And in goes the Central Line....

So on November 26th 2007 I went into Derby Hospital. When we got there we were told to wait in a little side room while they sorted stuff out. I was in a right state as I was so nervous about what was going to be happening. I think I cried straight for the whole journey and while we were waiting. Anyway after about an hour we were told that my Hickman line wasn’t due to be put in until the following day (Tuesday 27th) so in fact I could go home until 9am the following day and things would progress from there. Well that Monday was probably one of the worst days I’ve had, I spent the whole day in tears, paranoid about what was going to happen or if this didn’t work and I was petrified about having my Hickman line put in. You aren’t put to sleep for it but you do go into like a type of mini theatre. You are given sedation but I remembered from my bronchoscapy that I was totally aware of everything. You are given a local anaesthetic to numb the area but I was still so scared! Anyway I think that day helped in a way as when I went in on the Tuesday I was much more relaxed, knew more what to expect and although was still terrified coped with it a whole lot better!

WHAT IS A CENTRAL LINE?

Anyway if you are wondering a central line or Hickman line is a line which is inserted under the skin of your chest into a vein and the top of the tube sits in a large vein just above your heart. The space in the middle of the tube is called the lumen. The tube can have two or three lumens but mine has two. At the end of the tube outside the body each lumen has a special cap and this is what they attach the drip or syringe too. My line is actually quite a broad one, not a thin one like what are more common. It was put in with the intention of using it for the stem cell transplant. But it’s a pretty good one!

INSERTING THE LINE

The line, like I said was put in in like a Theatre. I was wheeled down in a chair with a lovely hospital gown on! And my line would you believe was given me a box with my name on and ‘left side’ lol! Anyway once I was down there the nurse talked through what would happen, all the staff were really nice and I think they could tell I was nervous!! A cannula was inserted into my hand (I knew I’d never escape without one more!) but the nurse got it in the first time and it was ok though I did ask how bad it would be without sedation – as the cannula was purely to give me sedation, that’s how much I hated them by then!! But I was assured I would be better off with it! Anyway once all that was over I had an x-ray to look at the vein and check it and everything. However the vein they usually use, in me, was too small for my line. They couldn’t use the right side of the chest as I still had my biopsy wound. In the end they decided on an alternative vein which is sometimes, but less commonly use but was big enough for my line.

The actual procedure I didn’t feel. I felt the local anesthetic which stung a bit but that was the most pain I felt. I was expecting to be in quite a bit of discomfort and feel some pushing and pulling and although I felt some of that it was minor.

The actual procedure is as follows: A small cut is made in the skin near your collarbone and the tip of the tube is threaded into a large vein. This is called the insertion site. The tube is then tunneled under the skin to reach the exit site. The exit site is the place where the end of the tube comes out of your body. A chest x-ray is done afterwards to make sure that the tube is in the right place. When the tube has been put in you will have dressings covering the insertion and exit sites. The pic shows my line!

However I had to be awkward! They got the first line in but on the monitors and stuff it showed that it was making my heart flutter and in actual fact it was too close to my heart!! So anyway that line was hurriedly taken out, but I didn’t feel anything other than a bit of a panic at what was happening!! Nurses were sent off to find a shorter line, the problem was that the vein they had used was a little bit closer to the heart so the line was too long. Eventually the right size line was found and put in, again I barely felt anything and once that was in, it was all done!! I was put in the recovery room and soon a nurse of the ward came to collect me with a porter. I had some pain in the area for a few days but nothing major and painkillers took it off. My line also is held in by a stitch which normally they aren’t but cause of the complications with putting it in its in a slightly weird position or something! Anyway the top stitch is out like everyone else but the bottom one has to stay in.

So that is the story of my Hickman line! I have to say once it was in I was so relieved and although it took a bit of getting used too – I mean I now have 2 wires hanging out my chest I’m fine with it now and I don’t notice it! It has to be flushed once a week when not in use and the dressing changed once a week but that’s it. And even though I had a few complications getting it inserted it’s been fine since and the procedure was no where near as bad as I ever thought it would be! Now I love the line, it means far less worry when I go into hospital and they can usually take blood from it (with a one time exception when it wouldn’t bleed!) but its definitely worth it.

So now the line was in, it was on to the IVE…..