PORT PLACEMENT - Detailed description of process
Comments
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Post -op hydration or the taking in of oral fluids is very important to avoid dehydration. That was discussed a couple of posts ago.
BUT solid food you have to be careful with. The meds used during surgery can slow down the working wave like motion of the intestinal tract. Introducing too much food, too fast post-op can cause the intestinal tract to go to sleep. The medical term is an ileus. It's as if the intestine is saying "I'm not ready yet". You can avoid this problem post-op by starting first with clear liquids.
Clear liquids include anything you can see through--clear broths , jello, tea/coffee,Popsicles. If you tolerate the clear liquids i.e no nausea or vomiting,abd pain, bloating, burping, then you can move onto full liquids.
Full liquids include milk or anything made with milk --like ice cream,custards. If full liquids are tolerated, again no N/V-bloating, burping, then move to a soft low residue foods.
Soft low residue diet is easily digested and doesn't irritate the intestinal tract. The hyperlink below is a very complete listing of what is include on this diet-http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000200.htm
Again , if there are no abdominal complaints----N/V, bloating, pain, burping, The BIGGEST question of all, is are you passing gas from the rectum. This is important because it tells us the intestinal tract is awake and moving in the right direction-------Yeah And a first bowel movement is to be applauded.
The exact amount of time at each level cannot be predicted. The key is no symptoms/ passing gas/ and bowel movement.
Time to move to a regular diet------this means there are no dietary/food restrictions. Start with small portions, and may be 4-5 small meals for a day or so.
This is a limited outline of how to avoid an ileus. Googling ileus will give you more info. I've put this here, to make you aware of how to protect yourself from this complication of surgery. I suggest further reading and discussion of this with your doctor.
In general with IV conscious sedation, also known as twilght, you would not expect an ileus to happen, but being careful to avoid it can prevent allot of problems, So, have a little patience waiting for the positive passing of the gas and poop -er BM.
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Sleepdeprived------when i saw your post about the ride home and all the other problems, it bummed me out. I hope theses posts help someone in the future. I too, wish you would have been warned.
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Sas - "if I write poop well, someone might report me"
Ha ha....funniest statement I heard today!!! Too funny.... And uh oh, I just said it too huh? :-O
Thanks for all the great info on the port....I'm getting mine soon and it really freaks me out....0 -
Madi-----Well it does get the point across LOL. My posts here, there are three or four ,are really related to how to prepare for surgery, and post- op do's and don't's. To often I have seen on threads situations that didn't have to happen, had the person/patient been properly instructed beforehand. When I read sleepdepriveds awful problems on the way home and at home, that was it. There was some concern that I was giving to much info, and would be scaring folks.I suppose there may be folks that think so. But at least I know there are two, you and sleepdeprived that feel there is value here. Thanks.
tbird 57's description above in the topic thread is as relevant now as it was in 2008, even 20-30years ago when ambulatory surgery started. The port isn't that old, but the in's and out's of ambulatory sx are. AND so many gave good info in the previous pages directly related to the ports. I did some other work on some other threads, I'll try and add here as hyperlinks that may be helpful from a general perspective. One is on pain, a second on general organizational things, and a third on wound care.-------good luck Madi with the port placement and the pooping -oh I mean evacuation.
http://community.breastcancer.org/forum/8/topic/770655?page=1#idx_14
This hyperlink is in regard to pain management.
http://community.breastcancer.org/forum/5/topic/748296?page=3#idx_66
This hyperlink is something I wrote when I was fairly new into the BC thing. It's practical day to day things to help you manage. Other members also contributed some great ideas.
http://community.breastcancer.org/forum/44/topic/754935?page=1
This hyperlink is a question raised by another member that had wound care problems. Myself and others did a lot of work on this sight that you may find helpful.
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I have to agree here. It's frustrating when the doctors tell you that most people have no problems, etc. etc. And then you read the posts and find out how many side effects people still deal with. When I have a side effect, it would be helpful to know others have had that. I find that I am more afraid when I don't know what I'm facing. I don't expect I'll have every side effect (hope not anyhow!) but the forums help to know what has helped others when a se happens.
And really, my imagination can be worse than reality. Until someone finally explained, I thought they were going to be putting this cup like thing on my chest to pour the chemo in. :-D Was much less dismayed when I found out what from a doctor friend what a port really was. Blame it on brain cells scrambled by fear of the unknown.
There was more that would have helped me in the days after, if I had been prepared. I had a nightmare of a tape allergy. The dr on call told me to use something that seemed to make it worse. This morning when they called to tell me what time chemo was on Friday, I found out the best thing to use was neosporin and claritin if the itch was too bad. The area had started to dry a bit and the neosporin is mosturizing. I could have gotten relief earlier and the situation wouldn't have gotten as bad if they had prepared me ahead of time. And, yes, I did tell them I had a tape allergy. :-(
It would be easier to trust a doctor who prepared you for what you might run into, and then let you know how you could control or cope if it happened.
IMHO
Peggy
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Hello ladies; got my port today. The procedure was not bad at all, I was so relaxed and talking all through the process haahaha... BUT i passed out after the procedure!! They took me to the recovery area and i laid down on the bed, then they brought me bfast (as my procedure was in the morning at 8:30am), so i sat up and started putting sugar in my tea then i started feeling dizzy, so i kept telling my hubby that i am feeling dizzy as i was trying to lay down, and that was it!! he said he called me and i was not responding, my poor hubby was so scared:-( the nurses put oxygen, IV and i felt mych better afterwards, they said its the meds that hit my body and the fact that i got up to sit on the bed abruptly. Anyway, they kept me for 3hours, came back home slept for most of the anoon, feeling much better now. I took tylenol when i got home, dont feel much pain now. Just wanted to update you ladies.
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Snoopy glad all went well. Except for the fainting. It's that positional change thing I talked about a few post back. You tried to do the right thing --------lay down, Never thoughtto tell you to ask the nurse how to use the squeeze bar to put the head down--duh. Put it on your list for the next sx. If you'd been able to get flat you likely wouldn't have gone all the way out. -----Bummer.
Heres to all postive experiences from hear out------here , here
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http://community.breastcancer.org/forum/91/topic/767669?page=1#idx_30
sleeepdeprived this is a link in BCO on discussion ot tape allergies. Make sure you save in favorite places. They have some suggestions, but it isn't extensive, but it may help and things will likely be added as it develops.
Be careful with neosporin , use sparingly wipe of excess. It in itself, can cause an allergic response in the skin. Don't cover with anything
Talk to your dermatologist-------and get there recommendation. Important.
In the short haul use a non allergic soap and water to wash area after tape removal.
You might be able to put on a sports bra with a dressing held in place by the strap. Use and Ice cube over that for a few minutes, but then make sure area is dry
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Sas, I think you might be right about the neosporin. The area seems to be spreading though it isn't as blistered as it was. I haven't needed a dressing for several days. A few days ago I cut a big opening in pj tops because any covering is uncomfortable. For a small incision, it looks like I had a bb gun pepper the whole side of my chest.
Today we did some shopping for things I want to have at home so I wore a blouse. No bra.. Only got half of them. I'll redo my list and let my dh get the rest tomorrow. He does his best but sometimes ends up with the wrong things. Not a big thing in the big picture, is it!
Is castile a non allergic soap? I'll check out the thread on tape allergies (Thank you!). Do you know if benedryl is OK. I don't think I could have slept without using it before bed because of the itching.
I'll have my daughter or husband check with their dermatologist tomorrow. I don't have one.
Snoopy I'm so glad you were still in the hospital when the effects hit. Glad they took good care of you after and that you are doing OK now!
Peggy
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Peggy, I slept in 100% cotton tees amd mens boxer short, It in one of the hyperlink in my respose to Madi . The one connected with wound care. How to wash the clothing etc. And a suggestion on how to handle rapid bed changes with flashing.
Castille used to be used for evevrything . Dermatologist had me get FREE and CLEAR shampoo and conditioner, when my skin was reacting to everything. Publix had it on hand ---cheaper than then when we bought it off the internet.
L&H*P's if we don't post tonight again----edit fri the 8th- on the 7th tried to type while doing nu-- lightly. Please excuse all the typos . I'm editing them now
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I didn't what to scare you about the topical antibx. Neopsporin is the number 1 to cause a reaction, found this out when I had a reaction to Bactrcin oint. DUH-------I think getting the residue of the tape off is important. How you do that with out causing the skin to become more unhappy. That why I say hypoallergenic. Gentle cleansing not rough.
The FREE and CLEAR was good
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I started to wonder about the benadryl. Called the pharmacist we used to deal with where we lived before. I have a very social hubby and the pharmacist was glad to find out why we hadn't been there recently. He told me his wife is allergic to benaryl, topical and oral. He suggested trying polisporin if I needed an antibiotic cream because it leaves out the ingredient most people are allergic to.
I asked about Aloe gel and he said it couldn't hurt. Thought maybe calamine lotion might help the itching? Maybe I'll try make a baking soda paste if I have to. this is defintely spreading way beyond the tape area. So I cleansed it with Ceptiphil cleanser (gentlest I have on hand) and applied the plain aloe gel. D.H. just made another run to the nearby drugstore for calamine and polisporin (which I will keep on hand in case -- I don't think this is infected). The pharmacy here closes at nine (Eastern time) but the one where we used to live is open 24 hours.
He also said the Cortizone cream could help the itching, but I had two different opinions on using that from the oncology center.
I'm afraid I'm getting angry. What a great way to start out; if they let me start at all with this blazing red mess all around the port. Some of the pink has spread to the port area. I'll try to at least see the PA at the dematologists office, though the chance of getting in tomorrow are slim.. My husband was supposed to be going there for skin cancer checks every year and I just found out he hasn't been there for several years.
At this point I don't care if I get started or not. Anger chases anxiety away, doesn't it.
I couldn't find the tape allergy topic from your link, but did a search and found the following, in case anyone else needs it:
http://community.breastcancer.org/forum/6/topic/770820?page=1#post_2471632
http://community.breastcancer.org/forum/91/topic/767669?page=1
Thanks again, Sas. I never would have thought about being allergic to the benadryl or the neosporn if it hadn't been for you.
Peggy
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Peggy, it's like I said skin once it is sensitised , things can happen pretty fast, Watch forpimples that then explode like volcanoes and create 4-5 new pimples ---that is a cardinal sign of steptococcus infection. What I have described is very accurate-regretfully i went through it with bacitracin
yes you want to start chemo , but not at the risk of infecting the port.
It could be that some steroids will calm the situation down. let them tell you that. But let them tell you what it is first, if they are guessing ask for the next big wig
There was a statement that I made some place that we can become to aggressive with the skin. as long as you washed off the neosporin. that helps. They may want to stick you any way----------well you don't know what you are dealing with yet. It may be better to back off and let it cool down. and be CLEAR before touching it. WEll glad I decided to tell you about Neosporin. Not sure why it still recommended #1 when it has the highest rate of allergic reaction. There is Polysporin. When it comes check the ingredients------for neosporin
time for me to get ready for scope---------yes your right anxiety givesway to being pissed
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I called and asked to see someone today. A nurse checked and said, "My goodness!" and went for a PA. The PA said it was the worst she's seen. They prescribed an antibiotic, hoping if I get two in today and one tomorrow morning it would start to look a bit better. It will be up to the chemo nurse to decide if I get treatment tomorrow. Not that I was looking forward to it, but this is a bummer!
Hindsight: If you get a tape rash after the port and it spreads instead of looking better after the dressings are off a couple of days, insist that you want to see someone right away. They couldn't guess over the phone how bad mine looked. I should have been more assertive sooner.
Peggy
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Sleepdeprived, My allergic response occurred after they took out the triple lumen central catheter. They put a dab of bacitracin at the exit site ,then covered it with a dressing, by that evening it itched so much>>off the dressing came and I washed the area>> it continued to react and everywhere the clear tegaderm dressing had been > continued to react. It was called contact dermatitis >>>it was weepy yellow then honey crust yellow. Then outside the margin of the tape/tegaderm area is where the little volcanoes started they would pop and produce 4-5 baby zits, that then would pop. By this time my whole upper chest was covered. This was during the colon resection , thank god and not the BMX. Of course it was the weekend. MY CDC infectious disease book had an exact description of the volcano/zit thing. I received appropriate treatment and it worked out okay.
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http://community.breastcancer.org/forum/78/topic/770796?page=1
new thread on Hot flashes----lots of good suggestions
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Thanks for such a detailed report! I'm having a port put in sometime in the next week.
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Elyckap--------Pm me if you have any specific questions. I'm not the only poster here, but am willing to help
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Hi to SAS-SCHATZI: love the volcano/zit description. I'm a pharmacist currently on leave, so am posting here in order to get my "patient counseling" fix!
It's almost always the neomycin part of Neosporin that causes problems for people - the generic combination is often called triple antibiotic ointment. The other 2 ingredients are bacitracin (which is what I usually suggest, a little surprised you had a reaction to the single agent but maybe it was another component that was really the culprit?) and polymixin. That part gives the double product the brand name Polysporin.
On a personal note, with my port placement I had itching from the Chloraprep surgical scrub and started a thread here complaining/warning about that since the manufacturer's literature gave very few reports of that complication. Luckily, it was not close to the surgical site but up on the neck, over to the middle chest area and around to the shoulder & upper arm. Went in to have it looked at and the PA seemed to think it was more an issue of not being rinsed off...
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Vinrp-------so glad to have you here. You will be such a good resource. I think my reaction to Bacitracin was ??? When the contact dermatitis developed it was the exact square of the tegaderm type dressing. Who knows. Combo of chemicals? Then the streptoccal -volcanno/zit thing occurred out side the tegaderm type dressing margin. It was amazing to watch the v/z occurr right before my eyes. Which seeded the abdominal incisiion. I had Keflex at home.
I am now sensitive to all topical antibx's .
Haven't heard from Sleep deprived yet.
Again glad to have you as a resource. I read most of what you said when it happened to me , now to tired to search and remember.
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New thread on social security questions answered by a lawyer whose wife has BC. Knows his stuff------posting on a bunch of threads---------go to financial forum
Can't make link work without trouble, not up for it.
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Hey everyone, I haven't read thru this whole thread but was wondering if it's possible for a port to move a little bit? Mine seems to be irritating me more and I can't tell if its slipped or what. My bra strap seems to be irritating it more, I've recently stop wearing a sports bra as well as my reg bra (needed for healing lumpectomy). So I don't know if it's the weight of my breast pulling the strap tighter or if the port itself has moved. Has anyone every had something like that happen?
Thanks!
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MCC324--- haven't had a port, but I have had to access them and they can move a little in the pocket. that's why they are held firmly for assess. My twin who has asecond port , says this one when labs are being drawn, she has to turn her head opposite the port. If she forgets and starts talking or looks in the same direction it hurts. She can feel it sucking on the vessel wall.
She has this port for a different reason then chemo this time
I imagine you might have to Pm, some folks here and ask them if they wouldn't mind answereing your question. here. That way it's here for anyone that follow.
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Just what I was looking for. I found out I need a port put in because of irritation from my first infusion site. Nobody at the drs. office had even bothered to explain the procedure to me and what to expect. I'm having the port put in the day before my second infusion so it's good to know that won't be a problem. Think I'll opt for the drugs though.
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mccrimmon324, when I was having my first treatment, the nurse was having a little difficulty accessing the port. I heard her say that sometimes they can turn a bit sideways, but now that they know it will be quicker next time.
I haven't worn a bra since mine was inserted - (flaunting the 60 bra burning look) but that is because the area is still irritated by a slowly, very slowly, fading tape allergy. I don't even know if it's under the bra strap. Kind of gotten used to the freedom!
khs113, I've heard that some surgeons thoughtfully put the port where it won't be irritated from the bra strap. Be a good idea to ask when you go in for the insertion.
Good luck and God blessings on all of you,
Peggy
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sleepdeprived, had my treatment today and did ask the nurse she also said it could move but mine hadn't, think it was the bra strap. I would love love love to go braless, but my girls are too big for that plus I had a problem with my incision healing, I acutally had to wear a bra then sports bra over that for 24/7 for about 5 weeks. OMG, my first shower was soooooooooo nice. Hopefully after this is all I'm looking forward to a breast reduction.
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Hi I am new to this, not started tx yet, but had a bad reaction to the chloroprep at the lumpectomy surgery. Rash all over, still have some of it 3 weeks later. Can they use something else next time?
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Grimbol, the next time you need any surgery make sure you tell them that you had an allergic reaction to the chloroprep. I'm sure they have an alternative.
Best of luck.
Leah
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Grimbol, Please ask that your doc add it to your hospital records that you are allergic. There was a time that nurses could add something like this to the record , but some instituitions are prohibiting that now---duh. but true.
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Has anyone had their port in their arm? The onc dr. wants it fitted so that tx can begin and the wait is too long for the chest placement. I was wondering if this would be a temporary thing or is that just where it will be? Any ideas?
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