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9/5/06

9:15 PM: I bet you've been wondering where we've been and what's been going on! Well, it's been mostly uneventful, but I'll share a few details.

On Friday, I took Sophie to the clinic to have the nurse practitioner (Stephanie) help us change Sophie's dressing on her PICC line (with the help of the recreational therapist, who tried in vain to distract her). Sophie and I talked a lot before we got there about how it would go, and she seemed like she was going to be okay with it, but when the time came, she cried, screamed, and kicked. Stephanie used Detachol (an adhesive remover) to loosen the dressing, which helped a lot with the pain of removing it (although it took a lot longer). We had stopped using Detachol on her chest, because it seemed to really irritate her skin, but her arm skin doesn't seem to be sensitive to anything yet. Then, once the dressing was off, Stephanie was able to get nearly all of the dried blood off her skin and the line, leaving just a small amount right near where the line goes into her skin. Because the area had healed and wasn't bleeding anymore, the alcohol and ChloraPrep didn't sting or hurt Sophie like it usually does. By the time the whole thing was over, Sophie was talking about how it wasn't bleeding and it didn't hurt as much as she thought it would. I won't say that I'm expecting her next dressing change to be a breeze, but I do think it will be better.

We had a nice relaxing weekend, and on Sunday after church, we headed up to Virginia to spend some time with my mom during the Labor Day holiday. That night, right before midnight, Sophie was crying in her room, and she felt hot. You guessed it--she had a fever. We called the on-call doctor, and he said we'd better take her to the local emergency room (Lynchburg General Hospital). We knew what to expect (draw blood for a CBC and blood culture; administer an antibiotic by IV called Rocephin), but this doctor wanted to draw blood not only from her PICC line, but also peripherally from her other arm (they do this to help determine whether an infection is confined to the line or whether it's actually in her bloodstream. This is a great idea in theory, but Sophie hasn't had an IV inserted in her (while conscious, at least) since January of 2005, and I knew it wouldn't be an easy thing to do. But we had already been talking about doing a peripheral IV in her hand next time she goes to clinic, so I told her we would try the cream and do a little poke. I had the nurse put cream on me too (and we covered the cream with Tegaderm, which is a dressing similar to what we cover her line with), and then Sophie went to get a chest x-ray while we waited for the cream to work (Sophie has been coughing so they wanted to make sure her chest was clear). When the nurse came to insert the IV, we had to peel off the Tegaderm, and the screaming started (Sophie, not me--I did fine pulling mine off). Honestly, I think pulling off that little dressing hurt more than a needle would have! Anyhow, once she was upset about that, she was really squeamish about the nurse touching her arm to locate a vein. The nurse called in a second person, and they both decided that the vein on her elbow was too deep, and the one on her hand was too flat (or something). They talked with the doctor, who said we would skip the peripheral draw and just culture the one from her PICC line. At 4:00 AM, we came home (but it's only a 15 minute drive instead of an hour and a half, like it is at home). She had a couple more fevers during the day on Monday, but the antibiotic lasts 24 hours. The good news is that we checked with the doctor today, and the culture has stayed clear (and her counts are good), so it looks like she must have a little upper respiratory virus (which means no hospital admission, and the line can stay in for now).

After losing so much sleep (Randall hardly slept while we were gone, because he was so worried about us), we decided to stay at mom's an extra day (that meant Elisabeth missed school though). We sorted through (and rearranged) tons of stuff at mom's house. It's been very hard for her emotionally to change anything in the house since Nannie died, but with some support from us, we accomplished a lot. I think Nannie would want Mom to make the house her own and would be happy that Mom will continue to live there.

We're back home now, and I'll go back to work tomorrow for the first time in over a month. I'm not sure how I feel about that, but I'm sure it will be fine!