PORT PLACEMENT - Detailed description of process
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Lumpie, I did 8 rounds of chemo over 6 months without a port or picc line. The nurses and surgeon who were supposed to do my port placement in early March were so useless that I walked out and never went back. It was fine. Thechemo nurses were magical vein whisperers.
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IntegraGirl I'm glad you had a good experience. Don't mean to beat a dead horse. But must reinforce that it may appear that those veins aren't comprimised, but they may. You just may not know it for awhile.
Elizbeth, I did contact the hospital, unknown if it did any good b/c I never had to undergo surgery there again. The stories I could tell about written and verbal consent. But without going through the stories
Consent has several elements: Informed --procedures risks and benefits have to be explained. Consent requires written documentation. Particularly, where it's written, if you have denied consent for something, if they proceed, battery has occurred.
Consent can be implied when you are not conscious. BUT you had a written consent as did I that denied use of the extremity very clearly. IF the situation were during an emergency that changes the requirement of consent.
There is more stuff about consents, but I'll leave it at that, so, to not muddy the waters.
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Lumpie how you doing?
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Bump
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I am going in tomorrow to get my port put in. This is very helpful information!!
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Good Luck missbar
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Missbar-
Welcome to BCO! And best of luck on your port placement!
The Mods
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Hello everyone! I am so thankful for this post! However, I am still very scared of getting this, surgery, chemo and radiation. Any advice to help ease my fears?
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Terrified, stats on breast cancer have improved. Nothing though in life compares to the words "You have cancer" Your choice of a screen name says it all.
But we get through whatever by working the plan. Being an active participant in the plan versus a follower.
Others may say don't google, I'm the opposite. I've saved my own life and others b/c of google. But I'm a nurse(retired). For non medical folks, google can be troublesome b/c the words aren't understood.. I will bring back a few threads to help, I hope.
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This is just a thread of functional stuff to get prepared
https://community.breastcancer.org/forum/5/topics/748296?page=1
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Terrified Here's another link to read
https://community.breastcancer.org/forum/26/topics/843381?page=1#idx_26
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Terrified, Sweet pea, I'm older,,,,,,,, now getting older than the dirt in the garden. I read that phrase the other day and laughed so much. These days when you are going through things right now are truly frightening. So much info coming at you so fast. None of it making very much sense, b/c you really don't want to hear it. IT's not you.......
Lovey, hang in there. Many will come around to take you in here. Wander around Breastcancer.org --BCO. You will find many loving women.
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I appreciate all that you have shared with me! As I was reading your checklist to get organized, I kept saying "Ok, I got that, but I need that." You are very detail oriented! So far, as the days are passing, I am slowly feeling a little less anxious... but my surgery has been scheduled for a bilateral mastectomy on Feb. 13th, I have a feeling I may be a bit of a mess by then. Although, I will still be hopeful and not give up!
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Terrified, please, read the other link too :0 it's on the use of toradol intraoperatively.
It also, has links to blocks, and opioids, and Nsaids. The link brings all those other Theads together.
Viewing dr. V's video explains the importance of the use of Toradol (ketorolac).
Thanks, about the Just Diagnosed thread.
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sas-schatzi, will do, thank you again
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Thanks for such an informative description of this procedure! I'm getting this done next week and I am extremely apprehensive about it. It helps to know exactly what will happen to me. Thanks again.
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Had my port placed today. Teena wrote a great description. Thank you!!
Yesterday, I’d asked if I could have just fentanyl and local with Zofran and decadron for nausea—surgeon was fine with it, but today anesthesia talked her into Propofol with just Zofran for nausea. Ugh uh ugh! But she’s great, so I went along. Woke queasy which didn’t happen with lumpectomy 2 weeks ago. Today they gave me the pediatric dose of fentanyl in or “because you were moaning in pain,” and then a Vicodin after I ate and drank back up in room. Nurse there shook her head (she also thought stronger pain meds were needed) and said every Anesthesiologist has their favorite drugs and don’t often like to tailor them to patient history. For lumpectomy, I had fentanyl (adult dose in the or, plus a small bit in pre-op) and then Propofol, plus a combo of zofran and decadron for nausea. Worked great, getting that tad of fentanyl first since I can’t take versed. I just hate Propofol. No one believes me when I say it makes me feel awful. I think omitting the decadron also contributed to nausea.
The port site seems fine. I do have a lump under my collarbone from one of the local injections. Surgeon checked it and said a bit of ice would help—just a swelling from the local aggravating the blood vessels. Doesn’t hurt too bad. My head is still pounding and right shoulder feels like it ran into a door. Dang propofol...
For me, a port is a good thing. I have horrible veins—deep, small, and rolling. I think it will help me a lot
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Bump
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Anyone have advice/experience with a port in your arm? Scared to death- which seems normal.
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Welcome, Acann12233. We know it's scary, but you're not alone. We hope your placement goes well, keeping you in our thoughts!
The Mods
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Hi Acann, I didn't have a port in my arm, it was in my chest. Is you medical person suggesting a picc lineI instead? That's the first place to start--find out which one he is recommending. In case it is a picc line being suggested I found information picc lines vs ports. The link is just below (from Healthline). This may be too much information to walk through by yourself so don't worry if its TMI.
FROM HEALTHLINE:
PICC vs. Port
Although PICC lines and ports have the same purpose, there are a few differences between them:
- PICC lines can stay in for several weeks or months. Ports can stay in as long as you need treatment, up to several years.
- PICC lines require daily special cleaning and flushing. There's less to care for with ports since they're under the skin.
- PICC lines can't get wet. You'll need to cover it with waterproof material when you bathe and you won't be able to go swimming. With a port, you can bathe and swim.
To help get a better idea of what having a CVC may mean for you, you may want to ask your oncologist these questions:
- Why are you recommending I should have a catheter or port?
- What are the possible problems that can happen with a PICC or port?
- Is inserting a catheter or port painful?
- Will my health insurance cover all of the costs due for either device?
- How long will the catheter or port be left in?
- How do I take care of the catheter or port?
Work with your oncology treatment team to understand all the benefits and risks of CVC devices.
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I just had a port placed yesterday, without sedation, after reviewing the information I found here and concluding that it didn't sound too bad. For those who may be considering doing the same thing, I am pleased to report that everything went well and I would do it again. The only slightly hard part was making it plain to everyone that yes, you heard me correctly, I DO want to do it with just a local anesthetic. Once that was made clear, everyone was very supportive. I was told that because I wasn't getting sedation, they would give me a little more of the local anesthetic just to be sure I'd be comfortable, and if I felt that I needed more during the procedure, I was to speak up immediately and they would take care of it. The procedure went very smoothly and I didn't need any additional anesthetic. All I felt were the pinpricks when they gave the anesthetic and pressure when they placed the port. When everything was done, I was required to hang around for half an hour just to be sure that everything was OK, and then I was free to go.
Many thanks to those who have posted here regarding their own experiences, because knowing that others have successfully had ports placed without sedation gave me courage to ask for it myself. It isn't right for everyone, of course, but it was great for me!
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bump
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Thank you for this thread!! When I had the port placed the first time, it was during my mastectomy so I didn't really know what the proceedure even was. This time it's all I'm having done so this was really helpful!
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Good Luck BP, multiple people monitor this thread to answer questions, so, come on back if you need asssistance
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Having my port put in tomorrow. Scared worried!!! Will I be completely under? Don't want to know or feel anything! This also feels like to real thing now. Like being an astronaut. Practicing reading preparing for your space journey to the unknown. Now the day has come. You are walking the plank to the spaceship. You are about to sit in that chair! Are you ready? Sure you want to do this??? No I'm not sure....
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I totally wish my port placement had been so smooth!
The team working with me were really nice and made it seem like there was no chance of the procedure going any way but great, as they had so much experience. Not even a suggestion that I may feel a little bit of pain. Welllll….
I was not administered enough locals and it felt like they were ripping my skin open when they made the pocket to place my port. I screamed in pain and was completely ignored by the doctor. The oxygen placed in my nose was completely covered with snot from my crying. It was, without question, the worst medical procedure I had ever experienced, and the worst day of my life. I went in to the procedure with a great attitude and they really broke me.
It was such a blessing that I had a friend waiting for me. She was ushered in to the recovery area and when she walked in, I was crying and screamed to her, "THEY LIED!" We sat there and cried together. The doctor and his supervisor came in and apologized. "This never happens," was one of the things said. The doctor also said he couldn't have done anything after I screamed because the oxygen intake was low (DUH). So I guess ignoring my cries was acceptable to him. I was very traumatized and ended up sitting in the hospital lobby crying when my friend went back up and said how unacceptable it was that I was in that condition. A nurse supervisor came down and suggested to me that doctors hear "OW" all the time and that maybe I needed to be a little clearer. (WTF, right?) Then he suggested the Lidocaine was ineffective for me and put in my chart that I am allergic to Lidocaine!
I spoke with my Oncologist the next week, before my first chemo treatment, and told her all about what happened. She suggested that the Lidocaine was likely not administered deep enough for my comfort. WHOOPS! (My Oncologist is THE BEST, BTW, and I trust her implicitly.) Oh, and the best part of the story is that the doctors who visited me post-placement wrote a report on the procedure that said "The patient tolerated the procedure well."
Suffice it to say, not the best moment for the hospital. I have put my Oncologist team on notice that I do not want the doctor who performed the procedure or his supervisor anywhere near me during port removal!
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Alienkiller So sorry you had this terrible experience. If you are up to it. Write a letter to the CEO of the hospital. Include all the details and emphasize that you have the records which can be considered to be a falsification of the occurrence i.e "The patient tolerated the procedure well.". You could also copy the letter to the Physician Medical Council. This would cause both to do an internal investigation.
This does support always getting copies of medical records.
Hoping you never have an experience like this again.
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alienkiller, I totally agree with Sas-schatzi's suggestions. I have never heard of such a terrible experience. Do you mind if I ask you a few questions...why was the plastic surgeon putting in the port? My port was put in by a surgeon who does many ports. Why weren't you given the choice of sedation? That's how most of it is done. I wouldn't ever listen to a surgeon who said it was a simple procedure..what they don't tell you is its an easy procedure but don't add Most Of The Time. With all the trauma of a cancer diagnosis who needs a bad experience with this.
This also needs to be reported to the state medical board. They will look into this for which remedial actions can be taken which may be sure this will not happen again. It's not that he will lose his license.
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Alien ..I support. Cowgirl thoughts. My computer is broke ...on kindle. Many problems with messages on kindle.
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