PORT PLACEMENT - Detailed description of process
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You're sounding good April YAY !
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April, when my port was new, even a grimace would hurt. You know that "yikes" face where you make your lips into a wide frown and your jaw goes down a little? That grimace.
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I got my port a little over a month ago and even though it doesn't hurt or anything it seems like I'm ways "aware" of it. Especially when I try to lay down at night to sleep. I'm s stomach sleeper and it bothers me if I lay on it and seems uncomfortable if I try and lay on the same side it's on. It also seems to move around a little. Is this normal?
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Butta. Yup normal--off to bed.
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Thanks for the explanation, tbird57. I have a port placement on Friday.
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Asher, Tbirds been off the threads for several years. But several mentor this thread b/c she did such a fine presentation. If you have questions, they're will be someone along to help
You may want to put this thread on removal into your Favs for future reference. It's well done too
Port removal.
https://community.breastcancer.org/forum/6/topics/701514?page=3#idx_61
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Hi all,
Just wondering if anyone can comment on whether their chemo nurses uses a face mask every time they access your port.
I just got a Smart Power port from placed today. When I was discharged, the nurse gave me some materials from the manunfacturer and she highlighted the aseptic technique that the port should be accessed. One of the steps was that both the nurse and patient should have a face mask on during the initial access attempt. I am going in for my 5th weekly Taxol/Herceptin treatment tomorrow. I have seen the chemo nurses access other patients' ports and I never saw them use face masks. I can bring my own mask to wear but I am not sure I should insist that the chemo nurse wear one too if its really not necessary anymore.
Thanks.
Nibaum
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Hi Ni, sorry you are going through this. Yes, insist they wear a mask. If they aren't used to wearing one, you will likely get resistance. It's a herd mentality. My DH had to go to a place for antibx's one time that was outside our usual area. None there could justify why they weren't wearing one other than "We don't". They weren't happy that I wouldn't let them do it without a mask. It was a bit of a row each time we went in for antibx's.
Carry your instructions with you. If you get resistance, pull out your instructions.
When I say herd mentality. What can happen in something like this is someone stops, then the next one stops. Pretty soon none are doing it. The herd thinks it's okay b/c they are all doing it. They perceive they aren't breaking a rule b/c they are all doing it the same way. Wrong.
Your port, your rules according to the written manufacture instructions. It would seem that the simple answer " Yes, insist they wear a mask" would be enough. But wanted to give you enough ammunition to be able to resist the herd. I was shocked when it happened to us. They got the supervisor involved. It wasn't easy. I had to get bitchy.
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My chemo nurses never fail to wear a mask, and make me wear one as well, when accessing my port. No need when disconnecting. This thing goes straight in to our jugular vein! I put on my EMLA cream at home and cover with Saran wrap. They remove the cover and do a meticulous cleaning of the area first. Insist.
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Ugh - spent several extra hours at treatment yesterday as my port refused to return blood. The nurses pumped me full of saline and heparin and waited - no luck. Tried different positions, tried coughing, etc. Nothing. Finally, the nurses called the doctor for TPA, the drano of ports. They put it in, we waited 30 minutes, nothing. At this point I got up and started walking around, moving. Tried it again 15 minutes later, nothing. The nurses called the doctor, who said to give me a "peripheral" IV (ie - one in my arm or hand), and just as they were about to stick me they tried it again - and it worked! Lots of blood. So happy. Treatment as usual, about two hours late.
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Sas and Birdie56 - Thank you for your input. I was a little apprehensive at first, but I just asked my chemo nurse if she will will be wearing a mask before she accessed my port. She looked a little confused. But I brought out the instructions and pointed out that step. She read it and and said sure if it made me feel better. She brought a mask for both of us.
I am not sure what will happen if I get another chemo nurse next week. Just have to ready to speak up.
Thanks again.
Nibaum
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That's just so od
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Ni, keep doing the same thing. See, if they go against manufacturer recommendations, they are libel for an infection. When you pull out the info, they are stuck. They have to follow the directions.
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Scrunchie, TPA just has to be given time to work it's magic....................
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Bump
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I got no information re: hygiene for port access, etc. I just got my port today, and tomorrow is my first chemo. Maybe the nurse at orientation (which happens during pre-meds or right before, so..?) will go over it, but I am going to insist on gloves and masks until I learn more! Thank you all for sharing!
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Without barrier precautions, your nurses put themselves at risk as well. In the early days of the AIDS pandemic, I worked on a psych unit where nobody used UBPs and some of the nurses would mock me for gloving and masking before responding to a code. Their attitude seemed to be that old patients wouldn't have AIDS. My feeling was that they were making a pretty big assumption, and that I didn't want to get herpes, TB, Hepatitis B, or anything else, much less AIDS. [HIV hadn't yet been identified, so "AIDS" was what a patient would present with.]
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A minute ago - edited a few seconds ago by sas-schatzi
NEWS FLASH. This may be old news to some. Yesterday I saw for the first time the infrared vein finder. It's on a tripod with a long adjustable arm. It has about a 3by3 field exposure. It's light is directed over an area of skin. You can see ALL the blood vessels. Because you can see them a tourniquet doesn't need to be used. Vein scarring and valves can be seen and avoided.
I had my lovely nurse Marilyn do a whole tutorial. I so would have loved to of had it when I was practicing.
A biggy for me is to be able to take this to the port thread I mentor. Discussion periodically occurs about whether to have a port when only one round(4) of adjuvant chemo is the plan. I was refused a port, but not without a strong discussion.
I only had one single chemo b/c of complications. In that one chemo it took 3 nurses 5 sticks to get a vein. Some chemo extravasated (leaked). That vein where the extravasation occurred has always looked dark even though it's been 7years. The infrared showed that vein and the smaller veins extending from it as shriveled and almost hairy. I'm not describing it well, but the area was very visibly different. Also, unusable.
Wouldn't of happened had I had a port.
(Repost from Insomniacs thread)
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https://www.gofundme.com/Portpillows
This charity mails free port pillows that clip onto the seat belt and protect the port from being rubbed by the seat belt. The port pillows also feel really good over a tender sentinel node incision site. There is a form on the site for ordering the pillow either for yourself or for someone that is getting a port.
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Thank you for the link for the port pillows! I was just telling my son after my Herceptin the other day how the seat belt sits right on my port and rubs it and makes it sore! Just requested one
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Is the port pillow a doughnut? What is it made of? I've been thinking about how to make one to use when I get a massage, because when I lie face down, the port gets pressed on. I use a seat belt clip in the car.
The nurse where I go just told me their new policy is for both nurse and patient to wear a mask during the port access procedure.
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ShetlandPony- the pillows are cloth, stuffed, I suppose about 3" by 6". Would be easy to make one. Mine didn't have any strap to clip around the seat belt, I just tucked it under the seatbelt over my port
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Hi folks, a post on the run
I'll PM Smarrty and ask if she will come and describe how she makes them. She's a sewer of excellence
On using the masks during insertion as a "New" policy. It was the policy since they were invented around 1995 . Somewhere in the last 7 years, the trend got to be, not to mask. Too much practice in nursing is not based on scientific method. Not good.
If you ever saw a movie of what we spew from our mouths with each word you would get that a mask is important.
Insist on masking. It's the safest practice.
I used to teach my folks(patients) to mask before that was the practice. I'd teach them every step of cleaning and insertion. I instructed them to watch every step of anyone's insertion and if the saw a break in technique to stop them. Same with discontinuing.
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hi Sass. So I make 2 pillows for after breast sx. Here's a pic of them. As you can see they're a little bigger than the one designed for a seatbelt. I use one of mine in the car because the seatbelt bothers me on longer drives but I place it so it crosses over my breast.
All I use is some flannel material, pre washed before you sew. If you sew, cut a strip about 7" WOF. You can easily make 2 from this. Cut the strip in half. Fold each in half, right sides together, then Sew the 2 long sides and around both corners and leave an opening about 4" so you can turn your pillow right side out. It would be real easy to sew in the velco straps when doing this. Lay them inside before sewing. The last pair I made I took an old regular pillow, open it up to get the stuffing from it. So now I have lots of stuffing to make more.
. Once it stuffed then just fold the end together and top stitch it closed. So these end up about 6 x 10 or so. It would be easy to make a little smaller for the seatbelt. 
Hope this helps any sewers out there.
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Thanks Smarrty, well appreciated
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I have port scar pain, so I use a chip bag clip on the seatbelt and a stuffed animal (otter) between the belt and my shoulder or torso to keep the belt from touching the scar. This was my strategy while the port was in as well.
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Sas, is the VAD nurse supposed to wear gloves while unwrapping the supplies?
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Shetland, no, but hand washing is done before anything. The reason that no gloves are needed when opening supplies is they aren't contaminated with blood or body fluids.
Common one use sterile floor items: Remove outer pack, lay kit on table. If the inner sterile pack only has one layer, then that can be opened in a way to not contaminate the contents. But if one of the corners flips back an hits the contents, then it's contaminated. Always associated with an "Oh Shit". This CAN be avoided by donning sterile gloves before opening the kit/pack..
If a kit has two layers of paper. Then the outer layer is opened with the ungloved hand and gloves applied to open the inner layer(mostly surgical type packs i.e.chest tubes, central line packs, drapes. lot's more.
Back to single layer paper packs: Some packs have a set of sterile gloves on top for this reason. Others don't i.e a foley cath kit. For the kits that didn't I always took an extra pair of gloves. That way the edges were sterile after opening. If they flipped then the kit was still okay. avoiding the "Oh, Shits"
The port kits have the sterile mask which is picked up with ungloved hands without touching anything else. They are now clean contaminated and are applied to face. Then the gloves are picked up and laid on the table, opened, and applied in a non-contaminating method. Then the kit flaps are opened. B/c I'm OCD I would use a mask from the shelf mask box, that way it was one less thing to worry about. Then in the hospital, I brought an extra pair of gloves b/c the sizing is correct. Then I could touch the kit tabs. Then I'd give the kit mask to the patient if I hadn't given them on already from the box on the shelf. Discarding the kit gloves. In the home I'd have to use the kit gloves.
What makes it confusing are the small variances that you see the nurses do. I gave you three examples that aren't required. I use to teach my patients, basically, the same as above and instruct them they were my helper. If I broke technique they were to say stop or contaminated.
I don't think I missed anything. Sorry, if I did.
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Shetland VAD nurse----.Vein Access __________? Medicine and nursing make acronyms for things all the time that aren't consistent in the industry.
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Hi there - I just had my port placed today - was pretty easy and the team at the hospital was really fantastic. Not a ton of pain right now which is great! I took tylenol and arnica, and have been icing every 20 minutes since about 2 PM. However I just noticed I have a dark-ish (maybe purplish red, but not VERY dark) half-circle on my skin underneath where the dressing is taped over my port. it just seems a bit strange to my husband and me because there's a very clear outline.
Is this normal? Anything to worry about? Never had a procedure or surgery like this before! Can provide a picture if it's helpful. There seems to be several wonderful experts on this thread!!
FYI I marked the outline of the area lightly with some eyeliner so we can track whether it's spreading or receding.
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