Tag Archives: central line

Looking For Still Waters

Monday
With a long but encouraging clinic day behind us, I gently lifted Chase onto his hospital bed. We had just finished several rounds through the halls on the tricycle and he was finally ready to rest. After chasing him with a rolling IV poll and protecting/pleading for caution with his central line, I was also ready to rest. As I lifted him, his face contorted in pain and he let out a warning scream -I’d seen it a hundred times at home- the line was pulled tight and the IV tubing stretched from the pole to his chest. I quickly gave it slack and laid him down. He’s an active boy – this happens all the time.
Then he contorted and grabbed his chest, still screaming and crying – this did not happen all the time. With an all too familiar feeling of dread, I raised his shirt to see dampness around his central line dressing. Not again, please, not again.
The doctors and nurses confirmed what we feared. The line had been partially pulled from his chest when the IV tubing caught on the pole. With his new central line -a port- this wasn’t the same problem it would have been, say, two weeks ago – just remove the damaged needle and put in another one. The main features of the access are protected under the skin. It would have been so easy but for the chemo. There was chemo infusing when the needle moved and a particularly vicious one at that. Known for harming tissue and muscle; there was a small but very real chance that instead of going into the vein, the damaged needle had spewed this poison into the muscle around it.
For several hours, there was an intense spiral: immediately discontinue use of the port….apply ice…had we heard about the antidote?…IVs needed in his hands to keep him hydrated…surgery for a temporary line in the morning…and on it went. The door to our room was a constant portal to more poking, prodding, and bad news. Please God, no more
In the early afternoon of Tuesday, for the second time in about 24 hours, Chase was taken into surgery to place a temporary line. Moments before he went into the operating room, I received a text saying that a friend of our dear friend would be the nurse on duty in the room. I can hardly explain the encouragement it is to send your child into that cold, dark, unconscious place with a familiar face and friend at their side. A blessed moment in the chaos.
Despite the completed access surgery, there will still be more unfolding consequences of that malfunctioned needle. His hands are bruised and scarred from all the IVs, both failed and successful. He shows signs of the broken trust that comes from hours of people touching and hurting as they’re trying to save your life – anytime someone enters the room and greets him, he screams “No!”. The port must be left alone for at least a week -maybe two- to guard against the chemo damage, and when he leaves here, with his temporary line (in his upper arm…again), we will have to vigilantly continue to watch for the signs of that wretched drug doing its harm.
The irony of these last two days is that when you’re first given your child’s diagnosis, you expect that horrifying knowledge to be the all-encompassing stress and grief. In this moment, I can assure you that -at least in our case- it’s the little things, the daily, the back-and-forth, the multiple procedures. Those are the things that kick you when you’re already down.
But…
In this moment, he’s laying on the bed sleeping peacefully. …snoring, actually. His punctured, bandaged and tubed arm propped on pillows. His mouth relaxed from its pained expression.
Peace.

“He leads me beside still waters. He restores my soul.” Psalm 23:2b

Moment by moment.

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Facing A Fear

Chase’s doctor once told us that most parents know it’s time for more chemo when they see their child looking better, eating more, and having more energy.  Proving this theory, Chase’s Thursday lab results were really encouraging which means we are scheduled to go back to the hospital on Monday.  It’s time.  This particular round of chemo includes several days of being admitted to the hospital as well as a spinal tap under anesthesia.

You may remember that I wrote at one time about Chase’s vivid anesthesia memories.  Since that time, we have had really good experiences because he has been given a “forgetting” medicine in pre=op -while still with us- that relaxes him and saves him the memory of a sterile operating room and a mask over his face all without the comfort of mom or dad.

Because of some aspects of his new central line, Chase’s nurse will be removing the needle from his chest a couple of hours before he is scheduled for the spinal tap.  It’s a little tragic as there will be no shower or swimming pool to jump in and celebrate [children with the type of central lines he’s had until now can’t really bathe or swim], but mostly awesome as he has never officially been without his “tubie”.  However, there is a direct impact on the procedure.  The lack of needle in his chest means that there is no good way to administer medicine in pre-op, which means that Chase will go into the operating room by himself and be put under anesthesia while fully concious.

We have been talking about it every day.  How he will be a brave boy, and how he will take a deep breath and fall asleep, and even how -if he can be still- the doctors won’t have to hold him while they put the mask on his face.  He dialogues with us, and understands what he needs to do, but he is still very frightened.

Please pray for Chase on Monday, that he would be anxious for nothing and that God’s perfect peace would surpass and even confound all of our understanding about how Chase would most likely respond in that operating room. (Philippians 4:6-7)

This will be a big step for him and for all of us…but our God is much bigger.

Learning to let go… Moment by moment.

That Time We Went To The Hospital…

These last two weeks have seemed a little like a single long day that wouldn’t quit!  As parents of a child with cancer, we have been carefully prepared to be ready at a moments’ notice to pack and run…and pack and run again, but this has been extraordinary even for us.  When I think through “moment by moment“, I never expect each new moment to be totally different from the last, but that’s exactly what this two-week day seemed to hold.

It all started as we commuted to the hospital for five straight days of all-day chemo infusions [insert comments and mutterings about traffic here] .  We were mercifully able to be home on Saturday, but on Sunday, our best layed plans for “normal” and “rest” were blown to smithereens as soon as I heard the words “Come quick! Chase is bleeding!” and realized that one lumen on his central line had torn.  …so, back to the hospital we went.

A lumen repair kit...aka: needle salvation

A lumen repair kit…aka: needle salvation

Sidenote: we often tell hospital staff “It’s Chase.”…as in “Yes, we know this rarely ever happens, but….it’s Chase.”

Back to the story… in true “It’s Chase” form, Chase’s line tear was in an area for which they had no repair parts, so after hours in the ER and the vascular access team weaving what can only be described as a sterile burrito (comprised of alcohol wipes, gauze and tegaderms) around the line -to protect from the errant bacteria-, we were discharged.  Until Tuesday.  When we went back in for blood and platelet transfusions and the line repair.  We left that same night and managed to stay out until…Wednesday night.  A whole 24 hours.  At which point, Chase hit his chemo nadir (when the chemo is at it’s strongest point), spiked a fever, and after sitting in the ER until 2:30AM, were re-admitted to the hospital.

We were hoping to go home fever-free sometime on Thursday when the newly repaired central line malfunctioned (see: more blood everywhere) and so we didn’t leave until Friday night.  I should also note that we’ve become very close with the vascular access team.  On Friday night, the stability of the line was still somewhat in question, but with nobody finding anything decisively wrong, Thursday’s blood experience was chalked up to a freakish incident of nature and we were discharged with the niggling thought that the line would only ever show it’s cards once we left the hospital…and got home…and tried to rest.  …which did indeed turn out to be the case.

The malfunctioning repair

The malfunctioning repair

On Saturday night, about an hour into Chase’s infusion, I realized his IV fluids were running down the front of his shirt, so after a brief moment of parental freak-out, I calmly put my eyeballs back into their sockets and we went back to the hospital.  Triage in the emergency room lasted so long that by the time the doctors came to look at the line, they declared everything dry and in need of testing.  After an hour or more of testing, it turned out that the line was leaking, so around our favorite admitting hour (2:30am, for those of you just joining us), we were again given a room with the promise of surgery consults in the morning.

Without a doubt, the worst part of the loss of a central line is the need for peripheral IVs (the kind they stick in your hand or arm).  For Chase, that usually means three to five people holding him down and the collapse of at least one vein from his terrifying struggle to escape the needle.  If you were questioning why we’d put up with a central line and all it’s drama in the first place, don’t miss this… The reason we put up with and even love the central line is because it saves Chase from needles.  Medical staff can draw blood and administer any medication or chemo through this line – without ever touching his body.

Proudly displaying his IV - "You should see the other guy!"

Proudly displaying his IV – “You should see the other guys!”

It took four people and two tries, but they finally got an IV in Chase’s hand.  And that concludes the events that led to Chase going into surgery on Sunday afternoon and getting a new central line.

Which summarily ended our two-week long day.

You can’t make this stuff up.

Moment by ever-changing moment.

The heart of man plans his ways, but the Lord establishes his steps. Proverbs 16:9

Sleeping peacefully in pre-op moments before he was taken back to the OR

Sleeping peacefully in pre-op moments before he was taken back to the OR

The Running Of Chase

This weekend, we’re trying a video blog!  I’d introduce it, but our little movie does it all for me.  :)

[Please excuse the poor editing! I am still learning!]

Have a wonderful weekend!

~MbM~

Three Days And Back

We’re home again!!  …after our shortest hospital stay yet!!  (only three days!)

Thank you for praying!  Chase had a successful central line surgery on Thursday and his Friday and Saturday chemo passed without any excitement (adverse reactions, weird vitals, etc, just the usual “excitement” involved in AT/RT chemo…)

A couple updates on the specifics for which I’d asked prayer:

  • So far, the central line is holding and has not infected!
  • The cancer is still in his spinal fluid, but that we entrust (as always) to the One who made him.

Our next scheduled chemo clinic is Thursday and we have high hopes that Chase’s white blood count will still be high enough that we won’t be admitted at that time.

I will leave you with a small picture of my Saturday hospital experience… Chase, with his track pants and light-up Spiderman shoes, sans shirt, chest wrapped in an ace bandage, stomp-running down a hospital hallway (while trailing a large IV pole) pointing at medical staff and growling “No smiling in the hospital!” …

Never a dull part of our moment by moment … :)

Chase rockin’ his new central line!

Nuts and Bolts

Thursday morning, from the surgery floor

I just passed my nearly unconscious son into the arms of the medical team. Have I ever mentioned that this is my least favorite part of procedure days? They give Chase a small drug to relieve “separation anxiety” before they take him back to the OR and he immediately relaxes, but I still hate watching them wheel him away from me. I just do.

After almost two weeks, Chase is back in the hospital today. Right now, he is in the OR to get a new central line, remove the picc line in his arm, get a spinal tap, and receive his spinal chemo. After post-op recovery, he will be admitted for about four days of chemo infusions.

Many times, my thoughts and prayers are more general in nature, but today I have a couple specific requests: Please pray that this new central line does not infect (as his first one did) and please pray that the cancer is no longer present in his spinal fluid.

Thank you.

Hoping and believing outside the OR room…

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Another Average Week

I meant to write all week and the time completely escaped me.

Here is a brief (“brief”? A bit of levity there…) update from our week.

Monday: Chase went back into surgery to have his infected central line removed and a PICC line placed (in his arm).

Some things never change. Chase, before his central line removal, explores the cupboard.

Tuesday: We finally got to go home!!  …in time to meet Grandpa and Grandma’s flight.  (Early bedtime? Say what?)

Wednesday:  Bob and I checked Aidan into outpatient surgery at our local hospital – to have his tonsils and adenoids removed.  Surgery was successful.

Having to show up for surgery at 6:00 A.M…. Well, we may recover some day.  Aidan was a pro and he was genuinely excited about all the little things like monitoring vitals, the beds and the ID bracelets because he was getting to be just like Chase.  Watching them compare their hospital ID bracelets was both heart-breaking and a little hilarious.

Big brother joins the surgery club…

Thursday: Thursday is our scheduled chemo day. Anytime you think of us on a Thursday, we’d so appreciate your prayers.  This day meant rising early to get back to “Chase’s Hospital” (he really does call it his hospital) for his labs, chemo, and another lumbar puncture (injecting chemo into his spine).  This day was INCREDIBLY encouraging to us because Chase had been able to come home for a day (something never to be taken for granted on this chemo protocol), his counts had dropped – but not as low as they’d expected (so he could come back home instead of being admitted), and despite eating almost nothing, his body was doing well on the IV nutrition and he hadn’t lost any weight since his discharge on Tuesday!

Chase, Thursday, post-op recovery

Friday: The first day in SO many days that we didn’t have to be in either a hospital or a doctor’s office.  Ahhh…  We ended the day with a small celebration…cuddling up on the couch in our pajamas and watching the “Apple Dumpling Gang.”  Silly and perfect and all together for a moment.

Saturday: Chase had a rough night and a slight fever in the morning.  The fever got higher as the morning passed and we brought him back to the hospital early in the afternoon. (fevers in a chemo patient are really important as they are usually indicative of a system issue that the body can’t fight due to it’s lack of white blood cells).

Sunday morning: I’m writing this blog post from an inpatient room in “Chase’s hospital.”  Chase will be here until he completes a course of antibiotics, the fever is under control, and his blood counts start going back up.

Even though it’s hard to be back in the hospital, we have so much to be thrilled about this week… two kids through two surgical procedures in two hospitals with no complications, Chase doing far better than expected, for longer than expected after his chemo clinic, and getting a special family evening to relax in the middle of the chaos.

Moment by moment

An Unusual Complication

Tuesday, 3:30am…

The first round of chemo is done!

Chase was supposed to have been released from the hospital this morning… But it looks like his brand new central line (placed on Thursday) is infected. So, unless there is a miracle in the next few hours, Chase will go back into the OR to have the line removed.

What exactly this means for his next chemo or his ability to fight infection (as his white count is already rapidly dropping), the medical team doesn’t know. We have been told that this is the surgeon’s “call” in the next few hours.

In this moment, I have many unanswered questions about what the next few days will hold. I also miss my family and am frustrated to miss that small window to be together again. Along with this feeling there is a thankfulness and relief that they caught the issue while we were still here and that they’re carefully monitoring him.

I’ve been told that I have “every right” to be upset by this unusual “complication.” Really? Just this one? I don’t mean to be facetious, but in my mind, on some level, it’s all been a giant, graphic complication from the moment the local ER doctor walked into the room and said, “It doesn’t look good. The CT shows a large mass in his head.”

Where do we go from here?

Stay tuned …

How will we handle it?
Moment by moment

“Whatever may pass, and whatever lies before me, let me be singing when the evening comes … You’re rich in love, and You’re slow to anger, Your name is great, and Your heart is kind. For all Your goodness I will keep on singing… Ten thousand reasons for my heart to find…”10,000 Reasons (Bless the Lord), Matt Redman