Reply To: Port-a-cath

A mediport type of device is placed under the skin and can last several years without needing to be replaced. Since it’s under the skin, you can take showers, baths, and go swimming (after the initial incisions have healed).

The Port-A-Cath sounds like a good option for continuing IVIG treatments given your vein situation. The Port-A-Cath is a brand name made exclusively by: http://www.smiths-medical.com/catalog/implantable-ports/port-cath-implantable-venous.html

I have used 4 different types of implanted central venous access ports, but not the mediport type. All of mine required periodic flushing with a Heparin-Saline solution to keep the blood from clotting and blocking the valve or catheter. Maintenance instructions for the Port-A-Cath can be found here: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=9&cad=rja&ved=0CF0QFjAI&url=http%3A%2F%2Fnursing.uchc.edu%2Finfection_control%2Fdocs%2FPort%2520Care%2520Patient%2520Education.pdf&ei=XZxgUujVMaPgiALj6oHYBA&usg=AFQjCNGuGrNMk4dnzA2SyKbkg_ht66DQ6g&bvm=bv.54934254,d.cGE

My concerns would include: the number of needle pokes through the skin to access the “port” before the previous poke has healed, and if the skin might be prone to bruising. Consider having the nurse use a clock-dial approach to poking the needle so that the other poke points have a better chance to heal before being poked on again. If the needle pokes bother you, you can anesthetize the accessing skin area using Ethol Chloride spray, or cold spray. It should be sprayed as the needle is being placed or immediately before the needle is placed. If you tend to sleep on your stomach, or roll over frequently, you should probably have the device implanted in your arm to reduce the risk of discomfort and/or damage.

Another option to consider would be subcutaneously administered IVIG. This is a newer option for those experiencing problems with traditional IV’s. Subcutaneously administered IVIG does not require a port and some patients can give it to themselves, lowering costs substantially. Learn more about it here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817783