October 17, 2013 at 7:43 pm
Just curious if any of you have needed a port-a-cath. My veins are small and difficult to locate. They also have become exhausted from repeated IVIG treatment. I recieve my IVIG at home and it usually takes as many as 4-7 attempts to establish an IV line. I’m scheduled to have a Port-a-Cath placed on next Thursday. Anyone else have expierence with this?
October 18, 2013 at 2:49 am
Getting a port was the best thing we ever did. The amount of soft tissue aka chubbiness lol you have on the chest area makes all the difference in how the port is placed and the success you will have with accessing. If you are chubbier, make sure the port is up enough or access can be difficult. There are different kinds of ports, we have had 3 different ones. The best has been the last one, a passport I think it is called. It has 3 landmark raised dots that help when palpitating to gain access. Probably the 2 most important things I would suggest from mistakes we made the first two times would be: 1. Make sure the surgeon leaves you accessed when he checks the port to see if it is properly working. by doing this it makes things much easier for your first treatment if it is within a week of the surgery. Ours was 2 days after and the area was swollen from the surgery and we could no access even with a 1.5 inch needle. We ended up going through the arm anyway. The 2nd time we had a port put in I asked the surgeon to leave him accessed. You will have to flush with salene until the treatment, but no big deal. 2. For the next treatment after your stitches have healed, you will apply emla cream to the port area to help numb the dermal layer prior to access. In the hospital, they would use a tegaderm patch to hold the emla in place and it would majorly exfoliate the skin, even making it bleed and then another tegaderm would be put on to hold the needle in place and more skin would be ripped off. I tried GLAD PRESSAND SEAL to hold the emla in place and everyone was happier. It has little channels in it that have a little stickiness to it unlike regular saran wrap and it works wonderfully. Especially for the first month when the stitches are healing.
FYI the only reason we had 3 ports is because the first two were child ports and third adult. Typically they last 5-7 years. I think we are on 4 or 5 for this one. I hope to try sub q when this port needs to be removed, otherwise we will just go to arm access, older now. Good luck it will be the best thing you ever did so much less stress.
October 18, 2013 at 3:43 am
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
October 18, 2013 at 10:04 pm
Bob I could have written yoour post. You described me and my experience. Getting a port saved much time and a multitude of sticks. I wish I still had it. The record for me at one time is 10 sticks. I strongly recommend a port.
October 20, 2013 at 6:30 pm
The Infusion Center nurse talked me into getting one since my veins are deep, skinney, and rubbery. Then I brooched the subje ct with my docs and they all Poo Pawed it, said too close to the heart and potential for infections.
AnonymousOctober 21, 2013 at 11:17 pm
I’ve had my Bard chest port for over 7 years and use it 4-6 times a month. It’s held up well. My family was totally adamant for me NOT getting a port saying I’d get a serious infection, etc. After I blew 4 IV’s in one day I said I’m getting a dang port soon because I’m the one having infusions and I did. It hurt after the surgery as any surgery does and took a while for scar tissue to form filling in the area. My surgeon put a line above my bra so he could know where the port should be placed. He said when women were laying down for this surgery he really couldn’t tell the best place.
I put a bag of ice near the surgery site a few times a day (stuffed the ice in my sports bar). For women wearing a sports bra helped like wearing a bandage to hold the area in but not too tightly. I didn’t lift heavy items for several weeks (it pulled). I’m very happy with my chest port. Sometimes the area is tender and getting stuck might hurt but it’s quickly over. My nurses follow strict procedure sterilizing the port area and inserting the needle while wearing their mask and gloves. Any changing of the infusion bags or bottle is not done till the nurses first wash their hands. Following sanitary rules will help keep you safe and help prolong the life of your port. Just make sure you’re getting the right port for you and the surgeon is an expert on installing them.
October 30, 2013 at 9:23 pm
Thanks to all who responded to my original post. Your words of encouragement helped alot. Just a quick progress report. My Power port was installed last Thursday with no problem. Didn’t need pain meds other than a couple of Tylenol. I am back to doing all my regular chores, no restrictions. Today my infusion nurse used the port for the first time. The intial stick hurt quite a bit, but not worse than getting multiple sticks to get IV started. I did notice that I got extremely tired during the last half of my infusion, nearly fell asleep. I was also lightheaded and had a mild heaviness in my chest after this infusion. I haven’t had these symptoms before. These have all now resolved, but am wondering if anyone else experienced symptoms that they hadn’t had before, following the placement of their port?
AnonymousNovember 2, 2013 at 4:04 am
The port is handled differently than an IV and has less space to travel than an IV in your hand. Also if the nurse flushed the port too quickly–slamming the saline in to clear the line made my head spin so I made sure it was slowly administered after that. The port has a direct line to a major artery and this may make you dizzy…tired??
I’d ask what IV rate the pump was running?? If too fast this can cause light headedness.
November 2, 2013 at 5:35 am
Limecat, I’m pretty sure the port is in a vein.
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