Tape Travails

When healthy people think of chronic diseases, they think of them in the most cursory manner. When encountering a Type I diabetic, they think insulin injections. When meeting a heart patient, they think cardiac arrest. When considering the lot of a dialysis patient, they think of being hooked up to a machine. But every one of these conditions is so much more than this. And it is often the thousands of inconveniences and mishaps that go beyond this brushstroke approach to disease that cause the patient the most anguish and that can sometimes lead to her decline or demise.

For me, the current challenge is tape. That's right, tape. Since the beginning of July, when I first developed an allergic reaction to the tape I was using to hold the gauze around my exit site in place, I have had one difficulty upon another in regards to tape or the lack thereof.

Initially, when I first started taking care of my exit site in the middle of February, after the surgical dressing had been removed, I used paper tape. At first, it did a decent job of holding the gauze pads in place around the tubing that projects from my abdomen. But then a shift occurred, and the tape no longer held. The tape would come off during the day or at least become loose. The gauze would slip, exposing the exit site to the air--definitely not a good thing, since this provided a direct path for infection to enter my interior.

So I switched to plastic tape, which was much more secure. But then my body developed a reaction to the plastic, and the skin around my exit site became red and itchy. When I scratched, the skin quickly became more irritated and bled. This, of course, provided more inroads for infection, and I developed what is called a tube infection--germs in the tubing but not yet in the peritoneum. I was given the antibiotic ciprofloxacin, better known as cipro, which really did a number on me: three paramedic visits and hospital stays because of severe vertigo, skyrocketing blood pressure, and uncontrollable vomiting. Add to this depression and unprovoked weeping, and I have put cipro on my list of evil drugs to be avoided at all costs. My nephrologist said that, if I were to get an infection again, he'd have to hospitalize me with intravenously supplied antibiotics if I didn't want to take cipro. Though I dislike hospital stays and really dislike IVs, I said that would be much preferrable to cipro.

I discontinued use of the plastic tape and went back to paper tape. But now I had to apply Vitamin A&D ointment to the abraded areas, which gave the tape even less traction. Placing tape on top of ointment didn't work, so I tried to extended the gauze-padded area so that the tape adhered to non-irritated skin. This meant using a lot of tape--several feet--because one layer did not adhere, so I put tape on top of tape on top of tape. And often the whole thing slipped anyways, exposing the exit site to the air or my clothes. By this time, gauze and tape were covering three-quarters of my abdomen, from my left hip bone to three inches right of my belly button. What's more, the previously non-irritated spots then developed an irritation to the tape, increasing the area that needed to be treated with the ointment and avoided by tape.

Add to this, the hydrogen peroxide, which is to be applied after washing with antibacterial soap and drying the skin around the exit site. Hydrogen peroxide, though, irritated the already sensitive skin. So what to do? Skip the hydrogen peroxide and forego a means to prevent infection? Or use the hydrogen peroxide and irritate the skin, prompting more discomfort and scratching, and thereby encouraging an infection? I decided on the former course of action.

About a month ago, I started experimenting with tubular net bandages--large sock-like bandages that can be cut to any width. (Shown here is an arm with gauze pads and tubular net bandaging, but just imagine the same around my mid-section.) Think of them as midriff tops, only for my abdomen. I initially cut them too narrow, and the bandages bunched up, exposing the gauze, which then slipped down and exposed the exit site. Now I'm cutting the bandages about a foot wide so that they cover my entire abdomen and then some. My thinking was that, if the net bandage is tight enough, it will hold the gauze in place, and I won't have to use tape. This was the thinking at least. Things didn't quite work out that way. With all the stretching, bending at the waist, reaching, and just walking that I do every day, the tubular bandaging moves. I have tried to tuck its top side into the PD belt and its bottom side into my underwear, and this helps, but it still wiggles out of place. And with this wiggling, the gauze slips. So I am back to using tape, even with the tubular bandage, though not as much as I do without it.

The latest challenge is the irritation from the bleach that I use to wash the tubular bandages. I was only given so much bandaging, and since I have to change the dressing every day--on hot days, more than once a day--I ran out of tubular bandaging. So I washed the stips in bleach, as I do the towels I use during hook-up and capping-off. I'll have to ask the clinic for enough bandaging to be able to throw a used tubular strip away every day. Sometimes unusual items like these are in short supply, so I'll have to see.

This morning, while preparing to take a shower, I saw that the bottom side of my exit site, the side under the tubing, is red and sore. Definitely not a good sign. If this doesn't clear, I'll have to visit the clinic and have a nurse take a sample from my catheter. And if it is an infection, I guess I'll be checking into the hospital for a round of IV-fed antibiotics.