Jasmine Stalker-Firth

We have just got back from spending the weekend at Great Ormond Street Hospital (GOSH) after Jasmine’s PD catheter broke.

I connected Jasmine on Friday evening about half-past seven. We had had a nice day wandering about and had gone to the pub for a quick pint and an early dinner. Then we had come home to put her on.

She was on her initial drain and was a bit vomity as she was coming to the end of a feed. So, I picked her up to put her in the little seat which we keep at the end of the cot. When I looked down, her line had snapped clean in half and fluid was pumping out. The whole connector part (shown in the picture above, the dark blue part is normally always covered) had broken off. I got hold of the line and shouted to Neil to get the clamps, which we keep in a little pack in case of this kind of emergency. We clamped the line and wrapped the end in an alco-wipe. Then we got on the phone to GOSH and ordered a cab to take us straight there.

On arrival the nurses put us in one of the cubicles on the ward. They snipped the end of the line, soaked it in bromine for three minutes, and attached a replacement connector. Then, they attached a specimen bag in order to get a peritoneal fluid specimen to send off to the labs. Jasmine had lost most of the fluid in there by then, so with a bit of tipping her this way and that (we all took turns), they managed to get about 2mls.

A little while later, the results came back and her white cell count was 120. Not alarmingly high, but the cut-off point is 100. So, erring on the side of caution, Jasmine was put on continous peritoneal dialysis cycling for 48 hours. This meant that she was attached to her machine all the time. The dialysate had antibiotics in it (and will continue to have them in for a total of 14 days) and heparin, as the nurses had spotted some fibrins. Continous cycling hopefully prevents any infection and the development of peritonitis – something to be avoided at all costs when on PD.

I stayed on Friday night. Being there was a reminder of how quickly, if you are not super careful, you can end up back in hospital. And we were up quite late which made me tired and teary. It takes a while to organise a cot, prepare a PD machine, especially with antibiotics and heparin, and then Jasmine had to have her bloods taken and had to be examined by the doctors. And then her machine was alarming for the first cycle, and the lovely nurse looking after us had to listen to me chuntering on for a while, so it was 2am by the time I got to sleep.

Saturday

Neil arrived the next morning with coffee and croissants at about 10am and I had been up already for four hours thinking that it was going to be a long, long 48 hours.

As it turned out, the weekend went by in a flash and we had a lovely time. Jasmine seemed well in herself and the nurses took care of everything, as they always do, they even fed us when there was left over food on the trolley. Some of the nurses who looked after us when Jasmine was born popped into see how she has grown. And everyone said that we had done well to keep Jasmine out of hospital for so long. It was like being in a hotel with a load of your best supportive highly trained dialysis friends doing all the stuff you normally have to do whilst you enjoy room and laundry services and read books and snooze on and off all day.

On Saturday night we were moved over to the quiet side of the ward. I was going to go home, but since there was only Jasmine and Neil staying on that side I stayed too. I slept in a cubicle next door to theirs and slept really, really well. Poor Neil was up half the night, as Jasmine had to have her machine swapped over after 24 hours and then the machine was alarming with ‘low drain’ because people often get a bit dehydrated being on dialysis for so long and start absorbing all the fluid. During the night the nurses come in and check Jasmine’s blood pressure and temperature. They have to do this on a drain, so they often clamp the bags to stop her filling back up. (The kidney patient guide’s website has a really good animated explanation of how PD works.)

Sunday

On Sunday afternoon, Jasmine was taken off her machine for four hours, so that she could have an extended dwell (fluid left in her peritonium) and then we went off for lunch at Pizza Express. Jasmine had a fantastic time sitting in a high chair sucking the edge of the table and throwing bits of pizza dough on the floor. After that, we all went to the bookshop and then back to the hospital.

Before putting her on her machine around 6pm, the nurse took another specimen and when that came back that night, the white cell count was four, which meant that we had been very lucky and it seems that she hasn’t developed peritonitis. Neil slept in the cubicle next door and I slept with Jasmine. Since she was on her normal program she didn’t beep so I had a good night’s sleep and I didn’t even notice the nurse popping in and out doing blood pressures and temperatures.

Monday

Today we sat about drinking coffee and reading the papers until the doctor discharged Jasmine at midday, at which point we were ready to come home. We had all run out of clean clothes. Jasmine was wearing surgical gowns and I was wearing my new t-shirt with the tube map – a present from Neil – teamed with his underwear and my wedgy sandals. One of the nurses complimented me on my new stylish look.

Tonight Jasmine is back in her own cot, and we are back in our routine: Neil did the dressing change, prepared the machine, and connected Jasmine. We have washed all our clothes which we stored in a big bag of baby puke whilst on the ward as dialysis tends to make Jasmine vomit more. We enjoyed our mini-break and our dialysis respite and the company of our lovely nurses, but, it is good to be home.

This entry was posted on Monday, August 25th, 2008 at 9:28 pm and is filed under nephrology. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.