Nurse said its okay to use needles and blood pressure on me
Hi i had all my lymph nodes on one side removed on feb.2 /2012. I am still abit new to all this but me and my husband both were sure we had been told no blood pressure and no bloodwork etc... on that arm. We were told it could cause lymphedema.
I was at hospital last week and yesterday-last week they one nurse said it was fine to take blood from the effected side regularly throughout my chemo when it starts. I told here i thought that was what my PICC line was for and thought i was not supposed to use that side. She said i was wrong.
Then at hospital yesterday for complications they were confused on what to do as i am to what i understand not to have blood pressure on effected side and also was told not to have blood pressure on PICC line arm side either. I had been advised to have a leg blood pressure if needed. The nurse 2 days ago used one and said i was her first but she did use it. The nurses yesterday argued with me till i was blue in the face that it was a MYTH that blood pressure should not be used on lymph node-less side. And did blood pressure me once on that side. And then also agianst my better judgement they ended up using my PICC line arm 3 times because i had made a fuss about my effected side.
I got home feeling very confused and frustrated that i am new to this and am not quite sure what the right or wrong answers are. Or if anyone would have listened to me anyways.
If anyone could give me any valid info i would love it -thank-you Beth
Comments
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As far as I know, they should definitely not use the arm with no lymph nodes. I am not sure what a PICC line is, so can't tell you about that.
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Beth, the nurses that you have been dealing with are WRONG. Do not let them do blood pressures, lab work or start IV's on that side. Blood work, etc, is what the PICC is for. Here's a document that you can print out and give to the staff:
http://stepup-speakout.org/WHAT WE NEED OUR DOCTORS AND NURSES TO DO AND KNOW ABOUT LYMPHEDEMA.pdf
and this is a position paper by the National Lymphedema Network, a professional organization:
http://lymphnet.org/pdfDocs/nlnriskreduction.pdf
You may have to be stubborn and demanding to get the treatment you need that does not put you at more risk for LE. I'd also recommend going to the Joint Commission home page and filing complaint.
http://www.jointcommission.org/
DO NOT LET THE NURSES BULLY YOU.
(edited to correct the name of the NLN)
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Also, ask for a copy of your consent form, it will list the possible side effects and should include lymphedema.
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Once I got the port, I never let anyone poke a hole in me if they could access the port. If you're there for chemo, they should just draw the blood from your PICC line before getting you set up for chemo.
You are correct that you should not let anyone take bp or draw blood from the arm where lymph nodes were removed. Be firm with the nurses and don't let them browbeat you. My attitude is "This is what I want, and I'm not going to argue about it". That usually shuts them up.
I had not heard about any restrictions on the side where my port is; you may want to ask the surgeon who put your line in.
It's your arm on your body, so why let them do something for their own convenience. If you get lymphedema, it's not them that has to suffer with it.
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I have been emphatically told that no BP or blood draws or injections on surgery side. Don't know anything about the PICC side - I have a port. In 2 1/2 yrs I've only run into one RN that tried to argue with me about using right arm - don't know what he did but must have done something because when I went back to that office 2 mths later he was "no longer here".
Stand your ground and do not let them use the surgery side. They can do leg bp's and foot blood draws if needed. Protect your arm. -
I would not let them do it if I was you. I had surgery under my armpit when I had the lumpectomy but no lymph nodes were removed and even the nurses will not take blood or do pressure from that arm now even though I still have lymph nodes on that side.
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Oncology nurses should know how to draw blood from a PICC line. Most nurses in a hospital should know how to draw blood from a PICC. PICC lines are common.
What's been working for me(bilat disease), is telling the person with the blood pressure cuff that if they need to check my blood presure they need to use my leg. Half the time they decide they don't really need my BP anyway. Yesterday I was having this discussion with my internist, she forgot to check my BP afterwards. Fine with me.
You are recieving chemo & I undertand the need to monitor you. Try confidently telling them they need to use your leg. Probably a PICC line wasn't a good choice because of this issue. Maybe they can put in a "port", if they continue to insist on BP on your ALND side.
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What about if you have 4 lymph nodes removed? I was also told that it is ok to have blood drawn from the arm where the lymph nodes where removed.
Cindy -
Beth, I agree with everyone else. DO NOT let them use the arm that you had the lymph nodes removed from for any BP or blood draws. I just had surgery to swap out my expanders for implants and I told them not to use my right arm because I had lymph nodes removed from there. That's all they needed to know. They put the iv in my left arm and the bp cuff on my leg and were very accommodating. The nurse put a sleeve on my right arm that said no BP, no IV. If they give you any flack about it ask the nurse if she is willing to sign a form saying that if you get lymphedema she is considered responsible. It is your body and you don't have to give in to them just to make their life a little easier. I don't know about a PICC line. I had a port, so I mine was different. You may want to call the surgeon and see what he/she says.
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Cindy-there is a risk with only "4" nodes removed. I was told it was unlikely I'd develop LE in either arm(4 nodes left, 5 nodes right removed). I haven't developed LE but my left arm is achey so I don't want it used. Originally I was going to "sacrifice" my left side because I'm right handed. But this weird soreness has me worried, so I'm trying to politely refuse blood draws & BPs in either arm. I got my internist to write for my blood to be drawn from my foot. As for BPs, I'm not undergoing active treatment & most medical staff take BPs because it is routine & they use the arms(the nearest arm) because it is about their convenience. But to answer your question, you are at risk. The risk might be small enough for you to accept vs trying to get medical staff to change their routine.
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Earlier this week, my BS said I could use my right arm for blood pressure, draws, and IVs because I only had the sentinel nodes removed. Since August 2009, when I had that surgery, I've not let anyone touch that side and now my left arm has completely given up - no needles can get in! Has anyone heard it's ok to use if only sentinel nodes were removed?
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SNB only here too and was told not to use that arm (4 nodes taken) by my BS. I have a port for draws and infusions but if I have other PET/CT I will have to use the other arm because it isn't a power port. And the veins in my "good" arm are shot.
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I only had one lymph node removed, but was told no blood draws or blood pressure on that side by my BS and my Onc. I will not let anyone touch me on that side. I've been told by several nurses not to worry at my GP's office, but it's not their body!
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This is slightly OT but I had an issue right after I got my port where I wouldn't let the nurses use my port. I had to have the SNB site reexcised/cleaned out due to an infection and when I went in for the surgery, the tech came at my arm and I told her to access my port. She said "we don't do that" and I threw a bit of a fit and said "well find someone that does." Well, then the nurses came over and were discussing "can you do it?" and "I don't know" and then they asked ME "what size needle did they use to access your port" This was a major hospital!
So I just looked at them and told them to forget it and not to touch my port, I didn't need them screwing it up. Luckily, they were able to find a vein in my arm, but it was a very frustrating part of a very frustrating day. This isn't the hospital that my BS usually uses and I will never go there for a procedure again.
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Beth, I notice that you are in Canada. So here is some Canadian information that you can print off and take in to your nurses:
First, from the Canadian Cancer Society: http://www.cancer.ca/canada-wide/about%20cancer/types%20of%20cancer/lymphedema.aspx?sc_lang=en On the second page, under Ways to Prevent or Manage Lymphedema, it says "Use your other arm to have blood samples or your blood pressure taken, or for injections, if possible."
Second, from the Canadian Medical Association: http://www.cmaj.ca/content/164/2/191.full Under Practical Tips, it says "Whenever possible patients should avoid medical procedures such as vaccination, blood drawing, intravenous access, blood pressure monitoring, acupuncture, venography and lymphangiography in the affected arm."
Your nurses should know this. But since they don't, you need to educate them.
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I was told an unequivical "no", even after sixteen years by every doctor, nurse, phlebotomist. (though one phleb did cheat after my insistance, but only after 5 or 6 pokes on the other). Don't let any nurse talk you into it. Your BP may read slightly higher on your leg (and the nurse should know that), but that's the only difference. They can also easily take blood and run IV's through a vein in your foot.
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Thanks coraleliz... I was under the understanding that I had right arm precaution (no BP or needles) in the arm with node removal. So that is what I have told every nurse, dr, medical person since the nodes were removed. Well last time I was in the hospital, which was this past February I had them telling me that I was not right arm precaution.. They even got ahold of my BS who said she never restricted me... I asked another nurse and my nurse at the breast care center and they both told me to always go with the other arm but if need be blood could be taken from the node removed arm... They also said to not have BP or IV's done on that arm... Very confusing when you have different people telling you different things. You would think the medical profession would all go by the same rules!!!
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I only had three nodes removed from my right, mx side. And, I've been dealing with cancer 3 years and will not let anybody stick me or give me BP in the right side. I have to say 100% of medical people have been professional about it and not argued with me. Some just forget and try but I say, 'You can't use that side" and they switch.
Every time I've been hospitalized, they've had a sign up behind me about not using that side.
I have a port in my left arm - an unusual place. Underneath the port, they can take blood pressure. And, they have taken it off my leg before.
With only 3 missing nodes, the odds of lymphodema are very small but just about everything that can go wrong with me has, so I take no chances.
You shouldn't either. Good luck.
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If you have a PICC line(inserted at your elbow), they can take your BP on your forearm using a pediatric sized cuff if they have to.
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Kltb04,
You were right not to let anyone who is not trained in accessing ports touch yours . I will only let the infusion nurses go near mine or the few other nurses who are specifically trained in port access. Even in a major hospital, training in port access seems to be a bit of a speciality. This is why I get my blood draws at the infusion center not the lab.
Caryn -
I learned all this after it was too late, was not told by my bs.
Since I found the LE threads, have insisted on bp taken of left forearm, they try to take it on my upper large arm with a small cuff, not going to happen. The one IV person cannot hear it, so she now has to use my leg. I have learned to be adamant with all. They used to try to get by and ending up hurting me and it is not happening anymore. And how about those plastic cuffs that start pumping and do not stop, the automatic hard ones, one time did it - I was yelling for them to stop it, so watch out for those.
The IV, I have been getting blood tests and IVs ea week, before knowing what LE was - since my bs said I would have the swelling from surgery and it would get better, not a word about LE - I did let them use the affected arm for both. Now I insist on the left arm being used but no one, I mean no one can get blood or give me an IV in that arm, it's like I died or something.
I say, then it's ok to use my leg or foot for the vein. And they do not know how. After say getting the IV attempts in the left arm and hand four times, I have given up and said use my good vein. This is so bad I did not go for my UVB treatment which pulls blood to treat and reenter body - not this week, I am searching out a new place I guess. The main lady is gone for a few more weeks, and I hope she knows how to do this.
Any ideas on this one, besides finding someone who knows how to use leg, I just wonder whhy the left arm doesn't work for this.
Thanks. Good question, btw.
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Kltb04... I was told that a special needle is used with the port and to not let anyone access it who isn't completely in the know about ports.
Cindy and Beth... I am with everyone else... have always been told no BP or needles on my node (less) side... and Cindy, I only had 2 nodes taken SN and one other that was attachd to it.
I did have one problem where my port which was on upper right chest and left sided node removal... my port had caused a blood clot, so for one of my surgeries they couldn't use either arm, so they used my legs... I also have never had anyone give me flack... My GP did say once though that he didn't think it mattered, but moved the cuff to my right side regardless.
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Aarghh, I am frustrated for you that with all the other worries you have, you have to wrestle with the nurses over this stuff
grrrrrr. I had 4 nodes removed and have lymphedema, BTW.
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I am really glad reading all these replies that I was a b**** about it that day then! I very nearly got up from the bed in the pre-op room, got dressed, and walked out because I got such a bad feeling from everything. The only thing that kept me there was knowing I HAD to get that infection cleared up so that I could start chemo the next week (I already had to delay it a week). And my BS had had to pull strings to get an operating room before she started seeing patients that day and this hospital was the only place she could get in on one day's notice. But anyway, all's well that ends well I suppose.
So I guess moral to all these stories is we have to be our own advocates.
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Thanks bdavis.. I am glad I said no when they wanted and told me it was ok to use that side...
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Here is a reference re: blood pressures and IV's and LE risk
http://www.lymphedemablog.com/2010/10/22/lymphedema-risk-reduction-venipuncture-and-blood-pressure/
The whole "myth" thing is a constant battle: recently a breast surgeon published an article about lymphedema risk reduction--"is it fact or fiction" and the only one she could disprove, was that it's okay to exercise if you do it slowly. There are few studies to "prove" the risk, as they'd be unethical.
It seeems like this comes up when we're under stress/pressure/scared.
I had a colonoscopy today, and I have LE with 3 nodes out, and the nurse ran to get the big sign to leave my arm alone--now I came prepared, with a special sleeve that says to leave the arm alone, but she was right there supporting me, as were all of the other surgicenter staff. I came prepared to do battle, and was supported instead--a relief.
http://www.g-sleeve.com/g-sleeve.htm
The American Cancer Society sells it as well:
http://www.tlcdirect.org/subcategory/Lymphedema-Alert-Products.html?
Myth?? If a medical procedure that could be avoided triggers LE in even one person, it's not a myth. And we get to decide what risks we're comfortable taking.
Kira
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everyone should wear the bracelet.
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Hi Beth 1965,
I had 30 nodes taken out of one side, and I have had everyone, GP, oncologist, surgeon, lymphedema specialist, physiotherapist the lot, all say, don't let anyone do blood pressure and blood tests or the like on that arm. I developed lymphedema straight away as soon as I woke up from the axillary dissection, however I have been warned that any further intervention by testing, could make my problem worse.
Ched
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Hope this helps. Under no circumstances let them take IV's, BP or have injections in the arm that you had the nodes taken from. All GOOD NURSES know this. I wear a special Medic Alarm bracelet that states just that. You are runing a risk of lymphoedema. You must have injections on the other side or in your leg or stomach, NOT AT ANY STAGE on that side. All the posts on here are correct. Plus, do not let them do BP's on that side. I would tell them to stuff off it it was me and tell them to get someone who knows what they are doing. They can use a PICC line if you have one on the OTHER arm or a port if you have one in as I have but ONLY experienced Nurses should do the port. STAND YOUR GROUND ON THIS ONE. THE LADIES ON HERE KNOW WHAT THEY ARE TALKING ABOUT. Annie
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