My 87 year old mother had a pleurx catheter installed in hospital about 5 weeks ago. At first she drained about 500cc every couple of days but as weeks have gone by she has needed less and less draining (which became very painful) until last drainage got only about a tablespoon and this was after two weeks of no draining.
She has mets breast cancer and is on hospice care. Apparently there is some tumor mass on the outside of her left lung. She would like to have the pleurx removed. I have two questions:
1. I read on the pleux website that it can be removed after fluid stops draining. With her diagnosis and prognosis,is it likely that she may have a lot of fluid build up again in the future? and "just in case that happens" it would be wiser to keep the pleurx in in order to provide comfort care?
2. If it makes sense to remove it, how is it removed? i could find no info on that and want to know if she would have to go back to the surgeon to remove it? can that be done in office? with no anesthesia?
and (i guess i have three questions)
3. Are there any other reasons not to remove it? such as pain in removing it? or other complications?
I would be so grateful for your help with this. Both her primary care doc, the skilled nursing staff and her hospice nurse could give me no answers on this.
Blessings, Erica
Reply # - July 15, 2012, 01:24 PM
Reply To: Is is wise to remove pleurx catheter when drainage
Hello Erica, I'm so sorry that your mom is going through this. I'm not a healthcare pro but from what I've read and experienced people have different experiences with keeping a pleurx catheter in place. If it were up to my husband he would never have another, others don't seem to have comfort problems. For someone like my husband I'd work to get his out when not needed. It's a balancing act I know. I hope she can find comfort and balance in this area.
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I hope you and the hospice team will find the path to most comfort for your mom.
Janine
Reply # - July 15, 2012, 03:58 PM
Reply To: Is is wise to remove pleurx catheter when drainage
Erica, I just noticed I did offer you any reading material earlier. I know it will help you figure things out.
http://cancergrace.org/lung/2007/03/18/mpe-managment-options/
http://cancergrace.org/lung/2007/03/17/intro-to-pleural-effusions/
http://cancergrace.org/lung/tag/pleural-effusion/
Reply # - July 16, 2012, 06:03 AM
Reply To: Is is wise to remove pleurx catheter when drainage
People vary in their recommendations of when to pull the catheter, but because it can be replaced if needed (and the question of whether the fluid will reaccumulate is unknown, and because having an indwelling cancer can be associated with some infection risk (though not usually enough that we'd hesitate to keep it in if people need it), we often pull them if they are no longer needed.
I don't remove PleuRx catheters, but I believe that it's just removed by being pulled out by a pulmonologist or surgeon, without anesthesia or much pain (perhaps some transient discomfort, but no patient of mine has ever commented on the experience after having it removed. I don't think it's a very big deal.
-Dr. West