Normally, as having a Central Line removed falls low down on the priority list, and emergency cases continually bump them down the list further, it can take some time to have the line removed. Having a line put in is of course far more urgent as children at the start of treatment require chemotherapy to commence urgently. We were fortunate however that Romy’s ‘line out’ surgery got completed just a few days after we had the results of her scans! The team recognised that the line was now the only thing keeping us from going home, and that we had already had to spend such a long time away from home. The surgery happened late in the day, after anything more pressing was complete, and after returning from the surgical recovery area, the plan was to spend an hour back on ‘Dayward’. During this hour Romy would need to mobilise, have a wee and eat something before they would be happy to remove her cannula and discharge us. She did well eating the few snacks I had brought, and went for a wee fine, but at the end of the hour it was suddenly realised that there was a fair bit of blood on her gown and it wasn’t quite clear whether this had happened earlier when she had just come round from the anaesthetic or if it was still bleeding. The wound did indeed seem to still be dripping a little bit, but it was watery blood which can indicate it is the local anaesthetic rather than just blood oozing out. But there was also some confusion over whether a representative from the surgical department was happy for it to be left alone and that it had stopped or slowed down sufficiently, or whether it needed action. By this point a lot of time had passed and Romy was getting pretty hungry and fed up. I had spent over an hour watching the wound after the blood was noticed, so I was confident it was not bleeding, and we still had to get her cannula out which was not something Romy was very keen on, to say the least, let alone having her wound re-dressed or re-sutured while awake! Luckily the consultant from our own ward was supportive of my opinion and we came to a compromise with the surgical Dr (who was a different Dr to the one who had initially made a plan, the night shift had taken over by this point and it had caused a bit of confusion). The compromise was to apply a pressure dressing over the top of what was already there rather than undo it all and redress it. It was a long and stressful day, which came to a head with having to advocate for Romy regarding redressing the wound or leaving it be. It was also a very strange feeling to have the line removed. I had hated the central line so much for so long, it was a constant danger to my daughter, living for 18 months with a piece of plastic tunnelled into her chest, sitting in the large blood vessel at the top of her heart and acting as an immediate gateway to her blood supply. Any time the line was accessed to administer medicines or to take blood was potentially a risk. Any accidental mistake from any of the nurses could have led to a life threatening infection/ sepsis, or even just a bit of bad luck despite every hygiene protocol being completely adhered to. The line in her chest was the reason we had to take Romy’s temperature day and night every single day for the last 18 months. Any increase in normal body temperature could indicate an infection and the protocol once she had a raised temperature was for the hospital to administer antibiotics within 30 minutes of arriving at the hospital, even if there was a known explanation for the temperature. Cultures would be taken from both lumens to see if anything grew, indicating an infection. The antibiotics would be given as a precaution until the cultures came back negative, for at least 48 hours after the sample was taken. The line was also the reason for weekly dressing changes, something which I had taken on doing myself for the last 12 months. Romy was more cooperative with me doing the weekly dressing change, and I could take my time and do this at a time that suited us rather than having to have a community nurse do it as part of his/her rounds. Despite this, Romy hated dressing change and although she appreciated and recognised that the Line completely removed the need for cannulas and needles, she detested the weekly dressing change and was delighted its removal would mean an end to these. Despite all the worry it could cause, the Central Line had also been what had kept Romy alive by enabling her treatment, for 18 months it had allowed every chemotherapy drug to be pumped into her body, bar the odd one that was given orally. It had also allowed her to receive countless blood and platelet transfusions, and provided crucial information through blood taken from it at least once a week, informing decisions on her treatment and indicating whether she needed blood products. So, we had a love/hate relationship with this little piece of plastic that had become part of her. The line had also lasted the whole 18 months without needing to be removed and replaced, no mean feat! So, it was a bittersweet feeling to see it removed.
Helen & Tom
