I’ve had a Bard power port in my upper left chest almost 30 months, since December 2011. This consists of a small titanium reservoir with a layer of silicone under my skin, connected to a catheter than runs into a vein near my heart. I originally had it implanted so chemo could be administered through the port, sparing my veins. While I don’t need it right now to receive treatment–I take my targeted therapy as a pill–the port is accessed every month for my clinical trial blood draws, and every other month to administer contrast and the FDG tracer for my PET-CT scans.
Ports are really convenient. I don’t have to get poked every month, I can shower and exercise with it (unlike my former PICC line), and after so many months, the scar from the implant surgery isn’t even noticeable. All that’s visible are three tiny bumps on a slightly raised, faintly bluish area under the skin. The only accommodation it requires is a small pad between it and my seatbelt when driving. I’ve heard of people keeping a port for several years.
Here’s the hitch. My port has misbehaved fairly often since it was implanted. I am apparently very good at growing a fibrin sheath over my port’s catheter. When a sufficiently long fibrin sheath , similar to the stuff in blood clots, forms over the catheter, it’s impossible to draw blood–the suction from the blood draw pulls the loose flap of the sheath over the tip of the catheter and closes it off. The problem seems to be worse if I’m dehydrated.
To keep the port accessible, it gets flushed with drano on average every 1.5 months. No, not Drano the household chemical. Drano is my not-so-affectionate name for TPA (sometimes called Cathflo), a chemical which dissolves the fibrin sheath and clears the catheter. Typically, a small amount of TPA (just enough to fill the catheter but not go into the bloodstream) is injected and left in the catheter for about 30 minutes, then withdrawn. Usually this clears the port, although sometimes I’ve had the stuff left in overnight to clear a particularly persistent blockage–one interventional radiology xray showed I had a sheath about two inches long at the tip of my catheter. Well, everybody needs a skillset.
The fibrin sheath also sucks up the FDG tracer used for PET scans, so I often have a very bright spot on my scan right at the tip of my catheter. The radiologist can see the catheter in the associated CT scan, so he knows that hot spot is just the fibrin sheath, but sometimes I wonder if that spot could overshadow a tiny cancer nearby.
I’ve considered having the port removed surgically and just tolereating the monthly needle pokes for my labs and scans, but to be honest, my veins aren’t very cooperative nowadays either. I’m going to keep the port in as long as the drano can keep it functional. I just plan to drink a few quarts of water the day before it’s used so I’m well hydrated, and show up early for lab work in case my port needs a dose of drano.
My monthly labs today required more than the usual amount of blood. However, my port worked perfectly! I felt like celebrating, so I ordered a grande soy mocha at the clinic’s coffee stand.
I forgot to say “half-decaf.”
I expect to get an amazing amount of work done this morning and early afternoon. Just don’t expect much from me after 3 PM.
You can ask them to show you how to flush the port at home and flush it more often, like weekly or even more often. This would prevent the fibrin sheath from forming in the first place.
I did maintain my PICC line at home with daily flushes. However, medical professionals prefer a power port be accessed by a nurse in a medical facility. Unlike a PICC line, which terminates outside the body and can be sterilized with an alcohol wipe, the power port requires a specialized needle and sterile procedures to access to prevent infections.
While that is what they prefer, family can still be trained to access a port, and the truth is that PICC lines get infected more often than protracted! The risk would be preferable to having to replace the portacath, I would think. (Old oncology nurse here)
I love when there are no issues with my port! I’ve only needed the ‘Drano’ once, but it seems that every other time I’m in for a blood draw, I have to turn my head, raise my arm, cough, and sometimes stand on my head to get the blood to flow. In spite of all that, I’m glad I had the port put in early in the game.
Ruth, I am remiss in not mentioning the physical calisthenics we go through to get our clogged ports open. I’ve even tried exercising the half-hour before my appointment to get the blood flowing better, with mostly positive results.
Hm, maybe I should try exercising before I go.
Hey lady….very interesting. For months now ( port put in mid /December 2013) each time it is assessed for whatever even an MRI or ct, MRI was the worst I run fever after a few days around 102 in March it was higher…then it vanishes. In March MRI went to er per onc… they spoke to onc did cultures of port and peripherals and chest x ray… nothing. Then did another culture port right before tx 5/29/2014 tx per onc, nothing grew, labs fine but fever came and went So he wants me not to use it, having cataract surgery Thursday and other on the 24th then chemo and labs right after. My right arm is shot after all the hits and I had a bad flare in the left inb November 2013. But the right is bad. So praying the left works for all this. He is testing if it is the port by not assessing it, I think it is possible as my surgeon was pretty hap hazard in my eyes. Thanks for your posts always…love to have your input on mine, onc sounds like we need to replace or picc, I do not want a picc for fungal infections. I do thank you immensely for all your wealth of knowledge. Prayers and much love