Milestone Day — Bone marrow biopsy and catheter removal!

Deb and Tammy, her nurse practitioner

Deb and Tammy, her nurse practitioner

I must say that my daughter Deb is a very brave gal.  I was queasy just watching her procedures yesterday, but she handled everything amazingly well.  Even with morphine, ativan and lidocaine, there was still pain.  Luckily Deb has a great nurse practitioner, Tammy, who has done many of these procedures and is a pro.  Now we are praying for clean biopsy results.

First was the bone marrow biopsy and aspiration.  Bone marrow has a fluid portion and a more solid portion.  In bone marrow aspiration, a needle is used to withdraw a sample of the fluid portion from the bone.  This is spread on glass slides and examined under a microscope for quick results, but does not represent all cells.  In the bone marrow biopsy, a thicker hollow needle is used to suction out a sample of the solid part into the hollow middle of the needle (it looks like a core sample that might come out of a tree, and is about an inch long).  This provides cell constitution and represents all cells, but takes a longer time to process.  This was Deb’s seventh bone marrow biopsy, and less painful this time than the other times (thanks Tammy!).  The biopsy and aspiration was done on the left side of Deb’s hip.

Deb’s Hickman double lumen catheter after removal.  The curved portion (from a little above Tammy’s hand) was under Deb’s skin with the tip inserted into a vein.

Deb’s Hickman double lumen catheter after removal. The curved portion (from a little above Tammy’s hand) was under Deb’s skin with the tip inserted into a vein.

The catheter removal was actually the tougher procedure.  The catheter had been inserted in the right side of Deb’s chest three months ago, and secured by means of a “cuff” just under the skin at the exit site.  This cuff is used to anchor the catheter under the skin so there is less danger of the catheter slipping out.  The cuff also blocks bacteria so it doesn’t enter the bloodstream.  The body’s surrounding tissue grows into the cuff, securing it even more.  So in the three months’ time that Deb had her catheter, it kind of became part of her body.  This tissue had to be cut away from the cuff before the catheter line could be pulled.  Tammy used a scalpel and scissors to cut the tissue away, very carefully of course!  Once all the tissue was severed from the cuff, the line came out very easily.  This procedure took about 25 minutes, and even with the anesthetic there was some discomfort for Deb.

What does it mean for Deb, now that the catheter is removed?  Well, for starters, she can shower without me having to cover the catheter with a plastic bag and tape to prevent it from getting wet.  It also means we have no more daily line flushing with heparin, valve changes, and weekly dressing changes.  Such freedom!  On the downside, from now on Deb will need to have a needle inserted into her vein each time her blood is drawn for testing, which will be done on an ongoing basis for quite some time.  The catheter made it easy and painless to receive meds and have blood drawn.

Next Wednesday, June 18, is Deb’s appointment with Dr. Lowsky, her bone marrow transplant doctor.  We should receive the preliminary results of the bone marrow biopsy at that time.  Dr. Lowsky will let Deb know how often she needs to come back to Stanford for follow-up appointments, and how she needs to reintegrate with the Kaiser Permanente oncology department in San Rafael.  That night after the Dr. Lowsky appointment, we head back to Deb’s home in Marin County!  Yeah!!!

Thanks to all of you for your continued prayers and support for Deb throughout this long journey.  It will still be an on-going journey for some time, but she’ll be moving into a new and hopefully better phase, to continue her healing and start to regain her strength and energy back.

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3 Responses to Milestone Day — Bone marrow biopsy and catheter removal!

  1. Tara says:

    Deb, you are such a trooper! Love you!

  2. Cindy Winter says:

    Well, my suggestion of a codeine pill was pretty ignorant, wasn’t it! Glad you got more of what you needed, Deb, and the photos were reassuring, with you looking so very carefully and lovingly cared for, all bundled up, with Tammy at your side. Those two pics really hit home. For all the cheerful shots we’ve seen — and appreciated! — these convey a much sharper, and I’d suspect more realistic, image of what much of your life has been like during the past many months.

    Welcome home!

  3. Congratulations Deb – You are very brave and keep strong and our thoughts are with you. Love, doug and gail

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