No offense, but I hate you bro.

The relationship had a rocky start. I knew I would meet Broviac on the day of Gwyn's surgery. I knew he would act as the vehicle to administer the toxic chemicals to my 12 month old daughter that would clean up what cancer may have left behind after the tumor extraction. I knew we had to make nice for at least the next 6 months.

Gwyn was diagnosed, admitted, had surgery and discharged in 5 days. Everything happened so fast, I compare it to a category 10 hurricane that hit without warning. With a natural disaster, you have readiness, response and recovery. In pediatric cancer, you have no warning. It hits, you respond and you spend the rest of your life in recovery. Pediatric cancer is just unnatural.

Cancer aside, seeing your child in a PACU, still under anesthesia and recovering from major abdominal surgery is not easily prepared for. When I saw Gwyn, she looked perfect. I remember her skin had a beautiful color, they had pulled all the tubes from surgery already and she looked as if she was peacefully sleeping for once. Her arms were beside her, opposed to above her head and for the first time in months, her breathing could not be heard; the cantaloupe sized tumor took up a bit of space in that little body. The anesthesiologist spoke about the surgery and described any new marks Gwyn might have on her body. Then he lifted her gown and showed me the incision, which looked great to me. It was smaller than Dr. Weiner had projected to us, but maybe it's like seeing that movie after everyone else has seen it and you have this expectation that it's going to be a waste. Turns out, it wasn't half bad. So yeh, after the debut of the scar, the gown went higher as the word Broviac was uttered. Oh, crap. I forgot about him. Well, there it was. A six inch white tube coming out of her chest with a pretty large clamp and a single lumen at the end. Hmm. looks harmless enough.

But he wasn't harmless. Over the next few days, he got as much attention as Gwyn's vitals. He was needy. On the morning of discharge, the bro, the husband and I were given a formal introductory. We were given a crash course on how to properly care for it in one hour and then given a pop quiz. We were even given this vinyl manikin with a Broviac to practice on. You know, how to flush it with saline and heparin every other day, change the cap twice a week and the dressing at least once a week. My head spun and my stomach turned nauseous. Not that I cared that I had to give this new maintenance for one of my children, they had me unnerved at  "guard this with your life". I was a mess just watching husband follow instructions on flushing the line on the dummy. Just as he took his first practice run, he started to push saline through, the abused line broke. As in, the force from syringe push made the central line explode, leaving husband holding kibbles and bits of this colicky beast in his hands. If you could have seen the train wreck in husbands eyes as I gasped... time stood still...then our gal Carrie; HemOnc extraordinaire burst into laughter. "Don't worry guys, this won't happen at home. But now that this has happened, we can talk about if it does happen at home."

We were given a set of rules before Gwyn was formally discharged. You know, simple things like don't get it wet, don't let it come out and guard it with your life. Take the handful of hemostats we gave you and put one in the car, one in the diaper bag, one in the purse and tape a pair to the fridge. (wow, sounds like a special agent with a weapon. maybe i should have had an ankle strap made for a pair) Beside the hemostats on the fridge, I placed a ziploc with an extra large patch and a wad of sterile gauze in case the line was pulled out of place. You want to give the patch an inspection every day to make sure the adhesive is still sealed well because of the high risk of infection on this guy. When we went outside to play, I would make Gwyn a Press'n Seal tank top before dressing her because of the sand box. I worried about sand getting wedged in the cap and us pushing it through. She would crinkle when she moved, so we gave her the name Miss Crinkle, just like one of her sensory toys. The hospital gave us this mesh stocking that they use for burn victims, so we could cut a length and fashion a strapless bra. This wonder mesh held the Broviac in place against her chest and the onesies made sure if it did happen to snake its self out, it was still somewhat secure.

Flushing the line every other day was simple enough once you corralled and held the toddler down. The dressing change was a bit painful. I sat on the couch, turned on Yo Gabba Gabba and activated the spider monkey lock hold on Gwyn. I would sit up, she would sit in my lap and lean back on my chest. I would cross one of my legs across her legs and use my arms to hold hers back, then try to keep her head turned away from the site as husband would proceed to clean it and put a fresh patch on it. Think OR. Think sterile environment. You need to act as if you have entered the operating room and you have a patient on the table with an open chest wound involving a jugular. Remember, "guard this with your life". Put on your mask, scrub in. Don't touch anything until you put on the gloves, but the gloves are in the sterile packet and you have to get in there and your assistant is holding the patient(and your other child probably forgot to wash his hands after the last potty break, don't ask him), so you carefully open the kit and unfold the sterile "tray" with tools for the procedure and find the gloves. And that was steps 1-6 of 40. This 30 minute procedure happened once a week for 6 months. In the beginning, Gwyn cried. Jake cried. I wanted to cry, but Yo Gabba Gabba had a way of distracting us all and we eventually toughened up and trimmed a few minutes off of our weekly ritual.

The "My Central Line Book" that was given to us at our crash course in the hospital helped big brother see other families were like ours. When I placed the book on the coffee table just now to take a photo, Jake remembered that bro we used to have to care for. He and I agreed...we don't miss him.

This bro is so dangerous, he has a few aliases. Broviac, a.k.a. Central Line, a.k.a. Hickman Line.