Breast lumps

bathsheba,
Don't go away, I'm reading your post and will reply shortly.

Diane,
I can tell you lots about both the mediport and the PICC. A PICC is a Peripheral Intravenous Central Catheter. This is like a regular IV only once it enters the skin it is much longer and the venous line continues up the vein to the Superior Vena Cava(large vein that delivers blood directly towards the heart), distributing the medication throughout the body without the risk of damaging the smaller, more fragile veins of the arm. This can be done by an RN that specializes in IV therapy or an Interventional Radiologist/PA. The difference between the two is that a Radiologist specializes in procedures while utilizing imaging modalities. Why this may be a better option than an IV therapy RN is that the Radiologist will use ultrasound guidance to access a larger, deeper vein and then verify proper placement with the xray fluoroscope. Plus they have great help from people like me!
If you want more details on how the procedure goes I can get into that too. Just let me know. But a PICC has 1 or 2 ports outside of the skin to hook up to the infusion medication. These need to be secured as not to tangle on clothing. A PICC would be a better choice if you are currently fighting an infection due to the increased risk of infection with a surgically placed mediport. A PICC is typically placed with local anesthetic only.
Now, for the mediport. These can be placed by a surgeon or an Interventional Radiologist. They can be placed in the upper arm or the chest and are done with the patient mildly sedated as well as having local anesthetic. If placed in the arm, the vein will be accessed just like for a PICC. The catheter is introduced through the vein to the SVC and is then cut to the appropriate length for the individual. The catheter is attached to the small port and the port is tucked into a small pocket under the skin. The skin is then sutured with a desolvable suture. The incision is about an inch long. When infusing chemo into the patient, a needle is placed through the skin into the port. There is a cream available to numb the skin before needle access. For a chest port, the process is the same only the vein used is either the internal juglar or the subclavian. The port is slightly bigger with an incision about 2 inches long.
Some people prefer the arm port because they can simply roll up their sleeve to receive chemo rather than lie there with their shirt open. Most surgeons or IR doctors will consider bra strap allignment when choosing where to place the port. Some chemo RN's are not familiar with arm ports and some institutions will only place chest ports.

Hope all this helps. I can get into more detail if you wish. Good luck and feel better soon!!!

Thank you thank you thank you!!!!!! I'm aiming for the PICC. I have a probable infection in the left arm.....where the infusions take place. Would they place the PICC in that arm? I'm on antibiotics. I guess you read that I have phlebitis and cellulitis in the left arm as well (lower forearm below elbow) so would that affect the decision to insert a PICC?

I'm assuming that an IR would be better than an RN because they can access equipment to tell them exactly where the catheter is placed?

Is there pain involved in placing the PICC?

A friend of mine had either the PICC or mediport...she doesn't know which....and she said she could feel the catheter under her collarbone when lying a certain way. She said it wasn't painful, just a weird sensation. Would I be aware of the catheter if it's a PICC?

How often do they have to be flushed, if at all?

Bless you, hon, for taking time to answer my previous post. I will understand if you don't have time for more questions.

I thought of you immediately today when my doctor, the oncologist, didn't even know if they were doing PICC's where she works. Now, that's a confidence builder!

Anything you can tell me is great and I'm printing out your information so I'll have something in hand to give them Wednesday.

Bathsheba
Dianne

I've nothing to add here but hugs, Bathy. I thought I responded...

thus a thread on politics probably nests a post with hugs for you.

Anyway, baby yourself at the same time you're keeping a good eye on all the stuff going on.

The biggest defference between a PICC and a port is that a PICC exits the skin. A port is implanted. A PICC should be flushed on a regular basis. After each treatment and I can check on how often between. I think a PICC could still be placed above the elbow if your cellulitis is below the elbow. Of course another option is a short tunnelled central venous catheter or a hohn catheter which is similar to a PICC but exits the skinn near the collar bone.
It's not very common to feel the catheter and if you're feeling anxious about the PICC I don't see why the doctor would be opposed to you taking a valium before hand.
PICC's and ports are done in the hospital where I work. My dept(interventional radiology) does a lot of ports and only the PICC's that are too difficult for IV therapy.

Take care! I'll be checking back in later.

Hi there osso,

Hugs gratefully accepted And hugs back to you. I know you've gone on this road before with breast ca so you do know what it's like.

I'll be asking tons of questions alright and being a medical bully. You guys are the best!

B
Dianne

Fingers are crossed. Good luck Bathsheba. Keep on keeping us in the loop.

'k. I understand the diff now. I'll ask about the hohn cath as well. Whichever one is the least painful.

The BCCA (British Columbia Cancer Agency) stopped doing PICC's and mediports several years ago due to infection problems. Have you heard anything about that? Seems it would be preferable to screwing up my veins....

I know I"m asking lots of questions here. If you get time, I would like to know what your hosp. recommends as far as flushing PICC's. I'll be home until mid morning tomorrow then we have to head to the hosp. Yuck.

BTW - like your avatar with the photo of you and your pooch. I"m ready for spring....how 'bout you?

Dianne
Bathsheba

FYI


http://inforadiologie.ca//default.aspx?page=61&lang=en-US

http://www.ciraweb.org/en/patients.html

Hi Diane, great to hear from you, you are a brave lady putting us in the picture under a great handicap. You're not fighting a minor problem my dear friend far from it, it is a major battle just as my poor countrymen are fighting in the State of Victoria. Fires are still not under control and the death toll keeps rising, currently stand at 183 but is predicted to rise in excess of 300.

Will certainly be thinking of you this week and sending you heaps of warm vibes. Don't worry about not replying to us individually, just a few lines to us in one post is all we expect and will be gratefully received. Wishing you strength for the days ahead, take care Bathy. Hugs and love from downunder.

Sending you hugs from Boston. All this hugging is warming up the air, gonna hit 50 tomorrow, they claim.

That's 50 F.

((( bathy ))), sending you hugs from central Canada

these lumps shouldnt be taken lightly...you should try and get your self properly checked by a physicain

Philomina welcome to a2k. Please read a thread completely before you post. Bathsheba has consulted physicians, been operated on, and is currently undergoing post-operative treatment.

Hey D - you coping with the last treatment????? Haven't seen you round for a bit! Hoping you'll jump onboard soon and let us know you're alright. x

Hi you all,

Thank you for your replies and concern! It really helps. I had treatment #4.5 this past Thursday and am still creeping about. Seems each one is harder to bear. I will have one more treatment then done with the chemo part but still have to have the Herceptin infusion (takes an hour) every 3 weeks 'til Nov. God, what a long haul! I ended up not having a port or a PICC. So long as they can scrounge a vein I'm good to go. Miss having no hair and having to wear this damn wig. Hopefully by summer I will have a few inches. My oncologist wanted to use my right arm (the one that had axillary lymph dissection) and I said NO. Who needs lymphadema? I'm finding that one has to be their own advocate in the medical system and quite vocal.

Dutchy, I am so sorry about what you have had to endure! Such a tragedy. I couldn't believe how hot those fires were! I'm glad the winds have stopped. Hopefully, things will get back to semi normal soon eh?

One thing about this forum that is difficult is that I can't see other messages from other posters - just the one I am replying to. So - I'm not ignoring any of you, just can't remember everyone who wrote unless I can see the post! Izzie, yours is right here, and thank you for asking about me...you're a dear!

I am isolating myself from people for the duration, which means hubby has to shop and do any outside errands. You guys are on my mind, even if I don't always have enough energy or feel quite up to posting.

Got a question: any of you dealt with what appears to be a cold sore on your lip? I've never had one before & assume it's because of my low white blood cell count. Anything out there that works on them? Tea tree oil? I"m looking pretty scary with no hair and now lip sores! Help!

Dianne
bathy ((hugs)) back to y'all!

Hi Danny,
Great to hear from you as well! I'm glad you're ok....what a battleground Australia has been! So much loss of life, so tragic. How is your son doing?

Thanks for thinking of me - sending positive thoughts back to you. Keep me posted as you can about the situation in your country?

Hugs from the frozen (not really ) north
Dianne
bathy

Yay! I could go for 50! We are at 10C here. No snow just rain, rain, rain.
Thanks for the hug, jespah...all the way from Boston!
Dianne

Hey Bathy....

So good to see you. Don't worry about checking in too much - concentrate on you gal. It's good to know you are nearly done with the chemo.... step by step.... next meds to come. But the life will start a new chapter. You are doing incredibly well.

As for the coldsore. I get the all the time I take oral chemo every week - immune system is shot to hell - most attractive aren't they a? So, dab had at this..... ZOVIRAX works well - cream.

However, if you get a lot of them as for some "anti viral medication"

There is also a new thing called Compeed which is like a small see through disc that covers up the cold sore so you cab barely see it. As soon as the tingle tingles - put one on. Change as it states on the pack. Just kinda makes you feel a wee bit better when someone is looking at you. Vanity a? Hard not to be vain when you're feeling crap too. Give them a go. I get loads of cold sores (been lucky so far this winter) - they usually come in three's with me. NEVER EVER without zovirax.

http://www.compeed.co.uk/ worth a go girlie.


Talk when you can hun and know that everyone is thinking of you and holding your hand as best we can. Take care. Much love. x

Ah, ehBeth, how are you doing there in central Canada? Still knitting up a storm?

Hugs back from the rainforest coast of B.C.
Dianne