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» LymeNet Flash » Questions and Discussion » Medical Questions » Port vs. PICC line

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Author Topic: Port vs. PICC line
dbpei
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I am pretty sure that the only way I am going to get better is to resume IV ABX. I had some problems with a PICC line recently and it had to be pulled.

For those who are familiar with Ports, can you explain to me how they work?

How often would I need a nurse to help care for it?

What would I need to do to care for it?

I know that you can take a shower and exercise with them as long as they are not 'accessed'. But I am confused about this. Because if you need to infuse daily, wouldn't it need to be accessed every day?

Any info from your own experience or good websites would be greatly appreciated. Thank you!

Posts: 2387 | From New England | Registered: Aug 2011  |  IP: Logged | Report this post to a Moderator
foxy loxy
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I did I.V. Rocephin via a port and I think this is the way to go...If you don't mind the needle insert weekly.

A port gets placed in your arm once a week, and used for five days. Then you pull it out and replace it.

You can shower with it, if you cover it with Saran wrap and you can do mild work in them although you have to be careful with them.

Mine infiltrated (came out of the vein) a lot because my veins are small. If your veins are larger this will be better.

A periphial port is much cheaper and safer than a PICC, but it does require seeing a nurse weekly to place it. If you live far away from your Doctor, this could be a pain.

I happened to live only a few mile from mine, so it wasn't a big deal.

Truth be told, PICC lines scare me and I found that even though I had to do a lot of "poking" to get it placed I would do it that way again...

You don't need a nurse to infuse your meds. You can do that yourself. The only thing you need a nurse for is to place the port weekly.

I hope this helps. Feel free to PM me if you have anymore questions.

God bless your health journey!

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dbpei
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Thanks for this info, foxy loxy! I didn't realize you could have a port placed in your arm. I thought they were all placed in your chest near your collar bone. I wonder what the advantages of having it placed in your arm would be compared to the chest wall.

I am still confused about 'accessing' the port. On those 5 days that you would use it, do you do infusions yourself at that time daily like you would with a PICC line?

If that is true, then I would think that there must be part of it that is sticking out of your skin during those 5 days. Would this put you at risk of infection the same way a PICC line would?

You probably would need to protect it from moisture and also potential infection on those days? Are there restrictions to any lifting, housework, exercise?

Are there weekly dressing changes like there are with PICC lines?

Sorry for all these questions, but it is hard to understand the difference without having done both myself. I can PM you with questions too, but I thought it might be helpful to others to post publicly. Thanks so much.

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bluelyme
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Smart port is under chest ..there are threads on it...it is more of a procedure. I have one sceduled in 2 weeks...eek

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Blue

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foxy loxy
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Your Welcome dbpei... I am sorry you are so sick and not getting better. I want to help you as much as I can!

As far as I know there is no advantage to where I.V. is placed. I think both are equally effective.

On the five days you use it you infuse your meds twice a day. I did it morning and evening eight hours apart. I never had a PICC, but I imagine that part is the same.

Yes, the port is sticking out on your arm at all times but is temporarily "taped" down so it isn't flapping around...

The risk of infection is MUCH smaller, though you DON'T want to get it wet etc. because it isn't close your heart like a PICC. I felt much safer.

Yes, it does restrict you a bit, but I was able to do normal housework, exercise etc.

There are no "dressings" as you completely take it out and start over when you are finished every week.

No problem with all the questions, I hope this helps!!! Best of health to you and God bless.

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LaniMo
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This info is so helpful -- thanks for the questions, dbpei!

Could someone summarize what exactly a PICC line is and why you would get it instead of a port, since the port seems safer?

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foxy loxy
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As far as I know people don't like the idea of being poked ever week...

Some Doctors might not do this as it is time consuming... and can be tricky if your veins are hard to get. I happened to have a patient doc and an awesome nurse who patiently dug for my veins till she got it.

Lanimo, I am pretty sure Dr. J is familiar with this...

A PICC line is fed up your vein in you upper arm and gets closer your heart. There is more risk of air embolism and infection with this. Also a risk of your body rejecting the tube that feeds up your arm.

You have to "redress" the site weekly and watch for infection.

I never had a PICC so I can't say much more than that.

A peripheral port really is not a big deal. Just needle in a short little piece of plastic into your arm vein and WHOLA! Your good to go for five days...

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bluelyme
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So i believe you can get huber needles with smart ports and can leave them in for 5 days , sicksam had thread on this while back here is link to procedure http://youtu.be/FqYJC1J6qks..

is more long term and when you arent using it you can shower swim etc,i believe you do have to flush with saline if not in use but not sure about heplock and blood draws

You do go under they told me it take like 2hr in radiologist 45 min to install ...she made it sound routine as alot of cancer patients get them.....maybe someone else will share

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Blue

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Notti
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There is obviously some confusion here :-)

Foxy loxy is talking about a regular peripheral IV catheter and dbpei about an implantable port (usually called port-a-cath: PAC), which is a central venous catheter. A port-a-cath is inserted under your skin, usually on your chest.

Here are two articles about the different types of vascular access devices:

http://m.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/chemotherapy/central-venous-catheters

http://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/catheters-and-ports-cancer-treatment

Exercise/activity with a PAC:

http://www.breastcancer.org/tips/ask_expert/2003_05/question_13


If you need antibiotics every day, your PAC will be accessed once a week and the needle can stay in place for seven days. So the dressing is changed at least weekly.
The needle isn't replaced every day because it would increase the risk for infection and the PAC would wear out faster.

When the PAC is not accessed you can swim/bathe/shower with no precautions.
If the PAC is accessed it is covered with a transparent dressing (tegaderm) to keep the needle steady and protected. You need to protect the dressing and tubing from getting wet when taking a shower. Bathing/swimming is not allowed with the needle in place.

You can be taught to care for the PAC and access it yourself. It does require strict sterile technique, though.

I hope this helps.

Notti

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Pocono Lyme
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To add a bit of information here.

A peripheral line can be a great option as Foxy stated. It depends in part on the medication you're infusing.

Something like doxycycline is too caustic for a peripheral vein so would have to go in a large vein which would require a PICC or a port.

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2 Corinthians 12:9-11


9 But he said to me, �My grace is sufficient for you, for my power is made perfect in weakness.� Therefore I will boast all the more gladly about my weaknesses, so that Christ�s power may rest on me.

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dbpei
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Wow, thank you everyone. I took a look at those websites and they were very helpful. I am going to read again, probably over and over!

I think I would just be getting IV Rocephin.

With the PICC line, I had a sleeve I used in the shower to protect it from getting wet. Could this also be used with a port placed in the arm during accessed days?

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foxy loxy
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not sure, dpei, I used saran wrap and rubber bands!

The idea is that you don't want to get it wet, so however that is...

also, you don't want to put anything to tight on it, because trying to take it back off can cause the peripheral port to infiltrate. (come out of the vein) They are a bit delicately placed...

I made sure I had loose sleeves etc, but then again, I seemed to have particular trouble because my veins were small... A larger port can go in a larger vein and are more stable.

Thanks Pocono Lyme and Notti for adding your "two cents!" That was clarifying and helpful I am sure.

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tdtid
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You have gotten wonderful information here.

In my case, my port was one in my chest. It does leave a scar, but for me, it was so worth it.

As far as your schedule of meds and when it will or won't be accessed, that is up to your doctor and the schedule he/she gives you.

In my case, I had my port sadly accessed most of the time, so I didn't get the break that some talk of here.

I had a visiting nurse come out once a week. She would change the needle on Monday mornings, would take blood to check my kidney function.

Then I would start my drip all over again.

As time went on, my husband started pulling my needle for me on Sunday night after I had finished Sunday's drips.

That meant that every Sunday night I could take a REAL shower and not worry about the port. I did have other showers but always had to put all the plastic stuff all over the port and still try to avoid getting it wet.

It's just Sunday nights were much easier. Then when the port was accessed by the nurse on Monday morning, I would have the various meds I needed for the rest of the week.

As I said, every doctor is going to do it differently and give you a different schedule.

Mine was giving me vitamin drips as well as my abx. And at one point, I was having to do drips for up to 9 hours in a day. Some meds were shorter periods, so it depended on what he was giving me.

It does sound like everyones experience is different, but this will give you an idea of yet another story.

I do with you luck and please keep us posted as to how you are doing.

--------------------
"To Dream The Impossible Dream" Man of La Mancha

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