Port Infection/Rejection

Does anyone have any experience with a port incision that looked red and irritated after having one placed mid-way through their 6 scheduled chemo treatments?  Terry's has looked "inflamed" for a couple of weeks now.  We showed it to the clowns in that ER the other day but when I asked one of the RN's if it looked infected, he said . . . "Not yet".  For gosh sakes, if something were brewing in there, wouldn't you think they would be able to tell me if it was actually infected.  If something IS up with Terry's body reacting to it, what?  Are we just going to let that thing "cook" in there inside him?

Anyone experience a rejection or infection this long after they placed it?

We'll be sure to ask them next week, but I was just curious if any of you had any issues like that with yours.

 

Thanks!

Dawn

Comments

  • yesyes2
    yesyes2 Member Posts: 591
    Port Issues

    I have had my port since November 2009, still working great, but does need to be flushed every 4 weeks.  Sometimes TPA needs to be used to get it going good.  When you are receiving chemo your immune system is depressed so infections at the port site or within the port can happen at anytime.  It would seem unusual to get the infection at the incision site, but I am not a doctor so really can not answer.  Most problems with ports are either becoming clogged or causing a blood clot.  If the port does cause an infection the port is removed.  I did have a friend who got an infection in her port, it was removed and another one was placed on the other side of her chest same day.  But she was on very stronge chemo, had had 3 major surgeries, and her physical condition was very poor.  If he is worried have the doctor check it out at his next infusion.

  • ShadyGuy
    ShadyGuy Member Posts: 895 Member

    i just completed my course of chemo and go back in 8 weeks for my second go at Rituxan maintenance. Dr. Says keep the port until at least after my next scan. Hmmmm... why would he say that? But I hate the damn thing and would like it out. Don’t want to maintain it. Its a nuisance and I do not need it for Rituxan. Next infusion will be my 31st R infusion so I know I can handle it in the arm with no issues. Does anyone know if having a port installed the second time is any more prone to complications than the first time? Having a stiff stainless steel wire gouged into my chest is not appealing but neither is living with a port. As I said, I hate the damn thing. Any advice or suggestions?

  • yesyes2 said:

    Port Issues

    I have had my port since November 2009, still working great, but does need to be flushed every 4 weeks.  Sometimes TPA needs to be used to get it going good.  When you are receiving chemo your immune system is depressed so infections at the port site or within the port can happen at anytime.  It would seem unusual to get the infection at the incision site, but I am not a doctor so really can not answer.  Most problems with ports are either becoming clogged or causing a blood clot.  If the port does cause an infection the port is removed.  I did have a friend who got an infection in her port, it was removed and another one was placed on the other side of her chest same day.  But she was on very stronge chemo, had had 3 major surgeries, and her physical condition was very poor.  If he is worried have the doctor check it out at his next infusion.

    Thanks, yesyes2  . . . . We

    Thanks, yesyes2  . . . . We'll have the docs take a look at it next week.  Terry's incision, I don't think, should look as red as it is.  When I googled photos of port infections, his didn't look that bad.  But, I'm wondering if that little hiccup with his fevers last weekend may have had something to do with it.  Perhaps, something is brewing.  Hopefully, they won't think it an issue.

     

    Appreciate the info!

  • ShadyGuy said:

    i just completed my course of chemo and go back in 8 weeks for my second go at Rituxan maintenance. Dr. Says keep the port until at least after my next scan. Hmmmm... why would he say that? But I hate the damn thing and would like it out. Don’t want to maintain it. Its a nuisance and I do not need it for Rituxan. Next infusion will be my 31st R infusion so I know I can handle it in the arm with no issues. Does anyone know if having a port installed the second time is any more prone to complications than the first time? Having a stiff stainless steel wire gouged into my chest is not appealing but neither is living with a port. As I said, I hate the damn thing. Any advice or suggestions?

    Come on, Shady . . . tell us

    Come on, Shady . . . tell us how you really feel about that port . . . . 

    Terry likes his . . . other than a few "picky" sensations he gets from it sometimes.  Generally, he's so much happier having them use it than all the IV's they'd have to place.  He absolutely HATES needles.  Who likes 'em, right? 

    Hope yours can be removed sooner, rather than later.

    Thanks for the input!

  • PBL
    PBL Member Posts: 366 Member
    Keep it!

    My understanding is that if/when you need a new port, it is placed on the other side - not in the same "pocket" as the first one.

    My personal view on the matter is this: It took me over a year to make that port a part of me. I am also prone to thick, ugly scars. I have fragile veins (goes with the ugly scarring: conjunctive tissue anomaly).

    Knowing that I have an indolent lymphoma and that it is very likely to start acting up again at some point, I prefer the port to stay right where it is.

    In any case, it does seem reasonable to at least leave it in place until NED is confirmed, right?

    PBL

  • ShadyGuy
    ShadyGuy Member Posts: 895 Member
    PBL said:

    Keep it!

    My understanding is that if/when you need a new port, it is placed on the other side - not in the same "pocket" as the first one.

    My personal view on the matter is this: It took me over a year to make that port a part of me. I am also prone to thick, ugly scars. I have fragile veins (goes with the ugly scarring: conjunctive tissue anomaly).

    Knowing that I have an indolent lymphoma and that it is very likely to start acting up again at some point, I prefer the port to stay right where it is.

    In any case, it does seem reasonable to at least leave it in place until NED is confirmed, right?

    PBL

    Do you flush and how often?

    Do you flush and how often? Can you flush it yourself?

  • PBL
    PBL Member Posts: 366 Member
    FLUSHING

    Flushing, it would seem, is a matter of "equipment" as well as "policy". As to DIY, I suppose you could be trained to do it... I would, however, be cautious with that - imagine you develop some infection in your port, how would insurances handle that?

    PBL

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,803 Member
    edited June 2018 #9
    ShadyGuy said:

    Do you flush and how often?

    Do you flush and how often? Can you flush it yourself?

    ad Random, or "all things port"

    I was of PBL's opinion as regards a port. I did not want mine removed. A sort of Linus safety blanket, if you will.  My port never "bothered" me in any discernable way.

    At the end of treatment, when my oncologist gave me the NED PET results, he then added, "I have a call in to your surgeon to have the port removed."  I was disappointed to hear that, and wanted the port left in indefinitely, but did not argue with the doctor.

    Infection in port incisions is very rare. I would suspect curable with a topical.

    I have never heard of self-cleaning a port, but then again, some people wear chemo pumps home to self-administer drugs, so I guess it is possible.

    Periodicity of flushing a port varies widely also.  My next-door neighbor, who went to the same cancer center as me, when he finished R-EPOCH for NHL, was required to keep his port in for an additional two years.  After a while, he was only having it flushed every 4 months or thereabout, and never had a problem. I have read posters here who claimed to have gone a year without a flush.

    After port removal, when a second port is needed, it can be placed a few inches away from the initial port, or on the other side, and neither is a problem.  I discussed this with my surgeon, due to a huge amount of scar tissue on my right side, and he said placing additional ports for me would be no issue; might take a few minutes longer than if I did not have scar tissue.

    Port trivia: 

    Some ports will receive CT contrasting fluids, and some will not (at least this was true in 2010; the CT nurses always asked me if my port 'could receive contrasting element or not.')  I was unsure at the first CT, and called the surgeon; my port was NOT suitable for contrast.  What the difference is I do not know.   N.B.: I am not referring to the PET radiological element, but to conventional CT contrasting fluid.....

    The port is usually run to the superior vena cava, the largest vein in the body, but there are suitable alternatives.

    Ports can occasionally block some portion of CT images (despite 3D); I had this happen. But it is rare and only effects a very small area; I read this on a radiologist's report.

    When I first began chemo, the lab pulled my biweekly blood draws for CBCs and metabolic labs from my port. Then, they discontinued this practice, and all blood lab draws had to be from the arm or hand.  My onc said that port draws were shown to alter lab results, especially LDH.   I later read confirmation of this is a hematology journal, but I do not know if universally ports are o longer used for blood draws.

    When to remove a port is determined by an assortment of factors, but most oncologists (reportedly) base their recommendations upon liklihood of rapid relapse.  Some cancer centers have formal recommendations for when to remove.  Things considered are how well the diesease was eradicatd by therapy; occurence of relapse; strain of the disease, and others.  Subjective judgement on the part of the doctor is undoubtedly also a factor.  And patient request likely is considered also.

    So when to remove or retain is sort of like when to repaint the den; views vary, and there is not universal agreement on 'right' or 'wrong.'

    max

  • "Topical" ointment

    We were putting Neosporin over the reddened incision site.  It seems, maybe, a little less red but we couldn't really tell this morning; so we didn't put any one.  I think I'm going to go back to applying it, just to be safe.  The area around the port, itself, looks fine . . . and I should think it would look red like it did when they first placed it; so, hopefully, it's just a little "mad" at us for poking it when we go in for treatment.  Again, though, not sure why the incision after all this time would look redder than it had been.  I'm thinking that maybe? that area being a little angry at us could have spiked a small jump in Terry's body temp the other day???  I don't know.  That's the only "odd" thing we could see that MAY have spiked his fever the other night.

    Anyhow . . . thanks for the conversation on this topic.  All good info . . . as usual.

    :)

  • Rocquie
    Rocquie Member Posts: 868 Member
    Port Infection

    I had one. My port became infected at the small incision at the base of the neck where the catheter is inserted into the vein. The area around the incision was very red and inflamed. I had a temperature of 102. This was during regular business hours so I was told to go to the Doctor's office. The Doctor saw me, examined me, and ordered blood drawn for cultures. My WBC was zero and I got my first Neulasta shot. The Doctor said I needed to go to the hospital. I went into the infusion room where I was started on IV antibiotics while the hospital prepared a room for me. 

    The cultures were positive for staph and the port had to be removed. I wound up in the hospital for 2 weeks. I was discharged with a home health nurse and was taught to give myself two 90 minute infusions each day for another two weeks. My R-CHOP had to be delayed.

    Before my next treatment, I had another port placed on the other side of my chest. I never had any problems with the second port (which I named "Lucky") but I was very protective of it. I only allowed it to be used for chemo and religiously had it flushed every 4 weeks. Once my Rituxan maintenance was finished, I could not wait to get that thing out of me. It was one happy day when I came home with it in my pocket rather than my chest. 

    My Doctor's take on it is that it is a foreign object in the body and if not being used, take it out. Don't plan for recurrence.

    I hope this never happens to anyone else!

    Rocquie

     

  • ShadyGuy
    ShadyGuy Member Posts: 895 Member
    Decision

    I have decided to have it removed immediately after my 1st maintenance Rituxan on Aug. 20. I will call the surgeon tomorrow to schedule it. Only reason I am waiting till then is because I am out of town rest of the summer. I just don’t want it in me and if I get other than NED putting in a new port will be the least of my concerns. I can easily handle Rituxan in my arm. No big deal to do that.

  • Evarista
    Evarista Member Posts: 336 Member
    ShadyGuy said:

    i just completed my course of chemo and go back in 8 weeks for my second go at Rituxan maintenance. Dr. Says keep the port until at least after my next scan. Hmmmm... why would he say that? But I hate the damn thing and would like it out. Don’t want to maintain it. Its a nuisance and I do not need it for Rituxan. Next infusion will be my 31st R infusion so I know I can handle it in the arm with no issues. Does anyone know if having a port installed the second time is any more prone to complications than the first time? Having a stiff stainless steel wire gouged into my chest is not appealing but neither is living with a port. As I said, I hate the damn thing. Any advice or suggestions?

    Save those veins!

    My nearest and dearest has always adhered strongly to the philosophy that "You do not want to turn up at the ER and have them unable to find a vein!" Yes, your veins will withstand the Rituxan OK, but you do need to remember the possible long-term wall damage that can come from all those sticks.  Since I do not have a port, I am very careful to alternate arms.

  • ShadyGuy
    ShadyGuy Member Posts: 895 Member
    Rocquie said:

    Port Infection

    I had one. My port became infected at the small incision at the base of the neck where the catheter is inserted into the vein. The area around the incision was very red and inflamed. I had a temperature of 102. This was during regular business hours so I was told to go to the Doctor's office. The Doctor saw me, examined me, and ordered blood drawn for cultures. My WBC was zero and I got my first Neulasta shot. The Doctor said I needed to go to the hospital. I went into the infusion room where I was started on IV antibiotics while the hospital prepared a room for me. 

    The cultures were positive for staph and the port had to be removed. I wound up in the hospital for 2 weeks. I was discharged with a home health nurse and was taught to give myself two 90 minute infusions each day for another two weeks. My R-CHOP had to be delayed.

    Before my next treatment, I had another port placed on the other side of my chest. I never had any problems with the second port (which I named "Lucky") but I was very protective of it. I only allowed it to be used for chemo and religiously had it flushed every 4 weeks. Once my Rituxan maintenance was finished, I could not wait to get that thing out of me. It was one happy day when I came home with it in my pocket rather than my chest. 

    My Doctor's take on it is that it is a foreign object in the body and if not being used, take it out. Don't plan for recurrence.

    I hope this never happens to anyone else!

    Rocquie

     

    You are strong

    and have been through a lot. Good goin! I hope I do as well. Thanks for all the tips over the years.

  • Evarista said:

    Save those veins!

    My nearest and dearest has always adhered strongly to the philosophy that "You do not want to turn up at the ER and have them unable to find a vein!" Yes, your veins will withstand the Rituxan OK, but you do need to remember the possible long-term wall damage that can come from all those sticks.  Since I do not have a port, I am very careful to alternate arms.

    That dang thing looked redder

    That dang thing looked redder last night.  God, I hope they aren't going to refuse us Thursday.  He is so looking forward to getting to that half-way point.

  • PBL
    PBL Member Posts: 366 Member
    unknown said:

    That dang thing looked redder

    That dang thing looked redder last night.  God, I hope they aren't going to refuse us Thursday.  He is so looking forward to getting to that half-way point.

    Any doctor or nurse could

    Any doctor or nurse could easily reassure you by taking a quick look at it.

    If it is neither hot, nor itchy or painful, not suppurating, and Terry is not having a fever, chances are it's just the normal healing process.

    Why not let your PCP take a peek between two patients? 

    PBL

  • PBL said:

    Any doctor or nurse could

    Any doctor or nurse could easily reassure you by taking a quick look at it.

    If it is neither hot, nor itchy or painful, not suppurating, and Terry is not having a fever, chances are it's just the normal healing process.

    Why not let your PCP take a peek between two patients? 

    PBL

    I'm thinking we'll be okay to

    I'm thinking we'll be okay to, at least Thursday, when he goes in for Hit #3.  The port itself looks fine . . . just that incision.  I can't believe it's infected.  He had the thing placed on May 18th.