lines

I hate lines. A line is medical slang for an IV that is threaded through a vein until the end of the tube is in the vein right above the heart. They have different names depending on where they are inserted and the kind of tube. Anyway, Jacob has had more problems with his lines than I've ever seen before. I have never seen a line break before, granted the tubing is a lot smaller for a baby, but still it is rare. Jacob had his third line break this week. The first one the tubing just snapped, the second time the tubing basically had an aneurism and the walls of the tube started ballooning, and this last time the tubing got a hole in it and was leaking IV fluid everywhere. After this last break they had a really hard time getting a new one in, and ended up putting it in his hand. It is very important that these have a secure dressing on them because the dressing is the only thing keeping them in place, and there is a huge risk of infection if the dressing is compromised. How are you supposed to keep a dressing on a tiny baby hand? Not real excited about it.
They do an x-ray right after they put the line in to make sure it is in the right spot, which it was. Then they do another x-ray 12 hours later because the plastic softens with the body heat and can move a little. On this x-ray it was in too far, so they measured how much it needed to be pulled back, pulled it out a little, and did another x-ray. This time it wasn't in far enough. Unfortunately once you have pulled it back, you can't push it in any farther because you could cause an infection.
One of the reasons Jacob needs a line rather than a normal IV is because the TPN (his IV nutrition) is very hard on blood vessels so it has to be put in a huge vessel where the blood will quickly dilute it. Now that the line is not in the right place, and they don't wan to put a new one in, his TPN has to be less concentrated which means less calories. At this point he is only eating 18mls an hour which is a little over half of what he needs, so he will be on TPN for at least another 15 days. I am more than a little irritated, but the dietician has done all of her calculations and says Jacob will still be getting enough calories with the less concentrated TPN. Hopefully he keeps growing. He gets weighed every day, so I guess we will know pretty soon if it isn't enough.
Sorry for the rant. I'm just frustrated. It's really time to go home.