Wednesday, April 01, 2009

Hickman line inserted

Today I had my Hickman line inserted. We first started inserting these about 25 years ago. The idea is that we have long term access to a central vein so that the injected drugs will not damage small blood vessels and multiple injections are not necessary. The risk of leaving a line in so long (up to 6 months in my case) is that it will become infected. To avoid this a tunnel is made so that the line emerges from the skin some distance from where it enters the vein.

We used to use them in patients with acute leukemia, where we easily used up peripheral veins with multiple punctures, and where infections were very likely. They were very successful. In those days we used to insert them blind, judging where they should go from measuring so far from the middle of the collar bone. Nowadays, the line inserted under X-ray control, although at a hospital not far from here they still put them in blindly.

You can be sedated for the whole procedure, but sedation is for wimps. My line was put in by a colleague I trusted who worked with me for more than ten years. He was very effective and I now have a double lumen Hickman protruding from my chest wall.

Being a patient is a matter of trust. I trust Terry who inserted the line, and Basil who did the operation as well as Tamas who will give the chemotherapy. I trust them because I know them. How much harder it would have been to put my trust in strangers.

There is a story of a man who fell over a cliff edge, but as he was crashing down 100 feet to the beach below, he grabbed hold of a branch a dozen feet from the top.

He called out, "Is anybody there?" There was no-one there, the clifftop seemed deserted.

He cried out again,"Help!, Help! Is anyone up there?"

Suddenly a deep voice sounded as if from the sky, "I am here."

"Who are you? Can you save me?"

"It is I, God, I can save you. Please don't worry. All you need to to is let go of that branch and I will catch you in my arms and bear you up."

The man, clinging to his branch, pondered on this. At last he spoke, "Is anyone else up there?"

You see he wasn't able to trust God, because he didn't know him.

If the times are good now, take time to know him better so that you will be able to trust him in the hard times.


Anonymous said...

You wrote:

"If the times are good now, take time to know him better so that you will be able to trust him in the hard times."

This so true and applicable to our cancer battles -- trusting
Him through the difficult times.

You are blessed to know and trust those trating and caring for you. That type of confidence in those treating your cancer is a great source of peace.

Your guidance and advice have always given my family and me that very comfort and confidence. Thank you.

We are praying for your complete healing and recovery.


Mark said...


I was searching your blog for comments on disability. I wanted to know how you would define the terms of a medical disability for CLL.

In the U.S., a Social Security medical disability for CLL begins with monthly blood transfusions and last rites. Is there a more reasonable way to establish what is a medical disability for CLL?


Terry Hamblin said...

This is a matter for each country's authorities to decide. There are general measurements of disability like the Karnovsky score and WHO measurements, but these are not particular for CLL. The commonest disability of CLL is fatigue, but this is so subjective, it is difficult to measure objectively.

Anonymous said...

sedation is for wimps??????
certainly you are not serious

Terry Hamblin said...