I'm going to have a port and thinking about the long term I know it'll be for the best and be a lot easier for me, but am very nervous about actually having it done.
What is the difference between between a port in the chest and in the top of the arm and how do they decide where it goes?
Thanks for any advice! Sarah
Hi Sarah i've had two ports both in my arm. I chose my arm as it was less visible and i could hide it. The chest ones can stick out a little. If you want to ask me anything please message me, I love mine no more multiple cannula attemps.
I had a portacath put in last year. It's in my top left chest and isn't visible at all, apart from the scar from the surgery, but that's fading nicely. I don't imagine there's any difference at all in the ports whether they're in the upper chest or top of the arm, but I would think that the chest is easier to access for port use. I have to say that having my portacath fitted has been the best thing I've done! It's great, and has saved an awful lot of trouble and angst when trying (and failing) to get venous access. I love it!
Im on my 5th portacath(i think!). Unfortunately i had to have several removed due to infection and then some of them werent planned and.so were never meant to be permanent or even semi permanent. But this last one has been in for 9 months now and its working marvels. Its made my life and all the medicals teams lives so much easier. Im really pleased with it. The downsides are some residual pain, scar, and occassionnal difficulty using it either due to some blocage or due to the incompetance of the nurses. Especially since mine is of the smallest size available so it can be difficult sometimes. But very good overall.
I've had my port since February this year, replacing a string of Hickman lines that were causing constant infections.
Mine was put in at Heartlands, and although I did talk to the surgeon about arm ports, he wasn't so keen as said that there were higher complication rates, so mine is in my upper right chest. He's placed it so that it is quite well hidden under the straps of vest tops, etc etc, but the seatbelt does rub on it a bit! Apparently they can last up to 10 years, but in CF patients the average lasting length of a port tends to be 4 years, but in brittle asthmatics even shorter still, mainly because the ports can be used for such extended periods for aminophylline infusions etc. Mine is used once every three weeks for a day-long infusion, and then in constant use for 2 weeks for iv antibiotics every 6 weeks, so I don't imagine this one will last that long.
It was put in under a quick general, although I think some are done under locals with sedation. My chest didn't react that well to the anaesthetic so I was in hospital for 4 days, but some people go home the same day. I have quite a skinny chest so mine is quite prominent - a lump about a cm across and about a cm proud of my chest. I think many are much less obvious, and once I've put on more weight only the scar will show, as Becky says. Less prominent than a hickman line though! I do have pain from it every once in a while, and it rarely bleeds back so you can't always take bloods from it, which is a bit of pain given I have no iv access at all, hence having it put in.
For me, it's been a godsend. I'm aware there are potential complications, many of them serious, but I was already experiencing many of them with my hickman lines, and this is aesthetically much more pleasing. I did have a short wobble when it was first in, as it seemed so 'permanent', but actually I do need iv access at least every 3 weeks, and it has made that so much easier. My husband is trained to access it so that even if there is nobody trained in A&E or on the ward (which can be a problem - it might eb worth contacting your local hospital to see if there is anybody trained to access it?), we can quickly get the gripper needle in and get treatment started. Don't let anyone fiddle with it who hasn't been properly trained, and make sure proper aseptic technique is followed at all times. Nurses may grump, but make them do it!
Hope that helps!
hi Sarah,
i have had many ports over the years, and as the others have said a re a godsend, and take Carries advice and dont let anyone who doesnt know what they are doing fiddle with it.
Dont be nervous, you will soon get used to it and carry on with life as before.
i too had complications with infection but having been without one for 10 years i would still have another tomorrow, i do however only have 1 large vein on the left hand side of my chest and the risk is it could be damaged or block, leaving me with poor circulation to my head!!!.
i looked at the arm option, the port willl be smaller so if you are very slim and self consious you may not like the arm option, being a smaller port if you are larger the arm may be better as easier to use, it needs careful discussion with your dr, and his preferences!
good luck, george xcx
Thanks all for your experiences. It's nice to know there are others in the same situation. I just want it done now so I have less time to fret about it, but it will no doubt take months yet!
Thanks again,
Sarah
I'm interested to see that so many people here have long-term IV access. At what point did your team decide that you couldn't manage on just peripheral IV lines? Did you have any education or choice about the type of long-term access (e.g. Hickman vs Port)? Who looks after your port when you're outpatient(flushing, dealing with any problems)? Do any of you do your own line care?
Thanks!
Hello. I have my port upper left chest. Its my 2nd and it totally transformed my life having one fitted. My first lasted ten years and was positioned under my right arm near ribs. Would defo notcrecommend that position. Was rubbish to access and it moved alot!! Absolutly agree that never let anyone use it that isnt trained however in a few emergency situations i have been very luck that it has been accessed by untrained people to no detrement to myself or the port. The decision to have one fitted was simply no other access left and i had had hickman lines blah blah blah. We did discuss having one fitted in arm but after chatting to others and the fact that its a two handed job to access i decided on my current position. Good luck. Chell.xx
I have had 6 ports ( I think) in my chest and arms. I had them all done under local anesthetic with no problems. Would definately learn to access it etc yourself then there is less chance of infection etc, then again the longest I kept a port was 1 year due to either sepsis or a clot so I am not the best judge ah ah. I had the same problems with Hickmans.
I got to the point of needing a port because I was needing cut downs due to no iv access. Ports are great when working so I would definately go for it. Good luck.
Hi Wishes,
IV access had been becoming a problem for many years, and I'd discussed a port with my consulstny, but he'd always felt the risks outweighed the benefits. However, last year my chest was pretty awful and I ended up spending more than half of the year in hospital, with the admissions lasting 3-14 weeks, with constant iv access needed. I started off with cannulas, then moved to midlines/longlines, before several late-night trips down to theatre when all iv access failed and they had to fit femoral lines etc etc. Even these kept failing so eventually a Hickman line was put in, to solve the access problems for a while. I was felt to be too unstable to have a port fitted, so my Hickman line stayed in as we waited for me to get stronger. Unfortunately I had some very nasty line infections - septic shock 3 times in 5 months - so it was clear the line needed to come out, but at the same time, I needed some form of access in order to get the drugs to treat the infection! I finally got the port at the same time that the Hickman was removed, and so far, so good. Certainly it was only done when there really were no further options. I rather wish it had been done earlier, whilst I still had some access for untrained staff to use 'in an emergency', but never mind.
Mine is used too frequently to need routine flushing - should be every month - so routine care is not a problem, but yes, my husband
I had my 1st port fitted in jan but due to it moving has to have another one fitted. Wish I'd asked more questions before hand. Thought having on my left hand side would make it easier to use but wasn't told it's harder to fit & they had to retrieve it in theatre via my groin. Since the 2nd one was fitted in April it's changed my life. Can have my IV meds 6 days a week, the regular monitoring bloods can be taken from it & best of all no more trouble getting access. This used to really panic me as I got used to waking up with canulas in strange & awkward places. Didn't help that it was on my notes I wash hard to canulate so always had to wait for a doc rather than the blood guys or nurses. The delays used to panic me. Did take some getting used to but 6 months on was the best thing I did. You are best limiting the number of people who access it to cut the risk of infection & get the hospital to write down exactly how to use it. I was fine in the hospital which fitted it but my local hospital had no experience of using them & wanted to put a canula in! Needless to say I wasn't pleased bearing in mind all my past trouble.
I had a general both times as I was worried about them getting sufficient access to do a local & don't like being awake during procedures. Equally I know of people who had local &/or sedation & were fine. The choice will be up to you & your doc to decide.
All the best what ever route you go & I hope it will help you like it has me.
Take care
Rabbit
Thanks for all the responses! Really interesting. My local team have been discussing placing a port for me since January, though they're nervous that they wouldn't have anyone specific to look after it (the CF team and haem/onc teams look after their own, but the asthma team don't have anyone else with a port). Despite that, I think it's getting to that time.
I like the idea of upper chest (either side) so that I could self-care. I get very protective, even about my peripheral lines with people not using proper clean technique (I'm not anal enough to insist on aseptic!) and yanking around these tiny little blue lines, precariously placed in a finger or foot vein! The idea of being able to care properly and consistently for my own line is quite a relief.
Hope you can all stay safe from infection and that your ports last for many years!
Thanks for all the tips and advice. The CF team liase with my team as they have more experience with ports. Thanks again and hope the beginning of the autumn kicks off without any medical problems for all.
Sarah
ports
hi am on my third port in six years, i have had this one for twenty months and have had no problems .The last one the line in side was leaking so had to have it removed and one before managed to get septic so had to be removed, third time lucky no problems and although having the others removed would not be without one.ccess near in poss so the device has saved my life a few times i have been flushing it my self after been taught how to do it at my local hospital. My local emergencey department have quite a few docs who now know how to access it and many nurses who have now been trained to
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