Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
If you have a port, or have had one, or you know about it: how long can it last?
I had heard that it can last 8 years, if you take care of it well. I will have had mine for 6 years this coming August. I've tried to take really good care of it. I want it to last a good long while more, if possible.
Mine is small, close to a pediatric size with a small area to access it (put a new needle in), so the needle sticks are all in that small area.
Lately, it has been sluggish, and CathFlo has helped twice (an enzyme that it injected to break up any fibrin sheaths that have developed). But even so, it is still sluggish, but useable. I still get a good blood return.
Then, today, I had to use a gravity pole, instead of the the pump that I was using, for my IVIG. Without the pump to push the thick IVIG fluid, it was taking about 6 hours, instead of 4 hours, because
it would only go in very slowly, regardless of having the flow regulator all the way open, and sitting down or lying down.
I am hoping that it will last a good long while yet, as I'm certainly not through needing it. But I'm wondering about it.
I don't think that there is anything more that I can do, but if you have any suggestions or feedback, please let me know.
I just googled it, and it said that a chest port should last for 2,000 needle sticks. I have only had a fraction of that, once weekly on average. Some sites said 2-6 years. One person said that they'd had it for 11 years.
Thank you.
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bluelyme
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Thanks for the info ..my friend has had one get cloggy as she says after a yr ..mine got sticky after some phosphatidylcholine. Another was doing ozone a withdrawing quite a bit like 3 x a week and now has to hold neck in a sideways position to get it flowing . (Like a kink)?.i only do return once now and try to stay accessed as long as possible. .thw hospital gave me some cath flow i got in freezer for next time ..it may be tissue growing back up the line ..more meat tendorizor i guess..try moving around when dripping in various ..maybe a angio xray to see if tube is all good ?
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posted
Opinions differ (as with everything in medicine/nursing ;-).
Some say a PAC can stay in place indefinitely, if there are no signs of infection. If you know the brand and type of your PAC you could contact the manufacturer or check their website.
You could ask you doctor or nurse if using urokinase instead of Cathflo would be of help. Also, both can be left in the line overnight. An extended dwell-time of up to 24hrs can sometimes help. You could ask if your hospital's protocol allows this.
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Rumigirl
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Member # 15091
posted
Thank you bluelyme and Notti.
I am back to infusing the IVIG via gravity today, and it is unbelievably slow! As I said, I recently did CathFlo twice. I will ask about the urokinase. The extended dwell time sounds like that would help a lot. Thank you!
Also, I'll call Bard; it's a Bard Power Port. But I think the problem is the fibrin/tissue clogging it up. Plus, the IVIG itself is very thick and sticky, not like just saline. But before it flowed much better
through gravity, so it's definitely getting clogged up. Sigh.
Thanks, guys. If anyone else has experience/info, please let me know.
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sammy
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Hey Rumi! If it is a fibrin sheath, the nurse can do a cathflo infusion.
Basically it is same dose 2mg cathflo diluted in 50ml normal saline, drip slowly over 2 hours.
This is supposed to be more effective than the standard push way.
Also, once you get the port clear and functioning well again, double all of your flushes. After IVIG I use 4 NS and 2 heparins, for blood draws I use 3-4 NS and 2 heparin, after antibiotics 2 NS and 1 heparin. So anything thick, flush super well!
Your port should be fixable. They last a long time now.
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Rumigirl
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Hi Sammy! So the regular 2 mg dose in 50 ml saline im a drip over 2 hours---is that to dissolve fibrin around the tip of the catheter, or into the bloodstream?? It seems that it would do the latter, right?
Although that's a very slow drip, so maybe it would just do it around the tip of the catheter over a longer time period?
I wouldn't think that having it absorbed in the blood stream would work well, that's what has me puzzled about this way.
Have you done it this way? Has it worked better for you?
Is there any literature on it, so I can back up my request with the infusion company and doctor?
What about the suggestion above to do it the usual way, but to leave it in place overnight?
Thank you! I know that it is the fibrin that needs to be dissolved, so a longer time period of having it in place clearly is the ticket.
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Rumigirl
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quote:Originally posted by sammy: Hey Rumi! If it is a fibrin sheath, the nurse can do a cathflo infusion.
Basically it is same dose 2mg cathflo diluted in 50ml normal saline, drip slowly over 2 hours.
This is supposed to be more effective than the standard push way.
Also, once you get the port clear and functioning well again, double all of your flushes. After IVIG I use 4 NS and 2 heparins, for blood draws I use 3-4 NS and 2 heparin, after antibiotics 2 NS and 1 heparin. So anything thick, flush super well!
Your port should be fixable. They last a long time now.
sammy, another question from what you said here: Do you use Gammunex IVIG? I guess not, because you have to use dextrose before & after that, instead of saline. I was wondering if I should then
use saline after the dextrose, due to possible stickiness. The IVIG solution, of course, is very thick and probably sticky. So multiple flushes like make sense.
I'll have to talk to my IVIG nurse to figure out the next step. I have been using a pump lately, but didn't have it the other day, so in using it with gravity, it proved to be horribly slow----about twice as slow as
it should have been. But we can't tell the infusion company that she left before it was done, or they would fire her! She had another patient right after that, not knowing that I wouldn't have the pump. Arghhh! Thank you.
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sammy
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Hey Rumi,
yes, I'm on Gammagard. I understand that you are on Gammunex and have to initially flush with dextrose after your infusion to prevent crystallization. From what I understand, after the dextrose, you should be able to infuse/ flush/ use the port as usual.
So same idea can work for you. After your dextrose flush, which is also sticky (but works to fully/ safely clear the IVIG from the port), I'd seriously consider following with the 3- 4 NS to give the port a final good flush to clear the residual of all stickiness and keep it flowing fast.
I also change my end/ injection cap after IVIG. It is so thick and sticky, much like glue if you accidentally get it on anything!
Rumi, I've thought of you so often lately, and pray for you. I'd love to catch up with you. Maybe we could talk? I could call you or you can call me anytime! Posts: 5237 | From here | Registered: Nov 2007
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Rumigirl
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Yes, I've been meaning to call you (and a lot of other people who are concerned about me). I've been so overwhelmed dealing with so many medical crises at once! I know you know what that is like : - (
I spent a whole lot of time today calling the various companies: the port manufacturer, the CathFlo company, and the Gamunex company to see if they had any suggestions to help with the issue.
Of course, after all that time, it turned out that I knew far more than any "clinical" rep that I spoke to. One guy at the CathFlo company emailed me some articles though.
Your trick of changing the clave afterwards also sounds good. It's hard to know if it's mainly a fibrin problem (most likely), or if the viscousness of the IVIG is also part of it.
I certainly intend to make this port last a very long time. Bard, the port manufacturer said that some people had had one of these ports in since '06. And another person had had another port for
21 years! He said that it's unknown how long it could last.
He said officially it should last 2,000 huber needle sticks. I've only had approximately 300 (once a week approximately).
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bluelyme
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Member # 47170
posted
CONTRAINDICATIONS: Smart Port CT should not be implanted in the presence of known or suspected infections, bacteremia, septicemia and peritonitis, or in patients who have exhibited prior intolerance ...
do we have known infection or lyme doesnt count?
-------------------- Blue Posts: 1539 | From southwest | Registered: Dec 2015
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bluelyme
Frequent Contributor (1K+ posts)
Member # 47170
posted
CONTRAINDICATIONS: Smart Port CT should not be implanted in the presence of known or suspected infections, bacteremia, septicemia and peritonitis, or in patients who have exhibited prior intolerance ...
do we have known infection or lyme doesnt count?
-------------------- Blue Posts: 1539 | From southwest | Registered: Dec 2015
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