Wednesday 31 October 2012

Line out ...

Adam had his port removed this morning at St George's hospital in Tooting. We didn't realise it's more involved than a Hickman line removal, but apparently it is. The surgeon told Alison this … just to make us feel worse about putting Adam through the possibly unnecessarily procedure. Alison also got quizzed as to why it was coming out so soon. Ordinarily it's done as a last resort, when all other avenues have been explored, and all other treatments tried without success. Instead of four or five weeks, it's been only two-and-a-half since we first took Adam to Epsom with pain and fever. Anyway, following Alison's talk with the surgeon we're expecting to have a sore little boy for a few days.

As Adam's had no temperatures above 38° since Sunday he's actually been discharged from hospital all together. Tonight, fingers crossed, he'll be back in his own bed again. If that doesn't cheer him up nothing will. We'll be keeping a close on eye on him, and hoping that nothing untoward happens over the next few days.

We're due to fly out to America this Sunday. Keep everything crossed people, keep everything crossed ...

6 comments:

  1. Keeping everything crossed! Wanting the best for your little sweetie pie! I hope he can join us the in US soon!

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  2. Everything crossed over here, too!

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  3. Everything firmly crossed for things to go to plan for a change. Here's hoping Adam gets safely on that plane.xxx

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  4. such a beautiful little boy deserves so much more than this. thinking, hoping, finger-crossing...

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  5. Just wondering, if his port is deaccessed (while flying/travelling) how does it still pose a big enough infection risk on flying to warrant removal...?

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  6. Hi TTBA(v)JD, The problem is risk/fear of sepsis whilst on a long-haul flight. That bit of plastic inside Adam's body could (nobody knows, especially in the absence of positive blood cultures) be a sanctuary sight for bacteria. It's not the risk of it becoming infected (which is of course increased if the port is accessed), but the risk that the line is already infected and should Adam become symptomatic there is no way to get him the medical attention he would require. We've been told in the past that if bacteria gets embedded in the plastic there is often no way (other than removal) to stop infection recurring once antibiotics are stopped.

    Without the line there's no longer that (potential) safe haven site inside the central line. Ordinarily a case like Adam's would be treated with repeat antibiotics, then up to 14 days of Ambisome together with investigations. If nothing is found and symptoms persist line removal usually occurs after that. And sometimes the symptoms do then resolve despite nothing ever showing up in cultures or on CT/Ultrasound/Echo. In Adam's case we expedited both the investigations and the line removal so we could get him out to the US as soon as possible. We know we may have done it unnecessarily, but the doctors at the Marsden would not have been happy with him flying whilst a central line infection remained a possible cause of the fevers ... and in the absence of any other confirmed diagnosis that couldn't be ruled out.

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