Chemotherapy (4 of 12): 2 of 6 cycles done

Chemotherapy yesterday was a little different than the first 3 sessions.   I now have a central line.  This was placed on Friday (2/26).  Getting the line required a hospital admission, although it was for only about 5-6 hours, of which about 10 minutes was getting the line itself in interventional radiology.   The particular line type I have is called a Hohn catheter.  Mine is blue, unlike the one pictured in that link.  I had really, really wanted a port-a-cath, but due to my low white blood count, the risk of infection was deemed too high.


My arms are now spared, but I have this central line hanging out of my chest.  One concern I never thought of until after was the fact that it would need a dressing.  What this basically means is more adhesive, which isn't ideal in someone with a new tape allergy, or something due to Hodgkins that mimics a tape allergy. The hospital put a tegaderm dressing on it.  Due to a mix-up at the hospital, I had an "urgent" oncology visit immediately upon discharge at noon.  At this point, I was given a new dressing, made of paper tape, but still a tegaderm-like clear center.  This is pictured below.  (The urgency was nothing, btw.  All is well, other than a confused nurse practitioner).

The circular thing in the middle is a cottony biodisk impregnated with a bacteriostatic agent.   As you can see, this is a double lumen catheter.  That means one side will be used for blood draws, the other for infusions.   I'm not wild about using catheters for blood draws, as that can increase the risk of clot and infection, but oncology swears they do it all the time, and they are the boss.   This needs to be flushed with heparin (~300 units - locked), daily.   Heparin keeps it from clotting, hopefully.


So, the mission with this catheter is to keep it dry.  Hence the cling wrap and extra tape.   Due to my tape allergy, this was later changed to even more tape (paper tape), and a ton of it, also pictured below.

As you might expect, this paper tape made for a beautiful wick for water, and despite this 10 minute "lego-project" of a tape and wrap job, I still came out of the shower with the edges of the dressing wet.


And so, Sarah and I had to redress this yet again.   My skin was about as irritated as it was just leading up to the diagnosis, last fall in dermatology, of the tape allergy.  We were told that we'd expect a dressing change weekly, and by now we had changed it 3 times in 2 days.  Luckily, chemo Monday was the following day, and we had many questions for the nurses there.


By the time we got to the infusion center on Monday, and the dressing was removed, I had a bunch of tiny little blood spots from the tape.  The oncology nurses had yet another idea, and this was to dress the line simply by covering it with a 4x4 gauze, and taping that down with the paper tape.  It would still require daily dressings, but it wouldn't be quite as harsh.  (Hopefully.)  It would also still require cleaning with the disinfectant kit, and using gloves and mask, etc, but not the biodisk from above.   I'd also have to wrap it for about a week in the shower, but after that no more.


So, that is the story of my line so far.  We re-dressed it today, obviously, and the tape is still quite painful.  I'm just not sure how that is going to go over 5 months.  I have serious doubts and really, really wish I had a port.


Chemotherapy went great, however.  No more pain in my arm, and none of this dealing with hot compresses for the dacarbazine.  It is somewhat of a pain to sit for half the session with my shirt half off so they can keep checking for blood return.  I still flip between warm and cool sometimes.   I may "modify" a special undershirt for chemo next time.  We'll see.


Yesterday, chemo hit me pretty hard by the evening.  I was pretty stunned and dizzy as usual, but maybe more so.  Today was also a bit of a fog, although I was less nauseated than usual.  Hopefully that continues all week.   No taco bell this time.  Thankfully.


All in all, I was extremely thankful for this line yesterday, and I'm sure I will be more thankful as my arm pain lessens.  However, it is a little depressing to think that I have the pain of ownership of it for the next 5.5 months or so, and I only get to use it roughly 6-8 hours per month.  As long as the tape issue is kept in check, hopefully we'll be OK.  That, like so much else in my cancerous adventure, is just going to have to be day by day.