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» LymeNet Flash » Questions and Discussion » Medical Questions » Question for those with a Port

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Author Topic: Question for those with a Port
Razzle
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I had to get my PICC line pulled due to a blood infection (sepsis), and they were unable to place a new PICC, so I wound up with a Port in my chest instead.

Before today's needle change, it was flushing very nicely and smoothly. After the needle change, it take considerable effort to flush the port. The nurse is blowing it off as no big deal.

I'm new to ports, never have had one before. We looked at the gauge on the needle that was removed, and it was 19. The gauge on the new needle is 22. Could this change in needle gage be the reason for the difference in how hard it is to flush?

How concerned should I be about this?

Thanks in advance for any help.

--------------------
-Razzle
Lyme IgM IGeneX Pos. 18+++, 23-25+, 30++, 31+, 34++, 39 IND, 83-93 IND; IgG IGeneX Neg. 30+, 39 IND; Mayo/CDC Pos. IgM 23+, 39+; IgG Mayo/CDC Neg. band 41+; Bart. (clinical dx; Fry Labs neg. for all coinfections), sx >30 yrs.

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Rumigirl
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If it isn't flushing well, ie, with too much effort, then probably it wasn't placed correctly. In other words, if the needle is too far to the side of the well of the port, it will cause it to not flush well.

That's ridiculous that the nurse blew it off!

Plus, a 22 guage needle is smaller than a 19 gauge. Look for the card that the surgeon gave you when you had the port installed; it will tell you what size needle your port should have. If it doesn't, you can call the surgeon's office and ask. I keep the card in my wallet, just in case.

So, first off, you need the size of needle that is right for the port you had placed. Secondly, it needs to be put in exactly the right place, ideally, in the center of the port. There is a "well" inside, and if it is too close to the sides, it will impede the flow into your port.

When that happens, the nurse should take it out and try again, making sure that she/he feels for the outline of the port ahead of time. She should NOT give up until it flushes easily!

What kind of port do you have?

You should demand that the infusion company send you only a nurse that is experienced with ports (not all nurses are). Also, you should tell them to supervise the nurse accessing a port to make sure. You could ask that a supervisor come to supervise a nurse accessing your port.

They should have a nurse come out and access you properly soon, as it's not flushing well now. Of course, first ascertain what size needle you need and get the company to send the right size needle. They should NOT be just changing the size of needle on you!!

A port is much better for long term use, as it should last you a good long time. However, you really have to advocate for the right care, sadly. That's true with any kind of central line, but even more so with ports. You must do this, because it's your life! No laziness or inexperience allowed.

BTW, if a nurse has to access you more than once, because it isn't right the first time around, they MUST clean you all over again with the chloroprep first, change into new sterile gloves before that, etc. Never, never allow a nurse to cut corners; again, your life is on the line.

One other thing, there are lots of different kinds of huber needles for ports, and some are MUCH more comfortable for those of us who keep the needle in all week, due to infusing daily. I'll look up the name of the kind I find most comfortable and email you.

Most of them these days are made with safety needles that to me are like having an aircraft carrier on your chest, they stick up so high! REALLY uncomfortable! Since, most likely you de-access yourself (take the needle out), there is no worry about sticking yourself with the needle---which is the reason for the safety needle.

If you haven't de-accessed yourself yet, it's easy, ask the nurse to show you. That way you can do it yourself, take a proper shower, and get a small break without the needle in.

Any other questions about ports, I'd be glad to answer. It's a whole new world. I've learned it all the hard way.

One other thing: if you react to Tegederm dressings (I do!), you can have the company order a hyperallergenic kind. I'm blanking out on the name, I'll look it up and email you---or put it in the thread.

I've been wondering how you were doing for a really long time. I know it's surely tough to say the least.

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Rumigirl
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OMG, it just registered that you had sepsis!! Holy cow! That's horrible. Do you know why? (You may not know why).

But that's why, of course, I was saying how hard you have to advocate for perfect nursing care. Any short cuts or mistakes they make can leave you open to a life-threatening infection (I know you know).

With a port, that would mean emergency surgery to have it removed!

I am so sorry you went through that. Scary.

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Razzle
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Rumigirl,

Tried PM'ing you but it said your mailbox is full...

Sepsis was from a gut bacteria, translocated to my bloodstream somehow. PICC culture was negative, so I lost the line for nothing. Yeah, I'm pretty PO'd about that... especially since they couldn't get another PICC line in.

There is no card, paperwork just says power port, nothing else. Nothing about needle size or anything like that.

Nursing service says I'm not allowed to do anything with the needle or dressing, they have to do it all... so no breaks for showering, have to find a way to cover the site (or do like we did with the PICC and I'd shower right before the weekly dressing change, and just carefully sponge-bathe the rest of the week).

I have no trouble with tegaderm...it's all the other sticky stuff that gets my skin in a tizzy (including those shower patches...aquagard or something like that...).

I have too many questions and am freaking out constantly about this thing. Probably some of this is from a little Lyme herx from the Rocephin, since I've never been on it before...

Is it safe to wait until the next needle change (next Tue.) or do I need to get this difficulty flushing thing addressed sooner?

Thanks for responding and for your suggestions.

Take care,

--------------------
-Razzle
Lyme IgM IGeneX Pos. 18+++, 23-25+, 30++, 31+, 34++, 39 IND, 83-93 IND; IgG IGeneX Neg. 30+, 39 IND; Mayo/CDC Pos. IgM 23+, 39+; IgG Mayo/CDC Neg. band 41+; Bart. (clinical dx; Fry Labs neg. for all coinfections), sx >30 yrs.

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sammy
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Are still awake now Razzle?
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Razzle
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Sammy,

I just sent you a PM...

--------------------
-Razzle
Lyme IgM IGeneX Pos. 18+++, 23-25+, 30++, 31+, 34++, 39 IND, 83-93 IND; IgG IGeneX Neg. 30+, 39 IND; Mayo/CDC Pos. IgM 23+, 39+; IgG Mayo/CDC Neg. band 41+; Bart. (clinical dx; Fry Labs neg. for all coinfections), sx >30 yrs.

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Rumigirl
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Oh, sorry about the PM box!! I've been in crisis, so . . .

You can call me or email me. I'll email you in case you forgot my contact info.

Sammy is also a great port resource, as you've probably found out by now.

That's ridiculous that they won't let you deaccess yourself. Hopefully, over time as you get used to a stable nurse (when you've found a good one), she will let you do that. It's ridiculously easy. And it helps you a lot.

It's probably not unsafe to have it flushing with difficulty, but it just isn't right. No good port nurse would do that. But too many nurses aren't good with ports, not enough experience.

So you have a Bard Power Port. There are different sizes, however, and according to the size of your port, the right needle size would be chosen. 22 gauge is actually common. Most likely it isn't flushing well because she didn't get it positioned correctly.

YOu can call the surgeon's office and ask what size needle you should use for your particular port (the size of your port).

I'm so sorry that you've been through all this agita!! It never ends for us, does it??!!

That's great that you're doing rocephin, although it may not feel great, due to herxing.

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sammy
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I'm so very sorry to have not been available when you tried to contact me on 10/6/17.

Things have been so nightmarishly chaotic, stressful, difficult, etc... It's unreal, simply unbelievable!

So I keep thinking/ believing that things going to be better tomorrow...

If you still need help, I'd still like to help in any way possible 😁

sammy

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farraday
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I had a port for 6 years. My husband learned how to access it. He used lots of Heparin to flush it. When I was rushed to the hospital with severe septecemia, they removed it. The surgeon said it looked brand new.
My point is that if you care for it, it won't clog up. For heaven's sake, be VERY careful whom you allow to touch it. My husband had to access it in the hospital before it was removed because the nurses didn't know how.
My septecemia was not from the port itself. There was no infection around it. They said that 6 yrs was a record to keep a port, especially in that great condition. My husband was adamant that plenty of Heparin was the secret.
They think it was caused by having it in too long.
Any foreign body in your body can do it. I was on IV vancomycin and naphcillin for 6 weeks...twice daily for both. It was the herx from hell. But I walked out of the hospital and kept going. The nuns there called me the Miracle Lady who shoud have died.
That's when my husband realized that my CFS was a bacterial infection.He called lab after lab. Finally found someone who told him to send my blood for a pcr test. It can back with a shock: Lyme Disease.

Next line they put in my chest was not a port. It was for IV Rocephan...a much easier process.

After many months of that I got sicker so they pulled it out and began treating me for Babesia. Now I'm on Alinia and Biaxin. Once it's gone, I can go back to treating Lyme. I'm now bedridden again, battling Babesia. If they put another line in me, I'll have to see a plastic surgeon about all my scars!! :-)
Keep us posted and PM me if you have questions.

--------------------
DOCTOR: "I don't think you are sick."
PATIENT: "We are all entitled to our opinions. I don't think you are a doctor."

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farraday
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Btw, we used 22 gauge needles and he very rarely missed. He used gloves to lightly press around it, so he could feel where to go. Nurses were quite imoressed. I agree that you need an expert nurse, or they'll damage it.

--------------------
DOCTOR: "I don't think you are sick."
PATIENT: "We are all entitled to our opinions. I don't think you are a doctor."

Posts: 697 | From Northern California | Registered: Jul 2009  |  IP: Logged | Report this post to a Moderator
   

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