My Donor and Me

So, in a little over a month I am scheduled to have my bone marrow transplanted. It sounds daunting but according to my nurse practitioner it will be rather anti-climactic. Apparently, I will receive the bone marrow harvested from my donor in the same manner I would receive a blood transfusion: hang the bags, hook them up to the pump, plug the line out of the pump into my Hickman Line, and then lie back and relax. I expect it might not be quite as easy to relax during the transplant as a typical transfusion but still, my job during this transaction between my donor and me is relatively easy. My donor, on the other hand, has a much more difficult task.

It amazes me that there is someone out there somewhere in the world who is not just a perfect match for me, but who is also willing to follow through with the donation. I have no idea where my donor lives or how far he or she has to travel for the procedure–he or she could live halfway around the world for all I know. Fortunately for the both of us, my hospital will cover the travel expenses and my insurance will cover the costs of the medical procedures; but still, what a disruption to life he or she is willing to make on my behalf, especially since my donor knows nothing about me, other than my life depends on his or her marrow. Likewise, I know nothing about my donor, other than he or she is truly generous and caring.

I am told that a year or so after my procedure I will be allowed to make contact with my donor, provided my donor wants to make contact with me. I will have to make that decision when the time comes. Right now I appreciate the anonymity of the process. It enables me to focus on preparing myself prior to the procedure and healing myself afterward without having to feel obligated to establishing and maintaining a relationship with my donor at the same time. Even to me this seems completely selfish, but it is how I feel.

Besides, how does one thank someone for such grand generosity anyway? Right now the only way I can think of is by simply saying thank you and trying to live the best life after the transplant as possible. We will have to wait and see if I feel differently a year from now.

My Hickman Line

Johns Hopkins Instructions for taking care of a Hickman Line and a Heparin I.V. flush syringe.

I have an Hickman line inserted in my juggler vein to administer my chemotherapy as well as to draw blood for my many, many blood tests. It sounds rather creepy but it is better than getting an I.V. or vein sticks over and over again. Either a nurse at the hospital or my nurse at home (my wife) flushes the lines daily with Heparin I.V. flush syringes.

Because the line is sewn directly into a vein, risk of infection is always a concern. Consequently, the catheter is always covered by a Tegaderm dressing. The dressing provides for a snug fit over the site and enables you to see through the dressing to check the site for infection. It is changed weekly and the procedure is quite a mini production. Masks and gloves are worn and there is even another set of sanitized gloves that must be put on after the old dressing is removed. My wife has been trained to change the dressing and we have kits at home with all the items needed. To take a shower I have to cover the dressing with yet another dressing, called an AquaGuard. The AquaGuard is supposed to prevent the site from getting wet. Don’t tell my nurses but the site still usually gets wet.

My Hickman Line covered by white Tegaderm Dressing and clear AquaGuard dressing.

If you have not figured it out by now, we cancer patients are very needy and, unfortunately, require much care and attention. Often, it seems that I have it pretty easy compared to all of the work that others, especially my wife, have to do on my behalf.

The following is an explanation of Hickman Lines from Wikipedia:

“A Hickman line is an intravenous catheter most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis. Some types of Hickman lines are used mainly for the purpose of apheresis or dialysis. Hickman lines may remain in place for extended periods and are used when long-term intravenous access is needed.

The insertion of a Hickman line is usually done under sedation or a general anesthetic by a radiologist or surgeon. It involves two incisions, one at the jugular vein or another nearby vein or groove, and one on the chest wall. At the former incision site (known as the “entrance” site), a tunnel is created from there through to the latter incision site (known as the “exit” site), and the catheter is pushed through this tunnel until it “exits” the latter incision site.” [Read more]