Wounds and tubes – the gruesome stuff

I am sure there are a number of procedures that are intervention heavy, however treatment for oesophageal cancer surely has to rank within the top five. Besides parts of the brain, and maybe the pancreas, the oesophagus is probably the most inaccessible part of the body. This is why surgery is so complex and takes so long. The average length of surgery is probably around 8-9 hours and requires two surgeons; one to do the acoustic set and the other to do the electric. Anaesthetic prep time is long due to the amount of tubes and lines that have to be put in.

I have not added up the total of interventions I have had or the number of appointments but I will do one day when I have nothing to do. This post relates to the all the times an incision was made and includes the chemotherapy phase, which I have not even mentioned yet. I will rank each item in terms of pain, upkeep, complications, healing time and advantages.

The Hickman Line

Hickman Line
A Hickman Line in situ

A Hickman line is a venous catheter put into the chest – in fact put in so that chemotherapy meds can be administered straight into the circulatory system.  Some people have a PICC line which is similar but enters in the upper arm. My understanding is that PICC lines caused more clots with the regimen I was on so Hickmans or Portacaths were the preferred method of administration. This video tells you all about how the Hickman is inserted and how to look after it.

The thought of having something connecting my heart to the outside world intially gave me the heebeegeebees. However once it was in and settled, it caused me no issues at all.

  • Pain: The incision in the neck hurt for the first 24 hours as it pulled when I moved my head, however this was relieved by paracetamol and was fine after that. It was no problem when it was taken out.
  • Upkeep: A waterproof dressing was kept in place for 3 weeks and then removed. You could shower but baths were not recommended. The tube was kept taped in place so that if it got caught it would not get pulled out. I used surgical tape and changed and repositioned it as required. Hickman and PICC lines require a weekly flush with saline and a fresh bung applying. District nurses usually do this but I found that my blood testing and chemo appointments fell around the same time as a flush was needed.
  • Complications: Lines can get blocked and mine blocked just after the last administration of chemo but by then it had done its job. Infection is also an issue but I had no problems.
  • Healing time: I think it took about a week to heal – there were no problems at all.
  • Advantages: Having blood taken for testing is a piece of cake – it was hard to go back to the ‘small scratch’ in the arm scenario when you have been used to being syphoned off like a good vintage wine.

Surgical scars

There are a number of scars after laproscopy – they look small but you can tell which one has had the most action!

Scars at the front

Lap scars
Lap scars a few days after surgery

I have six scars at the front although this picture only shows three. They were essentially glued at the surface but sutured underneath. The one in the middle is the one where most of the action took place as it has been the most sensitive of them all. There is also one just in the centre near the solar plexus. This one and the highest one shown were no problem at all. Am guessing that one of these is responsible for blowing air in to inflate  the abdomen.

The bruise at the bottom of the photo is from one of the heparin injections you have to have for 28 days post-op. If I am honest, I never got used to those – although some hurt more than others.

The paper came off in the shower about two weeks post op and the scars were nicely closed up within about 3 weeks.


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