That Port Life
In my last post, I talked about my tale of horrible veins, which led me to getting a surgical powerport placed about 18 months ago.
What is a port?
A surgical port is a small medical appliance placed beneath the skin through an incision just below your collarbone. The device itself is made of either titanium, plastic, or stainless steel, and a silicone catheter connects it to a vein (usually the jugular vein, subclavian vein, or superior vena cava). This allows medications, fluids, and anything infused through the port to spread through the body very quickly. The port can also be used to draw blood.
How is the port accessed?
In my case, my port is usually accessed by a nurse at the hospital or my infusion center.
We both put on a mask, and the nurse puts on gloves. The first step is to start by cleaning the skin above my port three separate times with alcohol swabs. Once it dries, they repeat the process three separate times with betadine swabs. Next, they feel around for the exact positioning of the center of the device, and then they prepare the needle (usually 1-1.5 inch, 19-20 gauge).
Note: some patients utilize lidocaine or a topical numbing cream at this point before access; however, this is not something I have previously done. Once the nurse can visualize the positioning of the port, they use their thumb and index finger to stabilize the device and insert the needle into the center. It’s important that the nurse (and usually the patient) feel the needle hit the bottom of the port, as mis-direction of the infusion can occur if the needle is not all the way in.
Once the needle is in the correct spot, my nurse then attempts to draw back the heparin that was last used to lock my central line, and assess to make sure there is blood return. This signifies that the catheter is firmly in the right place and that my port is ready for whatever medication needs to be pushed through. The port is then flushed thoroughly with saline, and then the end of the needle is supported with gauze on either side and secured by a tegaderm dressing. The outside tubing, or catheter that comes from the needle is then used to push medication or draw blood in the same way any regular IV works.
How long can the port be accessed for?
The incredible thing about port access is it is available for whatever the patient might need. I’ve had times in the hospital where I’ve been accessed for several weeks straight, and the port is fine with that as long as it’s regularly flushed, and the needle is changed every 7 days. It can also be accessed for a day at a time, like when I have my outpatient infusions. Depending on my health at the time, my care team and I made a decision about access time and outline a plan for the duration of my port use.
What happens when you’re not using it?
Once I finish using my port, the nurse again puts on gloves and flushes my port again with saline. Next, my port is hep-locked, or heparin is injected and not drawn back. Finally, the needle is removed and I usually place a bandaid or a small piece of tegaderm over the site until I get home and can wipe it with alcohol wipes.
It’s important to note that a port is different from other types of central lines, as the device itself is under the skin. When it is not accessed, it is completely internal and hardly even visible. It requires no special maintenance, and things like baths, showers, or swimming pools are no different. However, as it is still a direct line to your heart, it is very important to follow sterile protocol when accessing/de-accessing your port.
I can choose to hide it
When my port is not in use, most people can’t tell I have it! Outside of the 1 inch scar on my collarbone where the device was placed and the corresponding small scar near my neck where the catheter was thread through, my port is not super close to my skin, and therefore I can mostly choose to hide it.
If you have any questions about getting a port, caring for a port, or why this was the best choice for me, please don’t hesitate to ask!
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