Could you help me explain this:
Breast cancer patient receiving adjuvant chemo (FEC). First treatment was given through PIV and yesterday pt was scheduled for treatment #2. She had had a venous access port implanted a week ago and we planned to use this for the chemo.
Flow by injection was OK, but no blood return or gravity drip possible. No coughing, twisting, turning, sitting etc. etc produced a blood return. We then installed alteplase (2mg) for 50 minutes and got a perfect blood return. The strange thing was that when flushing with saline at this point, the patient jumped in bed and complained of stinging pain over sternum approximately 10 cm from the port body. No pain when not injection and instant pain again when injecting several tries. When the physician came to look - no pain on injection.
We decided to go for PIV this time also and to do a dye study before next treatment. When I instilled heparin to pull the access needle, the pain came back.
What was this? Have you experienced this?
Mats in Stockholm