Wednesday, February 25, 2015

MediPorts

One of the nice things they do is place a medication port inside the body.  It has a little reservoir that can be punctured by a needle, just underneath the skin in the upper chest.  This is what the reservoir looks like with a needle in it.  Obviously not under the skin:).


This is what it looks like inside the body.  Although his comes in from the left side instead of the right side.  The end of the catheter is right by the heart.



The advantage of these ports is they are easy to access.  I think everyone knows someone or is someone who is a "difficult stick".  Even the best nurses have to fish around to finally gain access to vessels that just don't want to cooperate.  Problem solved.  You can take blood samples from the port. You can deliver medications.  The access can stay in place for about a week before they would have to change it.  When the port is accessed you need to keep it protected from potential infections.  Every access point is a potential source of infection.  Line infections are bad because they dump the bacteria right into the blood.  Not a good situation for healthy people; add chemotherapy, and the risk of serious infections is significant.  With some basic precautions, these ports are some of the safest with regards to potential for infection.

They took out the access when we were discharged home.  It was nice for a couple days.  Monday morning we received a call to schedule his follow-up MRI.  After a little bit of wrangling for a time (they wanted to do it Tuesday night at 6:30 pm, after he was readmitted for chemo), the time was set for 1:30 pm.  Check in at 1:00.  It was about 12:00 when this call came in.  A few minutes later the MRI tech paged me and said that we would need to get the port accessed, so we should go to the oncology clinic first and they could access the port.  Prior to this, we were instructed on the use of Emla cream for port access. It's basically a lotion that has numbing medication in it.  It takes about 45 minutes to an hour to work.  Sadly, we didn't have any.  Didn't see how we could get him into clinic, get the skin numb, get the access placed, and get over to MRI in time for a 1:30 appointment.

We discovered it didn't matter.  They have another way of numbing the skin.  They blast it with something to freeze the skin, so it's a cold numb.  Or you can let them access it without anything and just feel a quick pinch.  Let me remind you that J HATES everything that we do to him, especially getting poked.  It didn't take him long to realize that we were going to need to access his port, that we didn't have the numbing medication, and that he had to return to the noisy MRI machine.  He totally fought us from the time that we asked him to get out of the chair in the exam room and up on the exam table.  He's not strong enough to totally resist us, but I felt bad that it was coming to a point where we would have to force him to lie down so we could gain access.  (And yes, he's still on steroids at this point).  He screamed and screamed.  He was scared.  He was hypersensitive.  We were all a bit frustrated.  And then it was in and it was done (so much easier than placing an IV).

We will not leave the hospital next time without a supply of Emla cream.  And perhaps next time he will realize it's not as bad as he worries it will be.  



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