How does having a port affect my daily life?

Baird Cancer Treatment Port

Many conditions, such as cancer treatment, long-term IV medication or kidney dialysis, require frequent or constant access to your veins. Repeated needle sticks in the same area can be hard on you and hard on your veins. That’s why we specialize in placing vein access ports, so that doctors don’t have to stick you with a needle or restart an IV line every time you need treatment. That makes care easier — and your life easier.

Once you have a port, you may wonder how it will affect your day to day activities. We spoke with Richard Williams, RN, BSN, OCN at Baird Vascular Institute, who said to think of it as you would any medical procedure, “For the first few days, avoid any heavy lifting or strenuous activities.” Williams continued, “There are folks who like to hunt, or play tennis, or even have a job like a hairdresser where their arms move up and down frequently, for those folks we tell them they need to give the site a chance to heal, to let the skin start coming together and heal.”

Williams added, “We do ask people about their lifestyle and take that into consideration when placing the port. We can put the port on a different side if needed. All these things are discussed with the patient because we know they’re going to have this port for awhile.”

You can even travel with a port. Williams added, “If you do go through an airport scanner, it shouldn’t go off because there’s not metal in the port, but you can pull out a card that we’ll give you and show the agent what the ‘bump’ is in your scan.”

If you’d like to learn more about port and the procedure, we have a whole series of YouTube videos on the topic.

We’ll work with you and your health care team to choose the best long-term IV access option for your situation. Give us a call at (804) 828-2600 to discuss your options.

 

Why a port is a good idea

VCU Health Baird Port

From needle sticks and blood draws, from injections to IVs, everybody has had their shots. Usually, a pinch is all there is to it. But many conditions, such as cancer treatment, long-term IV medication or kidney dialysis, require frequent or constant access to your veins. Repeated needle sticks in the same area can be hard on you and hard on your veins. That’s why we specialize in placing vein access ports, so that doctors don’t have to stick you with a needle or restart an IV line every time you need treatment.

We talked to VCU Baird Institute’s Dr. Shep Morano about why someone might need a port.

“A port is a safe, reliable and low maintenance way to access a patient’s bloodstream,” said Dr. Morano. “Sometimes a port is recommended for patients who have used up all their peripheral veins, or doctors or nurses are having difficulty accessing their veins.”

Placing a semi-permanent catheter such as a “port-a-cath,” chemotherapy port or IV access port into a large vein in the upper arm or neck can make treatment easier for patients undergoing treatments that require frequent or constant vein access.

  • Chemotherapy or anti-cancer drug infusions
  • Hemodialysis
  • Long-term intravenous antibiotic treatment
  • Long-term intravenous feeding
  • Repeated drawing of blood samples

These ports can remain in place for several weeks or months and can help patients in many ways:

  • Fewer needle sticks to draw blood
  • Multiple IV lines accessible at one site
  • Lowered risk by reduced leakage, which is particularly important with chemotherapy agents that can cause tissue or muscle damage if they leak

Dr. Morano added, “The benefits of added safety, patient comfort, infection control, and ease of access make ports a great option for someone who needs long term central venous access.”

There are several types of long-term IV ports, the most well-known is the Port-a-cath. Unlike most other types of catheters, a port-a-cath is implanted completely underneath the skin. This type of port allows you to bathe and swim without the risk of infection. Port-a-caths can remain in place for months or even years.

A peripherally inserted central catheters or PICC line is inserted into one of the large veins in the arm near the elbow. PICC lines are generally used for shorter periods (one to six weeks) and are easier to remove.

These types of catheters, such as a Central line, tunneled venous catheters or Hickman catheters, are inserted into a large vein under the collarbone or in the neck and leave the body through a separate exit point, usually the upper chest. A “cuff” secures the line, providing protection from infection and holding the catheter in place as your body heals around it.

We work with you and your health care team to choose the best long-term IV access option for your situation.

 

 

Maintaining optimum health during dialysis

If you are starting hemodialysis treatments in the next several months, one crucial step before starting regular hemodialysis sessions is preparing a site on the body to access the vein. Dialysis access is the site on your body where blood is removed and returned during dialysis. To maximize the amount of blood cleansed during hemodialysis treatments, dialysis access should allow continuous high volumes of blood flow. There are three access options for the dialysis patient – AV fistula, AV graft or a central venous catheter.

To allow for the high volume of blood exchanged, dialysis access to your blood is usually in your arm or leg. Choosing your access is a decision that you and your doctor will make. We discuss the AV fistula, AV graft and central venous catheter options in this blog post.

As with any serious medical condition, you’ll need to make a few lifestyle changes while undergoing dialysis.

One of the most important changes for dialysis patients is diet. Maintaining a healthy diet during dialysis is essential to good health and shorter dialysis time. Toxins in unhealthy foods make the body produce more waste, resulting in longer dialysis treatments. The National Kidney Foundation has a great blog post from a dialysis patient who mastered her dialysis diet. You can read her post here.

Even though you may not always feel up to it, maintaining some form of exercise is still important. The combination of your kidney disease, and sitting for frequent, long periods of time during dialysis can expedite deterioration of your overall physical health. According to a program launched last summer in Australia, “Exercise has been shown to improve physical function, quality of life, muscle condition and the dialysis treatment in patients with kidney disease, as well as decreasing depression, cardiovascular risk and a range of other negative outcomes of kidney disease.”

Finally, mental health contributes to an overall sense of well-being. It’s normal to be concerned or overwhelmed with your diagnosis, but if you need to seek out professional help to sort through your feelings, do it. Try to stay as active and involved in your normal day to day activities as you can.

If you’d like more information about choosing your access site, please give us a call at (804) 828-2600 to discuss your options.

I’ve been told I need dialysis. What can VCU Health at Baird Vascular Institute do for me?

At the VCU Health at Baird Vascular Institute, our experts are uniquely equipped to deal with the maintenance and care of your dialysis access in a convenient, neighborhood setting. With the latest technology and highly skilled staff, each case is approached as a unique and individual patient, complete with plans of care and follow-up.

If you are starting hemodialysis treatments in the next several months, one crucial step before starting regular hemodialysis sessions is preparing a site on the body to access the vein. Dialysis access is the site on your body where blood is removed and returned during dialysis. To maximize the amount of blood cleansed during hemodialysis treatments, dialysis access should allow continuous high volumes of blood flow.

There are three access options for the dialysis patient – AV fistula, AV graft or a central venous catheter.

To allow for the high volume of blood exchanged, dialysis access to your blood is usually in your arm or leg. Choosing your access is a decision that you and your doctor will make.

Here is some additional information about your options.

AV Fistula

An AV (arteriovenous) fistula is a surgical connection of one of your own arteries to a vein under the skin of your arm. It’s the most natural dialysis access because it’s made with your own blood vessels. Most people can tolerate an AV fistula. However, if your veins are too small or too weak for a fistula, there are other options.

An AV fistula requires advance planning because the fistula takes a while to develop, or mature, after surgery, — in rare cases, as long as 24 months. However, a properly formed fistula is less likely than other kinds of vascular access to form clots or become infected. Also, properly formed AV fistulas tend to last many years—longer than any other type of dialysis access.

AV Graft

An AV graft is a surgical insertion of a special tube that connects to a vein and an artery. It becomes an artificial vein and is used like a fistula. If you have small blood vessels that won’t develop into a fistula, an AV graft may be a good option for you.

An AV graft doesn’t need time to mature as a fistula does, so it can be used sooner after its placement, often within 2 or 3 weeks. Compared with properly formed AV fistulas, AV grafts tend to have more problems with clotting and infection, and need replacement sooner. However, a well-cared-for AV graft can last several years.

Central Venous Catheter

If your kidney disease has progressed quickly, you may not have time to get a permanent dialysis access before you start hemodialysis treatments. You may need to use a central venous catheter as a temporary access. A catheter is a tube inserted into a vein in your neck, chest, or leg near the groin.

Central venous catheters are not ideal for permanent access. They can clog, become infected, and cause narrowing of the veins in which they are placed. But if you need to start hemodialysis immediately, a central venous catheter will work for several weeks or months while your permanent access develops.

For some people, AV fistulas or AV grafts are unsuccessful and they need to use long-term catheter access. Central venous catheters that will be needed for more than about 3 weeks are tunneled under the skin to increase comfort and reduce complications. However, even tunneled catheters are more prone to infection than AV fistula and AV grafts.

Your healthcare team will help you choose the best long-term dialysis access for your situation. If you already have an AV fistula/AV graft that is not functioning properly, or if you need a central venous catheter, speak with your doctor and contact us. We can diagnose and treat you to get your access functioning. Please contact us at (804) 828-2600 or email us at bairdvascularinstitute@mcvh-vcu.edu.