Day 2 Continued: Insertion of My Catheter for Leukapherisis

With the bone marrow biopsy complete, the medical staff did not waste any time and the people that were there to transport me to my next activity were ready and waiting. My hard old bones put them behind schedule. I barely had time to go to the bathroom before I was whisked away in a hospital bed. And if you are on IV fluids, you know how important that is!

I was looking for Joe but he was nowhere to been seen. I was really hoping to get that reassuring hug from him that would make the next procedure more tolerable. But the hospital bed transport Nazi wasn’t having any part of the “Where’s Joe?” game and whisked me quickly into the elevator. Turns out he was just around the corner making phone calls. I asked them to tell him how long I was going to be gone and to feel free to run the errands that he needed to run. Most important errand was to buy phone chargers as both of our cell phones were dead. The only phone number that both of us know by heart are our parents. You know how it is these days; you look up the person’s name in your phone and hit send. I don’t even know my children’s phone numbers.

So, off I go to the first floor of the hospital. There are three people in surgical gowns waiting for me. I was transferred from the moving bed to a table that had ex-ray machines and three monitors lurking above it. I was asked my name and date of birth and told that they would be with me shortly. I told them that I was freezing, partly from the temperature of the room and partly from nerves; they brought me one of those really expensive warm blankets. I told them that it looked like a construction site in here. There were all kinds of machines and metal arms that would move them from place to place. Of course, it looked like a very sterile construction site, but a construction site none the less.

I think that I must have arrived at lunch time as I could smell food  and there were several green cloaked people all gathered in a room just off of the room that I was in. Eventually one of the guys came in and told me what they were planning to do. They were going to insert a temporary right internal jugular vein leukopheresis catheter into the tip of the right atrium of my heart. Sounds fun, huh? Of course I asked about a thousand questions, first one was just how painful is this procedure? I told them about my bone marrow biopsy and they were surprised that I had not been given anything to combat the pain. Second question was how did they know when they got the catheter into the heart and how were they going to make sure that they didn’t puncture anything along the way? They assured me that they would be using direct ultrasound visualization and would be watching exactly where they were placing the tube.

This whole procedure starts with another one of those cloth/paper drapes with a hole in it. I was told to lay flat on my back and to turn my head to the left and leave it there. Once my face was covered and my neck exposed, they started to swab my neck with an antiseptic. Once again they walked away. They were chatting in the other room and I was having a pity party under my drape. Don’t leave a girl with leukemia too much time to think. Under the drape I was all alone with just myself and my thoughts, no visual distractions. A tech finally peeked his head under my drape to see my face and asked me if I was OK. I told him that I was great for a girl who had woken up with leukemia. We laughed and the procedure began.

The head honcho dude promised that he would tell me everything that they were doing and he did! He began by numbing the area. This stung a bit, but nothing like the bone marrow biopsy. He promised that once the area was numb that I wouldn’t feel anything except pressure. Luckily for the both of us he was right. Once the area was numb he proceeded to make a small incision in my neck to reach the jugular vein. The only real thing I felt while he was doing this was wetness on my neck. Yes, my cancerous blood was dripping down my neck, yuck. Once he made the incision, he began to thread a wire through it. He repeated this process over and over enlarging the opening. Other than a whole lot of pushing and tugging in and out, the process really wasn’t painful, just disgusting.

As they were doing all of this pushing and pulling they were using the ultrasound and taking pictures. They were also talking about the wires and I asked them why all of the discussion. They told me that they always bet on the length of the final catheter, the one that would reach the heart. I told them I get half the winnings and wanted to make a bet, too! Since the numbers ranged from 16cm to 21cm I chose 19cm. The guy that was shoving the enlarging wires in and out said 20cm and the ultrasound tech said 18cm. Turns out that I needed a 17.5cm catheter and they do not make one that size, so no winners and I got a 20cm catheter that stuck out of my neck and was taped up and really annoying.

They finished their business and used two sutures on either side of the catheter to hold it in place. They taped me up and sent me on my way. Unfortunately the transport Nazi was at lunch and I was left to hang out in the hallway with three other patients on rolling beds. After about 20 minutes I asked the gal in charge which way it was to my room. She asked why I wanted to know and I told her that I was starving and that I was sure that my cold lunch was upstairs waiting for me and that I intended to walk back to my room. She freaked out, got on the phone and someone was there to get me in less than a minute! I really wasn’t all that hungry, I was just anxious to get back to my room where I knew love and comfort was waiting.

And yes,  Joe was sitting there waiting for me in my room. The nurses didn’t give him my message and he had no idea where I had gone or how long I would be. I often think that it is harder on the healthy person than the sick one. All of the waiting and watching and feeling helpless and scared, of course, he would never let on that any of this bothered him. Once back in my room and in his arms I had another pity party. This one lasted longer.

It wasn’t until the lidocaine wore off that my neck started to ache and I realized that the way that they taped up my neck prevented me from turning and moving my head freely. So now I had an aching bum, neck and a romp stomping headache. The doctor came in and I let him have it! He said, “Well, that is why I ordered morphine for you, I don’t want you to be in pain.” I asked if he could add Tylenol and he said he would. I was so miserable that I finally agreed to try half the dose of the morphine, that being 2 mg. The poor nurse got 1 mg into my IV and I told her “Enough, Stop!” I was already loopy and didn’t want to go any further into la-la land. I am already tu-ca-lu enough without any help. It did however take the edge off of the pain and it never returned to that intensity. Verdict, Jugular Catheter procedure much less painful than a Bone Marrow Biopsy!