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Topic: Port issues?

Forum: Chemotherapy - Before, During, and After —

Regimens, side effects, and support from others going through chemo.

Posted on: Oct 12, 2017 01:45PM

Flynn wrote:

I've been in treatment since late March. The first several months, my port worked very smoothly. The last couple months, not so much. It's described as positional issues by the blood draw techs. Two weeks ago, I had to have TPA before treatment. That added an hour and a half to my day. Yesterday, it started working just as a nurse was called to give me TPA again. I was a half hour late to my chair.

A port study has been mentioned but not ordered. I have no idea what would be involved. I'm starting to dread dealing with my port. Wed between issues in blood draw area, being late for chair, waiting for nurse practitioner to come talk to me, needing a unit of blood b/c of low hemoglobin, treatment, then waiting for blood to arrive, I was at the center 8 hours! Certainly mostly not related to port but it's a stressful way to start a long day.

Thoughts?

Dx 2/2017, IDC, 6cm+, Stage IIB, Grade 3, ER-/PR-, HER2-
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Oct 12, 2017 01:58PM NotVeryBrave wrote:

Is the port problem just with blood draws or with infusions as well? It seems like I've heard of a number of people that couldn't have blood drawn from their port, but they were still able to use it for chemo infusions. If that's the case then perhaps they could just quit doing the blood draws from it and use your arm or hand instead?


TCHP x 6 rounds - Complete Pathological Response! Still have to finish the year of Herceptin ... Dx 11/21/2016, DCIS/IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2+ (IHC) Targeted Therapy 12/19/2016 Herceptin (trastuzumab) Chemotherapy 12/19/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 12/19/2016 Perjeta (pertuzumab) Surgery 5/9/2017 Lymph node removal: Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 9/9/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Oct 12, 2017 02:26PM Spookiesmom wrote:

I’ve had my port 5 years. I go for maintenance flushes every 2 months. Once or twice over those years there’s been problems. Each time I wasn’t hydrated enough, So now I make sure to chug lots of water before.

Basic labs are drawn from my arm.

Dx IDC, Stage IIIA, Grade 3
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Oct 12, 2017 02:50PM Flynn wrote:

Notverybrave, I need to clarify the policy at my dr appt next week but when I was TPA'd they indicated that if we didn't get a blood return after an hour, they could possibly give me the infusion thru my arm (how they ended up drawing the blood) so using the port w/o a blood return did not appear to be on the table. I don't have vein issues so I'd be open to weekly blood draw so in my arm. Thanks!


Spookiesmom, that's an interesting thought. I have early morning appointments and try not to drink much before getting in the car, in case I hit traffic. I could try getting up earlier and drinking more before I leave. Thanks!

Dx 2/2017, IDC, 6cm+, Stage IIB, Grade 3, ER-/PR-, HER2-
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Oct 12, 2017 03:11PM Denise-G wrote:

I had positional port problems during chemo - about 3 times. They had me put my head upside down almost to the floor

(wig fell off -it was quite funny - good thing I was in a room of cancer patients!). That worked a couple of times. The other

time I had to bend backwards and that got it to work.

My sister had to have an injection put into the port once when hers did not work. That made it work.

Crazy stuff, huh?

www.denise4health.info my BC Blog with over 175 informative posts - stop by and say hello! Myself, my mom, and sister were all diagnosed with BC within 3 years. What a ride! Dx 10/10/2011, IDC, Left, 6cm+, Stage IIIA, Grade 2, 9/14 nodes, ER+/PR+, HER2+ (FISH) Surgery 11/23/2011 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Chemotherapy 12/27/2011 AC + T (Taxol) Targeted Therapy 2/28/2012 Herceptin (trastuzumab) Hormonal Therapy 10/11/2012 Arimidex (anastrozole)
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Oct 12, 2017 03:40PM - edited Oct 12, 2017 03:43PM by NineTwelve

I had to get a port study done because my port stopped returning blood. The study was easy and painless. They injected some dye into it and did a scan (or an x-ray - can't remember which). Took about 45 minutes. The tube opening on my port is resting against the wall of a vein. They know that they will not draw blood from my port but it will still accept infusions. Go get the port study: it will save you loads of time and calisthenics (lol - Denise, I had to do some of those things, too.)

They give my port a Heparin flush once a month, when I come in for Faslodex and Zoladex shots. So far, the only infusions I've had were for Zometa, for my bones. But I will be able to use this port in future for chemo, if need be.

Right thoughts, right words, right action! - Franz Ferdinand Dx 9/12/2014, IDC, 4cm, Stage IV, Grade 2, mets, ER+/PR+, HER2- Hormonal Therapy 9/15/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin) Hormonal Therapy 10/1/2014 Dx 7/2016, IDC, Stage IV, metastasized to bone/lungs Hormonal Therapy 8/16/2016 Faslodex (fulvestrant), Zoladex (goserelin) Targeted Therapy 8/16/2016 Ibrance (palbociclib)
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Oct 12, 2017 06:11PM Kicks wrote:

My port's been in for a bit over 8 yrs now with no issues at all. Originally the protocohol for flushes when it not being used, was every 4 weeks. It is now every 8 weeks. Have always had a good return. Access port, draw back, good blood flow, saline flush, and a new heparin block put in and good to go til next flush.

I have great veins so have never used port for blood draws - easier to just hit the vein and any blood tech. can hit a vein but most don't have the required education/certification to access a port. I've always been told that only a certified RN, NP, PA or MD can access them.

I have had one blood draw done via my port as I had a port scheduled the same day as a blood draw so RN went ahead and drew blood when she did the flush. Several years ago, there were student RNs at the facility doing Clinical and I was asked if I minded if they did the flush. Sure - go ahead- how else can they learn? Well, they never did succeed - were not even getting into the port because they were just not using enough 'umph' to get into it but the instructor did with no issue. (It was well numbed so I didn't feel the sticks at all.)

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/24/2009 AC Surgery 10/20/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/10/2009 Taxol (paclitaxel) Radiation Therapy 2/3/2010 Breast, Lymph nodes
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Oct 12, 2017 09:43PM Flynn wrote:

Denise- I had to keep lifting my left arm up for so long, I thought it would fall off! Must have been quite a sight, losing your wig:)


NineTwelve- interesting that they don't use your port for blood draws but infusions are ok. I'll definitely see about getting a port study.


Kicks- 8 years is a long time, glad your port has worked out so well. I've noticed some people seem better at sticking into the port but I didn't realizingthere would be such a training curve. Fortunately the person I've had my last two times is one of the better techs, at least she seems to be.





Dx 2/2017, IDC, 6cm+, Stage IIB, Grade 3, ER-/PR-, HER2-
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Oct 13, 2017 10:37AM NineTwelve wrote:

No, they stick my veins for blood draws (at the cancer center and my regular lab). They say there is some regulation, they are not certified to draw blood from my port. Could be a state-specific rule or something like that.

Right thoughts, right words, right action! - Franz Ferdinand Dx 9/12/2014, IDC, 4cm, Stage IV, Grade 2, mets, ER+/PR+, HER2- Hormonal Therapy 9/15/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin) Hormonal Therapy 10/1/2014 Dx 7/2016, IDC, Stage IV, metastasized to bone/lungs Hormonal Therapy 8/16/2016 Faslodex (fulvestrant), Zoladex (goserelin) Targeted Therapy 8/16/2016 Ibrance (palbociclib)
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Oct 16, 2017 11:21PM Kicks wrote:

Yes - there are regulations as to who can legally access a port. It takes an RN, PA, NP or MD. Some ParaMedics can in Emergency situations.

It's not just being able to draw blood out but for a blood draw for testing the heparin block has to be flushed out before the draw can be pulled. Then a new heparin block has to be reestablished to prevent clotting.

Yes - my port has been in for 8+ yrs and there it will stay (unless 'something' goes majorily wrong). It is my 'Lil Soldier' (I'm a WAC) who is standing guard with rifle 'at ready' so the Monster will not try to raise it's Ugly Head. Also IF the Monster does 'attack' - Lil Soldier is there - ready to launch the attack and beat it again. (Yeah - a bit juvenile way of looking at 'it' but works for me.). With my DX (ultimate possible prognosis) - it only makes sense to me to keep my 'Lil Soldier' in place and ready rather than 'relieving him of duty' (take out). Just keep him there on duty raher than possibly needing to have surgery in the future to have another port implanted in a less than optiminal site. Yes - a bit different than how most would think about it BUT is how I do.

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/24/2009 AC Surgery 10/20/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/10/2009 Taxol (paclitaxel) Radiation Therapy 2/3/2010 Breast, Lymph nodes
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Oct 17, 2017 02:00AM - edited Oct 17, 2017 07:46PM by Wildplaces

a " port study " is simple - a dye gets pushed into port and a radiological image of your chest tells them if is patent and in the right position without any kinks - particularly if all was well and now it plays up

worth doing if port plays up - I had one

The port may be in the right place and patent but when withdrawing veins could collapse around it so hard to draw blood out - dehydration makes veins even more collapsible, putting you head down drains the major central veins by gravity so opens them up - all correct. However it sounds it is slow to flush/infuse as well - so get it checked if you can

Dx 8/5/2016, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/13 nodes, ER+/PR+, HER2- Surgery 8/12/2016 Mastectomy: Left; Prophylactic ovary removal Chemotherapy 9/11/2016 AC + T (Taxol) Radiation Therapy 2/21/2017 External: Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole)
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Oct 17, 2017 06:57AM fishingal68 wrote:

I had trouble getting blood flow from my first check on my port. It took 1 1/2 hours for the nurse to get blood to flow. She ended up having to push Activase a couple of times to 'dissolve' a clot. It worked, after I laughed, held up my right arm, and bent over all at the same time.

When I went in for chemo a few days later, (different nurse) she could not get blood, and because they were so busy, she did not even try all the other 'tricks'. I was not happy about getting stuck yet again...I thought that was one benefit of having the port. I go back for a re-check & flush later this week, and I will ask about it. I would rather they use the port for labs. I'll let you know what I find out.

Dx 9/7/2017, DCIS/IDC/IDC: Cribriform, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2+
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Oct 17, 2017 11:21AM Flynn wrote:

kicks- it seems like keeping your port in is working for you!

Wildplaces & Fishingal, thanks for your thoughts. I'm due for a blood draw & dr appt tomorrow so I'll see how things go & what the dr has to say.

Dx 2/2017, IDC, 6cm+, Stage IIB, Grade 3, ER-/PR-, HER2-
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Oct 18, 2017 02:02PM Flynn wrote:

Since I was seeing my MO right after blood draw, my port behaved perfectly. 😂 Nonetheless, she put in an order for me to get a port study. It's scheduled for next week, so we'll see what they conclude

Dx 2/2017, IDC, 6cm+, Stage IIB, Grade 3, ER-/PR-, HER2-
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24 hours ago exercise_guru wrote:

I would recommend they do a port study it's very easy they just basically but a tiny little bit of dye in the port and look at it to make sure that it's working correctly. had this done and it was really probably the least stressful thing that I had for my entire treatment. I'm sure that some great posters above-mentioned changing the position you sit or lay when they first hook things up. My port was a little sideways so I always ask for a very experienced person and once I figured out the trick I didn't have any more problems with my port. My chemo buddy had a bit of a flow problem so they put her on some thinning medication while she was in chemo.

Age 42 05/15/2015 PALB2 mutation, DBL Breast Cancer Type 1A Grade 3 ER+PR+(right 1.3cm,.5cm) HERr+(left1.6 cm), 06/26/2015 BMX with TE 8/27/15 Chemotherapy TCH 12/30/2015 TAH/BSO/Reconstruction 1/29/16 Arimidex 3/1/16 Femara 5/6/16 Tamoxifen
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24 hours ago karentwriter wrote:

As I'm reading the above posts, I'm getting the idea that once a port goes in, it does not come out? Is that true? Also, I am going to have one put in next week and I thought this would evade the pain of injections and IVs with chemo, is this not the case? It almost seems pointless to do a port if the pain is the same?

Dx 9/28/2017, DCIS/IDC, Right, 3cm, Stage IA, Grade 3, 0/3 nodes, ER-/PR-, HER2- (IHC) Surgery 10/11/2017 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy Chemotherapy
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19 hours ago - edited 19 hours ago by ShetlandPony

Karen, whether you keep the port largely depends on how you feel about keeping it vs. possibly getting another later if necessary, and how likely it is you would need it again. Mine has worked well for three years and has helped me avoid a lot of pain and anxiety for chemo, blood tests, and scan injections. (For these injections it needs to be a power port.) Usually the numbing cream on the port site works great, but even if I feel something, it is so much better than the hunt for a vein. You may want to talk to the interventional radiologist or surgeon about where he/she will place your port. Also ask whether your treatment center has port-trained nurses available for blood draws.

Only recently did my port misbehave a little, requiring an enzyme to be injected into it to dissolve the presumed fibrin blockage so blood could be drawn. That worked like a charm and the nurses and I expect no further problems. I will say I had not drunk enough water in the preceding hours, and that my have contributed.

2011 Stage I ILC ER+PR+ Her2- 1.5 cm grade 1, ITCs sn. Lumpectomy, radiation, tamoxifen. 2014 Stage IV ILC ER+PR+Her2- grade 2, mets to breast, liver, retroperitoneal nodes. Taxol NEAD. 2015,2016 Ibrance+letrozole. 2017 Faslodex+Afnitor; Xeloda
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17 hours ago Spookiesmom wrote:

Ports can and do come out after tx if you want. I’ve had mine for 5 years and have no intention of having it out. It doesn’t bother me, not visible, if the ca comes back, that’s 2 unnecessary procedures. Out and back in.

I go every 8 weeks for a flush. They use the cream and freeze spray. I don’t feel much.

Dx IDC, Stage IIIA, Grade 3
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15 hours ago Kicks wrote:

For most - a port is removed shortly after the end of Chemo (end of Herceptrin if HER2+). It is a personal choice to keep it as I have chosen to do. My DX is different than most as I'm IBC (Inflammatory Breast Cancer). Only between 1% - 4% of all DXd types of BC will be IBC and the 5 yr prognosis is 1 out of 4 will make it there. (I'm 8 yrs post DX and still NED - as far as I know today with no reason to think otherwise.)

IF (and I don't think I will ever need a port again) I had had mine removed it would be another surgery to implant a new one and the available sites for one would not be as inoccuous as where the one I have is with no issues - so there it stays as far as I am concerned (with my Drs agreement).

For me, all my infusion port accesses were done with 'numbing spray' so just a small prick as the needle went in. Now for flushes, I use EMLA (lidocaine) cream before each access and only feel a slight pressure as needle is put in. I put the Numbing Cream on the center of the port 1/2 - 1 hr before access and put a small piece of 'saran wrap' over it to keep it from getting on clothes.

It wasn't about sticking my veins for me - I have great veins that are easy to hit. It was about once I had surgery that I would only have veins in one arm to use the rest of my life (foot/ankle/leg veins can be used) and I wanted to keep it/them 'good'. The Adriamycin part of my neoadjuvant A/C can cause major issues IF it infiltrates the surrounding tissue. So it was to protect my veins and surrounding tissue. I did 4 DD A/C neoadjuvant and then 12 weekly Taxol adjuvant with no issues or pain.

There is no 'One Size Fits All' when it comes to our individual experiences - we are each so unique! The vast majority who have a port implanted for Chemo DO have their port removed shortly after the end of TX - a very few of us don't for varying reasons.

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/24/2009 AC Surgery 10/20/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/10/2009 Taxol (paclitaxel) Radiation Therapy 2/3/2010 Breast, Lymph nodes
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4 hours ago Flynn wrote:

I hadn't realized that people leave their ports in, by choice, until this thread. I can absolutely see the thought process for keeping it. I will probably have mine removed, mostly because it stresses one of my 7 year old sons out. He was upset when I took the dressing off the incision and now he think it feels/looks like a bone sticking out. I wear shirts that cover it up. It's actually been a good insight that I majorly need to prep him for how things may look after surgery.

Karen, I've had my port since March and the issues are pretty new. I'm overall, it's gone smoothly and my arm veins were getting sore, in the beginning,so it's been a good break for them. I have 5 treatments left and I'm willing to do the blood draws in my arm, if necessary, just to get treatment done. We are all looking forward to a fresh start next year.

Dx 2/2017, IDC, 6cm+, Stage IIB, Grade 3, ER-/PR-, HER2-

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