Over the past week, it has become increasingly difficult for Emily’s Home Health Nurses to draw blood from the Broviac catheter in her chest. The Broviac is a critical tool in Emily’s treatment, as it minimizes the number of pokes she is subjected to by providing a permanent entrance for all medications and fluids. The line has continued to work effectively for Emily’s drug infusions and flushes, indicating a problem specific to drawing fluids from the line.
Broviacs consist of a long, hollow, silicone tube connected directly to the central venous system. Anchored to the skin by a cuff that also acts as a bacterial seal, is the lumen, or opening, of the Broviac. Emily has a split lumen, making her Broviac essentially two catheters in one. Exiting from her chest, the single tube splits into two, allowing different medicines, fluids, or blood products to be infused at the same time. There is no communication between the two lines as they enter her body through the double lumen.
The first concern this week, was that the tube inside Emily’s vein had been somehow dislodged or bent, thus causing a block when fluids were being withdrawn from the line. If this had happened, Emily would likely need an entirely new Broviac put in place. An x-ray yesterday determined this was not the case!
It did reveal, however, that a fibrous “trapdoor” had formed at the top of her line. Essentially a flap of tissue, this trapdoor is getting sucked over the opening of the tube every time the line is used to withdraw blood. When fluids are being infused, or pushed, into the line, the trapdoor is lifted out of the way – thus explaining why the Broviac has still been functioning for Emily to receive medications. A special flush was pushed through the line yesterday and allowed to sit and break down the fibrous tissue. Her line is now drawing blood better than it has but it is likely an additional flush will be needed to finish the task completely.
After an additional two weeks of Induction level treatment, Emily returns to the hospital today for a bone marrow biopsy to determine the level of Leukemia cells remaining in her body. We must wait until next Monday to receive results and ask that you pray with us to hear “Complete Remission” from Emily’s doctors so she can finally move forward into the Consolidation phase of her treatment.