So much for a more positive year!

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For some reason my body does not like the internal stitches they use. A little over 3 weeks ago the docs went in and removed the 8 or so wires that were wrapped around my sternum from my heart surgery. Only one of the wires was causing issues, but they were going to be "revising" my scar (chopping out all the extra tissue from where it kept getting wider), so we figured they might as well just get them all out.

On Friday the bottom of my scar was looking infected. It was red, swollen, and quite hard. I went into the clinic, and they could see a stitch right under the surface of the skin, so figured that's what was causing it, and decided to open the incision enough to remove that stitch and find the knot at the end and remove that too. They did so, and it all looked better the next day, but for some reason I was in excruciating pain, in a band across my chest just under my breasts.

I ended up going to ER where after a bunch of tests, one of the surgeons who removed my wires was called in - he was the guy on call for the weekend luckily, He knew the situation and my history, so poked around in the incision that was made the day before, and saw a bit of fluid, poked a bit harder there, and the cotton tip he was using disappeared a good cm or two under my skin which fluid came out of - a pocket of infection.

I was sure this was the culprit, so was pleased when he opened my incision a bit further using local anesthetic this time (*#^& those lidocaine injections hurt). That night was ok, but the pain started coming back. I had vicodin and a sleeping pill before bed (which would generally knock me out for at least 8 hours), but I woke 2 hours later in possibly the worst pain of my life - worse than anything post-heart surgery. It hurt to breathe, and it hurt to make any sort of movement. I have a fairly high tolerance for pain, but this was the sort of pain that took my breath away, made me nauseous and had me crying.

So back to Stanford we went, where they decided to run some more tests, then admit me. They gave me IV Delaudid which is supposed to be 8 times stronger than morphine, and it didn't do a thing for the pain. (Apparently it's also supposed to be 3 times stronger than heroin on a per mg basis...)

All tests have still been clear still, so they've had me on IV antibiotics which will hopefully sort out any hiding pockets of infection, and regular IV pain medication. They've been giving Zofran for nausea as well as the pain meds as I don't tolerate the drugs very well, and have only had 1 bout of vomiting (6 1/2 hours after the last pain meds!).

I declined pain meds after that 1pm dosage as my pain levels were finally dropping, and I was starting to move around a bit, and I wanted to know if it was due to the pain meds, or if the pain was actually going away. I went to bed around 9pm, and woke up every 2 hours (sleeping in a hospital is not easy), but I still managed to get a good amount of sleep, so that's fine. I was woken at 2am or so to get more IV antibiotics and I was in pain then, so got more pain meds. The pain wasn't as bad as the day before, and it stayed pretty much under control after that.

Given that this has happened twice now, my cardiologist, who popped in on Sunday to say hi (very nice of him, since he has weekends off!), thinks I might have some sort of allergy to the Vicryl stitches they use. They are supposed to be absorbed by the body, but I have another stitch coming out at the top of my scar (possibly another knot). It's poking through the skin, and it's not red or sore, so hopefully it will come out problem free.

So on Monday, they got test results back and confirmed it was staph. Again.

They wanted to do aggressive treatment of it given the graft in my aorta so they inserted a PICC line. It's intravenous access, but it can stay in for weeks so they can do IV fluid without me actually staying in hospital. They're assured me it's just like inserting an IV, but they feed a long tube up to a bigger vein. I was feeling quite faint just thinking of it. The bad thing about having a laptop at the hospital is when they say what they plan to do, you can Google it and flip out.

And for someone who doesn't like needles, looking at this IV thing that goes in the inside part of your upper arm (see any veins there?) and a 50cm long tube that connects to it is enough to make a sleep deprived person throw a hissy fit.

My main freak out was on Tuesday morning. I had almost no sleep thanks to the lady in the bed next to me whose oxygen levels kept dropping which meant her alarms kept going every couple of minutes (BEEP BEEP BEEP!), and it sounded like it was coming from my alarm, so it kept me awake and worrying.

I was waiting for someone to come and do an echo to make sure this infection wasn't ripping my heart valves apart (lovely thought), and waiting for someone to come and insert this scary long tube into a vein that I was sure would be impossible to find. I had no idea when either was happening, so was losing it. For those who think I'm being brave, trust me, I am not and was not.

Andrew thankfully left work to come spend the rest of the day with me and keep me calm. He went to speak to my cardiologist about all this. As a side note, this is what I like about the cardiac team and being in the hospital where they are. Andrew just goes to their clinic area, walks past reception, goes to find the coordinator who most probably gave him a big hug when she saw him, he asks questions about the PICC line, and she immediately calls the doc's mobile phone who comes straight in to see him (he was looking at my echo at the time that had been done not long before, so could also assure Andrew everything was fine).

My doc said that the risk of infection to my heart was increased due to the nature of the infection, and having an aortic graft, but unlikely, but there is no way anybody wants to risk it, so yes I should get a PICC line, it will be done at my bedside, under local anesthetic, and I will be fine.

I was still worried, but at least by this stage I could nap on and off with Andrew watching over me.

So the echo on my heart was clear (WHEW!), and the nurse came in the afternoon to do the PICC line. She is a PICC nurse - that's all she (and a team of others) do because it's so common in hospitals as it causes less trauma in the long run.

She was also so lovely, and she had a girl there who was interviewing for a nursing job who was just coming to watch. So my nurse was explaining everything to the interviewing nurse which was good - I like to know what's going on.

The lidocaine injection was about as hurty as I expected (I hate those), then it was fine from there on in. The nurse makes it a sterile environment, finds a good vein using ultrasound, then somehow feeds an IV into the vein in my arm (I couldn't see and didn't want to), and then places this cool thing on my chest which tracks the path of the wire inside my chest. It was pretty amazing to watch the screen and just see this little wire snaking through. Once the wire dropped down, she knew it had passed through the vein, and reached the larger superior vena cava. She then uses a "wing" lock, and stitches that to my arm to keep the tubing in place, places another lock a bit further up the tubing so if anything tugs on the tubing, it tugs on that lock rather than the tube coming out of my arm, does some more anti-tug and anti-infection measures, and covers it all up. There is also 2 ports attached to it that I can use. One of them is a bit bigger, so if they want to take blood, they can do it from there rather than poking me.

Once I had that done, I was pretty much able to leave hospital as I could then receive my IV antibiotics from home through my line. So the next day (Wednesday) I finally got released - I just had to wait for a home nurse to be available to bring me all my supplies and show me what to do, and they had to keep giving me antibiotics in the mean time.

The home nurse came, and we were quite impressed with the set up. I have a 2 week supply of IV antibiotics (sitting in the fridge between the OJ and the tortilla wraps), and a heap of saline and heparin solutions in plungers, alcohol wipes, IV tubing, and other exciting bits and pieces. Each bag of fluids is a 24 hour supply and delivers 100ml doses of antibiotics every 4 hours, and it takes 1 hour to deliver the fluid. So there's 3 hours break in between, and in that time it delivers small amounts of the same solution just to keep the line clear and flowing. So I wear this constantly, and don't need to worry about constant care throughout the day, or accidentally missing a dose which is nice. I do have to carry it everywhere for 2 weeks though. Also included is a computerised pump which controls the dosages and pumps the fluid through, so the bag doesn't need to be kept above the level of my arm.

They gave me a bag for the fluids and pump that I could throw over my shoulder and carry everywhere but by last night my back was aching - it's not the most ergonomic design. I had a think about it, and discovered the Camelbak that I used in my triathlon days would be a good size to hold it all though. So the pump and fluids are now in that, and it is easier to carry around and puts less pressure on my back.

You have to be very careful because everything comes in sterile packets, and you have to make sure everything is super clean, as the line goes straight to your central bloodstream, and you REALLY don't want to introduce germs/bacteria from touching or even breathing on anything that can be transported through the tube. It's all gone fairly smoothly apart from one small incident today when I forgot to unclamp the tube (the instructions say to clamp the tube, but don't say to unclamp it, so if you just follow the instructions, it's easy to forget), so when the time came to pump the antibiotics in me, pressure built up and exploded the filter that the antibiotics go through. No big deal, it just meant changing the line again. The whole process could definitely be more idiot proof.

So that's where things are at. I still have a hole in my chest from where they drained where they thought the infection was, so those dressings need to be changed 3 times a day (something I can do myself), the IV fluids need changing once a day (can do myself now), and showering is just a bit challenging as my left arm is covered in a plastic cover, since the PICC area can't get wet, so I have just the one arm. I also have my Camelbak sitting on the loo, next to the shower so I can shower without disconnecting everything (the tubing can get wet, just not the insertion site). All this makes showering a slightly more challenging process, which Andrew is still helping me with (washing my hair with one hand, and a line between my arm and the toilet is the most challenging thing so far).

Otherwise I'm feeling fine. I was feeling exhausted at the end of last week, but feel a bit better now. I can't lift things or move my left arm too much or the insertion site of the PICC line hurts. I'm doing a Certified Nursing Assistant course at the moment in the evenings, and we just started clinicals, which are just too hard right now, so I'm going to see if I can do the Fast Track course which they are just starting next month - it's more hours each day, but it's during the day time which is more practical for us, it will give me time to heal, and it will only finish a couple of weeks after the current course. I also have an exam on Wednesday, and I'm well behind on my study, but I should do ok still.

Oh and I should add (I copied most of this from Facebook, and know a little more now), that they think at least some of my pain may be caused by gallstones. Where the majority of the pain was is more like gallbladder pain, and I have a heap of gallstones apparently. They did an ultrasound while I was there which confirmed the gallstones, but didn't show any of the usual signs of the sort of gallbladder problems that require immediate surgery. It may be coincidence that I got them at the same time, or maybe stress from the incision brought on the gallbladder pain? Either way I need to get all my scans and get it checked out by someone who isn't a cardiologist!

Andrew's been wonderful once again - if it wasn't for him I probably would have demanded to be checked out of hospital without getting any of this done, and ended up in much worse shape. Poor thing may end up with a drinking problem by the end of this though - neither of us can take much more! The fact that he helps with dressing changes, IV bag changes, and watches people cut into me so he can hold my hand is really quite amazing.