September 5, 2008


One of my home care nurses came by yesterday to show me her chest.
Her name is Jill.
Her chest's name is Chester.
Chester the Chest. Truly corny.
Maybe Mr Dressup and his tickle trunk can pay me a visit next week.

Chester the Chest is a model.

Too bad he's the rubber kind that comes in a trunk.

Jill brought Chester by to help educate me about Central Lines.

Currently I have a PICC Line - Peripherially Inserted Central Catheter. A PICC Line is inserted into one of the large veins in the arm. The line is then threaded through the vein, up the length of your arm and into your superior vena cava, where the tip of it sits just above your heart. At the point of insertion, a portion of the line exits the body. At the end of it is a special cap. This is where my IV tubing is attached when I need to administer my IV meds. I am currently on IV 4 hours a day.

A Central Line serves the same purpose as a PICC Line. The biggest difference is that a central line is implanted in the chest. It is a better choice when long term IV treatment is needed. There is less risk of infection and it is designed to be in the body long term. When DR H first prescribed me IV treatment back in June, he recommended that I have a Central Line put in. It is highly likely that I will need to be on IV treatment for 9 to 15 months. However, at that time getting a Central Line was not immediately possible which is why we opted to have a PICC line put in.

There are two different types of Central Lines to choose from. And Chester very graciously modeled both types for me.

The external catheter (on left) is very similar to the PICC line. Similar, in that the line exits through an opening in the skin and hangs several inches outside of the body. Different because part of it is implanted inside the body BEFORE an entry point is made into a large vein. This makes it more sustainable long term.

Subcutaneous catheters (on right) are called medi ports. In this type of catheter, the line does not exit the body. Instead of coming outside the skin, the tube ends in a chamber or port that is implanted under the skin. The port is accessed by sticking a needle through the skin in to it. The IV tubing is attached to the needle, which needs to be changed every seven days. Which means a weekly poke in the chest.

Obviously, the needle less line is more appealing. The needle is not the issue, it's just that I'm a little tired of being poked and prodded, thank you very much! However, I need to carefully consider both options as there are pros and cons to each of them.

I'm super appreciative that Jill brought Chester by for a visit. He's pretty cool, for a plastic chest. And I'm grateful for Jill's guidance and input. It will help me make an informed decision should it still be deemed necessary by DR H for me to trade in Mr PICC for a Central Line.

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