Izzy & Noah ✔️

Seventeen: A Boy's Journey - Facing His First Treatment

VAP, as we call it, stands for central venous catheter.

It's a special type of catheter inserted into the jugular vein, with a subcutaneous pad placed next to it, all of which are hidden under the skin.

This method ensures the catheter remains discreet, but it's not always invisible—often, the catheter is positioned just under the left or right collarbone, or in the upper arm or thigh.

The choice of placement depends on the patient's vascular structure—specifically, the condition of their veins and how they pass through the body.

Central venous catheters are typically inserted by a doctor specializing in catheter placements.

The procedure itself requires a great deal of expertise, as it's crucial to avoid complications like accidental puncture or improper placement.

This type of catheter is particularly common in young patients undergoing aggressive, long-term treatments, like chemotherapy, since it provides a more durable solution for administering fluids, medications, and nutrients over extended periods.

As I was about to ask Suzy how she knew so much about these procedures, it struck me that she'd been working through the weekend, just as she had with M.D. earlier.

Logical, I guess—Suzy's been in this field for a long time and has seen it all.

Izzy doesn't ask stupid questions, I remind myself—especially not when I don't even know if Suzy likes me.

I take a deep breath and focus on preparing the tools for administering therapy via the catheter. I double-check everything. "This is your first chemotherapy treatment, right?" I ask again to be sure.

"That's right," the patient confirms, his voice a little shaky, but steady.

Suzy steps out of the room, leaving me alone with the patient and his mother. I feel a slight wave of discomfort rise in my chest, but I quickly push it aside. I can't afford to let my personal feelings cloud my professionalism.

After all, one of M.D.'s mothers—his primary caregiver—has come back into the room.

Not only is she watching me, but she's also a nurse, which adds an extra layer of pressure.

I pause, steadying myself before continuing, "It's important to rinse your mouth regularly, especially with chamomile tea. The chemotherapy drugs target rapidly dividing cells, and that can lead to stomatitis, which is inflammation of the mouth. Staying hydrated is key, and you should avoid crowded places, such as concerts, as your immune system will be weakest for the next 10-14 days. If you feel sick, be sure to take the medications prescribed by your doctor, and eat several small meals—preferably ones that suit you. Nausea and vomiting are common side effects."

I take a deep breath as I connect the system and set the premedication on the pump. Both the patient and his mother watch me closely.

"What will happen first? Are there any potential complications we should be aware of?" his mother asks, her voice tinged with concern.

I feel my cheeks flush slightly, but I clear my throat and speak, "The first step will be pre-medication, mainly to prevent nausea. Generally, there shouldn't be any major issues, but when administering cytotoxic drugs, we always have to be cautious. If there are any signs of palpitations, fever, trouble breathing, or skin rashes, we could be looking at an allergic reaction."

M.D.'s mother nods, absorbing the information.

Meanwhile, M.D. seems detached, playing with his phone like nothing is happening. His nonchalance strikes me as odd, but I can't focus on that now. I finish setting everything up as quickly and efficiently as possible.