If you tuned in to yesterday’s blog, you learned a bit about
my husband who has been undergoing lipo-apheresis treatments since last year to combat familial hyperlipidemia. In today’s blog, I will continue
to tell the story of how he got into the treatments, and what he had to endure
to get them started. I will also issue a couple of warnings. First, I am NOT a
medical professional, so anything you read in my blog needs to be discussed
with your doctor. Second, I will be including photos in this and future blogs so
if you get woozy looking at scars or incisions, please view the "text only" version.
Late last year, Kevin was enrolled in a treatment called
lipo-apheresis. Once every other week a machine pulls his blood through very
specific filters that remove all LDL and triglyceride components. He suffers
from familial hyperlipidemia that led to three heart attacks (four interventions total) resulting in six stents. Kevin’s cholesterol levels have often been
immeasurable because the serum is too turbid. In the past, his doctors put him
on a variety of medications and diets. The diets didn’t work and the medication
(statins and fibrates) left him unable to function.
Cholesterol is necessary for certain functions inside our
body (it is involved in cell membrane creation and repair among other things). The
foods we consume give us about 20% of our cholesterol (called dietary
cholesterol). The other 80% is produced in our bodies, predominantly by the
liver. When we have too much and the body can’t metabolize the excess, it can
lead to clogged blood vessels, heart attack, or stroke. This is why it is
important to have your levels tested regularly, especially if anyone in your
immediate family knows they have high cholesterol.
Despite the fact that Kevin is in great shape and follows a
healthy diet, his cholesterol cannot be controlled without medical
intervention. This is the frustrating part of familial hyperlipidemia. In order
for Kevin to start his lipo-apheresis treatments, he first had to get a
hemodialysis catheter installed in his chest. This pair of tubes goes through
the neck, into the jugular and straight into the heart. The external part of
the tube is channeled under the skin and the access ports come out just above
the breast line (to make it easier to manage the dangling tubes). It looks like
this:
The process of getting the catheter into Kevin was a bit
brutal. We went to the vascular access center on a Friday morning and the nurse
took us into an office to discuss what would happen. Kevin had to fill out an
endless barrage of forms. He points out that the paperwork must equal the body
weight of the patient before they can be discharged. As the nurse goes over the
whole procedure, we wonder what we’re getting into. This sounds pretty
involved, but we’re thankful it is only temporary until the fistula can be
created.
An hour after they wheeled Kevin into the surgical suite, I
am called back to the recovery area. He had a huge dressing on his chest and
neck, and he was still woozy from the sedative. The doctor explained to me that Kevin
will be sore since they had to jam the tubing through his very strong neck
muscles. They schedule us to come back the following Monday to get the dressing changed
and to do the vein mapping in preparation for the fistula.
Here is what the dressing looked like (the huge compression
bandage on his neck had already been removed):
Tomorrow, I will discuss the vein mapping and fistula surgery,
and Kevin’s first lipo-apheresis treatment. I will also explain what was involved to care of someone with a chest catheter.
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