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My Bone Marrow Transplant

Pain is inevitable, suffering is optional.

Today I thought I would write about my shower routine. Why? I hear you ask. Well mine is a little different due to the tube coming out of the middle of my chest. It’s called a Hickman line after the doctor in the US who devised it. It is used to administer all IV drugs, saline etc. and to extract blood. As you can imagine it saves a lot of needle sticking. It enters my chest between my man boobs, runs up under the skin to a vein in my neck and then down inside the vein to just outside my heart. It has a Y junction on the outside so that there are two tubes (lumens) within a covering tube running the entire length.

The critical thing when showering is to keep the lumen ends dry and the entry site sterile. So, first off I use a Tegaderm water-resistant covering over the site dressing to protect it. The lumen ends go in a ziplock bag, Glad sandwich bags about 7″ x 5″ are good if the hospital won’t cough up their longer bags. The ends and the Y junction are placed inside the bag, the bag sealed as much as possible, then the bag has to be rolled up so the opening is pointing downwards and stuck with several pieces of tape over the Tegaderm. Now I can shower, being careful not to dislodge anything.

After the shower I towel dry and then take the bag off and let the lumens dangle while I clean the entry site. I remove the Tegaderm and existing dressing, then use a 3 pack of Povidine-Iodine swab sticks to wipe the skin around the wound, starting close and working in a spiral outwards to avoid bringing anything into the site area. All 3 sticks are used.

Now I wait while the P-I dries, otherwise the dressing won’t stick properly. I usually use this time to moisturise and apply cream to my arms, armpits, upper chest areas where the GVHD affected skin is gradually being replaced by new skin.

The last step is to take a fresh Megapore dressing and stick it on over the wound, tuck the ends of the Hickman into a little bag suspended around my neck and I am done.

SGH staff are impressed that I clean it myself, they usually do it for their patients once a week because they use a different entry site and shorter lumens. As I am on my third Hickman line it has become second nature for me. The one thing I don’t do, but I could in a pinch, is flush it myself. Both lumens should be flushed at least once a week to keep them clear. It involves extracting about 5cc of blood, then injecting 10cc of saline and 5cc of Heparin saline per lumen. The heparin saline stops the blood clotting in the tube.As I am at the hospital at least once per week they flush the lumens after taking blood for the battery of tests they run.

This evening we had dinner with our long time friend and the CEO of Cambridge University Press, Stephen Bourne, at Au Jardin in the Botanical Gardens. My first restaurant meal since the transplant. Getting there was a real problem as the taxi driver had no idea where it was, so in the end I called the restaurant and they gave him instructions. But once in the gardens it isn’t sign posted well so it still took us a bit of time to find it. Stephen had the same problem with his taxi driver who dropped him off at the other side of the gardens so the restaurant sent a golf buggy to pick him up. What was supposed to be a leisurely dinner turned into a bit of a rush as he had a flight to catch at 23:20 back to the UK . It was great to catch up with him again. The food by the way was excellent, I can’t comment on the wine. It seems to be a common problem with taxi drivers in Singapore on Sundays that they operate on as few brain cells as possible, the taxi that took us home went all around the houses and Linds got annoyed with him and lectured him on the best route! Oh well, we had a really good time catching up and that was the main thing.

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