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PORT PLACEMENT - Detailed description of process

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  • Grimbol
    Grimbol Member Posts: 139
    edited August 2011

    Ok port is in my arm and it is a permanent placement.  Not a fun day but at least it's in, all ready for treatment day on Wednesday.  I did have to remind them not to use the chloroprep, thank goodness, I caught them just in time.

  • ellenquilt
    ellenquilt Member Posts: 54
    edited August 2011

    Grimbol, Good luck with treatment on Wednesday!

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited August 2011

    Grimbol. Congratulations on a good placement. Please keep us upto date on your experience. Arm placement came about in this past decade, not sure what year. I'm sure they gave you the no BP warning etc.

    Please continue to try to get chloroprep added to your allergy list.It's keep in your computer record until the doc or pharmist follows aprotocol for removal.So, if ther isn't a ER or In house visit for years it's still will pop up in your record. 

    Chloroprep-----It's the IN disinfectant these days. Whats supposed to happen when you have an Allergy bracelet , is everyone besides asking you your name and checking your arm band is supposed to be doing the same with your allergy bracelet and re-asking your allergies. If someone approaches you and doesn't check your bands , put your arm up and say  "According to hospital policy you are to look at my banding etc" If you really want to throw in a home run add "Verifying my information with each contact is a JACHO safety initiative" Accrediting institution.

    Story time-----once picking up blood-------procedure: name sticker from chart checked against arm band and verified with patient>>>to blood bank>>>all numbers are checked by two people in blood bank. There was a set of numbers that didn't match, the tech said that's okay. I said it wasn't okay. The supervisor was brought in. I asked for a run of that number through the computer----Yup there was a patient in the hospital that carried that number, but different name. They could not figure it out. But what the supervisor did was the safest action. The patients blood was redrawn and a full type and crossmatch was redone. She was safely given the blood. What if I hadn't said no, it could have killed the patient.  Also the patient was issued a new band correcting numbers/and a root cause mtg held. Just for completeness. Once back at the beside the blood is checked by two nurses against the bag and the paperwork, and the band& patients verbal verification of name.

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited August 2011

    bump

  • artemis
    artemis Member Posts: 105
    edited August 2011

    Grimbol ~ my port is in my arm.  It took some getting used to, but now I hardly notice it.

    Best wishes to you! Smile

  • Flautalee
    Flautalee Member Posts: 46
    edited August 2011

    tbird57--Thank you very much for your detailed description of your port placement.  I especially appreciate your mentioning that Levaquin was the antibiotic given during your surgery.  I have a second primary tumor (yes, a different Triple Neg subtype) in the breast that I had a mastectomy 11 years ago.  Apparently this is incredibly rare, but I am back to this "country of breast cancer" again.

    Anyway, when I had a phrophylactic mastectomy on the other breast in 2001, I developed cellulitis, was hospitalized, and put on a cocktail of anitibiotics through a PIC line that I administered to myself at home.  After a short time, the docs took me off Levaquin (one of several antibiotics that I was on) because I developed "chemical hepatitis." They didn't know whether the chemical hepatitis was from the anesthesia or from the Levequin.  My liver enzymes had shot up to 1200 (norm is around 50, I think) and very gradually came down after the they stopped the Levaquin.  I think they returned to above normal (60-100ish) within a few months, but it took until about a year ago for them to usually be in the normal range.  So they were elevated a long, long, time.  I will call my oncologist's assistant tomorrow to ask her to put allergy to Levaquin on my chart (I had forgotten about this until I read your post) so they don't give me Levaquin for the port placement this week.

    One odd thing, though.  When I was in Mexico last year, I developed a really serious GI diarrhea.  I waited 3 days to see if it would improve.  I actually had a doctor called to my room (a house call - it was wonderful!).  He gave me a shot of something that stopped the diarrhea immediately and put me on Cipro that I took for several days.  He said that I waited far too long to be treated.  Anyway, I believe that Cipro is chemically related to Levaquin, but I didn't have any problem with it as far as I know, since my liver enzymes have been OK.

    Since my liver may be "fragile" - my description -  I told my oncologist on August 11 that I had decided to stop drinking completely - I'm a social drinker at most, and I asked if he thought that this was a good idea.  He said," Yes."  But when I am completely finished I will have some champagne or a good Dogfish Head Beer that they make in Delaware.

    Thank you so much for the time you took to share this info with us.   I start 6 rounds of Taxotere/Cytoxan every 3 weeks, followed by radiation, this coming Friday (8/26).  I don't know whether the port will go in early this week or just before chemo.  I really, really, don't look forward to the dressing changes - I have a problem with adhesives - everything but the clear IV dressing film pulls off the top layer of my skin, but I will manage, as we all do.

    THANK YOU tbird57 - You may haved my life because if your liver isn't working well you can't have some chemotherapies.

    Best to all of us.  I was not computer literate in 2000 (when I had 4 rounds of A/C) - did they even have them then?  These forums are really helpful to me this time around. I think this is a great website  where we can help each othe as well as receive info ffom the experts.

  • olgah34
    olgah34 Member Posts: 300
    edited August 2011

    I am afraid my port is misplaced, it is 2 weeks after, I have noticed big vein in my neck and pain in my chest , almost constant, goes to my throat and jaw. However, my surgeon told me that it happens sometimes, I mean big vein in the throat... I just have a constatn feeling, that something in my throat... I have my BMX next week, then in 2 weeks chemo, I don't want to have any problems...Anybody had problems like that?

  • ellenquilt
    ellenquilt Member Posts: 54
    edited August 2011

    Olgah.  I had the same sensation for a few weeks.  Watch it and see if it dissipates over time.. My port hardly bothers me now. Occasionally a twinge here and there.  Had it put in July 20.  Started chemo July 22.

  • K-Lo
    K-Lo Member Posts: 826
    edited August 2011

    Me, too, Olgah. What I thought were major problems seemed to be the norm. But keep having them look at it for sure. The oncs, chemo nurses, surgeons can all take a look until you feel secure.



    Down the road, you may want to try EMLA cream (prescription) to numb the skin for access. I apply it 2 hours ahead or so, then I let the chemo nurse use the cold spray as well. Many of the needle accesses caused zero pain. This is a treat.

  • olgah34
    olgah34 Member Posts: 300
    edited August 2011

    Thank you, ladies, sooo much!

    Olga

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited August 2011
    olga here's a list of fluroquinoline drugs that are in the same family as Levoquin.

    Quinolone Antibiotics

    GenericBrand Name
    First Generation
    FlumequineFlubactin
    Nalidixic acidNegGam, Wintomylon
    Oxolinic acidUroxin
    Piromidic acidPanacid
    Pipemidic acidDolcol
    RosoxacinEradacil
    Second Generation
    CiprofloxacinCipro, Cipro XR, Ciprobay, Ciproxin
    EnoxacinEnroxil, Penetrex
    LomefloxacinMaxaquin
    NadifloxacinAcuatim, Nadoxin, Nadixa
    NorfloxacinLexinor, Noroxin, Quinabic, Janacin
    OfloxacinFloxin, Oxaldin, Tarivid
    PefloxacinPeflacine
    RufloxacinUroflox
    Third Generation
    BalofloxacinBaloxin
    GatifloxacinTequin, Zymar
    GrepafloxacinRaxar
    LevofloxacinCravit, Levaquin
    MoxifloxacinAvelox, Vigamox
    PazufloxacinPasil, Pazucross
    SparfloxacinZagam
    TemafloxacinOmniflox
    TosufloxacinOzex, Tosacin
    Fourth Generation
    clinafloxacin 
    GemifloxacinFactive
    sitafloxacinGracevit
    TrovafloxacinTrovan
    prulifloxacinQuisnon
  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited August 2011

    olga tried to list fluroquinoline drugs------apparently the site didn't allow C&P.  Yuo are correct to have it added to your allergy list. For anyone else in a similar situation ask for a copy of the anesthesia record and a consultation with an anesthesiologist to review what possibly might have been another offending drug. In your case, it is likely to late to do this, but if you happen to be in the same hospital. You can obtain it from Medical Records. If you can't set up an individiual one on one with an anesthaesiologist before surgery for port.---- Take old anesthesia record with you to the prep area. If you can't get a copy , the anesthesia doc will still be coming to talk to you in the prep area. Talk to rhem regarding your concerns. ---Cipro-----ciproflocaxin is in the same family as levaquin---levofloxcin.

    Good luckSmile

  • Grimbol
    Grimbol Member Posts: 139
    edited August 2011

    Hi guys, I haven't posted here for a while.  I had my first tx, was down for about 8 days then came back to life again.  Next tx is next Wednesday, not looking forwad to that.  Tonight the incision site from the port is bothering me!  I'm quite adjusted to it and for the most part I like having it in my arm.  However the last couple of days the incision site has been getting a little red and tonight it is itchy.  I had disolvable stitches but it seems like at one end there is a knot that hasn't dissolved and that's where it's sore now.  The final dressing came off on Monday, I couldn't see it before then.  I promise I haven't been picking at it, although I really want to!!

    So, should I go back in and have them check it out or is this ok and it will settle down on it's own?  Any thoughts anyone?  Thanks in advance :)

  • Grimbol
    Grimbol Member Posts: 139
    edited August 2011

    oh yes, Olga, I am sorry about your neck placement bothering you so much, makes me glad mine is in my arm, I would freak out a little if it was in my chest I think.  My arm was very painful the first day and then lessened over the next few days until it was fine.  The guy putting it in said I wouldn't have any trouble at all, huh, like to put one in him and see how he likes it!!

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited August 2011

    Grimbol------today is fri------definitely go have it checked today in the am by whomever put in the port.  Sorry it's 330 am , You won't see this till whatever time tomorrow morning. The reason you want it checked-- the sight of the surgeon on the wound/incision is better than anything else. They may even ask you to meet them at ER. b/c it's there day in surgery.and they aren't in the office.  Avoid Er charge by saying doc told you to meet them there. If they insist on making out a chart refuse and call doc's answering service to let them know you are in the ER waiting room.

    This avoids -------you being concerned-------and avoids not having the actual doc looking at the site.

    I have learned through life that all problems occur after 5 pm or on the week-end. It's Murphy's law. Hope you see this in the early am and call the office early. In our location many doc's offices close on friday. It's a bit of a joke really.

     Call office at 8 am----if it's closed and their in surgery it gives plenty of time for a response----make sure cell phone is charged

    If your doc's office is closed stay on the line and leave a message with the answering service for him to call you. They will ask why----tell them what you said here, and ask him where you can meet him so he can lay eyes on it--------feed the ego---------tell him/her you trust their judgement so much, you're concerned about going through the week-end without his/her opinion------and frankly that's the truth.------------don't hesitate on what I have said---------you need to protect your port.-----------PROACTIVE IS SELF PROTECTIVE--------these are the words you must live by to get the best care--------good luck

    sorry there is a bit of redundancy here, but it is 4 am

  • Grimbol
    Grimbol Member Posts: 139
    edited August 2011

    ha-ha, thanks Sas, I will go in this morning promise!!  I'll post later to let you know how it goes.  It is easier again now, of course, but I will still go.

  • Grimbol
    Grimbol Member Posts: 139
    edited August 2011

    I went in, they said it actually looked ok, but they did take out the offending undissolved stitch, added some steri strips and sent me on my way.  So, at least it's been looked at and been deemed to be ok and it won't interrupt chemo next week.  hmm is that good??? yes I know it is really.

    Thanks for your help.

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited August 2011
    Grimbol-------great------now you don't have to worry through the weekendCool
  • Denise2730
    Denise2730 Member Posts: 320
    edited August 2011

    Why do I need a port if I'm only going to have 4 chemo sessions?

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited September 2011

    Chilvur. Chemo can severely damage smaller vascular tissue. It is better  to put the chemicals  into a vein that is larger and can the chemicals can be more quickly diluted, so that the vascular tissues are undamaged.

    You had node dissection on one side which means for the rest of your life , you only have one arm to draw from. Those veins in your good arm, you want to protect.----------enough info or not?

  • Grimbol
    Grimbol Member Posts: 139
    edited September 2011

    Can you help me?  I'm sure if I read enough here I will find the answer, but being very tired I'm hoping for a quick answer!  How do I stop the port from stinging sooo much each time they use it.  I thought it would get eaiser over time but apparently the chemo gets you here too and it wont necessarily heal well inbetween txs.  Plus I keep having to go for more meds and fluid.  So, I believe there is a numbing  cream you can use??  Can anyone tell me what it is??  Thanks.

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited September 2011

    EMLA---needs a doc prescription, put it on per directions-generally 1/2 hr before and a boost smear maybe ten-fifteen minutes before. Wash hands first or apply with a q-tip. Cool

    Ask the nurse to allow alcohol or chloroprep to dry first before they stick. The sting is coming from them. Think about what it has felt like when pouring alcohol over a cut

  • Grimbol
    Grimbol Member Posts: 139
    edited September 2011
    Thank you so much, they do dry the alcohol first, the nurse is very good, but she told me I could buy a cream at the pharmacy?
  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited September 2011

    Grimbol-------I could be wrong, but EMLA I believe is still a perscription item. Anything less -------is well     less. EMLA is the gold standard, if it has gone to OTC (over the counter ) good, but unsure.

  • Grimbol
    Grimbol Member Posts: 139
    edited September 2011

    hmm, yes I think you're right that EMLA is prescription, I was surprised that they didn't offer that and just said to try the pharmacy.  Oh well, thanks for the name I will go back in and ask for this now.  I'm not exactly a wimp but I don't like how sore it can be either.

  • ellenquilt
    ellenquilt Member Posts: 54
    edited September 2011

    Grimbol: I asked about the EMLA cream but the nurse told me to try it without first because it can thin the skin.  Just FYI, don't know if that matters.  We do a 1-2-3 countdown and I take a deep breath as she puts it in and we do the reverse when she takes it out.  Works okay for me, but each of us has different tolerance levels.  To me it feels like a quick pinch and then it goes away.  Not too bad

  • Grimbol
    Grimbol Member Posts: 139
    edited September 2011

    Thanks ellenquilt,  I will persevere.  I don't mind it too much I was really just surprised it wasn't getting easier.  It is sore until they actually begin the infusion, and then it gradually fades.  I'll give it more time and will probably survive fine, but thanks for all the help.

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited September 2011

    Ellen quilt---------please find a resource about the thinning of the skin-------very important that it is evidence based and not an urban legend. I'd do it , but not up to it , thanks sheila

  • sas-schatzi
    sas-schatzi Member Posts: 15,894
    edited September 2011

    Hillck ----------thanks for your individual report------it was the same as my DH's .......... The thinning of the skin has value b/c if it's true could make a difference. BUT if NOT BASED ON EVIDIDENCE BASED STUDIES--------------it holds no value. So, whomever gave you that piece of info -------------please , ask them for there resource

  • k8eekatt
    k8eekatt Member Posts: 3
    edited September 2011

    I hope someone can read this one day.    I had  my port put in only three days before the first chemo treatment; it was just the time the doctors could do it.  When the chemo nurse installed the needle, it felt like a burning stabbing in my shoulder since the wound was so recent.  He was very sympathetic.  The following treatments were easier but it hurt quite a bit most times I had a needle installed into the internal port dome.  For the installation, I had a knock out sedative not full anesthesia so I could wake up more quickly; the procedure took about an hour and a half and I was under for only two hours.  I prefered my surgeon do it, not her assistant, and she agreed but I was dismayed when she made a joke about how she did not usually do that procedure since she had poked the catheter into the lungs of patients on two other occasions.  Laying on the gurney is not when you want to hear that piece of information.  It was sore for the rest of the seven months it was in, and I slept on my back.  I had it out six weeks ago and the area is thick with painful scar tissue.  It was helpful to have my sister with me when I got the port out, they just did a local anesthetic and removed it in the office.  The tape and dressings came off a day early, after two days, but it has healed. The scar is raised, red and sore now, about six weeks after having it out. I often had brusing and soreness increase after a chemo treatment or a blood draw at the hospital. I know that chemo can really rip up your veins too, and its worth while to have a port to spare your arm veins, especially if you can only have IV and injection treatments in one arm after a cancer surgery, but I am not sure it was warrented with only four chemo treatments prescribed.  I left it in after chemo for the administration of other drugs, and had it removed the day after I was given the "once in six months" IV therapy I was waiting for.   I got it installed on the advice of my friend, who was a nurse in a chemo unit at M.D. Anderson.  I am not sure I would recommend it for only a four treatment regimen.   Good luck to any who read this in the future.  I am currently free of signs of disease, surviving since Feb. 2, 2011....going to the race for the cure this weekend to walk the 5k untimed event.