Reply To: catheter for plasma exchange
I am glad the process went reasonably well. It is too bad that the initial round did not yield dramatic results, but if you noticed any improvement, then at least is was a worthwhile experiment.
The low BP is not uncommon at first. If you do plasma exchange on a routine basis, you will learn to recognize the symptoms early and the staff can make the appropriate adjustments.
Typically, you should notice an improvement in a couple of weeks. Most textbooks say that PE has to be repeated every couple of weeks to maintain effectiveness. That is not necessarily true, but waiting a couple of months to see if it worked seems to me to be out of line with standard experience. I would press your doctor for another round much sooner.
The reason people opt for a more permanent catheter is not because the insertion process is so difficult. It is because a) they are getting PE often enough that they may as well leave one in, b) the risk of infection with the jugular catheter is higher than with the permanent ones, and c) constantly inserting a jugular catheter creates significant scarring of the vein.
I hope you find a good treatment.