pros and cons of pic lines or a port

I had a port as do many ladies I think.  It will leave a small scar when removed but nothing terrible.  I hate needles so this worked for me.   I had it taken out the same day I had one breast re shaped by plastic surgeon.  If you get sore after an infusion just tell the Oncol or surgeon, cancer nurse etc.  I got nervous when they hooked it up found it a strange sensation hut I preferred it over all.

Rague/Susan just gave a good synopsis of PICC v. Port. I venture to say most of us on this Message  Board have had a port placed before chemotherapy - but not all, of course. I'm not sure where your sister-in-law is getting her information about ports/medi-ports/power ports, but they do not need to be flushed at home by a nurse. I got a port implanted by a general surgeon before I began chemotherapy. I was immensely glad that I did. I have small, next to invisible veins and am a difficult stick. It is a chore to find a vein and often a pediatric size needle has to be used. Believe me, I am definitely not a pediatric sized person  . Between blood draws, chemotherapy, IV fluids, other  procedures, etc. I cannot imagine being poked that many times in an attempt to find a good vein. I only kept my port in a couple of months and then went to the surgeon's office and had it removed. I am fortunate in that it has not been needed for chemo since that time. My husband had colon cancer and also had a port. He kept his in for probably 3 years after chemo was completed. The aesthetics of it didn't bother him in the least and he seemed to feel it was like a lucky charm for him - as long as it was there it wouldn't be needed. Well, it has been 5 years since his treatment is over and he has never needed it again. 

I would suggest that your sister-in-law get additional information on ports before she dismisses the idea of getting one. There is a lot of information out there. Good luck to her. You are a wonderful relative to come here and try to obtain knowledge on her behalf.

IRENE

sandra4611 said:

I've had PICC lines placed twice

My large regional military hospital uses both ports and PICC lines. Most chemo patients get ports, but not all.

I've had a PICC line twice because I have developed terrible veins. After developing a bad infection, I had 25 unproductive sticks (even in my feet!) after my bilateral mastectomy. They brought in people from the ER and ICU to try but these "uber-confident" people fared no better. At 25 tries over 2 hours, I put my foot down, said NO MORE and demanded to see my doctor. My doctor agreed with me. She was mad that the nurses had put me through the torture of 25 sticks. She ordered a PICC line for IV antibiotics and blood transfusions. I went home after a week still on the IV antibiotics for a month. I kept it through a second surgery (because of damage done by the infection) and then two months more for continued IV antibiotics and for iron infusions due to anemia. I would have liked to keep it a month longer for my third surgery, but my plastic surgeon was worried about infection and preferred that I have it taken out and then replaced the day before surgery. The PICC team nurses told me a PICC line can stay in several years as long as it is maintained properly but we had to go with what the doctor ordered. I had the PICC line for several weeks after surgery 3 to get more IV antibiotics to avoid another infection. I'll have surgery 4 in March and will get one again the day before surgery.

For me, they are wonderful to have and easy to maintain, once you are taught. My husband learned how to do the IV antibiotics and flush the lumens (I had two - one for antibiotics, the other for blood draws.) It's easy. Getting one put in is not a big deal. They do need to be put in by a specialty nursing team using sterile techniques, but you don't have to be in an operating room or be sedated. They use an ultrasound to find the bracchial vein inside your upper right arm, then give you a little shot of lidocaine, mixed with saline so it's a little short sting, not a big one. The soft PICC line is fed into the vein, up to your shoulder, across your chest and down towards your heart. You get two sutures to hold the line in place. They do an x-ray to make sure everything is in the right place and that's it. The dressing needs to be changed by the PICC team at 24 hours and thereafter once a week. I did have a series of visiting nurses every other day at home for blood draws and two of them did dressing changes. I did not think the last one did a good job and was suspicious of her sterile techniques, so I chose to go back to the hospital's PICC team each week for perfect cleaning and dressing changes. They were happy to do it. I had to go for saline fills in my tissue expander each week anyway, so it was no trouble for me.

 It is to be kept away from water so you have to wear a waterproof shower sleeve, which is mildly annoying after a while, but no big deal. There are companies that make PICC line covers in an assortment of colors and fabrics since most people have them for months and months and get tired of the white stretchy mesh the hospital gives you. It doesn't hurt AT ALL to have it or get it taken out. You don't feel it. You will have a little scar from the two sutures and a tiny dot scar from the PICC line itself, but they fade quickly.

Depending on the number of infusions they are recommending for your sister and the current condition of her veins, she might not need either.  I had 4 sessions of Taxotere and Cytoxin.  I did not need a port nor a PICC line.  My veins are ok and I have had blood drawn often since chemo.   I was 63 when I had chemo, so if age plays into the equation, I was old, and I'm fine.  I'm under the impression if I had needed a longer protocol, I would have had a port, and I've noted the women here who had longer chemo protocols had ports while those of us on the 4 cycle protocols didn't. 

Suzanne

When I say felt strange a couple of times to connect to the port was on the rough side.  Experience counts, some just have the knack, some don't.  

I have a port, it was so much easier then getting stuck each time. I still have it 2 yrs after chemo and never had a problem with it, I'd get it removed byt they charge for that.

joanwayne said:

port

I have a port, it was so much easier then getting stuck each time. I still have it 2 yrs after chemo and never had a problem with it, I'd get it removed byt they charge for that.

But it costs to have the monthly (or every other month if that's what you schedule is) flushes so in the long run wouldn't it be cheaper to remove it if you're worried about cost?

I don't have mine numbed when being accessed, and I just feel a little stick, not uncomfortable, more like a sensation.  I wouldn't do chemo any other way and it does make it easier for blood draws and testing.  I have gotten used to it being there after just a few months.  Not uncomfortable for sleeping either.  Good luck!

Rague said:

PICC lines and Ports are very

PICC lines and Ports are very different and the care needed with them.  A port is totally enclosed in the body (vaguely like a pacemaker is).  A PICC is external and needs more care and it more open to infections.  A port only needs to be flushed once a month (I was recently told every 6 - 8 weeks is now considered fine) when it is not being used after chemo is finished but while on chemo it is flushed at every infusion.  Basically there is no more risk of infection with a port than with any vein stick.  I would have had a really hard time deciding to have a PICC because I'm a very active 'ourdoor' woman around a lot of animals so to me the PICC would have not been an option I'd probably have taken but it was never discussed - power port was from 'day one'.

Chemo is very hard on veins.  I have great veins and after surgery only one arm (neither if BMX) will be available for blood draws so I wanted to protect my veins I'd still have useable.

My port was put in in Aug 09 and it's still in.  My last chemo was 4 years ago this month so I go to my Clinic monthly to have it flushed.  My choice to not have it removed - I'd rather it be there ready incase it's needed again than to have to go through more surgery to implant another one.  We are all different in how we 'look at' things.

Winyan - The Power Within

Susan

Risk of infection is not the only severe possible adverse effect with a PICC.  In my career, I have personally seenmalposition (fairly frequently, clots, and cardiac tamponade (life threatening).  PICC's are safer these days, but I would not consider one for chemo if I could help it.

I have had my port for 9 months now.  Recently while getting chemo, I asked my oncology nurse how long could it last.  She introduced me to a lady next to me with sickle cell anemia who has had a port for 15 years! 

I love my port and I hope it lasts forever.  I wish I had had one with my first round of chemo because now my existing veins are so damaged and IV options are very limited (especially since they can't use my left arm).

As far as flushing, I will have chemo every 21 days indefinitely, so I don't have to worry about it.  If I had to get it flushed, I would ask my oncology nurses if I could just run over and have them do it.  If you are far from an infusion center that might not be an option.

One final word about my port, I no longer let anyone touch it except my oncology nurses (if I can help it).  I had a bad experience in the ER when an ER nurse did not use the central line kit and accessed it like an IV (you are supposed to wear mask, sterile gloves, etc.).  Fortunately, I was in the ER with febrile neutropenia and was started on IV antibiotics.  That experience shook me up though because I have seen central line infections.  And, yes, I should have spoken up, but when you are shaking with chills and fever, you aren't thinking straight.

In spite of that, I strongly recommend a port.  Chemo can do permanent damage to veins and it is much better to have chemo infusing into a very large blood vessel where it is quickly diluted and much less likely to cause vascular damage.

I had 8 and didn't have anything. I have skinny veins so they used my hand and it was always just fine. They did do something for my huge long surgery cause I needed continuos IVaccess for 3 days, but for chemo...you may not need anything.  Enjoy!