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Topic: tubes, IVs, catheters during/after surgery

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Mar 20, 2008 12:58PM

abbadoodles wrote:

Just had my pre-op testing today for next week's free TRAM.  The anesthesiologist (not the one I'll be having for the surgery) made some comments that worried me because these things had never been brought up before.

He said I may have a neck IV/catheter for several days after the surgery instead of the usual IV in my arm.  So that I "wouldn't be a pincusion" or something like that.  I had never heard of this.  Did any of you have this?

Also, he said the surgeon might want to give me a spinal/epidural to place a catheter to deliver pain meds to my abd. and other drugs to help blood flow during surgery.  SHit.  I never heard of this.  Have you?

Wanting some answers.  He was useless.


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Mar 20, 2008 02:37PM otter wrote:

Man, I hate when they leave us hanging like that!  I would have pitched a fit, and demanded some answers ('course, I'm a real nuisance in a hospital setting--that's why I usually get cut loose to go home early).

The "neck catheter/IV"?  I'm sorry, I didn't look back--are you going to need to have chemo after all this?  Did anybody say anything about putting in a chemo port?  Is there some reason why your veins might be hard to hit, or an i.v. cath in an arm vein might cause a problem?  I admit I haven't heard about getting an i.v. cath placed in the neck (jugular vein or subclavian vein?) for a mast/recon surgery.

As for the spinal/epidural cath for pain relief, I did have a spinal nerve block along with placement of a very fine (hair-width) catheter that delivered local anesthetic to a spinal nerve.  The catheter was in my back, right next to my spine, but not in the epidural space.  The anesthetic (bupivacaine I think) was being infused through the catheter onto a spinal nerve so the area of skin & muscle that sent pain signals along that nerve would be numb.  (Your dentist does that same thing with an injection of local anesthetic for painful dental work.)

Other women have had different sorts of pain relief delivered to their surgical sites through catheters, though.  My nurses all thought I was getting fentanyl, which was not true.  I don't know what they would deliver through a catheter that would help blood flow during surgery.

This all sounds scary, but remember that they probably won't stick you with any of those things until you're asleep in the O.R.  Once you wake up, you won't be thinking about a needle stick or an i.v. catheter all that much.

I sure would ask more questions, though, if that's possible.



Dx 2008, IDC, Stage IA, Grade 2, 0/3 nodes, ER+/PR-, HER2-
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Mar 20, 2008 06:23PM BethNY wrote:

I've never heard of anything like this... Call your surgeon and find out whats going on.

Be your own hero
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Mar 20, 2008 07:45PM Kathy_K wrote:

I don't know - seems like extreme measures to me.  I hope things go smoothly for you, though.

When a woman tells the truth she is creating the possibility for more truth around her. Adrienne Rich
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Mar 21, 2008 05:31AM abbadoodles wrote:

otter, I'm not having any chemo.  Been there, done that.

This guy implied that since they cannot use my right (LND) arm for IV, they might not find my left arm usable for the duration of the surgery stay.  I had never heard of this, either.  My left arm veins are totally okay (even after chemo last year) and I had an IV in that arm for the exchange surgery last August.  I don't know why he thinks it will be different now.

The epidural:  He said this would be done while I was still awake because they had to have my feedback to make sure they were not impacting any nerves!!!  He also said I would have the right to refuse such measures. 

This boob (no pun intended) was an unsmiling, unhappy looking fellow.  I almost think he took pleasure in scaring me.  OTOH, I am very glad he brought these things up BEFORE the morning of the surgery so I would have time to consider them and not have to make a snap judgement.

I e-mailed my regular ps (who will be assisting the microsurgeon, with whom she works) late yesterday afternoon with my questions.  I'm sure I will hear something back from her sooner or later. 

Don't you just love it?


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Mar 21, 2008 07:25AM BethNY wrote:

I don't understand why your left arm wouldn't hold the IV for the entire time.

My surgery was 17 hours, and even with sh*tty veins, my left arm held up.

An epidural seems like a lot, but then again, you have to hear what your PS says is the norm for him.

Keep us posted.

Be your own hero
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Mar 21, 2008 04:23PM Kathy_K wrote:

Before my last surgery, they were going to tap the veins in my feet to keep my arms free.  That didn't work so they just went with the better arm anyway.

When a woman tells the truth she is creating the possibility for more truth around her. Adrienne Rich
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Mar 25, 2008 12:59PM abbadoodles wrote:

Update:  PS says (via her secy) the guy gave me wrong information.  I wouldn't need a neck IV unless I had a bilateral and they couldn't use either arm.  NO epidural, who knows where that came from. 

Thank gawd this guy doesn't actually treat patients anymore.   They stuck him in an office during pre-ops for a reason, I assume.

Gee, the surgery is Thursday.  Coming fast.  Kinda dreading/looking forward to it at the same time.  Am just about finished with tax prep and other household stuff and feel like I'm already starting to zone out.  Tongue out


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Mar 25, 2008 01:16PM BethNY wrote:

good to hear that it's all worked out.  You're gonna do great!!

Be your own hero
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Mar 25, 2008 01:42PM lvtwoqlt wrote:

Tina, I just saw your question and I had bilat done last June and they put the iv in my neck. It was an unusual procedure but doable. They actually did it in the pre-op area of the surgical suites by a qualified anesthesiologist. Good luck on Thurs.


Women are like tea bags, we don't know how strong we are until we were thrown into hot water. Eleanore Roosevelt Diagnosed ADH Feb 2005, ADH Sept 2006 Surgery 2/11/2005 Lumpectomy: Left Surgery 9/9/2006 Lumpectomy: Right Hormonal Therapy 10/11/2006 Dx 4/27/2007, DCIS, Stage 0, Grade 1, 0/7 nodes Surgery 5/31/2007 Mastectomy: Left, Right
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Mar 25, 2008 07:32PM bbmom wrote:

I had my IV in the neck also for bilat. My ps does this to kee the IV out of his way.

He may have been talking about the On Q pump when he told you about the catheter for pain relief. It is a catheter inserted into the abdomin connected to a ball of medication to keep the incision numb.

Good luck to you and God Bless!

"The Will of God will never take you where the Grace of God will not protect you." Dx 11/25/2009, ILC, Stage IV, Grade 2, 14/17 nodes, mets, ER+/PR+, HER2-
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Mar 26, 2008 07:02AM abbadoodles wrote:

Thanks, girls, for your answers.

No, this guy just wasn't thinking.  I had a uni mast a year ago with expander/implant and now am having the implant replaced with free TRAM only on the one side.  There should be no reason not to use my "good" arm as it was used for chemo last April/May and for the exchange surgery last August.  Unless something has changed in the meantime, which I hope isn't the case.

He wasn't talking about the pump, either.  Definately an epidural.  Said it would have to be done with me awake so I could bend over while they did the insertion and be able to tell them if it was hitting a nerve!  This was something inserted through the spine or close to it.  Kinda like having a baby.  Yikes.  Total numbness.

No mention off the pain pump.  I don't really care about that, it wouldn't freak me out, but no one has mentioned that option.  I hope I can be okay with pain meds only the first day.  Hey, I had an abd. hysterectomy years ago and never did pain meds.  Sure, it was tender, but doable.  I'm hoping for the best this time around, since I won't at least be sliced through the belly.

Oh, boy.  Tomorrow.  I will miss talking to you girls for the next week or so.  My computer is not in my house but in another building on my property.  (Less intrusive that way)  I don't know how soon I will be making the 150 foot trek out to my office. LOL 


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Mar 26, 2008 07:36AM , edited Mar 26, 2008 07:37AM by sam408

Tina -- Just wanted to say good luck with your surgery tomorrow. I'm sure everything will be fine. Mine is scheduled for next Wednesday and I sooo understand what you're saying about dreading/looking forward to it. I've been planning this since last November, so I think my state of mind will be much better once it's over.

Good luck, I'll be thinking about you.

Sheila . . .Never regret something that made you smile. Dx 2/16/2007, DCIS, <1cm, Stage 0, Grade 3, 0/4 nodes, ER+/PR+, HER2+
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Mar 26, 2008 07:58AM BethNY wrote:

good luck! I sent you an email.

You're gonna do great!!!!


Be your own hero