Pleurex Catheter Removal: Office or Hospital??

Ladybug1952

Hi Friends,


In 2012 I was diagnosed with IDC, was treated with Chemo, a modified radical mastectomy, radiation and 4 years of Femara and I figured I was home free. HR+ Her 2 -, Chek2 mutation.
In 2016 I couldn’t shake a cough and after 3 courses of antibiotics, a chest X-ray showed a large pleural effusion. After a few taps, I opted for the pleurex catheter after researching the topic and finding that it likely leads to drying up of fluid and spontaneous pleurodesis. I had the catheter inserted as an outpatient at the hospital under twilight anesthesia. It was a breeze but it took all day, from 7 am until 5 pm with checking in, blood work, waiting for surgeon pulmonologist, and a long wait in recovery mode before they allow you to leave. I started a new oral chemo also.
Luckily, after almost 16 weeks, the fluid has reduced to between 25 and 40 ml every three days. My onc thinks it’s time to have the catheter removed, to avoid possible infection or scar tissue. I have some back pain and rib pain as well as itchy rashes from the sticky tegaderm dressing.
My tumor markers have dropped with Afinitor/Aromasin after 3 months and I feel very well. No shortness of breath.
Here’s my dilema: I read that some patients have it removed in the pulmonology office but it is quite painful. I assume they can only give me lidocaine in the office. The Dr wants to remove it as a hospital outpatient, same as the placement. He is concerned about a sterile environment but mostly my ability to deal with pain. I did experience pain when I was tapped or when drained but that only happened when I was draining 500/1000 at a time. Now I don’t feel that awful pain in my ribs that felt like getting kicked.
So can any of you give me your opinion if you have had your catheters removed.? Where did you have it removed, how was your experience and would you do it again if you had to? Office or hospital outpatient??
Of course, the cost of outpatient removal is thousands of dollars compared to the Dr’s office. Luckily, it shouldn’t be a hardship at this time of year, having met my deductibles. I know the extra cost may be worth it to avoid problems, like infection or bleeding.
I appreciate your input and wisdom. I will be so happy wherever it is removed when it’s over! Can’t wait to take a bubble bath, go for a swim and sleep on my other side too! My hair is thinning from lying on my right side every night while sleeping for almost four months!😌
Thank you all!

Best Regards, Deb

Chicagoan

Hi Ladybug,

Congrats on getting your catheter out! It will so wonderful to be able to swim and take a bath again. Mine was taken out in the doctor's office. It was very brief-a quick yank (a bit painful) and then it was out. I had a slight complication because my procedure was done by a "fellow" and resident without the full-fledged pulmonologist supervising. The fellow told me a would have a slight scab and that would be that. Instead I had a lot of fluid and blood leaking overnight. I went back the next day. The nurse told me that it was actually good that a lot of fluid came out and then she sealed it with a liquid stitch. All in all, even with the complication, it was not big deal and not worthy of a hospital stay in my opinion. Such a relief to have it out!

Sadiesservant

Hi Deb,

I had mine removed at the hospital but not as an out patient procedure. The surgeon simply used local anaesthetic to numb the area. He had to dig in the incision to cut the suture holding the catheter in place and then one dissolving stitch to close it up. There was more discomfort from the tugging and digging than pain. I recall being a bit sore for a couple of days but it wasn’t bad.

I know it will be a relief to get it out. It was marvellous not to have to go for thoracentesis all the time and certainly brought relief but I was glad to finally get it out. I had mine for over 5 months and the constant draining caused scar tissue to buil up in my lung.

Good luck.

Ladybug1952

Dear Chicagoan,

Thanks for your response. I am seeing the pulmonologist tomorrow for a chest X-ray and to discuss removing it

Wishing you the best !

Thank you,

Debra

Ladybug1952

Hi Sadiesservant,

Your dog is beautiful! Thanks for your fast reply. I will see the Dr tomorrow and discuss further.

I was amazed to read your history of 17 years!!!

I know it must have been quite a shock after all that time. I hope you are doing well and have at least another 17 years of stability.

I appreciate your input and wish you the best!

Thanks again

Debra