Monday, July 11, 2011

The Hickman Catheter


I awake to the sound of voices outside my hospital room. I know they are coming for me. It's "Hickman Catheter" day. I prop myself out of bed to quickly wash my face. There's enough time to exchange kisses with my husband. I put my mask on and lay in a horizontal position on the stretcher. As the nurse is wheeling me out the door, Adam leans over and squeezes my hand as another sign of affection. I can feel that he is sharing emotions of compassion with me. His strong desire to alleviate my suffering is killing him inside. He stays in the room as I disappear into the hallway.
*
The oncologist had given me precise information about this medical procedure. A tubular, flexible port-a-cath would be inserted and passed through my central venous system for the long-term administration of substances such as high-dose chemotherapy agents, antibiotics, drugs and blood products. I was given two detailed sheets about the Hickman catheter which I chose not to read before the surgery. I had grasped mentally the significance of this implant from my conversation with the doctor. That was sufficient. The recommendation for the presence of double lumen is beneficial for leukemia patients. It allows introduction of fluids via two access points.
*
Once in the operation room, I was switched from the stretcher onto the surgery table. I scanned the room. The medical staff was wearing scrub gowns, gloves, hats and masks. They placed specialized garments on the table; packing gauze, solutions, dressings and a series of instruments. Everything emphasized cleanliness to protect me from intra-operative wound infection. The room quickly became a "scrubbed" environment.
*
The nurse approached the surgery bed and introduced herself. She gave me a brief summary of the procedure. She directed my attention to where the two incisions were going to be while she applied a great degree of pressure at those spots. I listened but thought: "let's get it started". I was ready-to-go with my fingers clutched to my cross. Little did I know the nurse would advise me to remove my necklace. Disappointed by the failure of my hopes to wear it for comfort, I asked her if I could keep it in my hand. She nodded to express her approval. Guarding it tightly in my left hand, I rubbed the stone surface in a back-and-forth motion.
*
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The day before the implant, Adam went out and got matching chains and pendants. I was moved by all these emotions as tears rolled down my cheeks. These necklaces were perfect and had strong representation for us. It gave me good energy by inspiring me with faith and to always keep a positive attitude. I love my husband's ability to find special meanings through this journey.
*
The nurse completed her explanation and in walked the surgeon in his short sleeve v-necked shirt, drawstring pants, mask and cloth cap. The nurse dressed him into the gown and gloves. He asked if I had any questions before he started and I said no. Then the antiseptic blue drapes went up and blocked my view. I kept a firm hold on the cross which allowed me to meditate and remain calm before being introduced to the anaesthesia provider. Guy explained that the insertion of the Hickman line was going to be done under sedation and that he was going to control the degree of the dose given. His friendliness and professionalism made me feel relaxed and completely at ease. I declared him my bartender and told him to give me a good shot on the sedation scale to make sure I felt no pain. The maintenance of my conscious state was in his hands. Guy said that they would take good care of me. I felt reassured. Then he said: "In goes the sedative drug".
*
The bright operating lights were right in my eyes. I tilted my head to the left to avoid eyestrain. Guy snuck under the steril blue sheet to ask how I was doing. I told him that I wasn't anxious and doing fine. I was tired but was able to co-operate with Guy during the procedure. He kept following up on how I felt. I responded that he was doing a great job.
*
At one point, I remember the surgeon sewing with sutures. Then I realized the procedure was completed. The Hickman line tunneled under my skin. I wasn't sure how I felt about having this intravenous catheter in my body for an undetermined period of time. It was something that I would have to get use to being there. However, I was happy that the procedure was over. The entrance site where my sutures joined my two skin surfaces wouldn't stop bleeding. The nurse applied pressure with a sterile gauze. She realized that one stitch had ripped off. She called the surgeon to come back and add a new stitch. The tissues were joined and a fresh new bandage was applied. Later, I looked at the dressing and all looked better.
*
To be continued...

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