Thursday, September 5, 2013


If you follow my Blog, you know that I have been working toward resuming at home instillations. I posted recently about all the phone calls and perseverance it has taken to get everything I need in order to start doing my instillations at home again.  This has been an ongoing process, still having to call several more times (yesterday yet again) because I didn't have quite everything I needed to last the 90 days supply I was sent.

However, I had enough for "today" so yesterday I was ready. I was going to mix a cocktail and give myself an instillation. Now, I've done this before! I'm pretty darn good at it. Before I stopped doing them at home about 1+ years ago, I could mix up a cocktail in no time. I had a system, had it down pat and frankly think I could do it safely, accurately but quickly. 

So I was not prepared for what happened to me yesterday, not once, not twice not three times but four times!

Most of you are familiar with the usual medicines included in an instillation. My cocktail is Heparin, Lidocaine, Sterile Saline and Gentamicin. Everything but the saline comes in a vial that requires I use a needle and syringe to withdraw the medicine from the vial, then put it into the sterile specimen cup for mixing. 

So if I need 10ml of Lidocaine and the bottle is 10ml, then I need the whole bottle. The syringes I have are 10ml syringes. So that means you must pull the syringe plunger back to the 10ml marker, insert the needle into the vial, push the air into the vial, then pull back on the syringe plunger to withdraw the medicine.

I've done this a thousand times. I was taught by my doctor's nurse. My Mom is a retired Nurse so she went over this process with me too when I began doing these about 6 years ago. I had it down! 

Attempt No. 1 yesterday: I look at the Lidocaine vial and see 20ml on the bottle, so I think it's got enough meds for 2 instillations. Fine, that means I need 10ml of air to push into the vial. OK; ready, set, go! EXPLOSION!! The vial exploded all over me and the bathroom! Good thing I wear glasses as I had spots all over my glasses (wouldn't want Lidocaine in my eyes); Lidocaine everywhere!

This was very upsetting and had NEVER happened to me in all the years I'd been doing instillations. I take a closer look at the vial and see there is a second number that says 5ml so now I'm confused. Time to call the insurance company again for clarification; why two different numbers on the vial? OK; this one is my fault. The vial is actually a 5ml vial so pushing 10ml of air into it most definitely will cause it to explode. Dial back the distress and start over.

Attempt No. 2; only push 5ml of air into the vial, go super slow. Should work fine. Nope. EXPLOSION #2! Again, Lidocaine everywhere! Now I'm upset. WHY? I KNOW how to do this. What's wrong? Mom's not home so I call her and review process and she reassures me I am doing it right. OK, try one more time.

Attempt No. 3; Nope! EXPLOSION #3!! Now I'm really upset. Medicine is being wasted; why isn't this working? What the heck is going on?

Also tried doing it with the smaller Heparin vials - nope - EXPLOSION of Heparin all over!

Tears are flowing and I am at a loss. This is how it's done; why isn't it working? Call Mom again and go over procedure one more time. Yes, she assures me, I am doing it right. 

Plan B - let's try it a different way. Just insert the needle into the vial and do NOT push any air into them. Just try to pull the meds out without doing it the way I was taught. 

Well, it worked. Mission accomplished. This process is not super easy; the pressure wants to pull the needle and medicine back into the bottle, so I must hold on and have a steady hand. But it worked and I got my instillation done. I was exhausted! 

I have been doing this, as I said, for years. I know how to do this. I have taught others. I NEVER had this happen - EVER - in the literally thousands of instillations I've done in the past. 

This was an EPIC FAIL of EPIC proportions! It was very upsetting and I was beginning to wonder if it was worth it. 

Decision after calming down: It IS worth it. I will make this work. I am going to bring samples of all my meds to my next instillation appointment at the doctor's office and go over everything with the nurse again. Let's see what happens then. I have problem solved it for now and can "make it work" so that I can do my instillations.

We all face frustrations and things that set us off, as they say. This was one of those days for me. I will recover and thanks to my Mom, I problem solved things yesterday and still got my instillation done. That's the most important thing.

Gotta say, I was beginning to wonder if this was some sick joke being played on me, or if there was a hidden camera. You really should have seen it; medicine EXPLODING all over me, the mirror, the counter - everywhere! It's amazing how much of a mess 5ml of liquid can make when that much force is used to spread it around! But then, do it 3 more times and you've got a real mess on your hands. 

Oh well, this will make a great Support Group story that we will laugh about later. It wasn't funny yesterday when it was happening. But at some point I have to recognize how ridiculous it was and make a joke out of it. 

As the saying goes, if we don't laugh, we'll cry. Well, I did cry yesterday, but today it's time to laugh about it. 

Oh well, "tomorrow is another day" (who knows that movie quote?). I will figure this out and move on. We all have challenges, big and small, and wanted to share one of mine. 

Still, EPIC FAIL is all I can think about! If I was being given a grade, I would have flunked!

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