Port discussion day!

October 31, 2007 at 2:25 am

Hello, three comments since it is port discussion day.
1. You can ask that the port be placed while you are asleep under anesthesia in outpatient surgery that you go home from after it is over. Sometimes ports are placed in adults without general anesthesia (just using local anesthesia), but this may be a good time to be treated like a child!
2. Personally I have seen a lot of reactions to IV IgG including severe allergic reaction to IV IgG (anaphylaxis with trouble breathing, low blood pressure, and swelling of the airway). It makes me really nervous thinking about IV IgG at home and I think there is too much danger with administration without someone able to act if there is an allergic reaction. People can do well for a long time with IV IgG and then react. As well, due to the national shortages, sometimes the brands change and there is a larger chance to react with changing brands because there are definite differences in them. It may be nice to not be stuck at a clinic or have a nurse stick around, but there are dangers with IV IgG that should not be treated lightly nor should insurance companies take risks with people lives just because it is cheaper.
3. There are risks of infection with a port-a-cath. It is not zero, but also is not as great as with a broviac/hickman/central line or PICC line in which tubing exists the skin and flushing is more frequently needed. Any time a needle goes through skin to the bloodstream or a medicine is given IV, there is a risk of getting an infection in the bloodstream and that the infection may settle on the portacath. Most of the cancer patients with ports that I work with also get antibiotics before dental procedures (like SBE prophylaxis) to prevent infection (from the teeth that gets transiently into the bloodstream) settling on the port-a-cath. There can be an infection that smolders under the skin along the pathway of the tubing for the port. I have seen a number of people with ports in which there was excellent care with sterility that still got an infection. Having a “foreign body” in ones body has a risk you have to respect at the same time as appreciating the benefit of having an easier time getting IV medications.

With hope for cure of these diseases.