SERIOUS Cannula concerns (any good medics in?)
Discussion
Morning peeps, question for the clever medical types, Mrs Speedy is undergoing serious medical attention/work to keep her on her toes, one of our big concerns is that following numerous (many numerous 
) blood tests, intravenous blood and drug inputs it is getting to the stage it is very very difficult for medics (nurses, registrars and anaesthetists) to get a cannula feed into my wifes RIGHT arm to get drugs in or any blood out, yesterday she needed the cannula completely replacng at least 3 times due to the veins 'closing up'?, and it is getting to be very painful and tiring for her. Both legs have been tried with little no effect and LEFT arm is a no go area due to previous surgical interventions any ideas where we can go from here At this rate I don't see her getting to the next hosp later this week for complex surgery due to this issue.
What options are we going to be left with to get drips in bloods in and out and later in the week anaesthetic. We are seriously worried
) blood tests, intravenous blood and drug inputs it is getting to the stage it is very very difficult for medics (nurses, registrars and anaesthetists) to get a cannula feed into my wifes RIGHT arm to get drugs in or any blood out, yesterday she needed the cannula completely replacng at least 3 times due to the veins 'closing up'?, and it is getting to be very painful and tiring for her. Both legs have been tried with little no effect and LEFT arm is a no go area due to previous surgical interventions any ideas where we can go from here At this rate I don't see her getting to the next hosp later this week for complex surgery due to this issue.What options are we going to be left with to get drips in bloods in and out and later in the week anaesthetic. We are seriously worried
Completely anecdotally, but 16 or 17 years ago my Dad needed regular and substantial blood transfusions and doses of chemo, and he had a "Hickman line" (?) permanently plumbed into his chest. No need to try to find a vein; everything just went into the same tube.
All the best to you and your wife.
All the best to you and your wife.
I have to have regular venesection due to an acquired condition brought on by high levels of chemo. My left arm is a no no and my right arm often closes up. The advice to me was to drink 2 litres of water before leaving home to open up veins. Once at the ward I then have an electric heat cuff put round my arm, which really does help. Some staff are much better that others inserting needles and cannulas. Couple of years ago I had 3 nurses trying to put the venesection needle in and then came along the best needle inserter ever, however due to the efforts of the previous nurses I ended up with a 6" X 4" bruise.
1 hour before my visit I apply EMLA Cream to numb the needle site.
OP wishing your wife good luck with everything she is going through.
1 hour before my visit I apply EMLA Cream to numb the needle site.
OP wishing your wife good luck with everything she is going through.
Edited by Mrs Muttleysnoop on Sunday 10th April 20:24
Thank you for all your responses and wishes, as already mentioned it gives us options.
I raised it at the local hospital saturday and was told we will have to wait until monday (today) before any other options could be considered or carried out, we'll see what happens today.
Unfortunately due to complications she is on various intravenous meds/antibiotics nearly every other hour 24/7 and blood removal for tests until we get transferred to another hospital for further 'works' so the problems of keeping access for this is imperative to keep her on her toes.
Once again thanks for the input, my wife and i just have to keep reminding a thousand and 1 people the left arm is a no no similar to Mrs Muttleysnoop, at this rate i think i'll write on it in permanent marker "do not use".
Eta too late got to the hospital and after a disastrous night trying to find a vein they've gone and banged a bloody cannula into her left arm as a temp ffs, talking about putting a 'long line' in at some stage, seems like about 5 days too late
but what do I know.
I raised it at the local hospital saturday and was told we will have to wait until monday (today) before any other options could be considered or carried out, we'll see what happens today.
Unfortunately due to complications she is on various intravenous meds/antibiotics nearly every other hour 24/7 and blood removal for tests until we get transferred to another hospital for further 'works' so the problems of keeping access for this is imperative to keep her on her toes.
Once again thanks for the input, my wife and i just have to keep reminding a thousand and 1 people the left arm is a no no similar to Mrs Muttleysnoop, at this rate i think i'll write on it in permanent marker "do not use".
Eta too late got to the hospital and after a disastrous night trying to find a vein they've gone and banged a bloody cannula into her left arm as a temp ffs, talking about putting a 'long line' in at some stage, seems like about 5 days too late
but what do I know. Edited by anonymous-user on Monday 11th April 13:11
My son has exactly the same problem due to his veins having been attacked countless times over the 12 years of his life (i remember him having a canula in his head when he was about 9 months old due to not being able to access any where else!).
He's had a central line and a number of long lines, but now has a portacath and this is great. No problem getting blood, although there does seem to be a need to take quite a large (8ml) waste to avoid sample contamination and it's also important to remind the nurses to heplock it too to avoid it clotting. Also, there don't seem to be that many nurses who are trained in accessing ports, so that can be a bit of a pain logistically.
He's had a central line and a number of long lines, but now has a portacath and this is great. No problem getting blood, although there does seem to be a need to take quite a large (8ml) waste to avoid sample contamination and it's also important to remind the nurses to heplock it too to avoid it clotting. Also, there don't seem to be that many nurses who are trained in accessing ports, so that can be a bit of a pain logistically.
plfrench said:
My son has exactly the same problem due to his veins having been attacked countless times over the 12 years of his life (i remember him having a canula in his head when he was about 9 months old due to not being able to access any where else!).
He's had a central line and a number of long lines, but now has a portacath and this is great. No problem getting blood, although there does seem to be a need to take quite a large (8ml) waste to avoid sample contamination and it's also important to remind the nurses to heplock it too to avoid it clotting. Also, there don't seem to be that many nurses who are trained in accessing ports, so that can be a bit of a pain logistically.
I'm assuming Heplock is the same as Heparin, my wife has a Port fitted and have always found the staff to be very good at accessing it and remembering to charge it with Heparin on completion. Wonderful devices imhe. He's had a central line and a number of long lines, but now has a portacath and this is great. No problem getting blood, although there does seem to be a need to take quite a large (8ml) waste to avoid sample contamination and it's also important to remind the nurses to heplock it too to avoid it clotting. Also, there don't seem to be that many nurses who are trained in accessing ports, so that can be a bit of a pain logistically.
HarryW said:
I'm assuming Heplock is the same as Heparin, my wife has a Port fitted and have always found the staff to be very good at accessing it and remembering to charge it with Heparin on completion. Wonderful devices imhe.
I think heplock is the verb the nurses use, with Heparin being the substance.Please insist on a PICC line (Hickman Line). It takes minutes to fit and makes life so much easier if you have poor veins.
It requires weekly flushing/dressing change but this only takes minutes (and it sounds like your wife is constantly seeing the medics anyway so this should not be a problem).
Unfortunately, sometimes you have to be very insistent and not allow them to stab away to their hearts content.
It requires weekly flushing/dressing change but this only takes minutes (and it sounds like your wife is constantly seeing the medics anyway so this should not be a problem).
Unfortunately, sometimes you have to be very insistent and not allow them to stab away to their hearts content.
Thanks for the further input a line was put in just above the elbow on Tuesday afternoon (only a week too late), believe me I am on their case.
The new line is been used for a variety of intravenous drugs, samples and now more pain relief etc Unfortunately some of the 1st blood transfusion seems to have 'disappeared' so another couple of units were slid in Tuesday along with a raft of tests and scans,
It's a very messy complicated situation but thanks for the input. The line is being 'flushed' before and after each treatment. The staff really have been excellent but really are in a tricky position. The surgery has been postponed/put back due to the 'blood complications' and disagreements between ENT and Neurosurgeons presently (all caused by onco treatment complications)the efficacy of actually doing the work as mentioned it's complicated and it has been a week of ups and mainly downs for my wife who is going through a terrible time whilst I just hang on in there trying to provide support.
We'll see what next week's MDTM brings on Wednesday between a group of various consultants.
And in other news her dad went into hosp about 4 hours ago following a fall and blood issue still waiting for news at the mo, unfortunately I was on the ward with my wife when I was told he had a 'fresh' cancer in another part of his body (not secondaries) somehow I don't think any of this is going to have a good outcome for either
The new line is been used for a variety of intravenous drugs, samples and now more pain relief etc Unfortunately some of the 1st blood transfusion seems to have 'disappeared' so another couple of units were slid in Tuesday along with a raft of tests and scans,
It's a very messy complicated situation but thanks for the input. The line is being 'flushed' before and after each treatment. The staff really have been excellent but really are in a tricky position. The surgery has been postponed/put back due to the 'blood complications' and disagreements between ENT and Neurosurgeons presently (all caused by onco treatment complications
)the efficacy of actually doing the work as mentioned it's complicated and it has been a week of ups and mainly downs for my wife who is going through a terrible time whilst I just hang on in there trying to provide support.We'll see what next week's MDTM brings on Wednesday between a group of various consultants.
And in other news her dad went into hosp about 4 hours ago following a fall and blood issue still waiting for news at the mo, unfortunately I was on the ward with my wife when I was told he had a 'fresh' cancer in another part of his body (not secondaries) somehow I don't think any of this is going to have a good outcome for either
Edited by anonymous-user on Friday 15th April 23:30
Sorry after a bit more knowledge if pos,
Due to ongoing issues and complications we are trying to get my wife home for what short time we have left but we may have a serious problem in trying to organise a "HIT" team for intravenous antibiotics due to the amount of time they are needed minimum 6 bottles a day spread over 2 bottles 3 times minimum & intravenous pain relief etc between, she is too weak to make the visits to hospital where they could possibly do it twice a day only.
To cut the antibiotics will likely involve a faster more painful downhill spiral than the underlying problem, the other option to keep them going means my wife will be stuck in hospital to the end in the near future, talking it through it seems Macmillan cannot help, Marie Curie cannot help and the district nurses and hospice are not set up to do it, this will also need to be interspersed with blood transfusions.
I have the details of the local providers below in order of closeness but the Macmillan nurse isn't holding out much hope, i'm throwing this open any idea's how to get round this ???? Stuck between a rock and a hard place springs to mind.
http://www.eastcheshire.nhs.uk/Our-Services/Home-%...
http://stockportccg.org/wp-content/uploads/2012/02...
Due to ongoing issues and complications we are trying to get my wife home for what short time we have left but we may have a serious problem in trying to organise a "HIT" team for intravenous antibiotics due to the amount of time they are needed minimum 6 bottles a day spread over 2 bottles 3 times minimum & intravenous pain relief etc between, she is too weak to make the visits to hospital where they could possibly do it twice a day only.
To cut the antibiotics will likely involve a faster more painful downhill spiral than the underlying problem, the other option to keep them going means my wife will be stuck in hospital to the end in the near future, talking it through it seems Macmillan cannot help, Marie Curie cannot help and the district nurses and hospice are not set up to do it, this will also need to be interspersed with blood transfusions.
I have the details of the local providers below in order of closeness but the Macmillan nurse isn't holding out much hope, i'm throwing this open any idea's how to get round this ???? Stuck between a rock and a hard place springs to mind.
http://www.eastcheshire.nhs.uk/Our-Services/Home-%...
http://stockportccg.org/wp-content/uploads/2012/02...
Sounds s
tty, I'm sorry.
Is anyone able or willing to train you, and/or anyone else who will be around at home during this difficult period, to do it?
The DNs may not be set up for it: can they GET set up for it? I know there's been talk of ours (Manchester) getting IV training, presumably for situations just like yours.
The final, and possibly actually most helpful option, is Continuing Healthcare. It's a BIG pot of money to meet the needs of people with complex medical needs in the community. It can be referred to and assessed for from hospital and I believe although do not have personal experience of it that it can be fast-tracked when things are bad. You might actually be able to use continuing healthcare money, perhaps supplemented with PIP and whatever else your missus is eligible for, to privately employ an IV-competent nurse if you run out of other options.
Strength to you both.
tty, I'm sorry.Is anyone able or willing to train you, and/or anyone else who will be around at home during this difficult period, to do it?
The DNs may not be set up for it: can they GET set up for it? I know there's been talk of ours (Manchester) getting IV training, presumably for situations just like yours.
The final, and possibly actually most helpful option, is Continuing Healthcare. It's a BIG pot of money to meet the needs of people with complex medical needs in the community. It can be referred to and assessed for from hospital and I believe although do not have personal experience of it that it can be fast-tracked when things are bad. You might actually be able to use continuing healthcare money, perhaps supplemented with PIP and whatever else your missus is eligible for, to privately employ an IV-competent nurse if you run out of other options.
Strength to you both.
Firefoot said:
Please insist on a PICC line (Hickman Line). It takes minutes to fit and makes life so much easier if you have poor veins.
It requires weekly flushing/dressing change but this only takes minutes (and it sounds like your wife is constantly seeing the medics anyway so this should not be a problem).
Unfortunately, sometimes you have to be very insistent and not allow them to stab away to their hearts content.
a Hickman line is NOT a PICC It requires weekly flushing/dressing change but this only takes minutes (and it sounds like your wife is constantly seeing the medics anyway so this should not be a problem).
Unfortunately, sometimes you have to be very insistent and not allow them to stab away to their hearts content.
a hickman line is a durable central line for access
a PICC is a peripherally inserted central catheter - i.e. it;s a 'long' line
a picc can be put in in minutes , a hickman line takes rather longer
ultrasound guided insertion is also something to consider with peripheral or PICC
Just a quick update, Unfortunately my father in law passed away on Friday in the room next to his daughter after a bit of a fight,
My wife ended up with the Picc line but
after a fair bit of phoning around no one was prepared or able to do home 'HIT'.
Likely tomorrow my wife will be told the IV's are failing and she will be given the option of removing treatment to try and come home but possibly more likely hospice due to pain issues.
Somewhere in the middle of that lot I'll have to register her dad's death and arrange a funeral or 2 whilst trying to juggle the kids and exams, hey ho, keep plodding on.
My wife ended up with the Picc line but
after a fair bit of phoning around no one was prepared or able to do home 'HIT'.
Likely tomorrow my wife will be told the IV's are failing and she will be given the option of removing treatment to try and come home but possibly more likely hospice due to pain issues.
Somewhere in the middle of that lot I'll have to register her dad's death and arrange a funeral or 2 whilst trying to juggle the kids and exams, hey ho, keep plodding on.
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