Permcath Removal

[lcamanini]

How many of you have had permcaths removed? I've had mine in since February and I'm finally getting it out this Thursday. I'm way excited, but I'm also really nervous. The nurse told me that they just pull it out, and that sounds extremely unpleasant. She told me the other patients said that it wasn't too bad, but I'm starting to freak out. I just wanted to know what other people's experiences were like.

[tamara]

I just remember them putting the pressure on that hurt more than the actual removal. Other than that, The Relief !

[boxman55]

I had mine "pulled" on Sept 1st after a year with it. I did not feel a thing because I was out like a light having gall bladder removal at the same time. I can't tell you if it will be painfull but, I can tell you that not having it show through clothes and not having to deal with it at dialysis and being able to take a normal shower is worth all the discomfort of having it removed....Boxman

[thegrammalady]

i've had 2 removed. they don't exactly just pull it out because there is a little "cuff" that grows into tissue to keep it from falling out. it doesn't hurt to take it out and it's really no big deal.

[stauffenberg]

It is an utterly trivial and usually absolutely painless procedure to have a permcath removed.

As for it being a relief, I have often argued on this forum that a permcath is the best access for dialysis, since it provides a totally pain-free, efficient dialysis connection without damaging the appearance of the body, as well as permitting free motion of both arms and hands during treatment, while at the same time avoiding all the many complications to which fistulas are prone.  I was dialyzed that way from 1996 to 2005 and was perfectly satisfied with it.

[George Jung]

...... I have often argued on this forum that a permcath is the best access for dialysis, since it provides a totally pain-free, efficient dialysis connection without damaging the appearance of the body, as well as permitting free motion of both arms and hands during treatment, while at the same time avoiding all the many complications to which fistulas are prone. 

I have been using the permcath for 10 months now and I agree with the positive aspects of it.  It has served me well.  I gave my reasoning to my doctor just last week and his reply was "I can respect that."  I was almost in shock.

[lcamanini]

Thank you so much for your replies. I'm beginning to feel better now. I wasn't really too worried about pain. I was more worried about unpleasant sensations since it seems to sit right on my collar bone. I have practically no body fat, so there's not much cushioning between it and the bone. I realize it's probably going to be pretty quick, so I'm probably just working myself up over nothing. Also, just the idea of pulling it out sounds so gruesome. And I can understand your reasoning behind permcaths being the best access, but I actually prefer my fistula. Yeah it hurts a little and I can't move my arm much at dialysis, but I hate having something foreign sticking out of my body, and I'm extremely excited to be able to take a normal shower again. Then again, I got lucky and so far my fistula doesn't actually look too bad. However, it's still pretty new, and it seems to get bigger every time they use it.

[LightLizard]

well, i was relieved, big time, to have mine removed. it didn't hurt in the slightest, either. but it sure felt good to be able to scratch that part of my chest again.
the doc practically had to put his feet on my chest to get enough pull to get it out. i laughed while he did that, because i had been so cautious while it was in, so careful. if i had known it was in that secure, i could have done high-wire acts with it, if i wasn't terrified of heights, that is.
nice to be able to take a shower again, without having to cover my chest with plastic wrap.

love

~LL~

[boxman55]

I used my cath for over a year, yes there is positives to it but the negatives and that would be getting an infection is the drawback. You can go a long time with it but if you are unfortunate to develop an infection then it's bad news....Boxman

[donnia]

the doc practically had to put his feet on my chest to get enough pull to get it out. i laughed while he did that, because i had been so cautious while it was in, so careful.

OMG! that does not sound painless.

What exactly is the process??  Don't they have to go in and "unhook" it or something.... or am I a total idiot?

[Rerun]

It is an utterly trivial and usually absolutely painless procedure to have a permcath removed.

As for it being a relief, I have often argued on this forum that a permcath is the best access for dialysis, since it provides a totally pain-free, efficient dialysis connection without damaging the appearance of the body, as well as permitting free motion of both arms and hands during treatment, while at the same time avoiding all the many complications to which fistulas are prone.  I was dialyzed that way from 1996 to 2005 and was perfectly satisfied with it.

I am with you on this one Staff.  I would still have mine if they weren't on me all the time to get it out.  There is a "Doctor" on dialysis at my unit.  He has a permacath and no intention of getting a fistula.  What does that tell you!   

[Roxy]

When they took out my permcath, what hurt (because I'm a big chicken and I don't like needles) was the lidocaine needles that they kept using to numb the entire area around it. After that, I mostly felt pressure as the doc was pulling it out and that was all. I was also completely freaked out but it wasn't as bad as I thought it would be.

[LightLizard]

the doc practically had to put his feet on my chest to get enough pull to get it out. i laughed while he did that, because i had been so cautious while it was in, so careful.

OMG! that does not sound painless.

What exactly is the process??  Don't they have to go in and "unhook" it or something.... or am I a total idiot?

well, i may have exxagerated a little.

it wasn't quite that dramatic. they freeze the area around the site first, so you don't really feel anything. but the doc said that my body 'didn't want to give it up' after he yanked it out. and that's what they do, really, just yank it out. don't worry, it's not as bad as you might imagine.
besides, if a weak, flawed man like me can deal with it, I'm sure that you can, too.
love

~LL~

[George Jung]

No infections here and I shower every day w/o covering, I was just told not to have the shower head blasting on it.  No worries, no problems.  I used to get harassed every treatment then it went to weekly harassment and just last week I gave my reasoning to my Doc and he said "I can respect that." 

Saw a Neph today at transplant evaluation and he couldn't have cared less, took a look at it and moved on.  I was worried about compliance issues but that was unnecessary worry.  Every person is different, there is no right or wrong, but I think people should know of others experiences so they can make those decisions for themselves rather than the doctors word being holier than thou.  Yes there is risk of infection with the permcath but there are risks with anything, so as long as one takes the best care possible then what more can you do.

[poohkari]

Wade had no problems when he had his out, before they put in the new one. He's curently on his third since May (ughghg, dont even get us started!) but his first permacath - the others were Quintons. We've had no problems at all with this one, and he has these plastic sleeve things he showers with. He has had no problems, and we've already decided that if his fistula (that we havent even got going yet!) fails, he's not going in for more prodding in his arm. Permacath all the way!

[keefer51]

I had six of them in a year and a half. The fever they brought on was horrible. The first time i was on dialysis in 92 i went through seven of them. They were a little different. The last permacath i had was taken out with out much pain. He did have to cut the skin that grew on the cuff. The lidocain needle sucks. I don't know why i kept getting infections. I was always conscious of it. Some people are lucky and can keep one for years. i was not one of the lucky ones. I know your collar bone will be sore for a while. The scar will be there but if you only had one or two it's not so bad. The fistula i have does give me more freedom. I can shower without any plastic and swim. There is a great deal of pain with my fistula because of where it was made. The Emula cream helps with the stick but then they always hit the nerve which then makes me wish for the catheter.

[KR Cincy]

The anxiety was worse than the procedure - other than those damn little lidocaine shots. Silly thing slid right out after they disconnected the tissue (that's the part you don't feel, thanks to the shots.) It'll be over before you know it.

[NurseNae]

OK here is my....never humble, always blunt.....opinion.  My aunt had a prmcath that worked great for her!  It was really easy to work with and she didn't have to deal with the pain of cannulation and bad techs poking around etc.  However, my aunt was also on emergency hemo.  What I'm learning at the center is that docs like giving patients a fistula or a graft for several reasons....

1. In California....only the RN can use a cath as an access.  A tech. on the other hand can work freely with other types of vascular  access and work at a fraction of the cost.
2. Non-Cath access takes TIME....if the renal team anticipates extensive dialysis they chose a graft or fistula...so as not to damage vital veins like the jugular, subclavian vein, or femoral vein.
3. Caths have poor blood flow rates compaired to a fistula or a graft which means dialysis adequacy is reduced....which usually means some extra time on the machine or an extra day for some people!

Either way they both have problems and advantages!  It is my belief that if a patient WANTS their cath and is aware of the risk then so be it!  Afterall, an access is an access in the end if it works wherever and whatever it is....and you feel "better"....then it is a success.  After that you should be able to go home and live your life without being bugged about it!


Nae

[goofynina]

Thank you for your "opinion" Nurse Nae,  very informative 

[KR Cincy]

Nurse Mae, I do agree with you...if someone wants to keep the cath, they should have that option...as long as all the risks are full understood. My neph and clinic staff wanted that thing out of me as soon as possible to avoid the infection.

What's crazy is that in Kentucky, only RN's can mess with the catheter in-center (the techs couldn't hook me up)...but give my non-RN wife 12 days of training, and she can do whatever she wants with the cath! There's a certain level of hypocrisy there that I don't get, but it worked out in my favor, so I'm not complaining!

[pdpatty]

What side of you bodies were your caths on. I have an access port on my left and they had to put my cath on the right. The cath is very long inside,goes up to collar bone and then crosses over to left side.So ,I am curious how many ahd the cath on left and how many on right?
About 2.5 inches above my cath was a tiny incesion (Couple stiches ,wher they turned the cath to go across my body to my heart.

I was wondering how difficult it is to remove when it is this long or si eveyones on the right side?

[KR Cincy]

That sounds about right...I think that's the preferred location for the first catheter...if it goes wrong, then it could go left side or, in an emergency, in the neck.

[kitkatz]

I have had the right and left. The left goes over the major blood vessels and is more dangerous, they told me.  They also knicked a lung while they were at it with the left cath and gave me a good case of pleuresy in the lungs.  Nice job guys!   

[George Jung]

I had to have my cathater replaced today.  The removal and reinsertion was a breeze.  Reason for replacement - a hair-line fracture on the red hub which would not allow the machine to pull.  After gettint the new one in the surgeon commented how good the flow was.  I do hope that this one lasts as long as the last and works just as well.

[donnia]

George, did they reinsert in the same place?  I have had mine for about 6 weeks, and we are having problems with it, so I think we will have to replace it.