Central Venous Catheter (CVC)

The past several days have been spent doing the multitude of tests that are required before a stem cell transplant.  PET scan, CT scan, chest x-rays, EKG, echocardiogram, pulmonary function test, dental exam, eye exam, another bone marrow biopsy, and labs, labs, labs.  We have met with the doctor, transplant coordinator, research coordinator, had a social work evaluation, business center follow up, and attended the “Everything You Ever Wanted to Know about CVC’s” class.  My CVC was inserted yesterday morning and followed by classes on how to take care of it.  By the end of the day, Paul was certified.  So now he can “officially” take care of me.  :)

So…what is a CVC and why do I have one?  CVC stands for Central Venous Catheter and is a tube that is inserted into a vein either in your arm or under the collarbone (as mine is) for infusion therapy.  The CVC has many uses such as infusion of chemotherapy or immunotherapy drugs, blood products, antibiotics, total parenteral nutrition (IV feeding), and other intravenous medications.  It will also be the means by which I receive my stem cells! 

The benefit of the CVC is that I will not have to be stuck EVERY time they need to do something.  Additional CT and PET scans will still require another IV, and some blood work will require additional sticks, but it will definitely cut down on the invasion of my veins.  Generally chemotherapy drugs are very toxic and can cause irritation to the skin, tissues and veins.  Injecting such potent medications into a small vein would allow the medication to leak into the nearby tissues and cause damage.  Administering into a large central vein allows them to be immediately diluted by a large volume of blood and delivered effectively throughout the entire body.

I was a little nervous about this procedure.  Even though I have now had four bone marrow biopsies, the CVC insertion had me a little weirded out!  But it was much less traumatic than expected.  They gave me some relaxing medication and then several doses of local anesthesia.  A “tunneled” catheter was passed under the skin from the insertion site to a separate exit site, where the catheter and its attachments emerge from underneath the skin.  The exit site is located in the chest making the access ports less visible than if they were to directly protrude from the neck.  Passing the catheter under the skin helps to prevent infection and provides stability.  Mine is called a triluminal Hickman catheter, which means that I have three lines.  It is held in place by an adhesive dressing and suture, which is covered by an occlusive dressing.  The lines much be flushed with a heparin solution daily and the caps and dressing changed weekly.  That is what Paul learned and was certified to do.  Mother (and probably Bethany and Bonnie) will learn it as well…just in case.

Today is just signing papers, and all day tomorrow I will receive outpatient chemo.  Please pray that the side effects are minimal.  The past week has been exhausting.  But we are thankful and more and more convinced that we are on the best possible path.  We have never seen our doctor more certain of the same.

We thank God for being with us every step of the way.