Then the heparin lock

Imbolc                                                                         Valentine Moon

tpnTwo saline flushes, then the heparin lock. Clamp the picc line. Half of the thiamine bottle, one each of the white cap and blue cap bottles, all injected into the tpn bag of milky, 950 calorie nutrition. The thiamine is yellow and floods into the bag creating a branched, river like stream. Shake the bag so that the vitamins and other additives mix up. Spike the bag with the plastic spike that connects to the tubing. Clamp the tubing. Connect the cassette that holds the tubing to the pump. It slides in and locks. New battery for the pump. Turn pump on. Wait, go through the pump’s programming. Unclamp the tubing. (lots of alcohol wipes in here. sterile technique required since the picc line ends just above the heart.) The tpn nutrients gradually, a milliliter at a time, snake up to the connector. Saline flush. Wipe. Connect tubing to picc lock. And, voila, breakfast, lunch and dinner.

I do this by myself this morning, with Kate’s assistance of course. The tpn pump, in Kate’s case, runs almost 24 hours, delivering approximately 41 milliliters of nutrition an hour, every hour. The objective here is not so much weight gain as getting her tuned up nutritionally for surgery. The feeding tube placement procedure is not major surgery, but it is surgery and she is frail. Most of the time people learn how to do this for a much longer duration. In our case 10 days. Learning new things everyday.

Still slowly emerging out of the cocoon in which illness places us all. Perhaps I’ll have imaginal cells (a real thing, see butterflies) which will alter my being, transform me into someone new after the last three weeks. I’m ready for some new, even if it’s taking up again the things I was doing before with changed purpose.

It’s 10 degrees here on Shadow Mountain, but, in Colorado fashion, a warmup is on the way. 47 on Tuesday.

And, btw, yes, it has occurred to us that 8,800 feet is not the best position for us with our ailments. Not likely to change soon however with the dogs and my almost pathological aversion to the idea of moving. The move that got us here felt like a last time for that sort of thing. Difficult.

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