IV Practice Pincushion

No Fluids For Me

Have been feeling ill all week.  Just thought it might be the new medication (cyclosporine) or quitting an old medication (plaquenil) or maybe fatigue (because I have been working some longer hours).  Started being nauseous on Wednesday, very nauseous on Thursday (to the point of quitting eating), and thowing up at work Friday and leaving early.  I tried to make it out of town but got sick again a couple of times, and decided I'd better go to urgent care.


I was able to be seen at urgent care right away, and they decided I truly am dehydrated, with orthostatic hypotension and elevated heart rate.  I told them I think I have a UTI but I can't tell because the radiation therapy messed up my nerves so the pain shows up in the wrong places or doesn't show up at all.  I also said it could be pancreatitis but it didn't feel painful enough.  The doctor ordered an IV and zofran in the IV for hydration and nausea control and some blood tests.  Then the circus started.

I am not easy anymore to "stick" for blood or IV's - and I am worse when I am dehydrated.  I know I need IV hydration BUT it is an ordeal to get a vein just to take blood for a blood test, and when they try to thread an IV it is impossible! 

The first nurse tried my right hand - I told her go for it.  She failed after partially threading an IV and blowing the vein (she was a beginner at putting in IV's so incorrectly blamed herself) and called in a second nurse.  That nurse looked over my arms.  I tell them the last time they used a pediatric IV set to start an IV.  I am ignored.  The nurse pokes my left arm and digs, no go on that vein.  Tries another vein on the left arm - gets blood enough for the blood tests (barely) and then tries to thread an IV.  Blown vein again.  Sigh.  Tries a third vein on the right arm this time, it disappears as she approaches it with a needle.  A fourth try in my right wrist that is extremely ouchy but dry hole.  Calls the parenteral nurse with the ultrasound machine.  I tell them - ultrasound techs couldn't do it last time, it was a pediatric IV set that did the trick. 

A third nurse who comes in and looks at my arms decides to get one of the pediatric nurses in to see if she can get an IV started because I am a small person with small veins.  I didn't have to tell her about the pediatric IV set.  The fourth pediatric nurse comes in, looks at my arms, said she probably could get a pediatric IV set started in my left arm BUT the parenteral nurse appears with her ultrasound machine and long long needles so the pediatric nurse does a fade while the fifth nurse tries to get an IV started. 

The fifth nurse tries three times on my left arm and twice on my right arm to get a vein to start an IV- some very deep.  As soon as she would get close to a vein it would disappear.  She got one partially started and tried to "float" it in and blew that vein.  Very interesting - she showed me the difference between veins and arteries on the ultrasound.  Very painful - at this point it is 10 unsuccessfull tries to get an IV in and over an hour of being messed with.  I told the ultrasound nurse I could have had antinausea medication and sucked down 3 liters of water by then, even if I barfed some of it back up!   She gets the hint and goes off to tell the doctor they can't get an IV started. 

I was shaking and my teeth were chattering - I think it was just too much digging around for me.  I can handle about 7 sticks and after that I get really shakey.  It is worse when I am dehydrated to begin with. Big Sigh.

The doctor comes in and says well you won't be able to get any IV fluids today even though you are dehydrated, unless I wanted them to go for the neck veins which he could order. Nope I said - had that tried before as bad as the other veins.  THEN he says - next time you are dehydrated go to the ER don't come to urgent care - they are better equipped to handle someone like you.  He said I appeared to have a UTI and he would prescribe Zofran and an antibiotic.  Boy they were really glad to see me out after that!

I now feel like I flunked Urgent Care.  Kicked out of class for being unruly. I'm in the "somebody like you" remedial course.  Poor nurses all felt bad because of my bad veins.  I felt bad because they had to try to poke my bad veins.  Not sure why my veins are bad and getting worse.  What is more, I started hiving in the arms they kept constricting with tourniquets and poking, and then my face started breaking out in long hives. My face is still swollen and I still have hives on my cheeks, but at least the Zofran has enabled me to keep liquids down and take my antibiotics.  I am more Rene Zellweger tonight than Angelie Jolie because I have puffy cheeks instead of puffy lips.

I am some better today (after a day of antibiotics) but the nausea is still pretty bad.  The Headache was not so good yesterday or today, but I think the dehydration is part of the problem.  Hoping tomorrow will be better!

Saw the A-team this week for a three month checkup on The Headache.  No new recommendations (yeah!) but Dr. Hannibal Smith suggested I see Dr. Jock Biodude again for further biofeedback training.  Told to practice my biofeedback on planes, because I reported issues flying.  I am not a nervous flyer - I spend most of my flight time sleeping.  I think the problem has more to do with carting luggage, getting through security (have to have a manual pat down because of the stimulator), and hurrying to catch a flight, and perhaps a pressurized cabin than any anxiety I might have.  I am sure Dr. Jock Biodude would say otherwise - I must have a deep seated desire to be ill and puke in a stinky airplane bathroom and biofeedback will stop it.

I guess Dr. Jock Biodude needs to make a living somehow but I am not sure if I will make an appointment with him or not.  I missed the last one because I forgot when traveling for work.  I think it was a subconscious desire not to have to sit and hear sports analogies for an hour.  I will have to check my insurance policy - I am not sure if it covers biofeedback, so its a convenient excuse for avoiding further sports talk annoyance.  Three strikes - yyyyooooouu're OUT!

Biofeedback Brain And Dr. Jock Biodude

Trying but Not Too Hopeful

Two years ago I went through two months of 3 times a week biofeedback training.  I got really good at relaxing muscles, controlling breathing, learning to use visualization to increase control over autonomic functions.  However for The Headache biofeedback really didn't work too well.  Pain levels went too high too fast - zero to 100 in the space of a few minutes at times - and I couldn't go to my happy place when I was too overwhelmed.  It did help some with keeping my breathing calm and my anxiety levels down so it was not a totally wasted effort.  This was totally "monitored" biofeedback where I was hooked up to a computer during my sessions.  I still use it when I feel overwhelmed physically.

The A-Team has psychologists on staff, and they seem to want everyone to practice biofeedback.  I had my first session last Friday, and it didn't go so well.  Number one, the office manager had spent a half hour of my time demonstrating the headicing machine which I told her would not work for me (too noisy, too big, and it seemed to be on the leaky side although it cooled and heated the recirculating water really well plus it had to be strapped to my head which bothers the supraorbital nerve pain I have), then some kind of migraine cap.  I DON'T HAVE MIGRAINES ANYMORE  I wanted to shout...I tried to explain that when I ice my head I use four (yes 4!) ice caps with ice and water in them to cover the area needed.  She did suggest I create some ice caps by sewing some covers and filling them with unpopped popcorn and keeping them in the freezer which was a useful and thoughtful suggestion (but I think she could tell I was a hard sell on the other equipment). 

After all the sales pitches I met the biofeedback dude [Dr. Jock Biodude]: he was very nice but he used sports analogies.  One of my pet peeves is when people (mostly guys) cannot discuss anything unless they use sports analogies (going for the three pointer, you have to take the first step to win a marathon, touchdown! etc. etc. etc. ad nauseum) so unbeknownst to him this prejudice made it very difficult to hear what he was saying because the sports talk interferred with my concentration.  I was in a bit of peevish mood by then.  I'm sure he could tell by my body language when he started talking about how we have convinced our bodies we are sick and that biofeedback will stop the cycle that I was not into his brand of hoo hah.

I'm not a fan of magical thinking, whether it is "I will be good and God will be good to me" or "The proper mind set will cure you" or "taking this special supplement will fix everything".  I'm a cynic by nature, an optimist by choice, and practical to the Nth degree.  After the session of biofeedback with tinkly new age music and lowered lights, my temperature dropped instead of raising.  You are expected to have a little thermometer taped to your finger to measure your temperature. Dr. Biodude said it was a sign I was not in tune with my feelings and living too much "in my head".  I'm sure he should have been able to easily see me raise my eyebrows each time a tinny sports term popped into the biofeedback reading which made it very hard not to live too much "in my head", but the drop in temperature probably came from his super cold air conditioned office where he sat with an undershirt, shirt, and tie on and I had on a thin summer weight blouse.

I told him that I am like a rabbit in a steel trap.  I will gnaw my foot off to escape the trap not idly sit by and accept the trap, feel the trap, and embrace the trap and then imagine the trap has disappeared while the hunter comes to dispatch my rabbity hide.  It's not in my nature BUT I will do the biofeedback 2x a day for the next three weeks.  I will try to embrace the moment and not live too much in my head: at least the recording he gave me doesn't have any sports terms on it so far.  I will attempt to be more open minded about it.  The other form of biofeedback training I had was much more guided and specific to me, so maybe I just prefer that method of teaching.  Don't know, but I do know I don't have a lot of patience for nonsense so I am hoping I will see some positive results.

I have been more heavily drugging myself with clonazepam to get a full nights sleep per the A-Team's plan. I am supposed to titrate up every other night until I get past the night time pain and insomnia issues. There will be a limit there I will not go past either.  I can take quite a bit of pain if the alternative is too many drugs for very little benefit.

Botox injections were mentioned, but after asking some people in my urticaria group (hives) there were no positive comments about botox for people with chronic hives like myself.  Some had bad reactions, and no one had a positive experience.  I'm going to save the Botox for  some desparate future time.  The A-Team is just going to have to get by with regular office visits, no extra sales of special equipment, and no big lots of biofeedback training fees.  They seem to be used to persons that are at the melt down point there, which is very sad for the regular new patient who has not been receiving adequate care elsewhere, but it takes quite a bit to get me to that point.  As long as I have a plan, I'm pretty well good to go.  If they keep up the sports talk, I may get to a different type of melt down point and grab someone's tongue and pull out their belly by the roots.  But maybe that's the menopause talking, eh??

Hurling Contest

Revenge of The Headache

Thursday night, The Headache tried to come to life.  I suffered through Friday with brain fog, but the stimulator kept most of the pain away.  Friday night the pain got worse as did the nausea, so I took 2mg of dilaudid at about midnight along with phenergan.  This got me through Friday night.  Saturday was marathon flying day, so The Headache decided to be extra pesky.  I took 2mg of dilaudid and phenergan, yet the pain and nausea kept increasing - I didn't have time to sit and rest and ice down my head  - so the vomiting commenced. 

I have vomited a lot of places over the years, because that has always been a part of bad headaches for me - projectile Linda Blair in the Exorcist type hurling.  I sorta expect my head to spin around too as the pain gets worse as I hurl and after I hurl.  I know I am in a bad way when I erupt in public toilets.  Putting your face downward towards the bowl that has held the excrement from thousands of butts is not my idea of a good time.  Thinking about it is about enough to make me vomit again!  I threw up twice before I got on my first flight, then I threw up in the airflight barf bag, THEN I threw up in the airplane bathroom/toilet.  Oh. My. God.  The odor of that thing.  My sense of smell is terribly heightened when The Headache is active, and I felt like I couldn't even breathe in that little stinky closet of a bathroom.  The plane was still climbing and banking so I had to brace my self so I didn't just blast vomit from one side of the thing to the other.  The flight attendant brought me a cold cloth from the ice chest and I just sat in my seat leaning over my lap wishing I was home already.  I was able to sleep through most of the flight which was a blessing.

I ate a little bit at an airport restaurant in Denver with my co-workers, but the noise and the odors were too much for me, and I skedaddled before they were finished.  I was able to keep my food down but had a minimum of fluids since The Headache really doesn't like a sloshy belly.  I slept most of the way home on the second flight, drove home, and slept for hours.  Yesterday I woke up and The Headache was still there - building up in the background.

I changed my stimulator settings, I drank caffeine, I iced my head, I used heat packs, I took benedryl, vistaryl, and phenergan.  Nothing worked, and the pain kept building.  At 1 am  this morning I took 4 mg of dilaudid and some phenergan.  It was that or call an ambulance.  I managed to keep the meds down, but have been up all night in pain.  The dilaudid did decrease the pain levels from a 9+ to an 8, but the pain is climbing again.  Not sure what I am going to do - I need to be at work, but I am afraid to drive and get caught with The Headache at full blown fury.  I don't think the travel agreed with It, and It is making me pay!

I'm gonna take a hot bath to see if I can get The Headache to calm down so I can go to work, even if I'm late getting there.  A rainstorm went through Saturday night which I am sure aggravated The Headache also.  I did practice my biofeedback skills last night as I fought the nausea and the itchiness from the dilaudid and The Headache pain  and nausea at the same time.  At least I got through the night without having to call an ambulance - that's an expensive headache when that happens. 

Attaching a picture of the lobby of a neat old hotel we ate at while I was away for work - it was quite unexpectedly elegant with Tiffany stained glass skylights and windows, marble colums and gilt decoration. You do get to see neat things when you travel, but I don't think my body is capapble of keeping itself workable on the road anymore.

No More Hydrocodone

Allergy Confirmed

I was able to hold down some applesauce and a soda this afternoon, and then some noodles boiled in no-fat chicken broth. Best meal I've had in days.

Unfortunately, since The Belly is no longer my friend, my pain increased exponentially after eating. I did not take my pancreatic enzymes because I wanted to figure out what medication is causing the hives out of the two possiblities - Creon (enzymes) or hydrocodone (pain medication). I had not taken any pain medication for a couple of days, so I took a hydrocodone tablet this evening, and presto-chango out pop the hives in about 15 to 20 minutes. They have just been getting worse all evening and they are getting bigger. I don't have to guess anymore, I know the hydrocodone is the culprit. No more good pain meds, I'm not happy.

I always have itched when getting strong pain killers, and was hoping maybe this was the same type of problem - benign itching - but I definitely got hives not just the creepy crawlies. Besides the big lumps coming out on my stomach, and my arms, and my legs, my mom said my back was broken out under the skin. My hives do that - little red spots all over my back, but not raised. If you press on one I then get hives elsewhere, or the hives get worse. My immunologist says they are collections of mast cells under the skin, so poking them just breaks the mast cells out and they go looking for more to irritate.

I can't take morphine, because I get violently ill. Codeine is out, same reason, plus hives. Hydrocodone is now off the list. I itch terribly with dilaudid. What's left to take for pain? Not much. I'm afraid I am up the proverbial creek without a paddle. I can't take anti-inflammatories of the pancreas and The Belly reacting to them. I'm a little panicky tonight, but I'm telling myself to be calm.

Reeeeelax. Breathe sloooowly and deeeeply. Imagine I'm in a snowy woods, and the crisp snow is scrunching underfoot with every step I take. Branches creak under the heavy burden of ice, and my breath puffs white into the cold air. I put my hand out and catch a heavy snowflake in my palm. I look forward to the promise of spring and the transformation from hibernation to renewal and growth, the springing of crocus and grass through the icy covering, and the wet breath of the wild March winds.

Ah, I feel better now; I guess that biofeedback training works, eh? Now if it would either make the pain disappear or the hives it would be perfect!