Options for clogged stents
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I think that it was the “A team” trying to do the IV.
I haven’t had chemo, but I do have small veins that “roll” and have had lots of IV antibiotics over the years and used to have the nurse anesthetist come in to start my IVs. I had them write it in my orders so that if my vein blew in the middle of the night, I wasn’t at the mercy of a reduced hospital staff. For me, though, the biggest factor was the size of the needle. With the larger gauge needles, they just kept blowing through veins.I’m not exactly sure why he isn’t keen on having a port, whether it is because he has to deal with having it in all the time (cleaning, etc?) or just doesn’t want another procedure. He has two more chemos scheduled before his next CT scan and then the possibility of a third one depending upon what the scan shows. I think that he feels at this point that he is close enough to a chemo break that he isn’t sure that he wants to go through the port deal and would rather “tough it out”.
How many Gem/Cis cycles do most people go through before they put one on a chemo “holiday”?
Peggy –
I agree with Lainy about asking for an IV team or specialist to put the IV in. The first time for chemo after my husband had his port pulled it too them 6 tries and they just kept blowing every vein. I even offered to start since I am a whiz at getting them in but they couldn’t go do liability issues. I finally refused any more pokes until they brought in the IV team from the hospital. One poke and she had it in. You are already doing so many of the right things – making sure he is well hydrated including starting the night before using water, juices, etc but staying away from caffeine the day of the surgery. Hot packs work great. We wrap warm towels around my husband’s arms as soon as we get there then cover the towels with the incontinence pads and keeping changing them out until the IV team gets there. They can also use ultrasound to look for deeper veins and that maybe an option too. We haven’t gone there yet. The port did make things easier but he had three bouts of sepsis while it was in and while I (and the docs) don’t think it was the port, we have had no more since it’s out.Good Luck.
KrisV
Dear Peggy, I know well about those dreaded veins. Your Brother does not have to have all those pokes! After 2 have tried he should then ask for the A team so to speak. My veins look good but when they go in, the veins roll. I have found that most often they cannot use the smaller needle for IV. We call them butterfly needles. But all in all the good news is your roller coaster is on it’s way up, enjoy the ride. Has he said why he does not want a port. So many are glad they have it. Thanks for this report looks like things are starting to turn around.
An update on my brother…his numbers were really good today (well 80% of them!) But, good enough to go ahead with his chemo treatment. Good news is that the doctor did confirm that they can probably swap out the plastic inserts in his metal stents when they get clogged.
He has small veins, though, and they have really taken a beating from the chemo and blood draws and it took 2 nurses 11 tries before they were able to do the blood draw. Of course, they had trouble with the IV to run the chemo, too. I’ve given him the suggestions to make sure that he is well hydrated before he goes in, no caffeine, and to use warm compresses. I’ve also found that I do better with a pediatric needle, but don’t know if they will have those on site. He really is trying to avoid a port, and so I thought that maybe some of you have some other tricks up your sleeve of how best to get battered veins to cooperate for blood draws/IV’s.
Thanks!
PeggyHi LadyLinden,
I’m sorry that you are still sore. Hopefully each day will be better. My brother does have a few rough days each time he has an ERCP, but he’s always been jaundiced when he goes in. This one was rough in that he got really sick afterwards. The doctor explained that when they “unclog” the stent, all that crap goes into your system and makes you sick.
Tomorrow he has his blood work done again and hopefully his levels will be good enough that he can have his chemo. He does feel like at least when he is doing the chemo, he is doing something to fight this disease!
Take care,
PeggyDear Peggy, Thank you for your support. This is the 6th day since the stent and I am extremely sore and soooo tired! It’s almost like this last ERCP triggered some kind of reaction. Prior to placement I was feeling quite well. My energy is zapped and I have started chemo. I didn’t have a chance to talk to Dr. Khan about what’s next. I must admit that I am feeling better because I’m up and typing. So your brother responded well to chemo. I am glad to hear something positive. I’ve been dragging my feet about taking it. It seems like I need to talk with my oncologist because the way I feel now, after the ERCP procedure, the thought of chemo doesn’t sound like a good idea.
Dear LadyLinden,
You have been on my mind so much lately as I wondered how your procedure had gone. I’m so sorry that you didn’t have the positive experience that you had with the plastic stents! Hopefully today will be a better day. Did they tell you anything about what the future will be with the metal stents? If clogged, will they put plastic inside them?
We were all worried about how my brother would respond to the chemo, but honestly the chemo has been the easiest part of his whole treatment so far. He said that it’s boring to sit there for 5 hours for the infusion and since he chose not to have a port put in, the veins in his arms are taking a beating. He’s had very little problems with nausea, though, and very little vomiting. It does seem like the chemo is having a positive effect, too, with no new growth and one tumor showing some shrinkage. So, we’re hoping that it will buy him some extra time!
PeggyLadyLinden….Yes, it would be great to witness your success with the chemotherapy and I believe that you will do so. You are much needed by your sweet animals and we need you as well. We need you to continue writing these wonderful stories about your life, your love for animals while addressing your illness with frankness and honesty. By the way, what happened to the goat?
Hugs,
MarionDear Marions, Thank you for your post. Yes, an abdominal x-ray was done to make sure the stents had not shifted. If I continue to have pain, I will definitely have to go back to the doctors. I have someone who will go with me to chemo. I have great friend who has been by my side all the way. I am fortunate to have him in my life. He has been an angel on earth. I have been a business owner (transportation and warehousing of products) but am retired. While being in business, I rescued several animals (including a goat!) from the streets of Detroit. I once had a large kennel, 2000 square feet. I have downsized now and have a home with a 1000 foot kennel; indoor runs, a/c, all the comforts of a home. I had hoped to outlive the 8 dogs and 6 cats I have. I once cared for 27 dogs. Now I have eight elderly dogs who still have quality of life. All my animals have been neutered/spayed and have lived to be seniors, just like me. They are a big concern for me. I would not want them euthanized, so I’ve hired a caretaker to care for them at my home. It would be great to see if the chemo would shrink the tumor and buy me some more time. Dying isn’t just about me but about the things I love, the animals being a very important part of my life. I hope for less pain tomorrow. I really am truly amazed at this website and all the exceptionally brave people facing cancer. I pray for that type of bravery.
Dear KVolland. Thank you for your encouraging e-mail. I will print a copy for future reference. I may choose chemo because I am beginning to feel so much pressure even with the little food I consume. I am not quite ready to go to the peaceful place yet. I have paperwork to do. I just hope by tomorrow, my stomach achiness will be gone. I had no problem with the plastic stents. In fact, I couldn’t believe I felt so good, but these metal ones are giving me a hard time. Thanks again for your e-mail.
LadyLinden –
So sorry to hear how things have been for you. I hear stories like yours and it makes me glad we have been reluctant to have stents placed. I know if the doc said it was do or die, I guess we would but we haven’t gotten there yet. Another blood infection and we probably we have to reconsider.As far as chemo, goes take a deep breath and think positive thoughts. I know that sounds silly but my husband went into it thinking there was no way it was getting him down and so far he has not really had any major problems other than cold intolerance and night sweats.
He takes oral pre-treatment meds of Zofran (ondansetron), Dexamemthasone and Ativan (lorazepam) then for the two days after chemo he takes routine twice a day Zofran and Dex then every 6 hours as needed he can have Compazine (prochlorperazine). Hopefully your ONC team will do something similar. My suggestion is that you take something for nausea at the moment you even think you might be nauseated. It’s like pain, if you let it get ahead of you then you will struggle to keep up. Drink lots of fluids if you are able to – even while doing the chemo.
My husband did two treatments with a port in and now has done three with the port out. He has the option to have it put back in soon but is declining to do it again because he is worried about infection (that was the reason the port was pulled). If you have any troubles getting IV’s started then drink plenty of fluids before chemo and limit caffeine for a few hours before they start. Those two things will make starting a line easier.
Hope all goes well for you. And keep us posted.
LadyLinden….I am so sorry to hear of the problems you encountered. Often times stent insertion can trigger severe pancreatitis causing the symptoms you are describing. I assume that the x-ray revealed that the stent was positioned correctly and wish with all my heart that today you are feeling much better. Not having undergone chemotherapy myself but, standing by my husband and daughter (the later was treated for Hodkins Lymphoma) I much understand your reluctance of the undergoing any type of treatment. Please continue to reach out to the board members. They will continue to support you and stand by you. Your courage will continue to guide you – trust in yourself. Ultimately though, know that you have the right to control your treatments. Will someone accompany you for chemo?
Hugs,
MarionFrom Plastic to Metal Stents: Late May, 2013, diagnosed with Stage IV cholangiocarcinoma, non-operable, metastasis in the nearby lymph nodes. ERCP from Plastic to Metal Stents….On 10/15 I posted that I had no problems with the placing of the stents. My 4th ERCP was scheduled for 10/16….Yikes! I spoke too soon! Two plastic stents replaced with two metal on 10/16. As day progressed, experienced nausea, could not even take a tsp. of liquid without vomiting green liquid, chills, extreme soreness, sharp pains throughout abdomen. Same evening went to emergency per doctor’s orders. My gastro doctor said to run a blood test to check for pancreatitis and administer fluids immediately. Morphine shot given and indigestion followed. Given shot to relieve burning. I also had an abdominal and chest x-ray. All blood work appeared normal except for one, which was not alarming. Sent home with anti nausea meds and Xanax. I have tossed and turned for the last 4 days, stomach extremely sore every where. Do not know why this happened. Today is a better day. Things can change so suddenly, in the blink of an eye. I am afraid of Chemo and just don’t know if I could stand the side effects. I’ve always been so healthy and independent. Scheduled for chemo next week, no port at this time, which I heard is the way to go to prevent infection. Between us, I wish for a quick death. Perhaps a blood clot. I cannot handle a slow painful death. My hats off to those who have the courage to fight because I do not….I just want it to be over with.
Hi Wallsm1,
They haven’t mentioned an external bile bag yet. I guess if they are unable to swap out the plastic inside the metal, maybe they’ll do that? We’re hoping that they can swap out the inner stents. Thanks.
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