If you recall, my PICC line has been recalcitrant when it comes to blood draws. We have Caf-Pow’d 3 times and we still don’t get blood return. So tomorrow, I am getting a brand, spanking new PICC line put it. This time on my right side.
Apparently, even though it is a longer route from my right arm to my heart, it is a more direct route. Left side PICC lines have tighter turns and can get pretty picky about how the body is positioned for it to work well.
It also turns out that PICC lines are put in by interventional radiologists (IR). While my PCP was discussing my case with the IR doctor, she brought up the subject of my G/J tube.
In theory, G/J tubes can be changed by IR doctors as well as by the interventional GIs, who do it endoscopically. When my tube flipped the first time in MA this past summer, I was sent initially to IR to have them replace it. They tried, but a combination of the angle of my stomach and my anatomy made it impossible to make a turn. They kept the stoma open with a temporary G tube and referred me to the endoscopy department.
The local IR doctor told my PCP that GIs have a tendency to place and angle their stomas in such a way that can make it difficult for IR to change the tube. So at least I know that he has encountered difficult placements before.
I really have nothing to lose by letting IR take a shot at swapping out my tube tomorrow. I am not using the current tube at all because it is all clogged from disuse. If they succeed at swapping out my tube, then I can start the process of slowly switching over from TPN to enteral feeding immediately. If they are unable to swap the tube successfully, then it will be done endoscopically at Stanford on December 19th.
There is some minor collateral damage from all this. David and I had to switch sides of the bed, after 26 years, because I needed to have my left arm on the outside so I could feed while I slept. Tomorrow, after 3 1/2 months, things return to their normal order.
But I do have some regret. Ever since we switched sides, Xena Malka has given me the most amazing early morning cuddles. David is really her human, but she has stepped in a bit since Dancer died and I was left catless. But since we switched sides, she has really stepped up her game. But if she is consistent, then those amazing cuddles are about to come to an end.
When we first moved to Astoria, two and a half years ago, David and I switched what side of the couch we sat on. This was to give David the seat closer to the window. Xena Malka’s response was to completely ignore David and lavish me with all of the attention. This hurt David’s feelings, so we tried to figure out what he was doing that was so upsetting to her. We swapped seats on the couch and suddenly David was back in her good graces.
So it is possible, even likely, that as soon as David and I go back to our usual sides of the bed, all of the love and affection that I had been getting will get redirected to her actual human, David. This is the price I have to pay for good blood return. So be it.