Hi,
patient with breast cancer, receiving weekly treatments with the chemotherapeutic agent vinorelbine. For some time she has experienced a tingling feeling on the side of the neck, just over the access port catheter, at or shortly after the infusions. If we wait a few minutes between iv betamethasone (4 mg) and vinorelbine infusion she does not get this sensation, however. The access port is patent with good flow and brisk blood return.
What is this and why the difference with/without the wait?
Mats in Stockholm
Tingling sensations usually indicate some type of nerve involvement. Maybe the port is compressing a nerve and the steroid relieves the inflammation. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
... but she feels this only in conjuction with treatment and never in the period between at home. So why no tingling at home three days later when she has no betamethasone left in her system a no tingling before start of vinorelbine infusion? If some kind of semi-permeability of the port catheter you would expect to see some tissue damage, right? Maybe we will have to just accept that the wait does the trick without knowing why.
Mats
Yes, one would think that it would feel the same regardless of whether infusion was going or not. There is a problem with some port access needles used in the US actually coring out the port septum. I am not sure if this extends to any being used in other countries or not. Is this a plastic port or some other material? There is at least one report of a port needle being pushed through the floor of a plastic port. I guess I would look at how many courses of vinorelobine she has received and how long this has been going on. If you are not seeing any tissue changes, even after one infusion, I would think that it is not leaking, but you could consider a dye injection under fluoroscopy to be sure. Just a suggestion Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
and not plastic in the bottom of the port, so I think we will just accept the situation as it is and keep taking a few minutes paus between steroid and chemo. What make and typ are the coring needles?
Thanks
Mats
Mats,
Can you give more detail about drug admininstration? Dose, what are you putting it in, how long are you infusing it, etc?