Late Night “Food” Drama

Since Karri came home from the hospital last week, each night we have changed her liquid food sack, the 24 hour TPN (IV infused nutrition) that Karri is receiving. Since none of us have a bit of medical training, it has been a fairly intense process. We have saline syringes and needles and alcohol swabs and all kinds of exciting procedures we have to perform using them. We take the sack with the nutrition mix out of the refrigerator two hours before changing it so that it doesn’t chill her veins when it begins to pump through. We have a $5,000.00 pump that is all programmed to dispense the liquid at the rate that is right for Karri. Before hooking up to the pump and connecting the tubing to Karri’s IV port line, we add a small amount of insulin as well as various multivitamins and an antacid to the mix. We have to draw it up out of vials into the syringes – we are beginning to look pretty darn professional after just a few days! Nonetheless, the learning curve has been somewhat steep and we have had a few surprises, such as when we learned that we had accidentally added 10 times the right amount of insulin one evening. Happily we learned that before we hooked it up to Karri! That bag went out to the garbage and we prepared another.

Last night we had the sack of liquid all prepared, and we started to flush the line into her port with saline solution. They have us do that each time to be sure the line is clear. The saline didn’t inject as easily as we had remembered from previous evenings, but it did all infuse into the port line and so we hooked up the TPN from the pump to the port line and pushed “run” to start. A moment later Karri looked down to see that rather than having the milky liquid infuse into her port, she had blood from her port running down the line toward the TPN sack. PANIC! Everyone had the presence of mind to clamp off the tubing at each end of the line and then we looked at one another and at the blood caught in the tubing and wondered what on earth we were going to do. Of course we immediately called the 800 number help line, but it was already about 9:20 and Karri was already tired and feeling quite a bit of nausea and pain from chemo, which had arrived, just as promised, on the second day after.

To make a long story short, we finally had two nurses arrive at 11:25 to take care of the problem. It was a little surreal sitting around looking at all the paraphernalia and not having the slightest idea what had gone wrong, particularly as the hours ticked away. First they tried to talk us through ‘trouble-shooting’ on the phone, but we ran into a road block when we couldn’t detach the tubing from the port line as instructed. We all tried and it was stuck tight with some clotted blood. We felt rather sheepish that we couldn’t detach it as instructed, but when the nurses couldn’t do it either, we felt somewhat relieved that we hadn’t screwed it up through general incompetence. In the wee hours of the morning, they ended up changing the needle input on her port line before they were able to hook up the TPN – somehow it had become blocked. The nurses were wonderful, but we felt a little shell shocked. We couldn’t even remember anyone telling us that such a thing was a possibility we might run into. They change the needle routinely once a week and we assumed it would just run like clockwork in the interim. For some reason, this needle decided to quit working early, which is what we felt like doing ourselves. A bit bleary eyed and a bit giddy from the late hours and the drama of seeing Karri’s blood coming down the line, we all fell into bed about 1am. Although Karri still felt a lot of nausea, she and all of us slept deeply (the sleep of exhaustion, I suppose), leaving tomorrow to take care of itself, knowing only what we have so far learned in this cancer journey - we can't predict what it will bring.