Tuesday, May 15, 2012

PICC Line Set

Last night Bea and I returned to Chicago for the long admission and stem cell transplant.  We had an uneventful trip and returned to our apartment in downtown Chicago close to the hospital.  Renting this apartment was a great idea as we were able to keep most of our things here when we were in NY for the past 10 days.  It was great to be able to walk when we arrived.  When we left Chicago a week and a half ago, the effects of the Neupogen and the chemo and oh yeah MS had me looking like the famous old man character that one of my all time favorite comedians Tim Conway used to do on the Carol Burnett show.  He played an old man whose steps despite great efforts moved him about 2 inches at a time.  That was me and it wasn't pretty.  The extreme weakness was caused by my very low WBC count from the chemo the previous walk.  Another indicator of my better health was on the way back from the hospital this morning in our taxi, passing all of these great pubs and restaurants it made me think about happy hour, bitter cold and powder dry Grey Goose martinis and bloody red steaks and not puking like the last time I was here.

This morning we went over to the hospital to have my Peripheral Inserted Central Catheter (PICC) line inserted.  This triple lumen (port) line was placed into my Basilic Vein on the underside of my right bicept.  This procedure was considerably easier than the Vascular Catheter inserted into my subclavian (jugular) vein for the stem cell "harvest" (apheresis).  Neither procedure was painful but the Vas Cath was much thicker and they pushed it in a little too far entering my right atrium causing arrythmia and a rapid heart rate for a few days.  This PICC line is 44cm and was placed into the underside of my right upper arm and pushed to the tip of my superior vena cava just outside of the right atrium of my heart.  The line was placed using ultrasound to identify vein placement and success was confirmed by a chest x-ray to make sure the line wasn't curled or in a bad spot.  Now I have the 3 lumens hanging out of my arm which is colored sort of an Avatar blue from the antiseptic cleaner they used to clean the area.

Bea and I returned home after grocery shopping and but for this blog post I'm spending most of the day working remotely.  The purpose of the PICC line is to deliver and extract different medications and blood respectively.  It's a much more efficient system than traditional IVs with great benefits like allowing for the multiple daily blood draws with a twist of the port instead of the stick of the needle. 

Admission is scheduled for tomorrow morning and will last for approximately 17 days.  For my last two admissions late last month I was lucky enough to have a lake front room with great sunrise views.  I called last week to try and reserve a lake front room and after a lot of laughter from the other end of the phone I was told it was luck of the draw.  Hey, it never hurts to ask!!  One of the nurses said to me that another patient beginning admisison tomorrow also called to request a preferred room...  I think it was the Scleroderma woman that overheard my good idea to call ahead...

Bea and I are really ready to get this whole HSCT behind us.  Leaving NY was more difficult this time as it's a longer trip and we just want to move on with life.  Today was my 13 year old son Matthew's last Honor Roll ceremony in his middle school and I missed it... again.  I will also miss his soccer game this weekend against the other undefeated team in his league.  I love to watch him play.  Last weekend he was captain of the team and they won 6-0.  Below is Matthew with the captain band around his leg from Sunday.  I'm so proud of him.



Our son Jose Miguel 11 has handled this remarkably well.  He really misses his mom and also can't wait for this process to end.  My parents are helping with child care this time around.  Bea's mom returned to Puerto Rico last Friday after almost a month in NY.  The support from family and friends continues to overwhelm us with grattitude.

Tomorrow will be day -5 signifying my stem cell transplant or "birthday" will be Monday or day 0.  From there we will begin counting in positive numbers until my immunity rises to a safe level for discharge and return to NY.  I will need to stay away from crowds, some foods that I love like blue cheese and rare meat and germs in general for several weeks after my return to NY.  My immunity should reach safe levels between day +8 and +12.  Tomorrow is also the first of 5 consecutive days of chemotherapy.  The fine staff at NWMH will welcome me with a cocktail of Mesna to protect my bladder from the Cyclophosphamide (Cytoxan), Cytoxan, rATG and plenty of Lasix.  It ought to be a fun day...

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