Portacath problems

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Can you advise please?   The last 2 out of 3 infusions I’ve had problems with my portacath.   The issue is no blood return or blood draws being possible.  The first time they drew blood from arm instead and then passed me to infusion centre.   The second time I wasn’t having blood test that day so went direct to infusion.  Both times they couldn’t set up blood return functionality.  The first time after lots of poking and prodding, arm raising, raising feet above head and massage of portacath site and internal tubing, they removed needle, tried a new one and it worked.  Yesterday, younger less experienced nurse, just set up and did infusion even though there was no blood return.   She asked if I’d had previous issues and I told her about the problem time before last and how they solved it. Of course I’ve come home and googled, seems that yesterdays infusion never have happened and infusion should have been stopped due to potential internal leakage of chemo drugs.   It seemed to go okay, drip rate set at usual hour rate and liquids went in without discomfort.    Should I be concerned?    I’m back again for another infusion on Wednesday this time with bloods to be taken.   I’ll flag previous issues.  If they can’t draw bloods I’ll make sure it won’t be used, there is obviously a problem.  

  • Hi  

    Thanks for getting in touch with our online community. My name’s Louise and I’m one of the Cancer Information Nurse Specialists here.

    It sounds like you have been having a difficult time with having bloods taken. It can be concerning when you have had issues, and then the procedure happens to be different from what you were expecting.

    I can see from your bio that you lived in Spain. We can only speak about cancer treatment in the UK because there are differences in health services and care in other countries.

    It’s natural to want to find out information about the correct procedure for using a portacath (implantable port). The different reasons why blood return may not be present. One of these is the presence of a fibrin sheath that cause a blockage and be treated with clot dissolver.

    Each hospital has its own policy on portacath management and chemotherapy administration. As we don’t have access to medical records here on the Support Line, it’s difficult for us to say why you had yesterday’s infusion without blood return.

    Chemotherapy and portacaths can cause other side effects and problems. You mention potential internal leakage of chemo drugs. This is also known as extravasation and can cause permanent damage if left untreated.

    It’s important to report any concerns and any new, worsening or changing symptoms to your healthcare team straight away when you are having cancer treatment such as chemotherapy.

    We would suggest contacting the 24-hour number you have been given, or a senior nurse in your hospital treatment team. They can talk through the concerns you have about having the infusion yesterday. You can also talk with them about the best way to manage the portacath and have chemotherapy going forward.

     

    Kind regards  

    Louise, Cancer Information Nurse Specialist  

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 Overseas +44 20 7091 2230 (7 days a week, 8am-8pm) or send us an email.  

    Our Ref:  LR/ RH

  • Thank you, very helpful.  I’ve contacted hospital and asked them to let my consultant know I have issues.   They’re not very proactive in getting back here, no 24hr line just a&e.  All good just now, so can wait till I go in next week.   MacMillan have been so very very helpful.  X

  • A little update.   They managed to unblock my portacath yesterday.  The blood draw nurse spent lots of time with me.  Did the usual gymnastics and massuage but no joy..  Injected some clot break up drug and sent me off for a big walk and to drink lots of water.  90 minutes later she tried again with huge success.   She then stayed with me during infusion when catheter worked beautifulllyl.  A heparin shot at the end after saline flush and all is good.   So so kind and I really appreciated her time, care and empathy.