Hickman Removal

Mi Amigos de Chemo 13

What a day. I mean it was a good day, but still -- what a day.

After the excitement of the night before when one of lumens on my Hickman exploded and the debate about whether and how to save the catheter ended with a tsunami of saline, I had been waiting for someone to come by and yank the thing.

At about1500 the pre-yanking flurry of activity began. Papers were signed, platelets loaded in the IV (to ensure clotting if things got messy), and Teddy Bears removed from the bed – that’s right Teddy Bears removed from the bed in the room – I wasn’t going to the OR like when they installed the device, the Hickman-ectomy was being done in the room. Kinda freaky huh – to move a fella’s Teddy Bears when he’s just about to get cut in his own bed. At least the bears were put on the windowsill so they could watch and take notes.

At about 1530 a PA from the doc’s office comes in carrying an ominous looking grey steel box about the size of a good camera case. She introduces herself and starts explaining the procedure in great detail. With any luck, she says, the explanation will last longer than the procedure. The whole thing should last about 30 minutes.

She opens the steel box and I don’t know what I’m expecting – maybe eerie vapors creeping down the side of the thing once it’s open, or special instruments for an incredibly complex procedure – at least something with enough gravitas to merit a grey steel box fit for a spy movie. It was laundry – sterile laundry I grant you, but laundry nonetheless. The PA pulls a towel with a strategically placed hole, some other towels, a gown, some gloves, and a mask from the box.

Well she gets suited up in her ‘I’m gonna cut Bill open’ duds and puts her tools on the room table to the left of the bed where she will be working. A nurse from the floor goes to the right side of the bed and holds my hand; she reminds she has been there for every “in room” procedure I’ve had including the very first Ommaya time they tried to access the reservoir – we all know how that ended.

The PA injects numbing medicine around the Hickman’s entry site. I have my head turned toward the nurse holding my hand, and pretty soon the digging starts. Digging, excavating, exploration – call it what you will but it is bull work. You see there are two problems: first, the PA is working in a tiny hole in my chest trying to free the line without damaging it and really can’s use a cutting tool to slice away any excess scarring tissue; second, there is a ton of scar tissue grown around the delicate latex tubing inserted in the vena cava.

So now it’s tough going, the PA has to tug, tear and rip her way through the tissue grown around the Hickman tubing in my chest muscles. Although the area is numbed and I can’t feel any pain, I can feel the digging and tearing of the scar gristle through the numbness.

At a several points in the procedure we stop and re-numb the area and start again. Every time we stop the PA has to refit herself in sterile clothing, gloves, and masks. Because the sterile gloves are flesh toned and covered in blood, she looks like a mad scientist from an old creature feature or a fiend from Dexter.

At about 1700 a food service tech wanders in to drop off my dinner, realizes she’s in the wrong place at the wrong time, drops the tray on a chair walks away – it’s all very surreal. I couldn’t see her face, but I bet she wished she had wandered into different room. Then the phone rings, the nurse picks it up.

 “Mr. Potter’s room,” she says. “No he can’t come to the phone right now. He is in the middle of something and can’t be pulled away.

“That was your sister. She wanted an update.”

Eventually the PA calls for help because the amount of scar tissue is so enormous; she is at a loss to explain it all. Pretty close to 1730 a doctor comes in.

“You know what’s going to happen,” he says. “As soon as I get in there, this thing will pop loose because of all the work she did before I got here.”

That’s exactly what happened.

The Doctor went in and with two tugs of gristle the line was free. I was covered in a bit of blood, but the infected Hickman was out. And where I expected to see a lot of blood and a big hole, all there was a small puncture hole the width of coat hanger wire and some translucent red swaths across my chest.

So we’ll what happens next. With the infected Hickman out maybe everything else will fall in line, or at least be a bit easier. Even so, I have to cool my heels in the room for 24 hours to ensure my fever’s gone.

Well, that’s it for now.

More tomorrow,

Bill