Paracentesis team: ‘No one wants to be here, but they’re glad to see us’

Patients call them “rock stars.” These team members quietly go about their jobs – working in a remote first floor hallway inside IU Health’s Simon Cancer Center. Here’s why they are loved.

By IU Health Senior Journalist, T.J. Banes, tfender1@iuhealth.org

It’s been described as “instant relief,” like a radiator letting off steam. There were other places Barbara Carroll would rather be on a recent Thursday morning, but her appointment with the paracentesis clinic at IU Health Simon Cancer Center was a priority.

Carroll, 71, has been coming to the clinic twice a week for about three years. Heart complications cause fluids to build up in her abdomen. By the time she gets to the clinic, she is short of breath and overwhelmed with pressure in her midsection.

The procedure starts with radiologic technologist, Erika Leary conducting a scan of Carroll’s abdomen. Next, nurse practitioner Jennifer Nielsen, administers an injection of a pain reliever. She then inserts a catheter that drains the excess fluid from Carroll’s belly.

For Leary, who has worked at IU Health five years, her job at the clinic is personal. Her father received paracentesis after experiencing multi-organ failure. He died at the age of 49.

“My dad got paracentesis in the 80s. It made me a little more passionate about this area,” said Leary. Back then her father received the procedure at IU Health Methodist Hospital. “There are not many things in medicine that provide instant relief. Without, paracentesis patients sometimes can’t even walk. Seeing that immediate relief is so rewarding, “ she added.

“I love Erika. She’s been here since I’ve been coming in,” said Carroll, who also has dialysis three days a week for kidney failure. As they relieve the pressure, Carroll talks to Leary about her hopes of a trip to visit the “Ark Encounter” in Williamstown, Ky.

“No one wants to be here, but they’re glad to see us,” said Leary. “It gets to be like family because we see the same patients almost every week and most have been coming for years.”

Many of the patients come in with complications from liver disease. Others have kidney failure, heart disease, pancreatic disease, or cancer. Ascites occurs when fluids build up in the veins of the liver. Essentially, the pressure blocks blood flow in the liver, blocking the kidneys from removing excess salt from the body. The clinic staff members also conduct thoracentesis to remove fluid around the lungs.

“We do a lot of patient education on the process,” said Nielsen, a nurse practitioner who has been with the clinic since January. Prior to that, she worked in surgical intensive care. “Personally, it’s nice to do procedural work and I also have the benefit of seeing inpatients,” said Nielsen.

On an average, the clinic staff of four conducts 15-20 procedures a day with both inpatients and outpatients. They may have as many as three beds occupied at a time.

As the liquid leaves Carroll’s abdomen she begins to talk about lunch. Like many patients, before she came to the hospital, she felt a fullness that left her with little appetite. Once the procedure is complete, 8.8 pounds of fluid have been removed from her abdomen.

“It’s like removing two 2-liters of pop from her abdomen,” said Leary. Some patients have as many as five liters of fluid drained. “It’s easy to see why they feel so much better when they leave – until next time.”