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» LymeNet Flash » Questions and Discussion » Medical Questions » Hickmann removel question...

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Author Topic: Hickmann removel question...
Melanie Reber
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Well, it is good news!

I just hung up with my doc, and it is time to get my catheter removed!
After 15 months with this octopus...I'm elated to hear that the good doc believes that I will no longer need any IV treatment.

But, I am also a bit anxious at the same time.

My question is:
I'm not too sure who to go to for the procedure.

I have read here that many of you who have had a PICC removed, did so at home.

This however, is a triple lumen Hickmann.
I had to go into the oncology dept. of the hospital to have it put in as an outpatient. So, I am wondering if the same major surgery is needed to remove this?

Or, if there is another less drastic way to do it without the surgeon's presence?

Can any of you experienced ones with this shed some light here?

Thanks in advance!
Melanie


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Posts: 7052 | From Colorado | Registered: Mar 2003  |  IP: Logged | Report this post to a Moderator
Melanie Reber
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Awww Angela!

How ARE you my dear???
SO nice to see ya again!

I actually spoke with my homehealth care and my local doc about this today, and they both agreed that I needed to go back to the place that put it in to get it out.

So, I have an apt. set for the 20th.

What a grand Christmas present! I couldn't have asked Santa for anything better!

Thanks for the sunshine...

Much love to you as always,
Melanie

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Posts: 7052 | From Colorado | Registered: Mar 2003  |  IP: Logged | Report this post to a Moderator
WildCondor
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Hi Melanie!

Definetly go back to where you got it put in. Also make sure they inject you with local anesthetic before they pull it out. Mine were pulled out in the ER due to sepsis and I had no anesthesia and it hurt like holy hell. Definetly get a doctor to remove it and not a nurse, they can really yank on it. You will be fine, just for sure go back to the doctor to do it. Congratulations on being Hickman free!!!

After the skin heals over and its not so raw, you can put vitamin E capsules and mederma cream on it to minimize the scarring. Freedom!!!

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Melanie Reber
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Hey there Miss Condor!
(or is it MRS. Condor now?)

Thanks so much for the tips. I know you have much experience here unfortunately.

When I spoke with the outpatient coordinator, she said that the whole procedure would take about an hour and a half, so, I am assuming that anesthesia WILL most definately be used!

It is sewn in for Goodness sake! I don't think that just yanking it out will do!

I will surely try the vitamins and cream to minimize scarring. I already have a small one at the base of my neck where they attached the end, so hopefully, that will be the most noticable if I take the time to follow your suggestions.

Hope you are doing well Pretty Bird. I have missed you!

Much love,
Melanie

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snowboarder
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Hi Melanie,

Best of luck with the procedure. So glad to hear you probable won't need IV's anymore... YEAH!

I'm just beginning lyme treatment but know I'll probable need a line at some point.

Doing orals right now and have had this awful stuff for years and will probable need aggresive tx to eradicate everything.



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Gace24
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Hi Melanie,
Hope I can help you as I am a radiology nurse. Ideally they should prep the site with betadine or if allergic some other type of sterile antibacterial wash. And then they should drape the site around the catheter with sterile towels or sheets. The reason for this is that because the catheter has been in awhile fibrous tissue has probably grown around the insertion site and will have to be cut in order to pull the catheter out.

There is a little velcro like cuff that sits just underneath the skin at the insertion site. It's job is to keep pathogens from migrating up the catheter, this is where they might have to cut the fibrous tissue away. They should definitly give you local anesthetic like lidocaine with epinepherine.
Epi helps control bleeding.

The whole procedure usally takes 10-20 minutes after the prep is done. Because the Hickman is a central line and is surgically inserted this is why you need to be prepped to have it taken out. It usually goes well and with the local no pain during the procedure. Maybe after they might apply some dermabond to close the incision.

You might get lucky after they prep you and they can just pull it out, but not usually. Just basic wound care after, just watch for redness, swelling, pus, and increased temp.

You must be estatic and what a great Christmas present! And yes a doctor or PA usally takes them out. Good Luck!
Grace


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Melanie Reber
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Hi there Snowboader,
Thanks for the kind words. I hope you will be able to enjoy all of this new snow real soon!


Hi Grace,
Wow, thank you so much for the information about the procedure. It sounds fairly close to what I went through getting it put in.

I have another question that I have often wondered about. It may sound goofy, but here goes anyway...

What happens with the hole that was formed by connecting the line to my artery? (I think artery is the right term) When the line is removed, does this heal up on its own or do they need to stitch that too?

It seems to me that they couldn't just leave it...I mean, wouldn't that allow for blood to seep into somewhere it shouldn't?

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lou
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Thanks, Grace, from me too. I have a hickman also and had been told that it was just pulled out. Since mine has been in a while, this gave me the heebie jeebies and I couldn't imagine it would go smoothly!

Not clear to me why others advised going back to the same doc. Mine was done out of state and this would be a big effort and expense. Is it likely that any doc, other than the one who installed it, would refuse to remove it, for that reason? Would it have to be a surgeon who did this or a PA familiar with ports?


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Gace24
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Hi,
Melanie no question is goofy! I actually typed a long reply last night but when I reread it, it didn't make sense. I just started minocycline a few days ago so I think I was a little foggy! Today is better.

The catheter sits in a vein, not an artery.
When they take the catheter out, the hole left where the catheter was should close up quickly. Kind of hard to explain, but the place (your upper chest I am assuming) where the catheter comes out from your skin and where the catheter goes into your vein are two different places! The insertion site for your catheter actually going into your vein is internal and is one the neck veins-jugular or subclavian, where that scar on your neck is.

So a sign of bleeding from the vein where the catheter is inserted internally might be neck swelling known as a hematoma. But it is really rare and just by appying simple pressure to the site is enough to stop it. Most problems are avoided by making sure the platelet count is normal along with PT and PTT(coagulation tests).

Lou-that is a tough question. Some docs don't like to touch another ones' "handwork", for fear of complications. Then they would have to blame each other!! Even though is a fairly simple procedure.

You definately want a someone who is experienced in removing Hickmans or ports, a surgeon, interventional radiologist or surgical PA.

Besides infection and bleeding, another complication might be if the cathter breaks off somehow-this almost never happens. Usually it is a straight foward procedure.
But this is why you just don't what just anyone taking it out. A PICC you can just pull out, these Hickmans and ports are called tunneled catheters, they are tunneled under your skin.

Hpoe I was able to help. Melanie, good luck on the 20th, I'm sure it will go smoothly!

Also Lou, the place where you had it inserted would have all the records of the procedure, the x-rays, the dictated report etc. I don't know your situation but maybe you ask your LLMD to recommend someone to remove it when you are finished with treatment.

Grace


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lymemomtooo
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Melanie, this is great news..You have given me much hope for my daughter..Continue to heal and move forward with that degree.
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Paisley
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dear melanie,

i'm new so you don't know me, but just wanted to say congratulations on getting the hickmann out - hope everything goes well.
regards
paisley


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just don
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My eyes dont tear very easily!
I cant see very well to type, they are very blurry!! With HAPPINESS for you!!!


I also have a hickman(?) port under the skin up by my shoulder. Doc that put it in says, just pop in the office and we will remove it, no problem. Made it sound so simple, in office procedure! Always wondered about vein / artery hole also so glad to read that info!


Wish I knew how to do those jumpin up and down thing'ees, like others do, I am just too dumb and mainly --just don--


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Melanie Reber
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Thanks SO much for the added information Grace!
Yes, I was referring to the subclavian place by my neck...thanks for clearing that up for me.

Angela, I am so pleased to know of your progress! That really makes my day. I pray it continues for you on MP!

Best of luck to you as well Lou!

Oh Don, that is so sweet, thanks for the nice sentiments!

Momtoo and Paisley, yes hope is sometimes in too short supply here, so I am thrilled that I was able to pass some on to you both, Thanks so much for the well wishes!

My best to each of you,
Melanie

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