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Port won't draw blood - has anyone had this happen?

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

Hello all:
Yesterday was a chemo infusion no. 6 and they could not get this to work even after the altapaste sp?
I have an order to get it checked at my local hospital where it was placed.

When I had my second surgery in April this problem occurred and when I went for chemo infusion a month ago it did work.
The nursing team didn't know I had a port to draw from until my oncologist stopped in because she saw my chart
and stopped in and said hi then confronted them why they weren't using it!
After being poked all day for draws. and 2 attempts at the port I said enough blown veins and I need a break. Ok too much tmi. My care was very good but the day after surgery was a little tough.

What do they do if the tip is clogged?
Do they take this port out and replace?

Ugh....its a little scary
I asked the port nurses if I can get money back for a malfunctioning port.
They chuckled and said good luck-ha ha! (I was serious lol)

Any experience or suggestions appreciated - yesterday was a nervewracking day beside my reaction to Oxyal.
At least the Benedryl they gave me made me sleep the whole way home....they almost weren't going to do the infusion because of the port..but it worked out.

Thank you
Barb

Sundanceh's picture
Sundanceh
Posts: 4306
Joined: Jun 2009

Did they offer you TPA....it is a clot buster, sort of like drano for your sinks and tubs:)

They inject that into the port and you wait about 30 minutes or so...they then go back and try and draw again....if they can't get it, they will refer you to an IR Radioligist who will inject you with a dye, to see if the port is damaged.

If the clot won't clear, you could get yourself a new one. If you are still able to accept chemo but not get a draw, you could just choose to do nothing.

Or, you could have your port replaced...

-Craig

Doc_Hawk's picture
Doc_Hawk
Posts: 685
Joined: Jan 2012

The chemo team has always had a very difficult time getting a blood return from my port. I tell them that in order to get blood I need to stand on my head and stack BBs while wearing boxing gloves. They did get a return a couple of treatments ago, but usually they have to go through a vein. At least that gives me a chance to flirt with the phlebotomist.

danker
Posts: 750
Joined: Apr 2012

How do you like those bloodsuckers?

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

Hey all - thank you for responding

Love the sense of humorous too! :-)

Craig, they did not offer TPA.
They used something called altapaste (spelling) for 30 min.'s and tried to flush and draw again.
They tipped back the recliner back and had me hold my arm over my head and cough! No luck....
It was close to standing on my head!

Yea, I have the order for the Inv. Radiologists to check it out.
Ugh...another hospital visit. Goody goody...

Guessing if I'll have a choice they can do the stick rather then replace the port.

It's so great to know questions about this new world, I am growing to accept, can be answered here.

I will make the IR appt. tomorrow- I really liked the bedside manner and competency of the Dr. who did my lung biopsy and placed my port. Maybe I will be able to request him. I will be able to go to my local hospital, which will be convenient.

Thanks again. I really got upset the first time this happened but getting answers gives knowledge to have some power over this disease.
I wish it were easier for all of us. I hate the cliche statement of treatment being a marathon but it kind of is.

Doc_Hawk's picture
Doc_Hawk
Posts: 685
Joined: Jan 2012

I like the one at the infusion room real nice. And best of all, she's single! Now that the weather is warming up, I'm going to see if she wants to go riding some time.

John23
Posts: 1832
Joined: Jan 2007

Part of the Port or PICC line maintenance procedure involves
the ability to draw blood back through the device. If it fails the
ability to give and take, then there is a problem with the device.

If the line is no longer where it should be inside your vein, then
it may not provide the ability to draw back from that location.
If that is the case, the infusion may not enter into the proper
location for proper dispersal either. That's the whole purpose
of the test!

Nurses do not always understand, or follow procedures, but
your hospital's interventional radiologist can explain the reason
for each procedure, and the importance of each.

Get the blasted thing checked out at the IR's office. If it has to
be reset, they will do it without pain or suffering.

Be well!

John

janie1
Posts: 753
Joined: Apr 2011

Even though i have a port, i have blood drawn every other week from my hand with no problem. That's what they do at Sloan. At first I was a little miffed that they didn't get it from the port.
((When I first got the port, it was always a challenge for the first onc's "medical assistant" to get blood return.))

If you are getting close, anyway, to the end of the line with chemo, I wouldn't even worry about it. Could you just finish it out with getting blood from your hand veins. Would everyone be OK with that?
Just a thought.

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

John and Janie - thanks for your input

I have to get it checked out. The port I have isn't the same one they would have
placed where I am getting treatment...ugh Not that it should make a difference I guess.
There is something about needle sizes etc., for contrast when getting a CT and drawing from the port.
Its almost faster getting the veni poke at times....

I don't mind being stuck but I don't know what the chemo plan is after the next 2 infusions..

Your responses are helpful and I can handle no pain and suffering!

Thanks!

dmj101's picture
dmj101
Posts: 526
Joined: Nov 2011

I had the port not want to draw once but it was allowing stuff in.. so they injected and enzyme they told me to break the clog up .. sort like a draino.. and it has been fine ever since..

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

Hope they can do this and not have to replace.

Thanks for your response.

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

Queen of port troubles here... ;)

I won't bore you with all the details, but will tell you that at different times with 3 different ports, we couldn't always get a blood draw with mine. As long as they could get a tiny bit, it was considered ok. Often I had to sit up, lie back, bend forward, cough, cough and cough, put my arms over my head, turn on my side, etc., just to get a bit of return.

I believe what they used on you was probably TPA (alteplase). They also call it Cath-flow sometimes. They inject it and you wait 30-60 minutes to see if it can break up anything blocking the catheter. One thing that can happen is a fibrin sheath. As long as it moves for anything incoming, it is still usable, even if it won't let anything out (blood). One of my ports had this issue, but still worked for chemo.

If you got your chemo to go in, and without any pain, there probably is not a problem, but getting it checked out in the Cath Lab is still a good idea.

My third port had to come out a few months back - I was going to keep that one forever (after what I went through with each of my ports being put in and taken out - 2 infections and a punctured lung), but it failed. When they flushed it, at first I felt a little "popping" sensation in my chest - uncomfortable, but not painful, and it went away. But the next month it was worse, and harder for them to flush, and even less blood return. And finally it was very painful, and they could get no blood return, and really had to force things to try and get anything in. I was sent to the Cath Lab and they forced in more saline, and then dye. That really hurt! I hurt for a couple of days after that until the dye found a way out of my chest. I had a big hole in the catheter, so anything going in was going into my chest cavity. Believe me - if you get a hole, you'll know! (Thankfully I've had a 6 month treatment break and haven't needed a port during this time. I'm not too excited at the thought of port #4 one day...)

Doc_Hawk's picture
Doc_Hawk
Posts: 685
Joined: Jan 2012

How did a Port cause your lung to puncture? That must have been horrible! My first Port got infected and the surgeon used only a local before getting out his chainsaw and the jaws of life to riiiiiiiip it out. Of course, local anesthesia doesn't work very well on infected tissue and it was easily one of the top three worst pains I've ever felt

What was funny about it was that a few days after the removal, I was walking the dog and not wearing a shirt because the wound was still oozing. One of my neighbors saw the blood dripping down my chest and said "dude, what happened?" With a straight face I told him I'd been in a local bar a few days before when some bozo decided to rob the place with a .22 pistol. "Before I could get the gun away from him and offer a .22 caliber enema, he got one round off." His jaw dropped and he asked "really?" I told him the real story after that. We both had a pretty good laugh about it.

PhillieG's picture
PhillieG
Posts: 4673
Joined: May 2005

Hi Barb,
I've had the same port in for many years. After the first year or so there would sometimes trouble drawing blood but never problems with the infusion going in. The Onc ordered a Flow Test and it confirmed that it was letting the infusion in which is the point of the port, it's more of an entrance than an exit.
There was no need for any further adjustments at all. Sometimes they get blood return, sometimes they don't, but there's no standing on my head or on one leg. IF there were a problem, you'd know (and they'd know) that there was and they'd do what they'd have to do.
Hope this helps...
-phil

Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

Same here, mine never returns blood but allows infusions. Its like it has a one way check valve on it lol!

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

Sounds like I need to check it out.

Hopefully I can keep it in and continue chemo

Always something with this journey....

Thanks!

marbleotis's picture
marbleotis
Posts: 498
Joined: Mar 2012

My port would not draw after chemo #3. They were surprised but used flush, flush. heparin then TPA. The TPA worked but caused me a fever (so keep an eye on that). I just finished chemo #8 of 12 and it has been working great.

fatbob2010's picture
fatbob2010
Posts: 397
Joined: May 2012

My port had the catheter flip. The IR docs were able to diagnose and correct with a wire that was snaked up through the groin. Asking the IR doc could be a great idea to help alleviate any concerns...there's enough other things to think about. Hopes and hugs for an easy fix

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

Thank you for your posts

Going to get scheduled come Monday.

I sure agree there are enough other things to think about and fear...ugh

I feel better knowing what to expect and this happens frequently.

I am on chemo no. 6 out of 8. (For now I can only hope)

Barb

Doc_Hawk's picture
Doc_Hawk
Posts: 685
Joined: Jan 2012

I had treatment today and for the second time in three infusions I gave a return from my port. It was a pretty slow draw, but she were able to get what was needed. So I didn't get to flirt with phlebotomist today, but wouldn't have anyway because she wasn't working at that clinic.

barbebarb's picture
barbebarb
Posts: 464
Joined: Oct 2011

Glad your port worked!
A possibility to flirt helps the overall infusion eh? Lol
I see my fav IR Radiologist the day before next infusion to check the port.
I feel less anxious now and they can do the peripheral draw.
I cant fathom a new placement and hopefully that wont be the case....
:-)
Hope you are felling well after treatment.

Doc_Hawk's picture
Doc_Hawk
Posts: 685
Joined: Jan 2012

Yeah, I'm absolutely shameless when it comes to flirtation. As for the blood draw, because of how slow the flow was compounded with a low anion gap and a high chloride count, I'm thinking it's a hydration issue. Reckon I'm going to have to start drinking more Gatorade to help resolve that. In my case, I'm betting that getting more hydration will help with the blood return through my port.

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