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Tuesday, April 20, 2010

Scleroderma and Implanted Infusion Pumps

Had a patient with scleroderma presenting with shortness of breath today despite their home oxygen therapy. Finding a radial pulse on super-thick skin is not the easiest thing ever. I had to go way higher up on their forearm, because the skin around all of the joints was super-bad. Also, every little thing we did was painful. Our patient took it like a champ, but they were all bones and thick skin and the beginnings of contractures. Totally alert and oriented and involved in their own care despite bed confinement.

They were just a pinch over forty years old.

There's no set explanation for causes of scleroderma, but the most common cause of death from the disorder is lung related issues.

Scleroderma - Google Health

Scleroderma - WebMD

Our scleroderma patient had an internal/implanted infusion pump for chronic pain management, so they could self-administer pain medicine as needed. It looked like a cellphone, and it had it's own little bag and everything:

(Compliments of medtronic.com)

But that circle bag is implanted under the skin, and it goes a little something like this:

(Compliments of kimberlygraves.tripod.com)

Your doctor fills up the bag as needed. There's a little portal hole type thing in the bag, so they can just do it with a regular needle through your skin and the portal. I didn't get the name of which painkiller he was on (I wrote it in my paperwork! Just not on my hand for future reference...) The pain medicine is delivered intrathecally, kinda like an epidural.

Most often seen on late-stage cancer patients and other serious chronic-pain-inducing conditions.

Infusion Pump- Wikipedia

Internal Infusion Pain Pump/Intrathecal Drug Delivery

Medtronic Fact Sheet

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