We had the dreaded conversation about line access with our surgeon today. There are only so many places in the body that you can place a central line, preserving vein access is huge in our world. Lucy will have a scan of her upper extremities sometime tomorrow or the next day to look at all of her veins so that we can strategically locate a new spot for her new central line that we are hoping to have placed on Friday. Our surgeon was urging us, however, to consider keeping the PICC for as long as possible, but in the same sentence did say that he would keep our OR time slot on Friday. We understand the need to preserve line access, but we also need to consider Lucy's quality of life when it comes to having to live with all of these lines and tubes in her body. Where the PICC is placed is a terrible location to have a bunch of tubes coming out of your body. Lucy woke briefly tonight and started pulling at her new line. She's not happy with where it is and wanted it out. She's still pretty out of it tonight, hopefully when she is a little more alert in the morning we can talk her into not pulling at it.
As for her gallbladder tube, after cauterizing the granulation tissue that was growing around the stoma they were able to successfully place a new tube with relative ease. One of the reasons we choose to keep Lucy's gallbladder tube is so that we can use it as a potential pop off drain if the stent were to become occluded. Last week Lucy put out more drainage from that tube than ever. When I told our surgeon this it prompted him to look further. When injecting dye into her stoma site they discovered that her stent is partially occluded with sludge and debris. The stent is draining, albeit not as well as it could. Our surgeon is going to call Dr. O at Hopkins and find out if he can clear the occlusion via ERCP. Our IR doc said that she could go in and try and clear the occlusion, but that would require having to make an incision in Lucy's liver. We all agreed that undergoing another ERCP, as big of a hassle that it is, is the better way to go about clearing the occlusion. Seriously, if it's not one thing it's her bile duct!
We are settling into our home away from home. Labs and cultures were done when we arrived on the floor tonight, please pray for negative cultures. I am choosing to look on the bright side of things, at least I will be able to get a full nights sleep for the next few nights.