PE Information

December 17, 2011 at 6:16 pm

Hello Lori,

I trust things will go well with the PE. I have one quick question, though, why do you need to be hospitalized? My first round of PE of was done on an outpatient basis, using a jugular catheter. I was careful not to pull on it (or let it be pulled) and kept it dry, and I had no problems. I would think that, barring other problems, you could do so as well.

If the PE works well, you might be able to tell in a week or so. In my case, it took 3 sessions before I noticed any improvement. I was very much improved by a few days after the fifth (final) session (Note: one round of PE is typically 1 to 5 sessions, spaced every other day or so).

The jugular catheter is not a permanent solution. If you elect to continue with PE, then you have a few options. One is to just have venipuncture done each round or session, depending on the hospital’s protocol. The negative is that big needles, typically 17 gauge, a size that a nurse of mine characterized as “medieval”, are needed. This is an option only if you have big veins. Another is to have an arteriovenous fistula made in your arm. Another is to have a shunt installed, serving a similar function to the fistula. The goal in both of these is to swell the vein so that the large needles can be used. Both of these have the disadvantage that they take 8 to 12 weeks to heal enough to provide useful access. The last is some sort of permanent catheter. There are several different names for them, but I think they are all effectively a “tunnel” catheter.

A tunnel catheter is called that because the catheter tunnels through the skin for a distance between the exit site and the penetration into the vein. The point is to reduce the chance of infection. Having one put in is mildly painful and full recovery can be a bit long. It can be used for PE immediately, though. It is a nuisance to put up with, but only that, a nuisance.

I could go into more detail, but let’s see how you do with PE first and then discuss options further then.

Godspeed with your treatment and Merry Christmas,