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hickman line infection again!

HI, I have posted on here before about my fiancé going in for transplant. Anyways he is now in on day -4 now. finished radiotherapy today. He spiked temperature 2 days ago and cultures show it is yet again another line infection, most likely will be pseudomonas again.
He has only just had this one inserted two weeks ago as his last one had three pseudomonas infections. When he had the last one out he went home on two days of oral antibiotics. I'm not sure this was enough. Anyhow he had this line only accessed 5 times prior to developing another infection.

His medical team want to take it out and again put a new one in again. This is distressing for my fiancé as they are painful and he does not want a new one in again, he would rather have it taken out and have a PICC/ cannulas inserted. Has anyone else had transplant with PICC line only?
We are also worried as his counts are dropping, they have not given him IV antibiotics except just locked the line for now. We are worried in case they take it out, put a new one in and have the same problems as he has not been treated. We don't know what to do, help!! any suggestions welcome.



  • Hia sorry to hear you are having problems

    I can not speak medically but can tell you i had numerous problems with hickman lines with infections and getting blocked etc. I have had 3 over the years for 2 transplants and had one removed because of problems and a new one fitted the other side that worked ok. They are not an exact science but i am sure your medical team are on top of it. Try not to worry too much , i know it can be distressing and painful having it re-done but the benefits are numerous. It took me a while to learn how to clean the area around the line insert correctly and to flush it through so some infections are inevitable.

    Good luck
    hope this little bit of support helps

  • Hi Leah,

    For all that I understand your fiancé is nervous about another Hickman line, I wouldn't have thought a PICC line is enough on its own for a transplant. The main reason I think that is because a Hickman line has two baluns as opposed to a PICC line which only has one. This means a Hickman line is more flexible and allows bloods to be taken from one balun and treatment to be given through the other.

    Through the course of my chemotherapy treatment I had two PICC lines but the second one was taken out and a Hickman line installed a couple of days before my transplant. I seem to remember it was because of the reason I've described above.

    If there is an infection in his current line I guess his medical team want to take it out to prevent the infection spreading and if his counts are already low he won't be able to fight the infection, which will mean antibiotics which may affect the transplant or certainly might make things more complex than they already are.

    His medical team will have his best interests in their minds. Once they're in, a Hickman line makes things much easier for taking bloods, and administering treatment, as well as giving transfusions which your fiancé is likely to need. He needs to talk through his concerns with his medical team and seek assurance from them about its necessity, but I'm afraid it's probably a necessary evil he may have to put up with for a short time.

    If it's any consolation I didn't keep mine in for long after my transplant and it was removed after an infection developed, but it wasn't necessary to have a replacement.

    How is he feeling otherwise as the transplant draws near? Please pass on my best wishes and I hope the transplant goes smoothly and he recovers quickly.

    All the best,

  • Thank you guys for your replies. We are keeping the Hickman in for him to have his cells, but the medical team want to take it out the following day. They have allowed him to have a picc line and he is happy to have cannulas also, this is the fourth infection in last few months, this one has only been in for two weeks. We think as soon as they out a new one in it will become colonised and infected and so it would not achieve anything for him. Also he has had them on both sides of his chest and he is too sore.

    He was poorly yesterday, had vomiting and had an anaphylactic reaction after having campath which scared us as he needed some oxygen and IV hydrocortisone and portion to help him breathe. He was much better after this and settled for the night. He is day -1 now. I think they will be putting NG tube down this week just as precaution if they need it. It's all very frightening but a necessary evil in order to get better again and live a full life after.
    He is a fighter so he is managing it really well.

  • Hi Leah,

    What the medical team are proposing sounds sensible and all being well the PICC line will be sufficient going forward. I found by the time I had my transplant that my veins had almost disappeared and getting a cannula in proved difficult. Hopefully he won't need too many.

    I guess today is day 0 and your fiancee will be getting his stem cells today. I hope he's feeling OK and ready to get those cells inside him. Fingers crossed everything goes smoothly and his cells graft quickly so that his counts climb soon.

    It's difficult to stay positive when you're feeling poorly, but I'm convinced it does help you recover. I hope he can keep his spirits up and perhaps setting himself some goals will help. Things like his counts showing, going home for the first time after the transplant, day 100 and something further ahead will all help him have a goal to set his sights on, and each one should be celebrated in some small way.

    All the best to you both and please keep us up to date on his progress.


  • Hi Steve,

    Thank you for the support. He did have day zero yesterday, all went well. He is day 1 today mainly sleeping today. Has been bit nauseous earlier but has now settled. They are going to place the NG tube for mucositis today just in case it gets painful.
    He is a positive person and has fighting spirit in him, hopefully his counts will soon come up and his side effects will be minimal.
    I will keep you update with progress and I'm sure i will have more questions as we progress through this journey.

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