Portacath Advice

Hi there @Twiggyjumps . I had a portacath put in prior to my treatment starting around this time last year. I have an autoimmune disease which affects my skin thickness, and makes inserting an IV very difficult.I had also been on warfarin for eighteen years prior to my diagnosis, needing my blood being tested every fortnight. This had resulted in severe scarring which was also a huge factor. Finding a vein for chemo (and ongoing herceptin) was going to be a nightmare, so portacath it was. Best idea ever. After so many sessions of "hunt the vein" for my blood tests, it has now been a matter or..."right, there's the port...whack it in". The port lies directly under the skin on my upper chest, and quite frankly, I get more twitchy about having a finger prick to check my blood sugar, than the small prick to access my port. At first, I was very aware of it, much like one is aware of a new filling in a tooth where your tongue constantly pokes at it, but soon pretty much ignored it. I'm obviously aware of it but the pros for me, way outnumber the cons. The small 1cm scar is hardly noticeable and the underlying device looks just like a slightly fat $2.00 coin under the skin.

I was really upset about my scar. However 12 months on it is barely noticeable and it no longer bothers me. I do understand how you feel about it though as it did me. I however found chemo much easier with it, knowing I needed 17 chemo sessions and then a further 13 herceptin after..

Personally I LOVED my portacath. I had to do chemo twice as I had a recurrence. I, like you didn't have it for first 6 chemos. However the drugs absolutely trashed my veins and they still to this day haven't recovered. Luckily as I didn't have chemo in my hands the veins there are ok, but painful. It is still a challenge when I need an IV or blood tests. The portacath, whilst an ugly little bump, and yes it has left a little scar, but the ease with which the next chemos went in after the recurrence was amazing. The nurses also used it if I had some blood tests due at the time of chemo. If they are having trouble with your veins now, they probably aren't going to get better. The other arm is not a great idea due to the lymphedema risk(I have that also). 

If you really don't want the port then you could try really well hydrating yourself before your infusion. Start the day before and drink heaps and lots before the infusion. Also go dressed in warm clothes as your veins hate the cold as the vasoconstrict and go into hiding. I know veins as I am a nurse at the blood bank ;). That's your best shot. It may work, but if it doesn't the port really makes infusions a breeze. 

Hugs. 

Paula xxxx

Thank you all for your experiences. Truly very helpful. Xxx

If you don't (really don't) want the port, make them talk to you feet.

When I had my recurrence I demanded a port before chemo. Lessons learned as I had miserable plebitis during my first treatment and my veins were knackered.
Anyway, in the interim I had to have numerous IV episodes. I only had one arm as option after ax. clearance and decided that was my 'emergency arm.' So anyone who wanted access had the option of using my feet.

I will admit I can be a raging pain in the arse, but there are reasons for that. Every single time I said my arms weren't viable, the person with the needle tried to convince me that everything was fine/they could see a good vein/they were an expert. Every single time. I'd see that speculative gleam in their eye, all of a sudden it's all about them. The usual argument is 'It really hurts if we use your feet' Like someone stabbing you twenty times with no result doesn't?

They can get stuffed. I found that any good phlebotomist will consider your feet and ankles if you ask them. I had a couple throw tantrums so I asked for someone more skilled. It works for me. Yes, it hurts sometimes, but it works. Maybe they are worried I'll kick them? Who knows. Funny thing to see is the look of triumph and confusion when a reluctant practitioner realises how easy (comparatively) it is.

As far as the port is concerned, it's better than the feet. The scar is only an inch long, it takes couple of weeks either side of insertion and removal for everything to settle down, but it made everything so much easier. And much, much less painful.

Funny you should say that, I went in to see one of the Onc nurses this afternoon to see how many vein options I had in my 'good arm' - I never thought of the feet. Thinking that would hurt

I have had my port since Jan 2016. Love it. Scar has faded and doesn't bother me. Not due to get mine out until October 2018.  If I should have it out in the future and then get a recurrence I will be getting one again.  I never had an issue with needles before, but after chemo I came so close to punching nurses who kept poking me after not finding a vein sometimes that it scared me. No such problems with a port.

Give it a go @Twiggyjumps. What have you got to lose? Why does everyone assume feet, or ankles, will hurt more? Old wives tale, in my opinion. And it is just my opinion.

The killer question is 'Where do you find a vein on a baby?' Feet. I just don't think most nurses are trained to consider it. I had one refuse because 'Feet are dirty'  Well, that's what antiseptic wash is for, besides, I can't remember the last time I wiped my arse with my toes. 

I do think it is something to consider. I, personally, have always found my hands and arms more sensitive. I've never had a drip fail in my feet--once again there have been some 'robust' discussions with anaesthetists before surgery. I win those because I know my body best and I've been there every time I've needed IV access.

Haha Couldn't help having a smile. I'm feeling way more at ease. What a champ Zoffiel. Yep I'll have a crack at the portacath. And if I need I to will ask them to go for my feet. Got some good ankle veins. Thanks for the advice gang xxx

I'll definitely be asking for a portacath if I need Chemo. I have awful veins and almost every time they need to find a vein under ultrasound. Two weeks ago I had an angiogram and it took 4 Drs and 2 nurses 12 goes to finally get a vein and that was using ultrasound again. Last week I had gynae surgery and yet again 7 tries by anaesthetists this time to finally find one. I'm having lumpectomy and sentinel node biopsy next weeks and it's highlighted on my chart to put an IV in when I arrive as it's  almost impossible when I am fasting. My veins have been described to be as small as a babies and crooked! When having long term antibiotics last year in hospital for three months I had a PICC line in and even that died and had to be replaced three times. I'm hoping a portacath will be more successful for me.