Nicked Thoracic Duct

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3/13/2013 12:48pm
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Replies: 8

Hello,

On Monday I had a WLE on top of my head and a modified radical neck dissection. During surgery my thoracic duct was nicked and now the lymph fluid won't stop flowing. The docs want to use a PICC line to help dry up the duct so it will heal. They want to keep me here (UNC Chapel Hill) for a few more days to perhaps a week. I'm having trouble summoning the extra strength to take on this procedure.

Is this a big deal? Are there other options to halting the flow? It's only been 48 hours and this drain tube is real old. I'm ready to begin healing and rehab but I can't seem to get out of the hospital.

 

Steve

Make today count

POW - (3/13/2013 - 2:35pm)

I'm sorry that you ended up with this unexpected problem, but I'm really glad that that complex surgery is done and that you came through it OK. Whew!

I've never had a PICC line and I'm sure that others here can answer your question better than I can. But it sounds to me like a PICC line can be positioned more accurately and will be more comfortable and portable than a standard drain line. I understand if you really don't feel like dealing with any additional nonsense just now, but I bet you will be happy once it's done. Keep us posted about how things are going with you.

Erinmay22 - (3/13/2013 - 5:20pm)

Haven't had the picc line in but remember the JP drains.  Nicking the thoracic duct does not sound good at all!   Who did the surgery?  My first surgery was at UNC with Dr. Amos.  I was in the middle of moving at the time and all other treatments have been at Sloan Kettering.

Best of luck!  no fun at all.  I had the JP drain for about 2 weeks I believe...

Erin

www.melanomaandthecity.blogspot.com

"people will forget what you said, people will forget what you did, but people will never forget how you made them feel' Maya Angelou

kylez - (3/13/2013 - 6:45pm)

Steve, I've had a PICC line installed for IL-2, but not sure that's the same as having a PICC line installed for drainage. I don't know anything about how that works differently than for my case (basically a better IV for administering medication).

I had a total of 4 installed, for about 5-6 days each time. Each time it was installed by a surgeon who used ultrasound to position it correctly in (a vein I guess) in my (neck or upper chest, I forget at this point). I think the bottom of my neck. I'm not keen about anything surgical eiher, but each of the 4 times it went smoothly, and I was happy that a surgeon was doing it. Mine was pretty skinny, I don't know if they come in different sizes.

I know what you mean about drain tubes getting old, I was so happy to get mine out when I had a lung biopsy/VATS procedure. 

Hope this helps -- Kyle

SteveT - (3/13/2013 - 9:13pm)

Hi POW, Erin, Kyle,

Thank you so much for your words of encouragement. The day started lousy - I thought I was going home but soon found out I would be here for a while with no food, only the PICC line for nourishment - but now I'm feeling much better. The drain is happening via a JP bulb (sorry I wasn't clear about that) and that is the one I'd really like to say goodbye to.

Erin, my surgeon is also Dr. Amos! He explained that the thoracic duct is tiny, hard to see, and often nicked during a neck dissection.

It could have been just a frustrating day. But love-of-my-life Helen came by and we went for a longish walk and then I got a gentle shoulder massage while reading your replies and encouragements.

Thanks, Steve.

Make today count

SteveT - (3/13/2013 - 9:19pm)

Hi POW, Erin, Kyle,

Thank you so much for your words of encouragement. The day started lousy - I thought I was going home but soon found out I would be here for a while with no food, only the PICC line for nourishment - but now I'm feeling much better. The drain is happening via a JP bulb (sorry I wasn't clear about that) and that is the one I'd really like to say goodbye to.

Erin, my surgeon is also Dr. Amos! He explained that the thoracic duct is tiny, hard to see, and often nicked during a neck dissection.

It could have been just a frustrating day. But love-of-my-life Helen came by and we went for a longish walk and then I got a gentle shoulder massage while reading your replies and encouragements.

Thanks, Steve.

Make today count

doro - (3/14/2013 - 12:35am)

Hi Steve,

Glad to hear the surgery went well besides this problem.

I don't have much to contribute but wanted to share that when my father had his bilateral neck dissection he had four drains that I suppose were JP bulbs (based on the what I just looked up online). The surgeon just explained they would help drain blood and fluid that would build up as a result of the surgery and didn't mention nicking anything so I'm not sure if it was exactly the same situation. But I thought you might appreciate hearing that the first two drains were removed in the first few days and all were out by 4 or 5 days, so hopefully yours will be out soon and you will be on your way any day now.

Don't forget you are working towards healing while in the hospital! Has a physical therapist stopped by to give you some exercises? I think a hospital PT worker came by within a couple days to give us some basic arm and neck exercises that Dad could do in or beside his hospital bed that were quite helpful for his recovery and helped him feel proactive about rehabbing even while he was in the hospital. Also, we were told walking around is important to keep the body's systems moving, muscles active, etc, so good job getting up and about today! 

Best of luck on getting out of there soon!

SteveT - (3/14/2013 - 9:14am)

 

Hi doro,

No PT yet but the doc should be by soon and I'll certainly ask him about exercises. I'm gingerly turning my head side to side and lifting my left arm slowly up and down but I'm a bit fearful of overdoing it. 

Thanks for the info regarding your father's drains. Docs are suggesting mine may be out Monday.

Spending my days healing - aren't we all!

Steve

Make today count

kkhalsten - (3/14/2013 - 11:38am)

Hi Steve, I'm new to the board, but not new to melanoma surgery! Hang in there- each day will get better with the drains. I was stressed and worried just with the drain from my lymphadenectomy- the stitches came out one night and we duct taped the tube in....I didn't get too much sleep that night. My thoughts and prayers are going to you for healing and peace. blessings.