One last 2007 punch

Peter's PICC line has unfortunately dislodged on us... Sunday afternoon... two days before New Year's Day.

Peter was getting his usual PICC dressing change on his usual day, Sunday. But he decided that he had had enough of the dressing change faster than we could stop him from moving, and the PICC line moved out of its insertion site about an inch. The look on my face told the other children that things were not good and then I burst into tears. I called Dr. Kamin in Boston to see if he thought it had moved too far. He said we should get an x-ray to determine if the PICC had moved too far out. The local hospital said they didn't want to x-ray Peter because they didn't have a radiologist in house... Sunday afternoon... and they don't usually do children.

Long story made short, we ended up going to CHOP's ER. We got an x-ray taken about two hours after we got there and were told the PICC had indeed moved too far to use for TPN... could end up throwing a clot. Lots of phone calls to Dr. Kamin in Boston(what a dedicated doctor!) and talks with the ER and ER calling Interventional Radiology... go to Boston's IR? ,go inpatient at CHOP?, need a transfusion?, will anyone get worked up about Peter's current anemia (normal for him, but still abnormal), etc. So we drew a CBC just to see where that was and behold he was 8.2, up from the week before, so no transfusion! Boston was expecting 8 inches of snow, so that answered the question of driving up there from PA. And IR was double-booked for the entire next day and closed for New Year's Day, so it was pointless to stay in hospital... and actually we were glad to hear that, so it made the decision easy to come home and wait for an available IR appointment.

Now Peter is home on a make-shift concoction of electrolytes and sugar in IV form until he gets a new PICC placed this Wednesday at CHOP. Fortunately it should be able to be done outpatient and he should be in and out within about three to four hours from arrival to departure. The procedure should quick once he is in there, with light sedation, no intubation expected.

Peter has had this PICC line since October 2006, so I guess we can't complain too much. The timing stunk, but at least it didn't happen on Christmas!