Translate Request has too much data
Parameter name: request
Error in deserializing body of reply message for operation 'Translate'. The maximum string content length quota (8192) has been exceeded while reading XML data. This quota may be increased by changing the MaxStringContentLength property on the XmlDictionaryReaderQuotas object used when creating the XML reader. Line 1, position 9104.
Depending on the specific chemotherapy regimen used, multiple myeloma patients may find that they are scheduled to undergo an autologous stem cell transplant (stem cells taken from the patient and returned to the same patient - no second parties are involved.) The Arkansas Treatment is one such regimen that combines chemotherapy with an autologous stem cell transplant. To collect stem cells from one's blood stream, a central venous catheter usually needs to be inserted in the jugular vein at the base of the neck. This article describes the details of this procedure from a patient's point of view.
One might expect that to collect particular blood cells, they would take blood out of one arm through an IV and return it to the other arm through another IV. That, however, is not usually the case. The process is usually accomplished by inserting a central venous catheter at the base of the neck into the jugular vein. It sounds much less reasonable or pleasant, but it turns out to be a relatively simple procedure.
Central venous catheters have a plastic base (at their center), with several plastic tubes coming out the top of the base which end with lumens to which IV lines can easily be connected. From the bottom of the base, one larger straight plastic tube extends about 6 to 8 inches to a smooth tapered tip. Close inspection shows a hole at the tip and one or two holes around the circumference of the tube about an inch back of the tip. The hole at the tip is connected to one or more lumens and the circumferential holes are connected to one or more other lumens. A typical catheter inserted into a patient's neck commonly has three lumens - two large and one small.
The design of the catheter allows one lumen to be used to draw blood out of the vein, another lumen to return blood to the vein, and a third remains free to administer medications if required.
Insertion of the catheter calls for the tapered tube to be inserted through the skin at the base of the neck and into the jugular vein. The tube then travels down (inside) the vein so the tip is positioned in the large vein right above the entrance to the heart. The insertion is performed by a physician in an operating suite at the hospital.
The typical process proceeds as follows: After arriving at the collection room, the patient lies down in the bed and the bed is wheeled to the operating room where the patient slides off the bed and onto the operating table. Then, the nursing staff begins preparations for the procedure. The physician who will be inserting the catheter will question the patient to make sure both of them are at the right place and that he is performing the proper procedure.
The operating suite will usually be equipped with several computer monitors overhead so the physician can see, as he inserts the catheter, that he has positioned its business end at the proper location at the entrance to the heart. The patient will usually be given a nasal cannula with oxygen for breathing and a blood pressure cuff will be fastened to their arm to allow measurement of blood pressure during the procedure. Then the patient will be covered with sheets - the only exposed area will be the area immediately surrounding the point where the catheter will be inserted. When all preparations are ready, medications are usually administered to make the patient relaxed (and frequently sleepy). A local anesthetic is used to numb the insertion site. One nurse will be assigned to keep a close eye on the patient while others assist the physician. The whole insertion procedure only takes a few minutes.
Before you know it, they will be asking whether or not the you remained awake throughout the procedure, and would you please slide back onto your bed. Another quick ride through the hallways will return the patient to the stem cell collection room where the newly inserted catheter will be connected to the collection machine and immediately put to use.
There are two major differences between a central venous catheter and a PICC line (a peripherally inserted central catheter.) PICC lines are usually anchored in place on the patient's arm by a bracket fastened to the skin with a strong adhesive. Central venous catheters are usually anchored in place with several stitches. This may not be obvious to the patient until a nurse, who wants to remove the catheter, says she needs to first remove the stitches that are anchoring it in place.
The other difference is that the tubes of a central venous catheter have larger inside diameters than those in a PICC line. This allows greater volumes of blood to flow easily from the patient to the collection machine, and back again.
The stem cell collection machine is an instrument based on a continuous centrifuge. Since stem cells are small and light, when spun in a centrifuge, they will float to the top where they can easily be separated and collected. The remainder of the blood is then returned almost immediately to the patient.
A central venous catheter is considered a "temporary" device - it can remain in place for at most 5 days. After that, it has to be removed and stem cell collection must cease. In most cases, sufficient numbers of stem cells will be collected within the five days allowed. In some cases, one day of collection is sufficient. When collection is complete, the central venous catheter can be removed.
The removal procedure simply requires the anchoring stitches to be removed and the catheter to be pulled out. No anesthetic is required. Once the catheter is out, pressure will be applied to the entry sites for about 10 minutes. After that, the vein and the skin should be sufficiently sealed that a bandage can be applied and the patient can be sent on their way.
Although one might become anxious about having a catheter inserted into the jugular vein at the base of the neck, this procedure is a common one that is not painful nor should it be feared. Many patients find that they were anxious for no good reason. The insertion procedure goes quickly and the day spent collecting stem cells is usually a long, slow, lazy, relaxed day. Watching TV, reading, sleeping, working on the computer, listening to the radio, eating and drinking, etc., are all allowed. The only restriction is that as long as the tubes are connected from the catheter to the collection machine, the patient must remain in the bed. Collection ends usually around 3 P.M. at which time the patient will be released from the collection machine and the bed.
When it comes time to remove the catheter, once again, it sounds worse than it really is. It is a painless procedure that can be performed by a transplant nurse at the cancer clinic.
The main recommendation for others who need to have this catheter inserted, and eventually removed, is to not fret about it. The procedures go quickly and they are relatively painless. The initial shot of anesthetic on the neck may feel like a bee sting, but only for an instant until the anesthetic kicks in. After that, the greatest inconvenience is that the dangling lumens are awkwardly positioned at the base of the neck. Usually, the catheter is not painful and it is hardly noticeable. If it's positioned properly, the only way for the patient to even see it is to look in a mirror.
In the big picture of things, the central venous catheter is a handy device to use to perform the stem cell collection procedure. Hindsight suggests it is not worth getting anxious or excited about. Other aspects of chemotherapy treatments can be nastier than the day(s) spent collecting stem cells.
The description given here is typical of this procedure - given from a patient's perspective. Complications can happen which can make the procedure seem very different to other patients. But this description of events is typical for many patients. Hopefully, those who read this article will see that this is a simple, routine procedure which is not worth losing a lot of sleep over.
Dennis Dinger is a survivor of multiple myeloma. Diagnosed in June, 2008, he received five cycles of the Arkansas Treatment: four of chemotherapy, plus the fifth - the high dose and the autologous stem cell transplant. His book, My Bout with Multiple Myeloma, chronicles his battle - to include the year prior to diagnosis, the treatments, and the recuperation period following all treatments. Throughout 2010, the cancer was in complete remission. For more details on the book, click on My Bout. In this book, he includes descriptions of most of the procedures to which he was subject, he gives helpful hints and suggestions to others who may have to deal with this or other cancers. The book was written for those who have been similarly diagnosed, as well as for their family members and friends who may be called upon to support their loved ones through similar battles.
Dennis Dinger is a Christian who is a Professor Emeritus of Ceramic and Materials Engineering at Clemson University. Since his cancer diagnosis and treatments, he has been spending his days studying and writing Christian books. His most recent book attempts to bridge the chasm between technology and Christianity. It is entitled Global Climate Change, the Bible, & Science. His other Christian books are The Coming of the Lord Draweth Nigh, a study of prophecy and the Revelation, The Tribulation to Come, a study of the Revelation of John, and Absolute Truth for a Relative World. All books are available in Kindle and paperback formats. Visit our website at http://www.timelessbooks.us/
Article Source: http://EzineArticles.com/?expert=Dennis_Dinger
View the original article here