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Hannah’s Broviac Top:

Comfort, Security, and Modesty for Juvenile Chemotherapy Patients

Inspired by Hannah Genauer, designed by her mother, Teresa Mallory Genauer, and written by Gail Brown

Hannah

Hannah Genauer, the inspiration for “Hannah’s Broviac Top” is shown here, during her treatment. The pink strap of her mother’s specially designed top peeks out from under her orange shirt.

Broviac Top

One of Hannah’s well-worn “Broviac Tops,” designed by her mother, Teresa Mallory Genauer, and the prototype for those described and photographed here.

Note from Nancy:
“Hannah’s Broviac Top” was featured in Gail Brown’s May 2004 Sew News column. So that you might better understand this project, we are repeating part of Teresa Mallory Genauer’s explanation here:

“My four-year old daughter, Hannah, was diagnosed with a brain tumor this year. Her treatment included surgery, chemotherapy, and radiation. Needless to say, the past months have been full of tremendous heartache for our family.

Hannah had to have a ‘Broviac Tube’ surgically installed in her main chest vein for chemotherapy, anesthesia, blood draws, transfusions, and any intravenous medications. The ‘Broviac,’ similar to a ‘Hickman,’ must be kept sterile to prevent raging infections, and held steady to prevent bleeding. Surgeons recommend coiling the tube against the child’s skin, and then taping it in place. But keeping the tubing secure and comfortable is a battle.

So, I bought fun tank tops and stitched a large buttonhole where the Broviac tube would exit. The tube could easily pass through the buttonhole, then be coiled and tied in place with ribbons. It worked like a charm—and no need to undress the patient.

Hannah’s nurses loved her new tops, and wanted me to market them. But now my full-time job is taking care of my daughter. However, I would be delighted if my design was shared with other children suffering from cancer.”

Important Safety Notes on Wearing and Using Hannah’s Broviac Top

Understanding that safety considerations are of utmost importance, Teresa Mallory Genauer shared the following tips for wearers of this specially designed top, and their caretakers.

  • NEVER remove the top without first untying and removing the tube coil. Also, if removing the outer shirt, hold Hannah’s Broviac Top in place (again, so the tube will not be pulled).

  • When you dress the Broviac site, allow at least 2" of tube under the tegaderm patch, and at least 1" loose under the tank top coil. This way, if the top gets tugged, it won’t yank the tube out. (Inquire with a health specialist if you don’t understand these terms and instructions.)

Disclaimer: Nancy’s Notions cannot be held responsible for harm resulting from wearing “Hannah’s Broviac Top” due to improper construction, use, fit or any reason whatsoever. If in doubt about how to safely dress and use this design, please consult a health specialist knowledgeable with care of Broviac sites and juvenile chemotherapy patients.

How-tos for Hannah’s Broviac Top

Broviac Top

The heart appliqué provided in these instructions, fused and satin stitched to a readymade T-shirt. The ties are 3/8"-wide grosgrain ribbon.

Materials Needed

  • One T-shirt, either purchased or sewn. Sleeveless or short sleeves are best, because the shirt will usually be worn under/with other tops, like an undershirt. Look for kid-friendly colors, and durable, comfortable cottons or cotton blends.

  • Fabric scraps for heart appliqué, about 4" by 4" (or so). Quilt-weight cotton prints work well and can also disguise stains. Or consider lightweight synthetic suede, such as Ultrasuede Light® (or other synthetic suede such as Sensuede™). For two of our variations, we created appliqué fabric using Quick Fuse™ Inkjet Fabric Sheets as appliqué fabric, transferring clip art from a word processing program to the iron-on fabric. Keep wearability, durability, and washability in mind when choosing appliqué fabrics.

  • Heart pattern or heart-design fabric for appliqué. A pattern is provided here. Decrease or increase the size of the heart as desired, using a photocopier. Or, use computer clip art available in most word processing programs such as Microsoft® Word or other comparable software.

  • Paper-backed fusible transfer web for the heart appliqué (about 4" by 4"), such as Pellon® Wonder-Under™ original (not heavy duty), Fuse ’n Stick, or Steam-A-Seam 2®. Note: Quick Fuse™ Inkjet Fabric Sheets are a fusible product, so if using them, you will not need fusible web.

  • Grosgrain ribbon, 1/4" to 3/8" wide, 3/4 yard (27"). Or any washable, durable, narrow flat ribbon to match or contrast with the T-shirt and/or appliqué.

  • Optional: Zigzag sewing machine, able to stitch a buttonhole and finish the edges of the appliqué. (A straight stitch can be also be used; see Steps 4 and 5.)

  • Optional but recommended: Tear-away stabilizer, such as Sulky® Totally Stable™ (or any similar product).

Instructions

  1. If possible, try the T-shirt on the child, marking the exit of the Broviac tube on the shirt. (The heart appliqué should be centered over this area.) If you aren’t able to try the shirt on the child, position the appliqué mid-chest, with the top of the heart aligned with the underarm seam or armhole.

    Broviac Top

    If custom fitting isn’t possible, position the appliqué mid-chest, with the top of the heart aligned with the underarm seam or armhole.

  2. Using the heart pattern provided, a fabric-print heart or clip-art transfer, trace the design onto paper-backed fusible web. Roughly cut out the heart, allowing approximately 1/4" around all edges.

    Broviac Top

    Heart appliqué pattern. Photocopy to decrease or increase size, depending on the size of the shirt.

    Broviac Top

    Heart appliqué pattern with optional accent lines for additional satin stitching.

  3. Fuse the heart to the wrong side of the appliqué fabric. Cut out the heart appliqué following the traced lines and peel off the paper backing.

  4. Position the appliqué on the T-shirt (see Step 1), and fuse in place. Then with a medium-width satin stitch (a zigzag stitch adjusted to 2.5 width and .5 or .3 length), stitch around the appliqué. (For faster stitching and less thread density, use a longer stitch, or on ravel-resistant fabrics, even a straight stitch.) The inner accent lines on the pattern are optional guides for additional satin stitching.

    Optional: Before stitching, place tear-away stabilizer such as Sulky® Totally Stable™ on the wrong side of the T-shirt, under the appliqué area. Remove the stabilizer after Step 6.

  5. Stitch a 1-1/4" to 1-1/2" vertical buttonhole in the center of the appliqué heart or design. Using sharp scissors or a buttonhole cutter, carefully cut the buttonhole open. Note: The tube should pass unencumbered through the buttonhole. Lengthen as necessary for functionality and safety.

    Note from Nancy:
    If your machine doesn’t have a buttonhole stitch, or if you don’t know how to stitch a buttonhole, simply straight stitch to form the buttonhole. Using a straight, short (about 12-15 stitches per inch) stitch, sew a narrow rectangle, about 1-1/4" to 1/2" long by a scant 1/8" wide. Using a Buttonhole Cutter Set or a sharp scissors, carefully cut the buttonhole open. The fused appliqué fabric will help prevent raveling.

    Broviac Top

    Instead of using the heart pattern appliqué, a heart image from a word processing program was transferred to Quick Fuse™ Inkjet Fabric Sheets. After the image was cut out, it was fused to the readymade T-shirt. To save time and decrease bulk, the edges, heart outline and buttonhole were straight stitched (see “Note from Nancy” under Step 5).

    Broviac Top

    Close-up of a Quick Fuse™ appliqué that was also printed from the clip art of a word processing program. The appliqué edges were straight stitched, and then zigzagged with a narrow, medium-length stitch. The buttonhole and heart outline were straight stitched using a short stitch length.

  6. Cut the ribbon into two equal-length strips (about 13-1/2" each). Fold under the ends of the strips 1/2" and secure by fusing in place, or with machine- or hand stitching. Fold and press-mark the mid-point of each ribbon strip. Machine tack the strips to the appliqué at the midpoint markings, centering them about 1/2" from the buttonhole opening, as shown.

    Broviac Top

    Machine tack the ribbon strips to the appliqué, centering them about 1/2" from the 1-1/4" to 1-1/2"-long vertical buttonhole opening.

    Broviac Top

    Close-up of the heart appliqué, fused and satin stitched in place. The ties are machine stitched in place as shown in and described in Step 6.

  7. If you don’t have a specific child in mind for your shirt, take it to your nearest children’s hospital or cancer-treatment center. A letter of introduction is recommended, including your contact numbers—and possibly a copy of the“Hannah’s Broviac Top” column on this site. Inquire about most-needed sizes, and input for fine-tuning your prototype for future production. Thanks for bringing comfort and joy to young patients in need, and their caring families.

Terrific news! Teresa Genauer reports that Hannah continues to be tumor-free, and is again attending school and walking. We appreciate the update, Teresa, and your efforts to bring “Hannah’s Broviac Top” to other juvenile cancer patients, their families and caretakers.

� 2004, Nancy’s Notions. Reprint by permission only, and for personal use only. Thank you.