IV Status

This is a good point to talk about IV (intravenous) lines.  Many tests and procedures will require either the collection of blood or the infusion of fluids through an IV line.  If the process being undergone is significant enough to warrant in-patient status, usually an IV line will be in place at all times.

However constantly trying to access veins can put a strain on your vascular system over time, resulting in collapsing veins that make new access either difficult or painful.  Some cancer patients who have had many medical treatments, including chemotherapy, may have had a porta-cath installed for easy access to the blood stream.  A porta-cath is a plastic catheter composed of a round entry port with a small line attached.  The port is embedded in your chest, below the skin, and the line is fed into the large vein leading directly to your heart.  When you need an IV, rather than searching for a useable vein in your arms or hands, the needle is simply inserted directly into the port through a thin layer of skin.  Outside of a small to medium protrusion under your skin, the apparatus isn’t very visible, although it is always easy to locate by touch.

If you have one of these ports, it may be accessed for all necessary IV work while you’re in the hospital, although in the case of  transplant the primary access will be through your Aphaeresis (Hickman) ports..  It may also be used for lab work/blood collection while you’re an out-patient.  As long as your porta-cath is taken care of to avoid infection, it can stay in for five years and perhaps more if required.  Having a porta-cath doesn’t mean you’ll never have blood drawn from your arm again, however.  Porta-caths can only be accessed by specially certified nurses, so there are some out-patient treatments that will require a non-cath IV to collect blood or deliver fluids or meds.

In short, if you’ve had some tough times with collapsing veins, a porta-cath is a great thing to have.  If you don’t have one and are having problems with your veins, you might want to discuss this option with your doctor.

Maintenance of a porta-cath generally consists of a simple flush of special fluids through the system once every four to six weeks.  These flushes are usually done in your oncologist’s office.  It’s imperative that the port site is cleaned thoroughly before it is accessed so that no dirt is transported by the needle through the skin and into the port.  If a port becomes fouled by infection, in may need to be removed and replaced, or left out altogether.  Your nurse will always clean the area before accessing your port, but it’s wise to shower well and scrub that area thoroughly before going for your flush.  My porta-cath flushes are scheduled every six weeks, and I see my oncologist every other time.  This is in addition to the follow-up treatment done by my transplant team.