Picc line vs Port

Artista928

I have an infection and have a picc line in already to administer IV abx myself. I was thinking to just keep this. Really don't relish another procedure, the port, in which you will feel needle pricks to boot. With the picc line, no needles going through skin. I've gotten the hang of keeping it dry with a plastic bag over it in the shower so I'm thinking since I have this, why get it taken out to get a port where I will feel needle pricks, which I hate cuz I'm still a baby after many of them.

What do you guys think? Those with ports.....and those with picc lines? Am I missing a nice benefit with a port other than you don't have to worry about keeping it dry? TIA!

Italychick

I got the port, love it, but I'm very physically active and didn't want to have to baby anything. I had a few days of discomfort and that was it, rode my bike a few days after installation. They numb it up, stab the needle in, and my hands were always free during infusions.

And I have grandkids that jump all over me, so a picc linewould not have been practical for me.

Spookiesmom

I've had my port 3 years, plan on keeping it as long as I can. They numb it, then spray, don't feel it. Used for blood draws too.

ElaineTherese

I typically swim for at least two hours a week, so I'd rather have a port. I have a few more Herceptin infusions left; I'm not sure whether I'll have it removed when they're done. It is very convenient for PET scans, heart scans, and blood draws.

Artista928

Do they change a dressing on ports once a week? One thing I didn't like was it was uncomfortable when they changed the dressing of my picc line.

doxie

A port has no dressings. It's inserted and the skin stitched closed. Mine healed fairly quickly even though I had chemo the next day. When it's removed there are stitches to close the wound.

exbrnxgrl

Yes, ports have no dressings. They are completely implanted under the skin and require no special care once they have healed after installation. Great for blood draws and scan injections too. I was told that PICC lines are not recommended for extended periods of time due to possibility of infection since the are "open".

Like others have said, numbing sprays works well. I never feel the prick when my port is accessed

Artista928

Thanks all! So I'm not seeing a reason not to get a port even though I have this picc line. Was trying to save myself another procedure since I have this already, but no dressings to change (which can hurt), less likely to get an infection, no worries of getting port wet like you do with picc line and the dangling nature of the picc tubing even though I have a mesh to keep them covered. Hmmm. Guess I'll suck it up and get a port! xo

Italychick

artista928 how many infusions do you have to get? That could factor in. I had Herceptin today. And there was a woman there with a picc line, no port, and she had to have them do a blood draw from her hand for some reason and she was moaning in pain. I'm not sure why. If you have four infusions, a port may not make sense. If you have a lot, definitely makes sense. I love mine, but I have Herceptin infusions for a year and I wanted to save my veins.

Artista928

Haven't met my new onc yet (see her Wed) but the old one was thinking 4 AC and 12 weekly Taxol. Then you have the lab draws to check your counts with possible neulesta injections which I assume can go in the port. Plus I didn't think you have many lab draws after treatments which I guess for some they do. I don't know about me though after chemo.

exbrnxgrl

Nope, no neulasta in the port

SpecialK

artists - Neulasta is a sub-cutaneous injection and is not given through the port. Mine were all in the back of the arm, but some use the stomach. I had weekly CBC done to check my blood counts

Italychick

ok, so enough chemo to get a port. Sounds like at least 16 chemo stabs and probably at least another 5-10 blood draws after the Neulasta. I think Neulasta may be only after the A/C, but I see some women saying their doctors recommend getting Neulasta after taxol infusions too. Every Neulasta injection typically results in another blood draw the week after to make sure white blood cell count is good and the Neulasta did its job. So it is hard to estimate the number of blood draws you will have other than the day of chemo. neulasta doesn't go in the port, they inject it into the fatty tissue, mine was in the back of my arm. Blood draws at my chemo center were done through the port. Other scans, PET, bone, MRI, etc. were done in my vein because the person doing the test, etc. has to be certified to access the port, and they didn't have anybody there who could do it. Some facilities do, and all those injections can then be done through the port. But those tests were not a big deal, the chemo infusions and blood draws were. I got blood drawn day of chemo, then a week later after Neulasta to check my white blood count level, and also a few other random blood tests, liver enzymes, vitamin d, etc. weredone through my port. Also 17 Herceptin infusions, which thankfully you won't be doing.

The main thing is the port goes in, the scar heals, and you have this thing about the size of a nickel that you don't have to baby, avoid getting wet, etc. For me it has been completely worth it. They gave me twilight sedation, I passed out and didn't know a thing. Had a few days of soreness was all.

Sorry for being so long winded!

ruthbru

I had a port. DH had a PICC line for antibiotics after a serious blood infection. The port was definitely easier to live normal life with. Under the skin and that was it. The Picc line was a major hassle.....so when you are thinking about many months of treatment; I, myself, would definitely opt for the port.

Artista928

Thank you so much ladies! Port it is! Even though I'm used to this picc line now with the infection I have, I've had it for 1 week. Not sure how I'll feel about it for months and also when the rain starts in N. CA like we're supposed to have an El Nino here. Having to worry about what is big enough to cover it as I'm in tanks much of the year and just throw a light jacket on for the "colder" months has been on my mind. I don't have long sleeve baggy to handle the bulky ends. Too bad they didn't just do a port install instead of this, but yeah, they don't want to put in another foreign item in there with an active infection going on.

Thanks so much again ladies! xo

doxie

I didn't want a port, but my MO's nurse had a fit. To me it seemed too much for 4x TC. But it made infusions so much easier and my veins are healthy in my none BC side. Good because I have mild LE in my BC arm.

I didn't get blood draws from it because that didn't work well with the flow of the clinic. If I remember right, the Neulasta shot is given in the belly fat.

VioletKali

I LOVE my port. As soon as I knew I would need chemo, I am a Nurse, I made sure I would have a port. I am finished with chemo, but I have kept my port 'just in case'. I am having a hysterectomy soon, etc, and I want to keep a good blood access.

I flush it every 4 weeks myself.

Artista928

Thanks again ladies. This picc line goes from sometimes itching to the burning sensation to a tad bit of pain, even when not administering abx. Hopefully with the port once you recover from the procedure, it will be like it's not even there. With the picc line, it's always there.

Monday I have follow up appts with infection doc followed by ps to see how the infection is doing. If I can finish it off with pills then I'll get the picc line removed. Once the infection is all clear, I can then reschedule my port placement procedure and hopefully start chemo a few days later. I had sx 8/6 and I'm hearing the window of effectiveness of chemo is closing in as after 3 months post sx to remove tumor, chemo becomes less effective. So I'm really hoping to be on chemo before the month is out.

Thanks again ladies for sharing- xo

Kicks

As others have said there is no dressing to change with a port - once the incision heals it is within the skin so no exposure to potential contaminates for just 'living'.

The only 'maintainence' with it is IF you keep it after the end of infusions, it has to be flushed every 4 -8 weeks. After an infusion (or it used for other procedures), saline is pushed through to remove the last of what was put in and then heparin is injected to prevent clotting. Once done with active use/treatment, if the port is not removed then a flush has to be done every 4 - 8 weeks to reestablish a new heparin block. Very simple procedure that takes no more than 10 min to do.

While power ports can be used for blood draws, contrast infusion, anesthesia, etc., not all can use them for all procedures - it takes an educated RN, NP, PA or MD to access them - not a blood tech.

My experiences with my 'Little Soldier' (my port) who was there to do battle during neoadjuvant (4 DD A/C) and adjuvant (12 weekly Taxol). He has been there for a bit over 6 yrs and since the end of chemo, he has been there standing guard to keep the Monster away (so far has) and is already there and ready for the next battle if it ever comes. Yes - that is a bit simplistic and child-like in outlook but it's how I am comfortable visualizing it. In no way does it limit or effect my very active life. I do not use it for blood draws - I have a great vein so it's easiest to just use it. Only one time has it been used for a blood draw but only because I had a flush scheduled for the same day so when she flushed it, the RN just went ahead and pulled the blood. It has been used once for contrast injection as a training session at the hospital. It was used once for anesthesia with a cataract surgery. While doing Chemo, they used numbing spray and only felt a slight prick, since then for flushes I use generic EMLA cream to numb it and only feel slight pressure (put cream on 1/2 to an hour before flush and cover with a small Saran Wrap square to keep it from getting wiped off by clothes).

Artista928

Thanks for the info, Kicks.

exbrnxgrl

Artista,

At my facility (Kaiser Santa Clara), they gladly do all blood draws at the infusion center. For scans, they always ask if I need port access. All in all, it's been easy to use my port for everything requiring access to a vein. Just ask, and hopefully, you'll find it just as easy at your medical facility.

Kimmer33

hi

So i am new at this and wondering if they also use the port or picc line for the taxol?

I will possibly be having 8 treatments, 4 treatments AC and 4 treatments of Taxol, thanks for the info!

Kim

exbrnxgrl

Kimmer,

I don't suppose anything is set in stone, but in the US, ports are almost always the choice for chemo, not PICC lines. Good luck to you

Artista928

Thanks exbrngirl! The infusion center is upstairs from the lab draw dept. They go the extra mile for you so I'll see if they'd be willing to do my draws so I can continue to save my poor beat up right arm and not mess with my left one that has 4 missing nodes. xo

ruthbru

You will be happy, happy to get rid of the Picc!

Kicks

I did 4 DD A/C (every 2 weeks) neoadjuvant and 12 weekly Taxol adjuvant both with my port. Adriamycin (aka 'Red Devil') Is the one that usually does the worst damage to veins if accessed via a needle.

Different Facilities are different in procedures used. Also remember that not all potential medical needs will be done at a Cancer Care Center where ports are common so they are are more prepared to deal with a port than other facilities that deal with other medical issues.

My UMX was done at the Facility/hospital but the anesthesiologist wanted to use a vein instead of port. My first cataract surgery was done using a vein but second was with port. Wrist surgery was done with a vein. Detached retina surgeries were done using a vein. None of these surgeries were done at the CCC.

There is no 'One Size Fits All' or 'Anything Set In Stone' dealing with ALL TX we might need after BC treatment Nor are we all the same or any/all Drs we might need to see are the same.

Artista928

Yeah Ruth, I will be happy to get this picc line out. I almost stepped in the shower tonight without the bag one to cover it, and I'm not chemo brain yet! Ah!

Kicks- I guess I'll be thrilled if most things can be done with the port. I suppose there are some anesthesiologists who aren't comfy with the port and would use IV in the vein. Washington Hospital and it's outpt sx center only use one anesthesia group. I'll have to ask if they are into using ports for procedures.

Spookiesmom

Just be careful who wants to access the port. Not everybody can, even if they say so. My FORMER PCPs rn assured me she could. Due to some clinic regs. a supervisor had to come watch. 3 tries, I said I was done, and so were they.

Chemo nurses are the pros. Zip-done. Just because they are nurses doesn't mean squat.

ShetlandPony

Yes, Artista, if your center is like mine, the lab has VAD nurses who can draw blood using the port, and then leave it accessed, i.e. leave the needle in and send you to the infusion center for chemo. Alternatively, maybe the chemo nurses can do the blood draw? If I have to have this port on my chest, I'm sure not going to let them stick a needle in my arm if there is a way to use the port. So, for example, if my PCP wants a particular blood test, I ask my onc to tack that order on to her lab orders for my monthly blood tests at the cancer center. Another note: I think that not all ports can be used for injections for bone scan, PET, MRI, etc. I know the Bard power port can because that is what I have. I appreciate it because those radiology pokes and IVs used to hurt worse than a blood test for me. So you might ask what kind of port is proposed for you. Finally, I find that I need the emla cream on for 45 to 60 minutes for best numbing.

Artista928

Spookiemom- The same goes even with RNs doing IVs in the arm. 4 different ones blew my veins. My veins are small so it's tricky. Finally got a competent experienced one to put it in the base of my thumb, which lasted 2 days until I got the picc line in.

Shetland- Thanks for the info. I'm going to ask my bs what kind of port it'll be and see if he can get the one where you can do all these things. If I have a port then I sure don't want to use my arm veins unless no choice.

Thanks! xo

exbrnxgrl

Kaiser has it down to a science. The infusion nurses don't just access the port, they do the blood draw. I haven't seen a lab in years. Same for scans. They make sure a port trained nurse is available and they come to the nuclear medicine department so I don't go anywhere to get your port accessed.,

Being the all inclusive medical model, patients have all services, birth to death, wellness or illness, pharmacy to farmers market, on one campus. So, oddly enough, all of my medical needs are in one location. My dd recently changed insurance plans and is no longer with Kaiser. She didn't realize how easy and seamless their system was until she left it