Central venous line for FEC

I was completely opposed to having a Hickman line (is this the same as a central venous line?) for administering my FEC, but on the first FEC (2nd October) I got phlebitis when the epirubicin in my wrist damaged a vein, this was bruised and sore, hot, red, swollen all the way up my arm to the elbow, for 2 weeks. By the time of my 2nd FEC (23rd October) it had faded to a couple of purple bruises on my wrist. But trying to find a viable vein for the second FEC was a nightmare - veins just weren’t giving up their blood, and the phlebitis from the first FEC has flared again.
I have had a day of hell today whilst 2 nurses and 2 doctors desperately dug about in my veins to try and get an IV in, even at one point suggesting my feet (ouch) just so they could get a line in for antisickness medication and IV fluids. Ican’t keep going through this.

My fears about having a line are: infection, blood clots, the line slipping if I cough or am sick, the pain of having it inserted, how much of a scar it leaves, etc. Can anyone help? My 3rd FEC is due 14th November.

Hi Irina - I would take the line without hesitation.

Agreed, there is a risk of infection, but when they used your veins, the result wasn’t all that clever, either. I’ve had a Groushon line - a while ago now (and now have a portacath) and can’t recommend them highly enough. The former was inserted under heavy sedation and I didn’t feel a thing. Scar wise, there is also a tiny mark on my collarbone, that’s all.

A line saves everyone - most importantly you - but also the medical staff and other patients waiting for treatment so much inconvenience and hanging around. They’re not exactly things of beauty, but we’re not talking forever here. I really think everyone should get one unless they have strong objections - an ‘opt out’ scenario.

Go for it - I don’t think you’ll regret it and I’m sure others on here will help with more specific info’ about Hickman lines and more reassurance.

S

Hi Irina

If you would like to give the helpline a call the staff here will be able to talk to you in detail about the different types of line you could have and the pros and cons of such. The number to call is 0808 800 6000, calls are free, open Mon-Fri 9am - 5pm and Sat 9am - 2pm.

Hope this helps

Jo, Facilitator

I had a Hickman inserted before my first treatment, as I already had pretty bad veins, I’ve had it now for nearly nine months (FEC, Tax & now Her)

I’ve had no problems at all, and the only thing it limits is swimming. I’ve had no infections, or problems with it moving, and insertion was really quick, painless & easy (certainly better than being stabbed for chemo)

Talk it through with your onc, but certainly for me it was the very best option

Rebecca

Hi Irina
I was diagnosed with BC in Sept 06 and had a Hickman line fitted and kept in til April 07. Got Liver secondaries in Nov 07 and had a second line fitted which I’ve still got. It’s a lot easier to have the treatments, just a bind having to have it flushed, cleaned etc every week. Overall the benefits outweigh everything. I had no usable veins at all and it caused alot more pain when they tried to get canulas in! Like you they tried my feet too - very painful!!! We go through enough having the treatments without suffering in the administration of it!
Once you get used to it it’s not such a worry and as it’s checked weekly if there are any problems you can discuss them.
Best of luck.
Carol xx

Hi

Hickman’s are a good idea but you do need to think carefully about them. My first one only lasted 8 weeks as it had moved out of the vein. I am now having to inject myself daily with a blood thinner as I have developed a blood clot in my neck after 3 weeks. This means I am unable to finish my chemo - have had 7 out of 8 FEC so not too bad.

I know this sounds scary and I have probably been the most unlucky line person in the world! On the plus side it makes treatment really easy and you don’t have anyone stabbing you with lots on needles.

xxx

Hi,
I have a port, which is similar to a line, but buried in your chest so no tubes hanging out and you can swim, shower, anything you want with it, nothing to catch on clothes, etc. You just can’t see it at all but it feels like a little hard backed beetle in your chest if you touch it. The downside would be that they stab into it to give you chemo, but it is close to the surface and you get numbing cream to put on, nowhere near the pain of veins just odd someone coming straight at you with it. The side effects are supposed to be reduced as it goes into a big flow of blood and your veins in your arms are totally unaffected. Some people have their blood taken from it, my unit don’t allow this. Another downer it is not comfy to sleep on your tummy or side initially but this reduces over time. I have 2 scars from having it in one of 2 inches and the other 3 inches and right above my collarbone so it shows all the time. They only have to be flushed if you keep it in after chemo/herceptin so don’t have the usual visits. Mine went in before starting chemo as veins all headed south and not many of them, mine will be taken out after chemo as in the way for rads. They put mine in on the BC side?? You go across to the cardio vascular team to have them put in. I had some teething problems but seem to have been more unlucky than most with mine, mainly due to them fitting a new type which the staff had not seen before I arrived. Overall I would say yes have one as any problems I had were minimal compared to the stories of vein stabbing and pain I read too often about unfortunately
Good luck
Lily x

I’ve had a Hickman for 6 problem free months, and recommend it highly. Having it inserted was quite pain free-an odd sensation at times, but certainly not painful! I’m hooked up and ready to go within seconds, whereas watching some other poor patients as the nurses struggle to find a useable vein…no comparison really. It does need flushed weekly, but this is straightforward, and takes a few minutes. Day to day living-no problem, once you get used to it! I even sleep face down and don’t find it intrusive.
I love my Hickman! Please take the opportunity to get one. When I had surgery last year, my foot was used for the anaesthetic as my veins were so bad (plus lymphoedema on one side cut down our options), and believe me, you most certainly don’t want to have your feet used in this way! Good luck-but I think you’ll be very pleasantly surprised at how much easier it makes your life.

Irina - I have similar problems and have just roday had a PICc line fitted as getting blood is a night mare so chemo nurse felt strongly that we should learn from past experience before attempting first of 6 xFEC starting on Thursday. Not a pleasant experience in my opinion but definitely better than hunting veins. Feeling a little bruised etc. Venous nurse says that infection, clots etc are in around 3% of cases so thought hose were reasonable odds as opposed to the half hour spent hunting a vein when I attended for pre chemo checks last week. Wishing you all well xxx.

Irina, I’ve had a Hickman line fitted for the last 6 doses of CMF. I had terrible trouble being cannulated for the Epi - most times it took 4 attempts, and once they tried 6 times then I had to go back next day when it worked first time - doh! They put the first two doses of CMF in my surgery arm, but the veins were small and the chemo took AGES to go in so I was relieved when they suggested the Hickman line. I’ve realised that I had been more bothered about ‘plumping up my veins’ ready for chemo than I had been about the chemo itself.

I had it done under local and it just felt a bit uncomfortable - no pain. Small scar just above my collar bone, and there will be a small scar just above my (smallest) boob when it’s taken out. I’m really pleased I can shower with it, but have not dared to sleep on my front yet so am propping myself up with a V shaped pillow to stop me turning over. I have to go for dressing change and flushing every week and on the weeks when I need blood they can take it straight out. The best thing is that the time it takes for chemo has been greatly reduced, it only takes about 25 mins for the drugs to go in - yea!

The danger of clots and infection are a bit scary, but I’m really pleased with it so far. Hope that helps.

Best wishes, Shelagh x

Thankyou for your comments everyone, I am still terrified of the insertion but that’s because I am a big girl’s blouse and scared of everything. Can anti sickness drugs be put through the line? x

Hi Irina, I have had two different sort of lines - the first was a groushon line which went into my chest and then ran up into a major vein in my neck. It was done under heavy sedation and I lived with it for six months with no problems. The only downside was that the tube stuck out of my chest and I had to be careful of infections. Also, it had to be flushed regularly and I had to take warfarin to stop a blod clot developing that would impede its use. Oh, and I couldn’t swim. Overall, though, I was glad I had it, even though the dangling tube was a constant reminder that I was a “chemo patient”.

When I was diagnosed with secondaries I had a portacath fitted. This was much better in so many respects - I could swim, no dangly bits and just a hard lumpy bit on the skin above my breast - like a hard pimple. But I kept developing infections in the area around the portacath, and was hospitalised three times. The wound where it was inserted never quite healed properly. In the end the portacath was removed, and it was then they discovered that the stiches they had used when they inserted the portacath had not disolved - in fact, they said I was allergic to them!

I should have suspected this might happen - since my breast cancer I have developed allergies to all sorts of surgical dressings so should have thought about the stitches. And I am the only person who I know this has happened to. In all other respects, the portacath was brilliant - it made chemo so easy and yes, you can have your anti sickness meds through it (although I also had to take them orally for a few days afterwards). If your hospital will do a portacath, go for one. Otherwise, the other lines have lots of advantages.

Deirdre

I get blood taken, as well as any i v drugs put through my Hickman line. Just spent 4 nights in hospital with neutropenic sepsis and all the drugs they administered were done through the lines. I was soooooooooooo glad I had had it done, as I reckon it would have been much more of a nightmare being in hospital otherwise.

Shelagh x

I’m to start Chemo in a few weeks, I have an appointment with the Chemo Nurse to discuss things… I understand that various lines go in under some form of anesthetic - does the same apply to when they take it out and has anyone exerienced pain when it has been taken out or whilst it is still in i.e. do you know its there?. I am a wuss when it comes to veins - I can have a blood test and injectons, but for suregry I have to ak them to put my to sleep with gas before putting the canular in.

I was told I could have intravenous sedation for the Hickman line, but not a GA - however they do it under GA in some areas. Sometimes they use local anaesthetic when taking it out. I am a wuss too, they have never offered me gas, that would be good!

Irena,
I had intravenous sedation when I had my Hickman line inserted and was told I would be ‘aware’ ie not asleep but I would remember very little because it has amnesiac properties. I too am a wuss when it comes to any new procedure but I can honestly say it was the best thing for me. When I was in hospital with infection all antbiotics were given through it, my bloods were taken through it and I never got any infection in it. When it was taken out a couple of weeks ago I wanted sedation again but due to transport problems I was late getting there and decided to go ahead withou sedation, just local anaesthetic and honestly I felt nothing and it was all done in 10 mins. Talk to the doctor doing it as mine were so understanding and talked me through everying giving me constant reassurance.
Good Luck and take care
Trish

I think some sort of line will be the way forward for me then - the less faffing about the better and if I can be asleep for most of it even better… My little cousin has something like that when he had Leukemia at the age of 4 and it never seemed to bother him… bothered us grown ups more!!

I had my hickman put in under local anaesthetic, though I did have the choice of GA if I wanted. I held the nurses’s hand very tightly but didn’t feel any pain, just stung a little when they put in the LA and felt a bit odd as they did the procedure. That night I was a bit sore, but one dose of paracetamol allowed me to sleep and no pain relief needed after. I expect to have it taken out without any anaesthesia. It’s a matter of mind over matter I reckon, and no worse than going to the dentist!!

S x