained inside.

So the big question was obviously, How did Mom get through all that bandaging-- the bandaging she was supposed to have had ever since the first time she removed her PICC? Dad's answer shocked me: after that first night back home from the ER last week, he hasn't been bandaging her arm to cover the PICC. Instead, he's been covering the PICC with a thin elastic cuff, or some other such frail shield. "She was doing so well for six days," Dad said. I have no idea why Dad would assume that Mom's previous behavior would be a guide for her future behavior, given how often her state of mind has been changing. Dad also said he had tried reasoning with Mom: "You don't want to go back to the ER again, do you?" I shook my head in wonder: we've known for a long time that Mom is no longer capable of proper reasoning. She is, in many respects, like a forgetful, innocent toddler.

Keeping the PICC line out of Mom's reach is so absolutely fundamental that this incident blows my mind. It didn't have to occur; prevention required only a bit of vigilance and a proper understanding of Mom's mental state. Blithe assumptions that she's "doing so well" are completely unwarranted. From now on, I will be the one to make sure Mom's arm is properly secured every night. Shame on me for not checking this from day one.

UPDATE, 12:49PM: Dr. Meister's office, which has taken over responsibility for monitoring Mom's PICC line (Dr. Yoho, the infectious disease doc, was seeing Mom through her daptomycin regimen), doesn't think Mom needs to have her PICC put in today. We're meeting with him tomorrow, so we'll know more then.


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