What the heck is a Broviac?

We had had several ugly situations occur where doctors and nurses were unable to draw blood from Clark, or put an IV into him. He has small, hidden veins, that tend to blow out when placing needles into them.  Unless someone is using an ultrasound machine to place an IV, we have never seen it be successful.

Through the 80 or so failed attempts we’ve seen doctors and nurses try and poke Clark, he has been incredibly stressed out as it often takes 4-5 people holding him down to try and place a needle.  He is extremely strong for his age, and he doesn’t stop fighting.

When we learned that Clark most likely had Aplastic Anemia, and that he was going to need regular treatments and blood draws, we opted to have a Broviac installed.

What is it?
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Little Clark showing off his Broviac

A Broviac is a tube that runs through a persons chest, and attaches a catheder to a vein in your neck.  This is effectively an “open pipe” directly into your heart.  You can pull blood from it, or you can push medicine into it.  And IV can connect directly to it.  So no more needles are required.

There is a similar device, known as a Port (or Port-a-cath).  This device actually sits beneath the skin, and requires poking through the skin to access.  It has less maintenance, but also requires the individual be a certain weight.  Both have their pros and cons.

In asking our doctor which of these would be better, they recommended the Broviac for Clark.

Is it painful?

Quite the opposite. Once in place, you don’t feel any pain from blood extraction or medicine administration.  The Broviac is placed into a person though surgery.  You are placed under general anesthesia (chemically asleep) and are not aware of the procedure at all.

Why did we do it?

With the Broviac in place, Clarkie no longer requires any needles to be placed into his arms or legs.  It takes 15 seconds to hook up an IV.  Clark went from hating doctors visits, to actually enjoying them. Nurses would enter the room, and he would start screaming.  Now he waves, and loves to watch the procedures.  His stress level has been reduced to zero, and his happiness is at 11.

What is the catch?

Of course there is a catch.  Having an open pipe into your heart carries risk.  Bacterial infection being the key risk.  As such, someone has to clean and maintain this piece of equipment, otherwise Clark could very easily get sepsis and die.  So we have reduced Clark’s stress, but it doesn’t go away – it just transfers to the parents.

We now are responsible for taking care of this medical device.  It requires strict daily procedures, and even more strict weekly procedures.  Small tasks from “flushing” the line with heprin, to larger ones like blood pulls (filling tubes with blood to take to the lab) and changing his bandage (very complex procedure, fraught with risk).

Was it worth it?

Definitely. While Beth and I stress a lot about keeping this equipment clean and functioning, we are very releaved that Clark is not longer feeling pain or suffering when we have to visit the doctors.  And we visit a lot, 2-3 times a week on good weeks.

Can it be removed?

Yes, absolutely.  With very little effort, compared to the surgery to put it in.  They sedate you, tug the cable out, and apply pressure on the vein it was attached to.  It is typically done as an outpatient procedure.

Can it be accidentally removed?

Technically yes – someone could pull it, or it could get snagged, and be pulled free.  That said, the device has a “loop” inside the bandage (you can see this in the image) that allows for slack it does get pulled.  So while you have to be careful, it has been designed to be worn over an extended period of time.

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