A Port -A -Cath Placement Through Pocket Insertion
A Port -A -Cath placement through a pocket insertion, specifically the pectoral muscle, for use in IV therapy & antiemetic protocol. Its purpose is to help patients with a quality of life and care thrive vs failure to thrive application for colonic inertia, chronic intestinal pseudo-obstruction syndrome, gastroparesis, chronic migraines, post orthostatic syndrome- POTS -dysautonomia, & mitochondrial malabsorption. These are specific diagnoses, but there are unfortunately soooooo many more incurable, invisible, illnesses we warrior through in layers daily. We need research, treatments, quality of life and care while seeking cures for chronic communities. Regardless of our variables in paralysis or physical symptoms, response or lack of response to varying treatments we all advocate for ourselves and others towards the goal of a better quality of life and care while seeking cures for our chronic communities. The best life we can achieve on this path until our day cures meet us all is what we live and breathe each moment in advocacy over adversity #1ForAll_All4One our #ChronicTruth is your #ChronicTruth your cure is our cure.
May we unconditionally love & support each other in comfort & strength today +++++
In Victory for all #Cures
#1OneAll_All4One
As I posted in an earlier writing, there are more options available to us as patient/advocates for ourselves and others, when access is critical to thriving in the chronic zone of nausea, vomiting, fatigue, repetitive dehydration, and malnutrition. We as humans cannot survive without an ability to take in nutrients and liquids in combination with an extra hit of absorption being a constant/chronic hurdle. Malabsorption accentuated by mitochondrial disease is as if you are trying to win a race without fuel, fuel injector, nor even a carburetor. Even with a fully functional engine available, were to put gas in this metaphorical race car it would not give you acceptable, quality, performance. If you managed your way through these obstacles, your battery is weak, you cannot bring it up to a full charge, after an indeterminate number of races.
It will never, predictably do what you need it to do. The type of car will not change any of these influencing factors. You could tinker and maneuver to always get your car moving, but performance will always be a roll of the dice. The best fuel, a special type of fuel injector additive, might enhance the performance with quality of spurts of performance.
How we approach a problem, with determination always helps us past an obstacle. This may have been a frustrating metaphor for any of our fellow warriors who know or are mechanics. I apologize for my dangerous amount of small knowledge being used to help (no apologies there we will always do all we can to speak truth to advocacy 24/7/366 in #2020Motility) I know you address mechanical issues as a set of facts- outcomes- results after having worked through all possible scenarios to solve any probabilities to arrive at an answer-fix.
Let me give a little bit of personal insight into why I chose this metaphor. My husband was a mechanic and in the process of getting extra Volkswagen training for the dealership selling Volkswagen-Rabbits. Fast forward to 30+ years later, he and I with a KIA soul mechanics (he no longer works as a mechanic, but is still very good at problem solving) are trying to solve a “thumping sound” in the front driver’s side. The car was under warranty and they tried really hard to solve this issue. Two years or so later, hubby is cleaning the floor mats area and sees a piece of the rubber mat catching under the gas pedal. That’s right there is the thumping sound. I could go through all of the expensive labor, parts, and time expended over this issue, I will spare you. Some past the warranty.
We, as humans, do not come with warranties. The nearest example of a warranty I can think of, in reference to my metaphor, is an insurance deductible. Once our deductible has been met, y’all know what I mean. We meet the in-network 100% . Then many of us address as many medical issues as we can before the end of the year. We fill our prescriptions which are too costly. Some of us cut back on our pricier prescriptions until we meet the fore-mentioned deductible. We then fill them each month to have enough to sparingly space them out within a self-prescribed budget. This is as close as we can get to a “human warranty.”
Our metaphorical race car with its malfunctioning battery compares incurable illnesses and their mitochondrial malabsorption disease illuminates our human race moment to moment. We put in our nutrition in every way we can, we tinker with our digestive tract trying to assist its brokenness. We do all we can to extend our battery= mitochondria and their energy source to every organ system. As we age, normally this process happens over time. Our sight, hearing, memory, skin, bones, as we age our mitochondrial cells slowly begin to reduce their life giving energy boosts due to the energy =batteries wearing out. We all know what the aging process looks like over time. If we have a mito disease this is accelerated by their malfunctioning disease. When you are told in your late 30’s your bone density is that of someone in their 80’s it is jarring to say the least. Having cataract implants earlier than anticipated is again part of the mito journey. There are idiosyncrasies in the journey as well. When you are 57, checking into admissions for a port-a-Cath the 11th (access because of vein loss- mito journey), and told you have beautiful skin! There is no way you are 57 years old. This is just on my face. My hands, legs, another story. Yet, I will take any grace with a thank you. Those idiosyncrasies of having good hair still. Some of the chronic journey takes a lot, but still holds blessings.
Seeing the positivity with optimism is what makes everything on the journey be a #IAmOkayNow #AllIsWell #PeaceBeStill #WeAreOkayNow
The other access information shared was a fistula graft and HeRo graft both of which were established through the chronic illnesses- chronic communities within dialysis treatments for kidney disease treatments as well as chemotherapy communities all magnificent warriors with their strength & advocacy in every way.
A history of port-a-Cath with explanation of their placement.
HISTORY
The physiology of blood vessels began to be revealed in the seventeenth century when Harvey, who conducted experiments with animals, published a description of the circulatory system in the 1616 work Excercitatio Anatomica de Moto Cordis et Sanguinus in Animalibus.1 This knowledge made it possible, a few decades later, to conduct interventions in the blood vessels of living beings, as Folly did in 1654, when he conducted the first blood transfusion between two animals using a silver tube inserted into an artery in the donor and a bone cannula inserted into a vein in the recipient.2
In 1656, Sir Christopher Wren, best known as the architect responsible for St Paul’s Cathedral, performed the first infusion into the venous system of living beings, administering, opium, beer, and wine into the veins of dogs, for which he employed a goose quill connected to a pig’s bladder.3
In 1663, Robert Boyle and in 1667, Richard Lower described blood transfusions from animals to humans.4 The first blood transfusion between human beings did not happen until 1818, when Blundell5 transfused to a patient in postpartum hemorrhagic shock blood that had been extracted from a different person.
In 1831, O’Shaughnessy,6 and the following year Latta,7 successfully treated cholera patients with intravenous infusions of saline solution, and the same principle was described for treatment of people in shock.8
The first polyethylene catheter introduced by puncture via the lumen of a needle was created in 1945 and was then released commercially under the name Intracath® (BD Worldwide, Franklin Lakes, New Jersey).9
Access to the venous system by puncture was pioneered by the French military surgeon Robert Aubaniac, who described the technique in 1952.10 The method he used of puncturing the subclavian vein enabled infusion of greater volumes of fluids more rapidly for treating people in hypovolemic shock on the battlefield. The technique described by Aubaniac involved a medial access, guiding the puncture laterally and inferiorly in the direction of the fossa adjacent to the sternum. Postmortem dissections showed that the point at which the catheters entered the subclavian vein was close to the junction with the internal jugular vein.10
In 1952, Seldinger11 described intravascular insertion of catheters, advancing them along a flexible guidewire introduced by puncture. This technique remains the basis for procedures used for endovascular access today.
Insertion of central catheters via peripheral veins in the limbs was described in 1960 by Wilson, with the objective of monitoring the central venous pressure of critical patients.12
Percutaneous supraclavicular access to the subclavian vein was described in 1965 by Yoffa.13 At the time, other techniques for percutaneous catheterization of the internal and external jugular veins were already in use.3
Evolution to long-term access routes began in 1973, when Broviac created a silicone catheter that exited via the anterior wall of the thorax after subcutaneous tunneling from the puncture site. The device was synthesized in silicone and included a polyester cuff that provoked an inflammatory reaction, offering better fixation of the catheter by adhesion of the cuff to subcutaneous tissue.14
In 1979, Hickman adapted Broviac’s device, creating a new, larger-caliber, model that could be used for plasmapheresis and bone marrow transplantation (BMT).15
Another major step in the evolution of vascular accesses was the creation of totally implantable catheters. This technique emerged during the 1970s, after Belin et al.16 described implantation of a central venous catheter (CVC) with a subcutaneous chamber for infusion of parenteral nutrition, in 1972. In 1982, Niederhuber et al.17 released the results of experiments with 30 totally implantable devices used to treat patients with cancer, 20 of which were placed with the tip in a central venous position, while the remainder were in arterial positions. Such totally implantable catheters are widely used today, primarily for cancer treatment, and are the subject of this article.
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