Might need to get needle in Lymphedema arm

Gingerlime

Hi everyone,

I've recently started a new round of chemo, and yesterday they tried 6 times and couldn't get a vein. TIme for a mediport, but it won't be scheduled for at least a week.

My doctor wants me to get this round ASAP (and so do I), so we will try again with my good arm Monday. However, she mentioned the possibility of using my LD arm if we can't get a vein on the good one. It would be a one time thing, since I will be getting the mediport within the next week.

I feel very nervous about this. Has anyone had to resort to sticking their LD arm?

Thanks for any insights you may have.

hugz4u

Not sure about chemo in other areas other than arm but I get my blood draws from my feet. Also they can use a neck vein.

If it's possible to get a alternate site for Chrmo push for it. Sometimes lab techs are not use to this but there are people that can administer. I had my surgeon find my foot vein before BMX

ChiSandy

I developed trigger thumb on my R hand, and with the reassurances of my LE specialist (who said that the tendon release surgery would also have been safe), I got a cortisone shot at the base of the thumb. It was 7 weeks before it “took,” but there were no ill effects.

ChiSandy

I developed trigger thumb on my R hand, and with the reassurances of my LE specialist (who said that the tendon release surgery would also have been safe), I got a cortisone shot at the base of the thumb. It was 7 weeks before it “took," but there were no ill effects.

Bravenurse13

I would certainly not get an IV in my LE arm.  It would depend if you have active LE; if not active, it will become active and if you only have mild LE, it will become worse, and be a lifetime of a chronic condition.  Chemo is hard on peripheral veins anyhow.  I hate to say it, but I would wait to get the next chemo in the Power Port. You could try to get the port in sooner because of your situation.   Also using a vein in the feet can cause phlebitis; which could cause more complications, especially how toxic chemo is.

Last IV Herceptin, my nurse had to stick me 3 times ( gave blood return, but could not draw blood from).They gave me my Herceptin through a peripheral line in my good arm( Herceptin not as toxic as regular chemo).  I was sent down to for a flow study to see what was going on with the port and he found nothing wrong with the port?  However I was lying flat on the exam table in radiology specials. I will have the nurses administer in the bed lying flat for now on it it does not work while sitting in the chair.

I blame it on my inflation of my tissue expanders then letting out 3/4 of the saline for proper alignment for radiation therapy.  I was thinking that may have changed the positioning of the port, that is the only thing that has been different.

Anyhow Gingerlime, hope you don't continue being a human pin cushion.  Under no circumstances should they use your LE arm; unless it becomes a life and death circumstance like in an emergency to save your life, other than that, they need to get that port in ASAP!  Please demand it, it is medically necessary.

Never ever let them do IV, give blood or blood pressure in the LE arm; if you already have LE it may become worse.  Remember, this is for the rest of your life, no exceptions.  Take control and don't let them hurt you.  It is your situation, not theirs!        You go girl! 

Binney4

Ouch, gingerlime, really sorry your veins are giving them so much trouble!

I sure do understand the importance of getting on with the chemo, but in that case they really need to rearrange their schedule and get your port in right away. The idea of using an arm with active lymphedema for chemo is really problematic. If it were anything less caustic it could be okay in an emergency, but this could be asking for trouble you sure don't need.

Have you done the practical things like staying well hydrated, warming your arm beforehand, and making sure that the nurse attempting the stick is the recognized best available? I have a personal rule of "2 tries and you're out"--I'll give a nurse or phlebotomist two tries and then politely but firmly request someone else try. I figure I have the rest of my life to use the limited available veins, and I don't need multiple jabs making them harder to access over time.

In the end you'll have to go with whatever you're most comfortable with, but it should be your decision--this is your arm, not theirs, and lymphedema is for life. If you end up using that arm, you'll need to be really vigilant about checking for early signs of infection and acting immediately if you see any, because cellulitis is a heightened risk with lymphedema. Here's information about what to look for:

http://www.stepup-speakout.org/Emergencies_and_Med...

Gentle hugs, and smooth sailing! Please let us know how it goes,

Binney

ChiSandy

It doesn’t always work, because veins can “roll” even if clearly visible, but ask if they have an Accu-Vein infrared lamp to try to find a site on your non-LE arm, thigh or hand. And hydration is really important.

Gingerlime

Everyone,

Thanks so much for your support. I do have active Lymphedema, and this is really feeling like too much of a risk. I'm not going to risk it Monday.

Bravenurse--sorry to hear you have had problems with your port. I've always thought the same thought: that I would only let someone stick my LE arm in a dire situation.

Binney4--they always heat my arm with 4 packs, and I hydrate a lot, but I just developed a systemic hydration problem where fluid is going to my mets areas-- abdomen and lungs, and not my extremities. Last week I looked 9 months pregnant because of fluid in my belly! Fortunately they were able to drain some and it's much more comfortable. This is one reason my doctor really wants to start this new chemo drug.

ChiSandy--I was wondering about that. I can barely see veins in my LE arm when it is swollen. And this drug (Carboplatin) is supposed to be particularly hard on veins. They did use an Accuvein, but only after a few tries.

Here's my plan:

- My last appt was at 8am so I may not have been the most hydrated. Monday I'll go later in the day to have more time to hydrate.

- Calling doctor's team Monday am to push for soonest port placement. I'm so lucky to have the most amazing doctor. She's not pushing me to do this, but wanted me to consider it. She calls and/or emails me on weekends!

- Trust my amazing chemo nurses--they always do the 2 stick switch. But I'll ask for the accuvein up front. And the best person for the job.

- Try to relax. Maybe I'll listen to a meditation on my phone. Ativan for sure.

Thanks again for all of your kind wisdom. I'll let you know what happens.

Health and happiness to all of you!

doxie

Sounds like you are thinking this through with good logic.

I had both a cortisone shot and trigger thumb surgery on my LE arm. I took the risk because the pain and triggering were too much to handle. I would have drawn the line, though, at chemo in that arm. I had chemo the day after my port was installed and others have had it the same day. Not ideal, but I had no problem other than disturbing my oncology nurse. The aftermath is pretty ugly, though the pain is well managed.

LymphActivist

There are a number of devices used to image the veins, surface and deeper, to guide venopuncture. My wife's veins are bad, and when the "vampire" cannot find a suitable vein for infusion, an ultrasound venous imager makes finding a suitable vein much easier. I would think that this would be a better solution than the more invasive ports or use of the lymphedema arm.

Denise-G

Gingerlime - glad you decided against using lymphedema arm. I thought of you this morning. I was having a routine blood test in my "good arm". Blood draw person had only been on the job 2 weeks and no one else there. After 22 pokes, rolling the needle and veins, she finally got a hit. I've always had bad blood draw veins. Thank goodness I had a port through chemo.

Sending you all the best!! Yes, do ask for the best person on the job!! I used to go to a gal who had the nickname "One Stick Wanda!" She lived up to her name!! Sadly, she retired.

amygil81

Gingerlime, I had to have surgery on my good arm last year, see my post here , and I needed an IV. I made arrangements in advance with my surgeon to use my foot for the IV rather than my LE arm. It worked fine for me. You have to arrange it in advance, you can't just stick out your foot and say "here". Sounds like you got things worked out OK, but that's another technique we can use to keep needles out of our LE arms. HTH

lovepugs77

Denise-g, 22 pokes??? I would have lost my mind

hugz4u

Ok 2 pokes is not good... my your patience is unreal. Ok if I see that the tech is having trouble especially when I request a tech that is suppose to know how to do foot. I just say"foot needles aren't your deal are they." They admit it, then I say why don't we call a tech that does them regularly. They agree.

Gingerlime

Just to update, I was able to have the port placement scheduled for Tuesday, and get my chemo same day! It all went very smoothly.

Thanks again all of you for your wisdom and support.

Now I'm going to take the world's longest nap.

Binney4

Brava! Have a good rest, and I'm looking forward with you to this chemo going after the bad guys big-time.
Hugs,
Binney