PDA

View Full Version : central line placement questions



KathK
06-26-2010, 09:53 PM
Hi All,

I have been reading this forum for the past 3 years. The forum members and their postings have been a big help to me on my journey. I have been to various spine specialists and am finally to the point where I am actually scheduled for surgery with Dr. Lenke on August 2nd (in 5 weeks)! (My original surgery date was June 9th, but was re-scheduled due to Dr. Lenke's schedule...that gave me a little bonus breathing time :) ). I had my pre-opt appointments on June 16th.

A little history about me:
My thoracolumbar curve measured 45 degrees when I reached skeletal maturity and stayed there through my 20s and early 30's. Twelve years passed (from the age of 31 to 43) and I didn't have any x-rays taken. When I finally had my back checked 3 years ago, I was shocked to learn that my curve had progressed 20 degrees (from 45 degrees to 65 degrees). In these past 3 years, it has progressed an additional 6 degrees to its current 71 degrees.

When I look at my x-rays, I'm amazed that I experience no pain from my back. Since I'm not in pain, it's a tough decision to go through with the surgery, but I feel that I need to stop the progression of my curve!!!

Since 8/2 is a Monday, I have to have a central line put in the Friday before, on 7/30. I have a couple of questions about this process that I'm hoping someone can help me with.


are you under an anesthetic for the placement of the central line or just a sedative?
will I feel like doing anything the rest of that day?
will I feel like doing much the rest of the weekend?
are you able to shower with the central line in place?



Thanks so much! I'm sure that I will be posting more as my surgery date gets closer.
Kathy

Doodles
06-26-2010, 10:24 PM
Kathy--
I had the same Friday central line with my Monday surgery with Dr. Lenke. It was not anesthetic--just sedative and local, I think. We may have gone out to eat Friday night--nothing big--but I think I felt pretty much OK. On Sat. we went to a function with my brother and sister-in-law at their church. I felt fine but the bandage came up higher under my top than I thought it would and part of it showed. Fine on Sunday too. Showering was a bit awkward since you had to keep plastic covered over the bandage. They will give you the special stuff for it.
Overall, you shouldn't have trouble going out. Good luck and congrats on your surgery date! Janet

LindaRacine
06-26-2010, 11:13 PM
Hi Kathy....

I had a central line placed without any sedation, and it was a very simple procedure.

Good luck with your surgery.

Regards,
Linda

KathK
06-27-2010, 07:30 AM
Thanks, Janet and Linda.
I know the central line is probably "the least of my worries" as my husband would say, but it helps me if I know what to expect at each step :).

I guess I will plan to really enjoy my showers prior to the central line (since they will be a little awkward afterwards) and plan some long, hot, steamy ones :).

Confusedmom
06-27-2010, 09:34 PM
Can someone clarify exactly what is a central line and why does it have to be placed days before surgery?

Thanks!

Evelyn

LindaRacine
06-27-2010, 09:41 PM
Can someone clarify exactly what is a central line and why does it have to be placed days before surgery?

Thanks!

Evelyn

A central line allows quick transfusion directly to the heart. Here's a diagram:

http://www.fmh.org/images/CQ_CentralLine.gif

I'm not sure why WUSTL does it the day before surgery. I think most other hospitals do it after the patients have been anesthesized for surgery.

--Linda

jenparker
06-27-2010, 09:47 PM
I copied this from wikipedia: A central venous catheter is a catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian vein) or groin (femoral vein). It is used to administer medication or fluids, obtain blood tests and directly obtain cardiovascular measurements such as the central venous pressure. Certain medications are preferably given through a central line.

I am a nurse and I was so excited to learn that Dr. Lenke used central lines!!! I have had other surgeries with plain IVs in my arms--oh the pain! Sometimes I could feel the medicine burning along my arms as they went in, and then when the IVs blew out/got old they had to start new ones.

The insertion of my central line was easy. They do sedate you. It is quick and painless (you only feel a little pressure--but not pain). The site did start to hurt later (a few hours later) when the anesthetic wore off--but nothing horrible. My mom and I went to mall for a few hours and I was fine and I felt fine to eat my last meal before surgery. You have to take a shower the night before surgery and one the morning of surgery for Dr. Lenke with a special antibacterial cleansing soap--but the site is easy to cover with the tape and plastic they will give you.

Good luck!
Jennifer

Back-out
06-27-2010, 09:54 PM
Thanks for explanation, Jen! Still somewhat confused (and I admit, feeling a bit queasy. Was tempted to skip this thread - how wimpish is that?)

Linda, transfusions direct to heart? ERp...Wonder if this has anything to do with the tragic death of a young member because of a rare anesthesoologist's error. Archived thread reported he had accidentally transfused blood into her lungs. Might the central line have been misplaced?

Jen, sounds like from what you say about it starting to hurt a few hrs after insertion, that it's one more reason why it's probably hard to get a good night's sleep before surgery in St. Louis! I guess they figure the less they have to do under a general, the better.

mbeckoff
06-27-2010, 10:16 PM
I had my central line placed same day as my operation. it was put in before my surgery began. I had some anesthetic given to me with a small butterfly needle just before I was wheeled to the OR. That was the last thing I remember . When I came out of surgery, it was covered with a bandage with the shunts still there in case they needed to be used

Melissa

JenniferG
06-27-2010, 10:28 PM
I am surprised they aren't all put in after being anaesthetised. Would save a bit of trauma (as if there isn't enough attached to this surgery.) I wonder what the reason is that they go in the day before. Thankfully, mine was done after I was asleep.

golfnut
06-27-2010, 10:33 PM
Kathy,
You're history sounds so familiar to mine. I have known since high school that I had scoliosis, but never thought it would be a big issue since it didn't cause me to limit activities and only had pain after certain activities, such as raking leaves, lifting things, standing for long periods of time,etc. Since I am so active, I had hoped that nothing would need to be done except to continue exercising to stop progression. Well, I now have an increase in the curve and Dr. Lenke recommended surgery. I will be 60, which scares me a little, but I've enjoyed my years of golf, tap dancing, exercise classes, etc. so I don't regret doing it sooner. I hope I will eventually get back to all of it, but who knows? I think we have one of the best surgeons, so that gives me confidence to go through with this tough surgery. Good luck with your upcoming surgery. Be sure to let us know how you are doing.

LindaRacine
06-28-2010, 03:48 PM
Wonder if this has anything to do with the tragic death of a young member because of a rare anesthesoologist's error. Archived thread reported he had accidentally transfused blood into her lungs. Might the central line have been misplaced?

I remember the story, and something was definitely misplaced, but I don't remember if it was the central line.

rohrer01
06-28-2010, 08:31 PM
My step-dad had a six-way bypass. His central line was placed in his neck. He went to sleep without it and woke up with it. He said something about feeling like robo man. :p They must use it for meds because he didn't have a blood transfusion, unless it was just precautionary.

LindaRacine
06-28-2010, 09:23 PM
My step-dad had a six-way bypass. His central line was placed in his neck. He went to sleep without it and woke up with it. He said something about feeling like robo man. :p They must use it for meds because he didn't have a blood transfusion, unless it was just precautionary.
I think it's done for all big surgeries, at least in major medical centers.

jrnyc
06-28-2010, 09:43 PM
years ago, i had to have an emergency line put in (got septecemia from infected PICC line)...triple lumin, i think it was called......did i spell that right?...to allow for putting in blood, meds and steroids....surgeon did it at bedside..i was a code blue and they were rushing me to ICU...he said they had no time, as i was down to 2 hours of oxygen left in my blood! it had 3 lines to allow for all the stuff to go in at once... the surgeon was BRILLIANT... i didnt feel a thing...of course, i was partly out of it with a high fever from blood poisoning...but it never hurt! he just used a local novocaine...then later, when i paid the bill in several installments, he cancelled the balance after a few payments...he was a great doctor!

i had a central line put in a few years before that... out patient at Lenox Hill (same hospital as above procedure)...no anesthesia! and they pushed it thru the artery (or i guess it was a big vein) in the neck! did it with pressure...now that was uncomfortable! the surgeon who worked on me at bedside did it so much better! i understand that now they use anesthesia or at least sedation!

jess

LindaRacine
06-28-2010, 09:51 PM
Jess...

I could be wrong, but I think the triple lumen is the same as a central line. Or, maybe a triple lumen is a type of central line. I suspect Karen Ocker knows.

--Linda

Confusedmom
06-28-2010, 10:54 PM
Linda et al, thanks for the explanations!

Evelyn

leahdragonfly
06-29-2010, 12:17 AM
A triple lumen catheter is a type of central line that has three separate ports on it, in other words, you can hook up three separate IV solutions that would not normally mix well together. So you could give a blood transfusion, a large amount of fluid, and antibiotics through it, for instance.

All central lines are placed in large veins (not arteries). The jugular vein at the base of the neck, or the subclavian vein, near the collar bone, are common sites. Central lines are always placed with local anesthetic (emergency or not). Light sedation or meds for "twilight sleep" are frequently used to make the patient more comfortable and less anxious. The central line is placed with fluoroscopic guidance (live x-ray) to verify correct placement.

I am sure Kathy's central line placement before surgery will go well and without incident. Good luck!

jrnyc
06-29-2010, 05:14 AM
thanks for the info, guys...i meant that if it could be done at bedside, imagine how much easier with the benefit of the OR!

i am sure the procedure will go smoothly...and i hope the surgery and recovery go just as smoothly...:)

jess

KathK
06-29-2010, 09:37 AM
Thanks for all of the info, everyone!

I feel more confident about this procedure now.

mbeckoff
06-30-2010, 11:42 AM
I wanted to ask how long does it take for the marks from the central line to go away. I had my surgery on May 3rd and the marks are still showing

Melissa

jrnyc
06-30-2010, 12:25 PM
the scars from the central line i had put in mid chest are still there very very light..but i had them zapped with a laser a few times to speed the fading...you probably wont need to...mine were raised...
the scar from the triple line i had put in at bedside is gone...there are no marks..it faded within about a year...:) (told you that surgeon was brilliant!)

jess

Back-out
06-30-2010, 07:14 PM
the scars from the central line i had put in mid chest are still there very very light..but i had them zapped with a laser a few times to speed the fading...you probably wont need to...mine were raised...
the scar from the triple line i had put in at bedside is gone...there are no marks..it faded within about a year...:) (told you that surgeon was brilliant!)

jess

What was he brilliant at, Jess? Never hurts to collect names of surgeons for passing on...(How much surgery have you had? :eek:)

jrnyc
06-30-2010, 07:53 PM
oh gosh..it was years ago at Lenox Hill Hosp in Manhattan! he was absolutely brilliant at putting in a triple lumen at bedside! i got no infection, even though he did not have the benefit of an OR...just operated on me while i was in bed!
i dont have his card anymore..he could be retired by now! i will always be grateful for his skill and kindness! and my doctor said he wasnt sure i would survive the blood poisoning...so i guess all the docs did a good job...i have heard that the hospital went downhill since then...it true, it's a shame!

that was not surgery...it was for delivering blood transfusion, antibiotics, and steroids, all to treat the blood poisoning...(and inflammation in lungs)
i've had more surgery than i care to think about...for reasons i dont wish to discuss!

jess

Back-out
06-30-2010, 08:31 PM
i've had more surgery than i care to think about...for reasons i dont wish to discuss!

jess

Gosh, that sounds just AWFUL. You could easily have been a statistic. God bless him and his kind - the true physicians. Fortunately you met a real Dr. House at your time of need.

Yes, I too have had quite a bunch of "down times" - I realize it every time I fill out those multi-page consult forms, and the P.A.'s eyes bug out (and I don't even include everything...heheh). Reminds me of gripe, cummon' - HOW are we really supposed to remember every date, hospital and surgeon's name?? For how long, did I figure I was doing well, to remember my kids' names and keep them separate from the dogs'! :D

(Hmmm, wondering about connection to anesthesia time...)