A PIK Line

I am going to try to forget that I spent over TWO STINKING HOURS attempting to access what I thought would be simple information for this post. I was able to vent my frustrations at Loren, who, in his infinite wisdom, just sat in bed and looked at me agape. (and just a hint of amusement) I felt better immediately. Soon after that, I was seen driving down the road in a cloud of dust. But I can hardly be blamed for that, since the road is gravel and I had to go shopping. (Bargain update to come)

First, a medical update. At some time in the not too distant future, Loren will proceed to the next step in the transplant process. I thought I'd let folks know about it ahead of time, as we will both be away for most of a week.

When heart failure progresses to the point of being difficult to manage, the transplant candidate takes on a new medication, Milrinone.This is instituted through the use of a PIK line. (and here is where you will have to endure my unprofessional description) Putting in a PIK line means undergoing a procedure to install a tube into a vein that runs up the right arm. It is through this tube that the IV Milrinone will be administered directly to the heart. The line can also provide access for other drugs and be used for routine blood draws. (I think)

{update as of 10/01/04: Here is a place where a tad more info can be found concerning Milrinone therapy. In talking with the nurse practioner on 9/30/04 we learned that the end of the interveneous tube comes to rest in the right atrium. Talk about a drug being administered directly to the heart! The infusion port itself needs to be flushed from time to time to prevent infection. Also, the outside needs site care, which would probably be accomplished by Home Health Care. }

Loren will have to wear something similar to a fanny-pack which will hold a cartridge of the med, which he can then exchange for another as it runs out. This IV drug is the stepping stone that moves him up to 1b status on the transplant list. Within, say, a nine month period of this happening, he will likely be called in for transplant. Possibly much sooner.

There are some risks associated with this new drug. It can cause heart arrhythmias. That is why hospitalization is required when starting on this medication. And, because of the potential for rhythm irregularities, patients have a pacemaker installed before returning home. Loren, having already enjoyed the "pleasures" of this device, can forgo that, at least. But, he needs to be closely monitored, probably for a week. Perhaps not all of that spent in the hospital. I am relying now, on information the nurse passed on to us. People at Mayo are extremely helpful. Would that their website were half so. (It's OK. I'm not that mad anymore. Really)

Because of it's side effects, Milrinone, also known as Primacor, is not recommended for long-term use. That is probably why it raises one's transplant status. Supposedly, it will make Loren feel better. A person being considered for transplant cannot be in such a deteriorated condition that their chances of surviving the operation would be compromised. That is why they evaluate the entire body before accepting a candidate, even psychologically. The medical team cannot be taking extraordinary measures on behalf of someone who has other significant physical issues, or does not have a strong will to live.

If I were to hazard a guess, I would say that the transition to this "round the clock" IV drug will take place sometime in the next two months. Hopefully, I have not spoken in ignorance on topics I am just becoming acquainted with myself. Enough of that, for now.
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There is nothing quite so satisfying for a gal as to go shopping and find a bargain or two. It is akin to the thrill of battle. A winning battle. As well as getting the usual boring new stuff at Walmart and the grocery store, I dropped by Goodwill again this afternoon. :-) I picked up a "new" floor lamp for only 3 bucks. And hey, it only wobbles a little bit. It almost matches the other one I purchased for 2 dollars on a previous foray. Then I found several very nice paperbacks, the last two in the LOTR series. These are desperately needed as the kids have practically worn the first TWO sets to a frazzle with their voracious reading habits. Other books acquired shall remain nameless, as they are being held for someone's birthday.

Speaking of presents,* I have very nearly accomplished my goal of purchasing all Christmas and birthday presents up through December. Trevor's birthday isn't until February and as everyone knows, it takes very little to make a child that age happy. He hasn't had time to become jaded and morose. Not quite.

I dropped off the all important annual family pictures to be developed. The hard part will be choosing the picture with the least amount of eye closure. (At least, that's what I tell everyone. The REAL criteria is: which one is the most flattering to ME?) Then it is back to the Walmart drop box, to be duplicated over a hundred times for their cheapo (but acceptable) Christmas photo/card offer. Now, if only I can get the Christmas letter completed early, I will check yet another "to do" item off my pre-transplant list.

*Chocolate makes a better gift than those little porcelain knick-knacks. Chocolate never needs dusting.
(365 Reasons to Eat Chocolate August 12)

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