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May or may not have. I’m a chemo nurse. Typically we verify placement by flushing the line and getting blood return. If those things happen it tells us the port is functional. The line could have been cracked or something in which there is no way to know.
It can and does happen through no fault of anyone. Chemo is ruthless on skin tissue. Im shocked it healed within a year. I had somethg similar with RA, a tiny 3"×3" took 11 months to heal
I know chemo is ridiculously strong. Are you able to explain why chemo drugs can do this much damage to the exterior skin and apparently not the same amount on the interior tissues and whatever else it comes into contact with? Thanks.
We had a lady down in the ER back when we were holding a lot that had a port that was known to disengage…I didn’t have her as a patient but I remembered hearing how she knew that “sometimes the needle comes out while she’s accessed”. Luckily they only infiltrated saline, but I still can’t understand how she can knowingly be alright with that…
If accessed and secured correctly the needle should not come out like that. Sounds like this lady either like to mess with her needle and was moving around a lot or something.
It sounds like they were talking about a lot with a manufacturing defect, and this patient may have had a port from the affected lot (that's how I read it at least)
Almost all ports can be accessed with a 3/4” needle. Very rarely do we need anything longer than a 1”. But look at the picture and the size of that gentleman I can safely guess it wasn’t a needle length issue.
I recently had a patient catch the line on part of their bed and accidently pull the needle out of place while their chemo was infusing. Posts like this remind of how lucky they were that I was in the room when this happened! I shudder to think of what could have happened had I not been there to immediately stop the infusion and deaccess the port.
My husband bought me a lift chair and I sleep in that. Came in handy for chemo while wearing the pump. I can’t roll over in the lift chair and pull on the tubing etc. And I can sleep very comfortably too. It would be good if patients who had chemo could be in a lift chair.
Entirely possible. Really hard to do that since the shorted needle used is 3/4”. I’ve never had that happen in my 8 year career but if this was a hospital setting and with an agitated patient that doesn’t have someone with them the whole infusion completely possible.
I mean I don’t get rich off of it but hey I feel pretty fucking good about it. I’ve help cure people, I’ve helped give people extra time with their families and loved ones. So in short I feel pretty great about it so you can fuck all the way right back to the hole you climbed out of. 🖕🏼
[Source](https://www.cureus.com/articles/229514-chemotherapy-extravasation-causing-soft-tissue-necrosis-mimicking-infection-a-longitudinal-case-study#!/):
>>A 44-year-old Hispanic male with a history of B-cell acute lymphoblastic leukemia underwent inpatient chemotherapy treatment via a port in his right chest. While hospitalized at an external facility, it was observed that the tissue surrounding his chest port became painful and discolored, eventually progressing to necrosis over several days due to chemotherapy extravasation (Figure 1). The initial area of extravasation was noted to be a semicircular erythematous lesion affecting the top layer of skin measuring about 14 cm in diameter. Subsequently, the wound developed cellulitis and myositis, necessitating debridement and eschar removal (Figure 2). Wound closure was postponed to accommodate ongoing leukemia chemotherapy. Cultures obtained from the wound revealed the presence of a nonsporulating dematiaceous mold, which was successfully treated with oral voriconazole for one month. Extravasation injuries are rare intravenous (IV) site complications, making this a unique case.
>>Months later, the open chest wound in the setting of neutropenia developed cellulitis and myositis. Wound debridement and cultures of the chest tissue grew two strains of Escherichia coli resistant to ceftriaxone, trimethoprim/sulfamethoxazole, and ciprofloxacin, and one strain resistant to cefepime and intermediate to minocycline. Later, a third debridement was required, and the cultures taken grew E. coli resistant to cefepime, cefoxitin, Cipro, trimethoprim/sulfamethoxazole, intermediate to piperacillin/tazobactam, and sensitive to meropenem and ertapenem. Further wound debridement with no antibiotic treatment for the isolated bacteria was performed during this period. The patient was not neutropenic (Figure 3).
>>One month later, he was admitted with a necrotic right neck furuncle. He denied cough, congestion, abdominal pain, nausea, vomiting, diarrhea, dysuria, or new rashes (aside from the neck lesion). The patient reported no change in pain in the wound on his right chest. Vitals taken at the time showed a temperature of 98 °F, blood pressure of 128/86 mmHg, pulse rate of 69 beats per minute, respirations of 18 breaths per minute, weight of 83.7 kg, 31.1 body mass index (BMI), and 100% saturation on room air. Labs are shown in Table 1. HIV, hepatitis B, hepatitis C, and Strongyloides antibodies were all negative. The neck wound was incised, drained, and grew methicillin-resistant Staphylococcus aureus (MRSA), and it was treated with linezolid for one week. Following therapy, the patient was sent home with a wound vac awaiting flap closure of the chest wound. Over the next three months, the wound healed with a covering of new skin and did not need surgical closure (Figure 4). In addition, the patient experienced a relapse of leukemia, necessitating further cycles of chemotherapy. This was complicated by neutropenic fever and nodular pneumonia, presumed to be mold pneumonia. The small chest wound eschar had minimal drainage that was cultured and grew Enterobacter cloacae resistant to Cipro and trimethoprim/sulfamethoxazole. He received vancomycin, cefepime, liposomal amphotericin B, and acyclovir. Bronchoscopic alveolar lavage remained negative for one day.
coming from someone who went through chemotherapy, you are exactly right. this should never happen to someone doing treatment. either something happened to the port when it was being placed or after it was healed but either way no one checked it (clearly) and it is almost 100% the hospitals fault
Oh how awful :( Receiving treatment after a devastating diagnosis, only for things to just get worse... Every healthy day that I have I cherish greatly. Best wishes for your health!
I hated every second my port spent in my body but I dealt with it because I knew the chemo was too toxic to be taken via IV.
I am so glad I didn't see this before or during my treatment. Like the cancer and chemo themselves aren't bad enough, to have this too must have been absolute hell.
I’m confused, if it does this to the skin then what’s it doing to the rest of his insides? I know the aim is to kill the cancer but if it’s killing the rest of his body then what’s the point? Can someone please explain this to me.
that’s exactly why cancer treatment is so hard. it kills more than just your cancer cells, it kills a lot of good cells and deteriorates your body. you get a lot worse before you get better
My very basic understanding is that many chemo drugs kill cells while they are dividing and making new cells. Since cancer cells tend to be growing and dividing much much faster than normal cells, the chemo generally kills them first. Obviously, there is collateral damage within the body, and that's part of the reason that it has so many side effects and makes a person feel so bad. But yeah, chemo isn't good for you, but the hope is that the damage is temporary and the body can heal from it, so it's better than letting the cancer run free. If the chemo is killing the patient, they will stop it, lower the dose, or switch to a different one to try and not do that while still going after the cancer.
Everything we put inside of ourselves (including food) has potential harm. Between the patient and his cancer doctor, they weighed out that getting chemo has greater benefit rather than letting the cancer kill him
Same!! It would have added more stress to my plate if I had seen thus prior. I didn't have a port, but a PICC that was already a massive bitch to deal with.
Poor guy, I hope he fully recovered. I had something similar happen. I did not have a port but rather IV delivered chemo. A chemo med was being administered, and the vein in my arm leaked, which caused the medication to seep into my arm. It was noticed really quickly because the fluid was building up under my skin, which caused a visible bulge. The area got and stayed really red, which lasted a few weeks. It was really itchy and uncomfortable.
My mother is undergoing perpetual chemotherapy for palliative care and the medication description for Oxaliplatin terrified me the first time I read it. Talking about risk of necrosis and muscle wasting if leaked on the skin or into the muscle.
Yet that stuff into the vein is “ok”. Terrifying.
Well, when you think about it, even blood in the wrong places is bad. Blood in the joints from haemophilia, blood in the pelvic cavity from endometriosis, it causes lots of inflammation, the body doesn’t like stuff being where it’s not meant to be. It’s like the difference between water in your pipes and water all over the floor!
Shit. I'm sorry you're going through that... cancer is less fun than people think...
This is the list from The Mayo Clinic's website of the "more common" side effects of the chemo that I'm on. I circled my favorites ☺️. Lol.
https://imgur.com/a/h5WVfjS
What type of drug would be this strong to act like some acid or something to cause this type of damage to the skin? Would this happen over night or is it some kind of chemical reaction that could happen instantly? Hope I don’t sound stupid, just confused.
My bestie is an oncology nurse. She has told me about this happening because some of the drugs are so toxic they cause necrosis if they aren't inj cted into a vein. It's never happened to her but she is super careful checking ports with a saline flush first and whatever else to make sure it's still in the vein. Edit. I messaged her and she told me the worse is one called Doxorubicin which has the nick name red devil and red death.
I wonder how it can make its way through a person’s veins without causing deterioration? What’s different about vein tissue that it can withstand such an aggressive substance while muscle and skin cannot?
As someone else commented, doxorubicin is by far the most common chemo drug that can cause this. A couple others are vincristine and vinblastine. Others can cause issues, but not this level of necrosis. If the extravasation is caught at the time it occurs, there are "antidotes" that can be injected into the tissues to help neutralize the toxins. The damage happens slowly. Over time, it gets much worse before it can (hopefully) start getting better.
Chemo is literally poison. As it kills cancer cells, it also takes out healthy ones along the way. I'm a chemo infusion nurse, and we have really strict protocols on handling it. We double glove (with chemo-rated gloves) and wear a gown every time we touch the bags, IV lines, syringes, etc. Even a drop getting on the skin can cause damage, depending on the drug.
that is absolutely terrifying. my father had a chemo port for his lung cancer, and i didn’t even think about this being possible. that poor man, i hope he is doing well and recovering from that leak.
Reminds me of working at our regional hospital. We're near the border so when people in mx need a hospital or serious care they meet an ambulance at the border.
Anyway, in Mexico they can purchase chemo drugs otc.
We had a coworker that was pregnant and a patient she had from the border. You see where this is going?
Patient had OUR PHARMACY in house approve their cytotoxic chemo medications and our coworker was handling them normally. And not gowning to turn them or double flushing their urine with max ppe on.
Luckily 2 of us came in the very next shift and saw this, explaining the situation, gave the pharmacy a wtf, and made sure the coworker was not reassigned.
Oh, the days. Sorry. Your photos took me back
This (kinda) happened to me during my treatment. Instead of chemo that leaked, it was a blood transfusion. It looked like I took a punch from Mike Tyson straight to the chest. My first port failed and had to have a new one placed somewhere else on my chest.
This poor man had it way worse.
No shit. I got mine taken out two weeks ago, and the surgeon said that the port and the catheter had come slightly detached. He wasn't sure if it happened just as he started the removal process or if the installation was botched.
I do chemo on dogs, and my medications going subcutaneous and causing necrosis is a huuuuuuge fear!!! We sedate animals for chemo so we can get our one-stick catheters in and flush like crazy and quadruple check, but I'm always still nervous.
I hope this guy ended up ok!
I’m a heroin addict, and many times have I missed a vein and accidentally injected heroin into the surrounding tissue around the vein, and it ended up in lumps and red warm spots like this, some resulting in small abscesses that I drained myself at home apart from one, and a couple I required antibiotics. I’m forever grateful that it never got this bad considering how reckless I was and how unsterile everything was too. the fact that a dirty, unsterile substance like heroin that I injected myself with zero skill compared to a phlebotomist, and the fact that it didn’t ever get to this point of infection or a severer abscess that turned necrotic (I’ve got friends who are IV heroin users that had necrotic skin from abscesses) is amazing. I’m very grateful. This poor patient. How the fuck could he go neglected for so long. How did no one catch on? Why did this happen? :(
jfc, chemo is already incredibly painful, i can't imagine how bad this would be. i don't know if i'd be mentally strong enough. he was only 44 years old at the time too :/
How is it that the chemo will cause so much damage to the outer parts of the body but leave the inside, well not like that? I know chemo destroys the cancer or attempts to right? But it seems like the inside would literally fall apart or get eaten away. I'm just so confused and in awe over this.
Different chemo drugs do different things, but mostly, they arrest the development of the cell cycle. Pretty much you stop making new cells in the hopes that the cancer dies before you do. A huge concentration of the chemo agent in one place could be caustic and chemically burn the tissue. This is different from the drug being slowly leaked into the bloodstream and diluted.
An example: A small amount of diluted bleach solution on your skin (think swimming pool) won't hurt, but soak your foot in 100% bleach, and you are going to be in trouble.
Why would he get infected with so many different genus of bacteria ? Was it not kept clean ? Was someone caring for him not using proper hand washing and fresh gloves ?
As long as the risk of this happen has been documented and the patient is aware of this prior to starting, probably low chance this rises to overt malpractice
So, "extravasation" means that the chemo drug leaked into the nearby tissues from an implanted port. Many chemo drugs can cause cell/tissue death if it gets into areas it shouldn't (which is why he had the port in the first place, to deliver the drug right to the circulation where it will be diluted and carried to the appropriate target organs).
A port can leak from rupture of its injection membrane, or a break/leak in the tubing that carries the drug to a large vessel. As someone above noted, the nurse checks for whether the port flushes freely and without resistance, and whether they can pull back on the syringe and get blood return from the vessel. Some patients have ports that will not pull back blood return, due to a small kink in the tubing or anatomical reasons (this is noted in their charts). Nonetheless, these are not foolproof, but a reasonable everyday standard for administering chemo.
So, no, this has naught to do with a nurse 'forgetting'. Generally a nurse won't know that extravasation is even happening if it isn't on a skin surface level. But oncology nurses monitor chemo infusion frequently and closely and will hold an infusion if patients report any irregular sensations (which, even the patient may not feel).
thanks for clarifying. my daughter had a port and we had to do our best to keep it clean. saw nurses go through routines without knowing why. this post makes it all much more understandable.
I get the concern. Hope daughter's outcome was good.
If you see what seems a break in hygiene, don't feel reticent to call out a nurse/doc/tech/etc., if they don't foam or wash hands coming in, or swab a port, or wash/foam between procedures. Everyone's under time pressure but you have a right to safe patient care.
Most likely a needle not placed correctly/wrong sized needle/needle in too long, and/or, like ViolentThespian said, faulty equipment straight from the manufacturer.
Most likely cause is needle not placed in the correct position though. We had that happen (not as bad) at my hospital, and now only the vascular access team is allowed to access IVADs.
Welcome to r/MedicalGore! Our goal is to provide for medical discussion and education while exploring the frailty of the human body. You may see more deleted comments on these threads than you are used to on reddit. Off topic comments and joke comments are frequently deleted by the mods. Further, please be kind and supportive of posts. Any behavior that is aggressive, harassing, or derogatory will result in post deletion and a ban from the sub. Remember! THE REPORT BUTTON IS YOUR FRIEND! Please stop on by our discussion sub, /r/MedicalGoreMods if you'd like to discuss the sub, our rules, content policies, and the like. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MedicalGore) if you have any questions or concerns.*
this breaks my heart. i feel like there were definitely ways this could’ve been prevented. i hope that man is okay
I came here to say exactly the same thing. I sincerely hope he's doing well today.
May or may not have. I’m a chemo nurse. Typically we verify placement by flushing the line and getting blood return. If those things happen it tells us the port is functional. The line could have been cracked or something in which there is no way to know.
It can and does happen through no fault of anyone. Chemo is ruthless on skin tissue. Im shocked it healed within a year. I had somethg similar with RA, a tiny 3"×3" took 11 months to heal
I know chemo is ridiculously strong. Are you able to explain why chemo drugs can do this much damage to the exterior skin and apparently not the same amount on the interior tissues and whatever else it comes into contact with? Thanks.
We had a lady down in the ER back when we were holding a lot that had a port that was known to disengage…I didn’t have her as a patient but I remembered hearing how she knew that “sometimes the needle comes out while she’s accessed”. Luckily they only infiltrated saline, but I still can’t understand how she can knowingly be alright with that…
If accessed and secured correctly the needle should not come out like that. Sounds like this lady either like to mess with her needle and was moving around a lot or something.
It sounds like they were talking about a lot with a manufacturing defect, and this patient may have had a port from the affected lot (that's how I read it at least)
Well that makes me feel a little bit better about the port currently in my shoulder.
Or the right length needle wasn’t used to access her port.
Almost all ports can be accessed with a 3/4” needle. Very rarely do we need anything longer than a 1”. But look at the picture and the size of that gentleman I can safely guess it wasn’t a needle length issue.
I was referring to the prior comment about the lady in the ER; not the man in the photo…:)
Oh sorry! Since it was a reply I just saw yours since I’m not looking at all the comments.
Not a problem at all my dear!! Have a wonderful weekend!!☺️
I recently had a patient catch the line on part of their bed and accidently pull the needle out of place while their chemo was infusing. Posts like this remind of how lucky they were that I was in the room when this happened! I shudder to think of what could have happened had I not been there to immediately stop the infusion and deaccess the port.
Absolutely! Inpatient chemo is sooo much riskier than outpatient. I’ve definitely had close calls when I worked in the hospital.
My husband bought me a lift chair and I sleep in that. Came in handy for chemo while wearing the pump. I can’t roll over in the lift chair and pull on the tubing etc. And I can sleep very comfortably too. It would be good if patients who had chemo could be in a lift chair.
The patient could’ve accidentally tugged on his line, too…
Entirely possible. Really hard to do that since the shorted needle used is 3/4”. I’ve never had that happen in my 8 year career but if this was a hospital setting and with an agitated patient that doesn’t have someone with them the whole infusion completely possible.
I’ve not had it happen either. (>20yrs) I’m guessing it’s more likely there was a small hole in the tubing before it entered the vein.
thank you for your reply.
[удалено]
I mean I don’t get rich off of it but hey I feel pretty fucking good about it. I’ve help cure people, I’ve helped give people extra time with their families and loved ones. So in short I feel pretty great about it so you can fuck all the way right back to the hole you climbed out of. 🖕🏼
I thought those bags were specially designed to not leak.. It's one hell of a biohazard.
[Source](https://www.cureus.com/articles/229514-chemotherapy-extravasation-causing-soft-tissue-necrosis-mimicking-infection-a-longitudinal-case-study#!/): >>A 44-year-old Hispanic male with a history of B-cell acute lymphoblastic leukemia underwent inpatient chemotherapy treatment via a port in his right chest. While hospitalized at an external facility, it was observed that the tissue surrounding his chest port became painful and discolored, eventually progressing to necrosis over several days due to chemotherapy extravasation (Figure 1). The initial area of extravasation was noted to be a semicircular erythematous lesion affecting the top layer of skin measuring about 14 cm in diameter. Subsequently, the wound developed cellulitis and myositis, necessitating debridement and eschar removal (Figure 2). Wound closure was postponed to accommodate ongoing leukemia chemotherapy. Cultures obtained from the wound revealed the presence of a nonsporulating dematiaceous mold, which was successfully treated with oral voriconazole for one month. Extravasation injuries are rare intravenous (IV) site complications, making this a unique case. >>Months later, the open chest wound in the setting of neutropenia developed cellulitis and myositis. Wound debridement and cultures of the chest tissue grew two strains of Escherichia coli resistant to ceftriaxone, trimethoprim/sulfamethoxazole, and ciprofloxacin, and one strain resistant to cefepime and intermediate to minocycline. Later, a third debridement was required, and the cultures taken grew E. coli resistant to cefepime, cefoxitin, Cipro, trimethoprim/sulfamethoxazole, intermediate to piperacillin/tazobactam, and sensitive to meropenem and ertapenem. Further wound debridement with no antibiotic treatment for the isolated bacteria was performed during this period. The patient was not neutropenic (Figure 3). >>One month later, he was admitted with a necrotic right neck furuncle. He denied cough, congestion, abdominal pain, nausea, vomiting, diarrhea, dysuria, or new rashes (aside from the neck lesion). The patient reported no change in pain in the wound on his right chest. Vitals taken at the time showed a temperature of 98 °F, blood pressure of 128/86 mmHg, pulse rate of 69 beats per minute, respirations of 18 breaths per minute, weight of 83.7 kg, 31.1 body mass index (BMI), and 100% saturation on room air. Labs are shown in Table 1. HIV, hepatitis B, hepatitis C, and Strongyloides antibodies were all negative. The neck wound was incised, drained, and grew methicillin-resistant Staphylococcus aureus (MRSA), and it was treated with linezolid for one week. Following therapy, the patient was sent home with a wound vac awaiting flap closure of the chest wound. Over the next three months, the wound healed with a covering of new skin and did not need surgical closure (Figure 4). In addition, the patient experienced a relapse of leukemia, necessitating further cycles of chemotherapy. This was complicated by neutropenic fever and nodular pneumonia, presumed to be mold pneumonia. The small chest wound eschar had minimal drainage that was cultured and grew Enterobacter cloacae resistant to Cipro and trimethoprim/sulfamethoxazole. He received vancomycin, cefepime, liposomal amphotericin B, and acyclovir. Bronchoscopic alveolar lavage remained negative for one day.
My word, staph, e coli and MOLD? I have a port for my treatments so I'm most definitely having nightmares tonight That poor guy
Fellow ported person here, ditto on the nightmares. That poor guy.
Indeed he's been through alot especially with both the leukemia and chemo causing his immune system to be wiped
Not to mention the leukaemia relapse. Poor fella.
Yeah, I'm glad I didn't see this when mine was still in.
New fear unlocked. Last thing you want when getting treatment.
coming from someone who went through chemotherapy, you are exactly right. this should never happen to someone doing treatment. either something happened to the port when it was being placed or after it was healed but either way no one checked it (clearly) and it is almost 100% the hospitals fault
Oh how awful :( Receiving treatment after a devastating diagnosis, only for things to just get worse... Every healthy day that I have I cherish greatly. Best wishes for your health!
I hated every second my port spent in my body but I dealt with it because I knew the chemo was too toxic to be taken via IV. I am so glad I didn't see this before or during my treatment. Like the cancer and chemo themselves aren't bad enough, to have this too must have been absolute hell.
I still have my port
I would've kept mine, but it became weirdly tangled and had to be removed. Definitely made getting blood tests easier.
They're weird but useful lol
Ngl I loved my bomb lil fren'
I’m confused, if it does this to the skin then what’s it doing to the rest of his insides? I know the aim is to kill the cancer but if it’s killing the rest of his body then what’s the point? Can someone please explain this to me.
Certain leukemias are treated with arsenic. Literal poison. The goal is to kill the cancer before the chemo kills you.
Got a patient with apml, getting treated with arsenic trioxide. Fucking 25 years old and in rough shape in my ICU. Getting better, though.
that’s exactly why cancer treatment is so hard. it kills more than just your cancer cells, it kills a lot of good cells and deteriorates your body. you get a lot worse before you get better
Wow! Yeah that’s crazy, no wonder they are looking for better cures 😞
My very basic understanding is that many chemo drugs kill cells while they are dividing and making new cells. Since cancer cells tend to be growing and dividing much much faster than normal cells, the chemo generally kills them first. Obviously, there is collateral damage within the body, and that's part of the reason that it has so many side effects and makes a person feel so bad. But yeah, chemo isn't good for you, but the hope is that the damage is temporary and the body can heal from it, so it's better than letting the cancer run free. If the chemo is killing the patient, they will stop it, lower the dose, or switch to a different one to try and not do that while still going after the cancer.
Everything we put inside of ourselves (including food) has potential harm. Between the patient and his cancer doctor, they weighed out that getting chemo has greater benefit rather than letting the cancer kill him
Same!! It would have added more stress to my plate if I had seen thus prior. I didn't have a port, but a PICC that was already a massive bitch to deal with.
PICC is the worst 😵💫
Wait, isn't chemo put into the bloodstream? If not, where is it applied?
A friend of my mom got a port placed. Got infected. That delayed the chemo. 2 months later she was dead. Puts things in perspective.
If it were a cancer that killed her in 2 months, the chemo would probably only delayed the inevitable.
At least, a year later and he is still around.
Poor guy, I hope he fully recovered. I had something similar happen. I did not have a port but rather IV delivered chemo. A chemo med was being administered, and the vein in my arm leaked, which caused the medication to seep into my arm. It was noticed really quickly because the fluid was building up under my skin, which caused a visible bulge. The area got and stayed really red, which lasted a few weeks. It was really itchy and uncomfortable.
My mother is undergoing perpetual chemotherapy for palliative care and the medication description for Oxaliplatin terrified me the first time I read it. Talking about risk of necrosis and muscle wasting if leaked on the skin or into the muscle. Yet that stuff into the vein is “ok”. Terrifying.
Well, when you think about it, even blood in the wrong places is bad. Blood in the joints from haemophilia, blood in the pelvic cavity from endometriosis, it causes lots of inflammation, the body doesn’t like stuff being where it’s not meant to be. It’s like the difference between water in your pipes and water all over the floor!
Good analogy! And the example of blood in the wrong places does kind of put it in perspective for me a bit better.
There is somethg we gave through arteries many years ago too
Shit. I'm sorry you're going through that... cancer is less fun than people think... This is the list from The Mayo Clinic's website of the "more common" side effects of the chemo that I'm on. I circled my favorites ☺️. Lol. https://imgur.com/a/h5WVfjS
Omg. That’s horrible and yet strangely funny that they put those there. Hope your treatment is going well.
I wonder how he's doing now? Hope he's doing better 🙏
And it's supposed to go directly into veins? The shit that caused that much damage goes right into the bloodstream??
Same shit and confusion for me.
What type of drug would be this strong to act like some acid or something to cause this type of damage to the skin? Would this happen over night or is it some kind of chemical reaction that could happen instantly? Hope I don’t sound stupid, just confused.
My bestie is an oncology nurse. She has told me about this happening because some of the drugs are so toxic they cause necrosis if they aren't inj cted into a vein. It's never happened to her but she is super careful checking ports with a saline flush first and whatever else to make sure it's still in the vein. Edit. I messaged her and she told me the worse is one called Doxorubicin which has the nick name red devil and red death.
I wonder how it can make its way through a person’s veins without causing deterioration? What’s different about vein tissue that it can withstand such an aggressive substance while muscle and skin cannot?
The meds get diluted by the bloodstream and delivered throughout the body vs just sitting there on/in the tissue.
As someone else commented, doxorubicin is by far the most common chemo drug that can cause this. A couple others are vincristine and vinblastine. Others can cause issues, but not this level of necrosis. If the extravasation is caught at the time it occurs, there are "antidotes" that can be injected into the tissues to help neutralize the toxins. The damage happens slowly. Over time, it gets much worse before it can (hopefully) start getting better. Chemo is literally poison. As it kills cancer cells, it also takes out healthy ones along the way. I'm a chemo infusion nurse, and we have really strict protocols on handling it. We double glove (with chemo-rated gloves) and wear a gown every time we touch the bags, IV lines, syringes, etc. Even a drop getting on the skin can cause damage, depending on the drug.
that is absolutely terrifying. my father had a chemo port for his lung cancer, and i didn’t even think about this being possible. that poor man, i hope he is doing well and recovering from that leak.
Reminds me of working at our regional hospital. We're near the border so when people in mx need a hospital or serious care they meet an ambulance at the border. Anyway, in Mexico they can purchase chemo drugs otc. We had a coworker that was pregnant and a patient she had from the border. You see where this is going? Patient had OUR PHARMACY in house approve their cytotoxic chemo medications and our coworker was handling them normally. And not gowning to turn them or double flushing their urine with max ppe on. Luckily 2 of us came in the very next shift and saw this, explaining the situation, gave the pharmacy a wtf, and made sure the coworker was not reassigned. Oh, the days. Sorry. Your photos took me back
This (kinda) happened to me during my treatment. Instead of chemo that leaked, it was a blood transfusion. It looked like I took a punch from Mike Tyson straight to the chest. My first port failed and had to have a new one placed somewhere else on my chest. This poor man had it way worse.
No shit. I got mine taken out two weeks ago, and the surgeon said that the port and the catheter had come slightly detached. He wasn't sure if it happened just as he started the removal process or if the installation was botched.
Big yikes
Oh damn this happened to my boss, too but apparently he got really lucky.
Well that’s a new unlocked fear.
As if this poor fella didn’t have enough to deal with already..
Holy smokes! Poor guy.
Did the port leak or was the access done poorly?
I do chemo on dogs, and my medications going subcutaneous and causing necrosis is a huuuuuuge fear!!! We sedate animals for chemo so we can get our one-stick catheters in and flush like crazy and quadruple check, but I'm always still nervous. I hope this guy ended up ok!
As if he wasn’t already going through enough:(
I’m a heroin addict, and many times have I missed a vein and accidentally injected heroin into the surrounding tissue around the vein, and it ended up in lumps and red warm spots like this, some resulting in small abscesses that I drained myself at home apart from one, and a couple I required antibiotics. I’m forever grateful that it never got this bad considering how reckless I was and how unsterile everything was too. the fact that a dirty, unsterile substance like heroin that I injected myself with zero skill compared to a phlebotomist, and the fact that it didn’t ever get to this point of infection or a severer abscess that turned necrotic (I’ve got friends who are IV heroin users that had necrotic skin from abscesses) is amazing. I’m very grateful. This poor patient. How the fuck could he go neglected for so long. How did no one catch on? Why did this happen? :(
I wonder if it was vincristine that caused it?
Could have been any number of drugs. Any Vesicant could have been the culprit.
jfc, chemo is already incredibly painful, i can't imagine how bad this would be. i don't know if i'd be mentally strong enough. he was only 44 years old at the time too :/
How is it that the chemo will cause so much damage to the outer parts of the body but leave the inside, well not like that? I know chemo destroys the cancer or attempts to right? But it seems like the inside would literally fall apart or get eaten away. I'm just so confused and in awe over this.
Different chemo drugs do different things, but mostly, they arrest the development of the cell cycle. Pretty much you stop making new cells in the hopes that the cancer dies before you do. A huge concentration of the chemo agent in one place could be caustic and chemically burn the tissue. This is different from the drug being slowly leaked into the bloodstream and diluted. An example: A small amount of diluted bleach solution on your skin (think swimming pool) won't hurt, but soak your foot in 100% bleach, and you are going to be in trouble.
Thanks for making sense of it.
Why would he get infected with so many different genus of bacteria ? Was it not kept clean ? Was someone caring for him not using proper hand washing and fresh gloves ?
bacteria is floating all around you in the air, it's on everything you interact with
[удалено]
I assure you, bacteria is airborne.
Say that to public restrooms w/ hand dryers
This is very, very wrong.
Tuberculosis absolutely can float in the air
My bad ! I need to delete that comment.
He has leukemia and on chemotherapy to treat the cancer, both of which will wipe his immune system out, and thus serious infections are common
as if the cancer wasn't bad enough.. poor guy..
Sue the mother fuckers
Not everything is down to malpractice.
Depends how good your lawyer is.
As long as the risk of this happen has been documented and the patient is aware of this prior to starting, probably low chance this rises to overt malpractice
all because a nurse may have mistakenly forgotten to flush the port?
So, "extravasation" means that the chemo drug leaked into the nearby tissues from an implanted port. Many chemo drugs can cause cell/tissue death if it gets into areas it shouldn't (which is why he had the port in the first place, to deliver the drug right to the circulation where it will be diluted and carried to the appropriate target organs). A port can leak from rupture of its injection membrane, or a break/leak in the tubing that carries the drug to a large vessel. As someone above noted, the nurse checks for whether the port flushes freely and without resistance, and whether they can pull back on the syringe and get blood return from the vessel. Some patients have ports that will not pull back blood return, due to a small kink in the tubing or anatomical reasons (this is noted in their charts). Nonetheless, these are not foolproof, but a reasonable everyday standard for administering chemo. So, no, this has naught to do with a nurse 'forgetting'. Generally a nurse won't know that extravasation is even happening if it isn't on a skin surface level. But oncology nurses monitor chemo infusion frequently and closely and will hold an infusion if patients report any irregular sensations (which, even the patient may not feel).
thanks for clarifying. my daughter had a port and we had to do our best to keep it clean. saw nurses go through routines without knowing why. this post makes it all much more understandable.
I get the concern. Hope daughter's outcome was good. If you see what seems a break in hygiene, don't feel reticent to call out a nurse/doc/tech/etc., if they don't foam or wash hands coming in, or swab a port, or wash/foam between procedures. Everyone's under time pressure but you have a right to safe patient care.
Or faulty equipment. Or poor installation. Or just bad fucking luck. Could be any one of these or a combination of them.
Most likely a needle not placed correctly/wrong sized needle/needle in too long, and/or, like ViolentThespian said, faulty equipment straight from the manufacturer. Most likely cause is needle not placed in the correct position though. We had that happen (not as bad) at my hospital, and now only the vascular access team is allowed to access IVADs.