Tough one here, I have just spend a frustrating 30 minutes on the phone to my GP, well not my GP after 6 months he has left - I am sure it was not me falling into his chair twice that made him run - so I am now without a GP until September anyway I digress another Dr from the practice called and we managed the saline flush but could not find the hepsal anywhere or the glucose used for flushing before and after one of the drugs. Poor chap was really nice and doing his best to sort me out. Anyone out there come across the same problems and could tell me exactly what the GP should type into his computer to generate a prescription! I have an appointment with my asthma nurse about needling the port tomorrow so I can probably beg more supplies from her for another week or so but we really need to sort out a proper repeat.
Hi Bex not sure about the glucose but the heparin I hve to flush my port is Heparin sodium 100 iu/ml i.v. flush solution. There are 10 2 ml ampules per box. Its made by leo laboratories. Can't see any more info on the box that may help.
Hope this helps
Might be able to answer this better tomorrow when I have my GP computer in front of me. Can you give me a bit more description of the solution and I'll try to find it? If it's anything like our formulary you sometimes have to think a bit laterally to get the drug searcher to find it...!
Thanks Cathy, KSD kindly found the right pages in the BNF but I suspect the GP's prescription computer programme and the BNF are miles apart bnf.org/bnf/bnf/current/106... and bnf.org/bnf/bnf/current/278... it says on the box 10i.u/ml 50 units in 5ml I hope this makes sense to you Cathy. I am going to try and beg some 100ml bags of glucose 5% tomorrow when I go for port needling practice. If push comes to shove though I can flush before and after drug with water for injections which we have got on the GP's computer. I do feel for this poor GP talk about patient from hell!
Bex
OK Bex, I will plug it into our system tomorrow and see what I can come up with
PS yes you are right, sometimes what it says in the BNF and what you have to search for to find it on the 'puter are quite different
Right, so on our formulary it is in as:
Hepasal: Heparin sodium IV flush solution for injection 10u/ml, 5ml ampoule
Hope this helps... I simply stuck in ""heparin sodium"" to get the full list and it's at the bottom of ours (EMIS PCS system).
Cathy
I have sent a copy from the online bfn page that KSD found plus your info so hopefully we will get it sorted. Port re-needled today it is looking great apparently Thank you!
Bex
Just be carefull there are several strengths of hepflush and central lines need the higher strength. You need 600 international units per hepflush for central lines.
All the info I have passed on to the GP has the same strength as on my boxes of hepsal but I will double check when I pick up script from the Dr's.
TIA
Bex
Hey Bex,
Hope you managed to get this sorted. Did you verify the concentration? I know that some people use the 100IU/ml strength for ports, but imagine the brompton would have made it quite clear to you.
Hope you're feeling a bit better by the way and make the wedding only if feeling up to it!
Speak soon,
KSD x
Sorry folks I should have posted sooner. On Monday OH picked up my script and the hepsal was exactly right it was even the same brand!
Thank you all for your help, I know I sometimes come across as confident know it all (ok a lot of the time) but I have really struggled with the port, mainly fear, scared I will get an infection worried if I was doing it right despite having 2 assesments at the RBH some how the enormity of it only hits home the 1st time you are sitting there with 4 syringes in front of you and then there is the time you were so sure of yourself you did not label them and you are suddenly gripped with fear as one drug should be flushed with the right thing the wrong thing ends up with it crystalising probably not a good idea inside a port! Needless to say I started all over again and now each syringe is labled prior to filling and I always double check.
Now to sort out supplies!
Bex
I am absolutly paronoid about my port getting infected, today whilst checking it in the mirro for signs of redness (see I said I was paroniod) I had one hand on my neck and could feel the end of what I assume is the piping going from my port. Is this normal???
Bex
Hi bex, Don't worry about being parainoid as i was completely at first with my port too. After a while of having it i was ok and was even able to flip it back after it flipped over (wasn't stiched in stupidly). I was also worried constantly that it was going to block. Don't worry it will get easier. I could feel the track like you said too and it worried me but it was normal on mine, but if it has suddenly appereaed on yours then if your worried get it checked, but it may be the swelling finally going and the line being closer to the top.
take care
Hi Natty, I suspect the swelling has gone down allowing me to feel things a lot better I have had a clot in my neck and it does not feel like that, it is not red or inflamed and everytime it is re-needled I am told it looks fine. Hickman lines I am an expert on, ports are a whole new ball game. I also have one of the new very small ports, needling it is hard because you only have a tiny area to aim at. It is working fine I am just being paroniod. I could feel the end of my hickman line apparently infact when I had a triple lumen one you could see it, so I think all is well. I will feel happeir when I have had the special MRI scan to see if they can do anything about my blocked or damaged viens as at the moment I my port is using the only one I have that is working properly so I am doubly protective of my port as a consiquence.
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