Wednesday, April 17, 2013

Ports and Procedures!

One of the things about cancer treatments is that there is a great need for IVs.  The chemotherapy medicines, because of their extreme toxicity, need to be given as close to the heart as possible, in order to dilute them in the blood, as fast as possible.  There is the need for numerous blood tests, to check hemoglobin, white blood , chemistry, and piles of other counts (which for me are taken daily!)!  I have really bad veins; before one of my surgeries, it took four tries to find a vein to anesthetize me- my veins, if they could find them, would collapse quickly, or blow- not to mention that it hurts like crazy!!

The Mediport
So I think one of the most marvelous inventions of all times is the Mediport.  I have had one installed for each of my cancers, and it has been a tremendous blessing! It is a surgical procedure, performed under general anesthesia   While the port itself is usually placed in the chest, they make an incision in the neck, to guide the main catheter line as they thread it.  Usually, my neck is soooo much more sore than the incision!  The port is a small reservoir (described like a metal Coke bottle cap) that is placed beneath the skin.  A catheter attached to the port empties into a major vein, in my case the superior vena cava. The port is surgically implanted, and is completely underneath the skin.  At the hospital, my port is "accessed", so that it is usable.  It is an idea like a snap button- one side is inside my skin, the other is outside.  The nurse will "snap" a needle into the center of my port (which you can feel); the port can now be used to draw blood or deliver medications.  It is a guaranteed access each time, eliminating the need for needle IVs!!

My Mediport incision.  The circle is the approximate location of the port- it's about the size of a quarter.  The arrow points to the dressing of my tri-fusion catheter.  
The Tri-fusion Catheter
For my BMT, I needed more than one vein accessed; I have had, at times, four different lines accessed with medications!  So I received a tri-fusion catheter, similar to a Broviac.  My catheter has 3 lumens, for three different accesses.  This procedure was done by Interventional Radiology   I was only under a "twilight sedation", which is basically la-la-land.  Interestingly, I heard the doctor explaining the entire procedure to a resident!
The tri-fusion sticks out of my body, which means that it needs flushed (so that blood doesn't clot in the lines) daily.  When I was at home, I flushed the tri-fusion myself each evening.  Also, there is a large dressing that covers it at all times, which means I cannot get it wet (because of risk of infection).  If the dressing peels or opens, it is necessary to clean and redress it, as there is another risk of infection (a sterile procedure which my parents and I also did at home!).  The tri-fusion is temporary, unlike the Mediport, which can remain in a person for a year!  I will be getting my tri-fusion removed before I go home!

My Tri-fusion catheter dressing
White arrow- where the tri-fusion is placed
Orange outline- a Stat-loc, which keeps the line taped in place on me
Black arrow- the outline of the three access lines

The three access lines; they are three different colors so that you know which ones you have used.  The arrow points to the lumen, or opening of the catheter lines
I have also had one other anesthetized procedure- an endoscopy.  The doctors wanted to examine my stomach, to determine the extent that my body had healed.  This procedure was also carried out by regular surgery, under a general anesthesia.  The basic idea is that a long tube, with a camera on the end, is stuck down your throat, to take pictures.  Also, they gathered a few biopsy samples from my stomach and intestines.

Ready for my endoscopy with Daffodil and Chuckles!  
My port and tri-fusion have convinced me of the need for new and improved medical devices.  These two medical devices have helped make my treatments so much more comfortable.  There is little we can do about the chemotherapy medicines or their side effects- they are necessary to kill cancer cells.  However, the field of medical devices holds so much potential to help make the lives of oncology patients so much more comfortable!

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