My previous post about my first trip to the Beatson will have learned a little about the protocol pre transplant. Day zero is transplant day so that first trip there for measurement and getting talked through what is involved in Total Body Irradiation (TBI) happens on day -14.
Day -13 was my last night out on the town with Dave.
Day -9 was the day reserved for insertion of my Hickman line
A Hickman line is a tube that goes into your chest and connects to the either the superior vena cava (the main vein into the heart) or the jugular vein from which you can either take blood or give intravenous drugs.
As far as inanimate objects go it is the piece of synthetic material I have the most affection for in the whole world (yes, even more than my lego star destroyer). You see having one of these things in means that you don't have conventional lines in your arm replaced so regularly. Where it is especially important is for Chemotherapy delivery as giving it through the smaller needles required for veins in your arm can cause massive damage to them so having this strange little thing dangling from your collarbone is an absolute godsend.
The surgery to insert the line is done under a local anaesthetic and is quite a strange experience for it. Being awake while a surgeon has to get up on the table to thread something into you while talking to you to try and keep you calm is very odd indeed. The surgery itself didn't stress me out in the slightest and I actually dozed off at one point which I'm told is just weird (I've also been known to fall asleep in my dentists chair). Previous to the surgery though a line was placed in the back of my hand and the junior surgeon responsible didn't realise he had speared the vein and injected ten mls of saline solution into the back of my hand. This hurt. A Lot. Probably more so because it was so very unexpected. After that little mishap though it was just fine.
It takes a bit of getting used to obviously but then quite suddenly it feels like part of you. The line I had is referred to as a double lumen which means it splits into two separate lines, one of which is devoted to giving meds and the one from which blood is taken. This is because there are some drugs that actually bind to the lines themselves so if you want to measure accurate levels of drugs in your blood you want to ensure you take blood only from one where no drugs from the line could influence the result.
From each of the two lines there was another splitter attached so at any time I could have four intravenous lines attached. This was quite commonplace it was to turn out. In fact at one point I had all four of those and a morphine syringe pump piggybacked onto one so I had five different IV pumps pushing drugs into me.
Now even though I have said it's something you very quickly get used to that doesn't mean there weren't mishaps along the way. On a few occasions getting out of bed during the night to go to the toilet I actually stepped on all the lines and tugged at my chest. I won't tell you the words I used at the time but it was a rather painful mistake to make. Thankfully the line didn't move under this stress but it was a very painful reminder to remember my surroundings a bit more.
Now it might have occurred to you that having a gaping hole in your chest isn't a great idea and you'd be absolutely right but great care is taken with the site itself and with the connection of the drug lines. Everything is conducted under absolute sterility to ensure that no infection occurs.
So having this line in place meant that on day -7 I could start the preparative Chemotherapy I was to have but before all that I got to go home for one last night in my own bed.
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